Peds Exam 3 Practice Questions
Which order should a nurse question for a child just admitted with diagnosis of bacterial meningitis? A. maintain isolation precautions until 24hrs after receiving IV antibiotics B. IV fluids at 1.5 regular maintenance C. Neuro checks q 1hr D. Administer tylenol for temps higher than 100.4
B
Which position initially is most beneficial for an infant who has just returned from having a VP shunt placed? A. semi-Fowler in an infant seat B. flat in crib C. trendelenburg D. in the crib with head elevated 90 degrees
B
The nurse is caring for an 8yo girl whose parents indicate she has slow writhing, and uncontrolled movements along with extremities whenever she tries to move voluntarily. She also has facial grimacing, poor swallowing, and drooling causing speech disturbances, they state it seems worse when she is anxious and does not occur when she is sleeping. This is what type of Cerebral Palsy? A. Spastic B. Ataxic C. Athetoid D. All of the above
C. Athetoid If answered incorrectly, you are encouraged to look at your book.
You are caring for a patient with hydrocephalus who is post-op from a shunt revision. Which assessment finding is your priority for increased ICP? A. nausea and refusal to eat post-operatively B. complaint of a HA C. irritability and wanting to sleep D. decrease in HR over the last hour
D
The nurse is caring for an unconscious 6yo who has had severe closed head injury and notes the following changes: HR dropped from 120 to 55, BP increased from 110/44 to 195/62, and respirations becoming more irregular. What should the nurse do first after calling the physician? A. Call for additional help, and prepare to give mannitol B. Continue to monitor pt and prepare to give a bolus of fluids C. Call for additional help, and prepare to administer an antihypertensive D. Continue to monitor patient and prepare to give supplemental O2
A
The nurse should assess a teenage child suspected of having early stage scoliosis for which of the following clinical manifestations? SATA A. truncal asymmetry B. curved spinal column C. unequal shoulder height D. prominence of one scapula E. altered gait with a limp F. limited use of one arm
A, B, C, D
A child is admitted with possible Reye Syndrome. Which of the following findings would the nurse expect to see? SATA. A. child has had vomiting episodes for past 24 hours B. child's ammonia levels are lower than normal C. child was administered ibuprofen when the child had the flu D. child is unusually argumentative and aggressive E. sclera yellow F. elevated temps
A, D, F
During an assessment, the nurse knows that well-recognized signs common with bacterial meningitis include: (SATA) A. Positive Kernig's sign B. Positive Brudzinski's sign C. Photophobia D. Negative Kernig's sign
Ans: A, B, and C: These are symptoms of bacterial meningitis.D: A patient with meningitis exhibits a positive Kernig's sign, not a negative Kernig's sign.
A child is recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. 2-3 oral anticonvulsant medications so that dosing can be low and side effects can be minimized B. 1 oral anticonvulsant medications to observe effectiveness and minimize side effects C. 1 rectal gel to be administered in the event of a seizure D. placed on ketogenic diet to see if diet alone can keep the child's seizures under control
B
What is the primary therapy for secondary HTN in children? A. low salt diet B. weight reduction C. treatment of cause D. improved exercise and fitness
C
SATA: Which signs best indicate increased ICP in a infant? A. sunken anterior fontanel B. complaints of blurred vision C. high pitched cry D. increased appetite E. sleeping more than usual
C, E
A child with a VP shunt complains of HA and blurry vision and now experiences irritability and sleeping more than usual. The parent ask the nurse what they should do. Select the nurse's best response. A. Give her some acetaminophen, and see if her symptoms improve. If they do not improve, bring her into the ped office. B. It is common for girls to have these symptoms, especially prior to beginning their menstrual cycle. Give her a few days and see if she improves. C. You are probably worried that she is having a problem with her shunt. This is very unlikely as it has been working well for 9 years. D. You should immediately take her to the ED as these may be symptoms of a shunt malfunction.
D
The nurse is caring for an adolescent who remains unconscious 24 hrs after a closed head injury in an MVA. She responds to deep, painful stimulation with decorticate posturing and has an intracranial monitor that shows periodic increased ICP. All vitals are stable. What is the most appropriate nursing action? A. Encourage the teen's peers to visit B. Encourage the parents to hold her hand and speak loudly to her to help her regain consciousness C. Attempt to keep a normal day/night pattern by keeping the teen in a bright, lively environment during the day and a dark environment at night D. Attempt to keep the environment dark and quiet, and encourage minimal stimulation.
D
A child is being admitted for meningitis. Which procedure should the nurse do first? A. administration of IV antibiotics B. administration of maintenance IV fluids C. placement of foley D. send spinal fluid and blood samples to the lab for culture E. Place child in isolation
E. rationale: isolation of the child is necessary for the first 24 hrs of therapy to prevent the spreading of the infection. two broad-spectrum antibiotics would be started as an initial treatment regimen, as well as fluid management as supportive therapy for fluid and electrolyte imbalance; however, infection spread prevention is a priority so you would place the child in isolation first so you do not need to do it later. foley implementation is not a priority because pt. can use a portable urinal to prevent UTIs. and spinal fluid and blood samples to the lab for culture is definitely not the first step because that is via a spinal tap procedure.
