Peds Practice Questions I

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented?

"Currant jelly" stools.

The school nurse has provided an instructional session about impetigo to parents of the children attending school. Which statement, if made by a parent, indicates the need for further teaching?

"Lesions most often are located on the arms and chest." Impetigo is a contagious bacterial infection of the skin caused by b-hemolytic streptococci or staphylococci, or both. Impetigo is most common during hot, humid summer months. Impetigo may begin in an area of broken skin, such as an insect bite or atopic dermatitis. Impetigo is extremely contagious. Lesions usually are located around the mouth and nose, but may be present on the hands and extremities

A nurse is admitting a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids?

0.9 percent Normal Saline (NS) 0.9 percent NS maintains Na and chloride at present levels. D5W can lower sodium levels so would not be used to initially replace fluids in severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent (¼) Normal Saline would not be used initially but later, as maintenance fluids.

A parent asks the nurse if there is anything that can be done to reduce the pain that his 3 year old experiences each morning when blood is drawn for blood studies. Which intervention would the nurse implement based on the parent's concern?

EMLA cream (lidocaine 2.5% and prilocaine 2.5%) applied to skin

The charge nurse is concerned with reducing the stressors of hospitalization. Which nursing intervention is most helpful in decreasing stressors for the toddler aged client?

Encourage a parent to stay with the child.

A nurse is planing care for a 2 month old infant following a surgical procedure. Which of the following pain rating scales should the nurse use to determine the infant's level of pain?

FLACC scale

a nurse is providing teaching about lice to the parents of a school-age child at well-child visit. which of the following information should the nurse include in the teaching?

Not to share hats with other children

Two 3-year-old clients are playing together in a hospital playroom. One is working on a puzzle, while the other is stacking blocks. Which type of play are these children participating in based on this scenario?

Parallel play is when two or more children play together, each engaging in his or her own activities.

A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions following feedings?

Place the infant in an infant seat

A nurse in an emergency department is assessing a 3 year old child who has a high fever, severe dyspnea, and is drooling. what is the nurses priority

Prepare for nasotracheal intubation

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the mother about the child's symptoms?

Projectile vomiting

A school nurse is performing a routine health assessment for school age child. Which of the following findings indicates the nurse should investigate further for pediculosis capitis?

Pruritus of the scalp

Which nursing role is not directly involved when providing family centered approach to the pediatric population?

Researcher A researcher is not involved in the family-centered approach to patient care of children and their families. Advocacy, case management, and patient education are all roles directly involved in the care of children and their families.

An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority of this infant?

Risk for Aspiration Related to Regurgitation With the most common type of esophageal atresia and tracheoesophageal fistula, the upper segment of the esophagus ends in a blind pouch and a fistula connects the lower segment to the trachea. Preoperatively, there is a risk of aspiration of gastric secretions from the stomach into the trachea because of the fistula that connects the lower segment of the esophagus to the trachea. Pain is not usually experienced preoperatively with this condition. The infant is always kept NPO (nothing by mouth) preoperatively, so ineffective feeding pattern would not apply. Tissue perfusion is not a problem with this condition.

An adolescent client with cystic fibrosis suddenly becomes non-compliant with the medication regime. Which intervention by the nurse will most likely improve compliance for this client?

Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.

A nurse is reinforcing teaching about nutritional considerations with the parents of a toddler. Which of the following statements by the parents indicates an understanding of the teaching?

The quality of food I provide is more important than the quantity

A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?

The toddler cannot stand upright without support

The nurse caring for a 9-year-old notices some swelling in the child's ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure and notices a markedly slow disappearance of the indentation. Due to these physical findings, the nurse would be most concerned with assessing

Urine output.

A nurse is caring for a 3-year old child admitted with acute diarrhea and dehydration. What client finding indicates that oral re hydration therapy has been effective?

Urine specific gravity 1.015

A nurse is caring for a child who has acute appendicitis. Which of the following results should the nurse anticipate when reviewing the lab values?

WBC of 17,000

A nurse is caring for a 2-month-old infant who is postoperative following repair of a cleft lip and palate. The provider prescribes restraints. The nurse should apply which of the following restraints for this infant?

elbow

After the nurse teaches the mother of a child with diaper dermatitis of how to bathe her child, which statement by the mother indicates effective teaching?

"When my child gets out of the tub I just pat the skin dry"

A nurse is assessing language development in all the infants presenting at the doctor's office for well child visits. At which age range will the nurse expect a child to verbalize the words "dada" and "mama"?

9-12 months

A nurse is preparing to discharge a child who has a new prescription for an oral antibiotic. Which of the following information should the nurse include in the discharge instructions? SATA

The reason why the child is taking the medication Written information about the medication The adverse effects of the medication

A child admitted to the hospital with pneumonia. the child's oximetry reading is 88 percent upon admission to the pediatric floor. Which is the priority intervention for this child?

Begin oxygen per nasal canunula

A nurse is caring for a toddler who is 24 hours postoperative following a cleft palate repair. which of the following actions should the nurse

Administer opioids for pain

the mother of a child with an umbilical hernia call the clinic and reports that the child has been vomiting and is complaining of pain in the abdominal area. The nurse would instruct the mother to take what action?

Contact the health care provider.

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestation found on assessment support this newborn's diagnosis?

Currant jelly, gelatinous stools; pain

A one month old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

Fontenels depressed, capillary refill greater than three seconds.

The nurse is performing an assessment on a child with suspected diagnosis of epiglottitis. Which action during the assessment would the nurse avoid?

Performing a throat culture

A nurse is planning care for a 4 year old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?

Putting a large piece puzzle together

A mother of a school aged client who recently had surgery for removal of tonsils and adenoids complains that the child has begun sucking his thumb again. Which coping mechanisms is the child using to cope with the stress of surgery and hospitalization?

Regression

The school nurse is conducting pediculosis capitis (head lice) checks. Which findings would indicate a positive head check.

white sacs attached to the hair shafts in the occipital area

A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse expect to administer first?

Albuterol

A nurse is providing care to a toddler age child. Which assessment finding is indicative of abuse?

Inconsistency of stories between caregivers.

The nurse is providing education to a pediatric client diagnosed with diabetes. The client will be playing soccer over the summer. Which changes in the client's management will the nurse explore during the education session?

Increased food intake Increased physical activity requires adequate caloric intake to prevent hypoglycemia, so food intake should be increased. Increased activity would not require decreased food intake, and it would not result in a decreased risk of insulin reaction. Exercise causes the insulin to be used more efficiently, so increased insulin would not be needed.

The nurse is teaching the parent of type 1 diabetic preschool aged client about management of the disease. Which teaching point is appropriate for the nurse to include in the session?

Allowing the client to choose which finger to stick for glucose testing The preschool-age client's need for autonomy and control can be met by allowing the client to pick which finger to stick for glucose testing. Administering the insulin, drawing up the dose, and testing blood glucose should not be done by the client until he or she is middle-school age or older.

The nurse is providing care to an infant in the emergency department. Upon assessment the infant is noted to have to be experiencing tachypnea, wheezing, retractions and nasal flaring. The infant has irritability and the parents state the infant has had poor fluid intake for tow days. Pulse ox reading is currently at 85% on room air. The infant's blood gas is pending. Which diagnosis does the the nurse anticipate for this infant?

Bronchiolitis The nurse anticipates the infant will be diagnosed with bronchiolitis. Symptoms of bronchiolitis include mild respiratory symptoms that progress to tachypnea, wheezing, retractions, nasal flaring, irritability, poor fluid intake, hypoxia, cyanosis, and decreased mental status. Symptoms of bronchitis include a dry hacking cough, increases in severity at night, painful chest and ribs. Symptoms of pneumonia include initial rhinitis and cough, followed by fever, crackles, wheezes, dyspnea, tachypnea, restlessness, diminished breath sounds. Symptoms of active pulmonary tuberculosis include persistent cough, decreased appetite, weight loss or failure to gain weight, low-grade fever, night sweats, chills, enlarged lymph nodes.

An 11 year old child is admitted for treatment of an asthma attack. Which of the following indicates immediate intervention is needed?

Intercostal reactions. because it shows increase in respiratory effort (labored breathing)

A nurse is caring for a child who has acute gastroenteritis but is able to tolerate oral fluids. The nurse should anticipate providing which of the following types of fluids?

Oral Rehydration Solution

A nurse is caring for a 6 month old infant who has a prescription for clear liquids by mouth after a repair of an intussusception. Which of the following fluids should the nurse select for the infant?

Oral electrolyte solution