Peds unit 3 exam

What is a symptom of allergic rhinitis? a) Sinus pain b) Purulent secretions c) Fever d) Laryngiti

Sinus pain Correct Explanation: The following are the symptoms that occur with allergic rhinitis: sinus pain, family history of atopy, and conjunctival pruritis.

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The mother informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The physician diagnoses the child with erythema infectiosum. The nurse tells the mother that this is also known as: a) fifth disease. b) pityriasis rosea. c) rosacea. d) enterovirus.

fifth disease. Correct Explanation: Erythema infectiosum is also known as "fifth disease." It starts with a fever, headache, and malaise. One week later, a rash appears on the face. A day later, the rash appears on the extensor surfaces of the extremities. One more day later, the rash appears on the trunk and flexor surfaces of the extremities.

Which measure would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis? a) Urging the child to continue to take oral fluids b) Assisting with racemic epinephrine nebulizer therapy c) Administering an oral analgesic d) Teaching the child to take long, slow breaths

Assisting with racemic epinephrine nebulizer therapy Correct Explanation: A bronchodilator increases the lumen of airways

An adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for what? a) Chlamydia b) Genital herpes c) Syphilis d) Trichomoniasis

Chlamydia Correct Explanation: Clients with gonorrhea usually receive treatment for chlamydia as well because they often are coinfected. Coinfection with syphilis, genital herpes, or trichomoniasis is uncommon.

Which of the following diseases is characterized by a "blueberry muffin" rash? a) Measles b) Viral hepatitis c) Mumps d) Congenital rubella

Congenital rubella Explanation: In infants with congenital rubella, skin lesions resembling a "blueberry muffin" rash, and major organ system defects, are the hallmarks. Measles, mumps, and viral hepatitis are not characterized by this type of rash.

Goal for DM pts

Goal is for self administration of insulin. It must be based on age and individual. May have to assist child with first self injection

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: a) not until all lesions have completely faded. b) 10 days after the initial lesions appear. c) as soon as the temperature is normal. d) as soon as all lesions are crusted

as soon as all lesions are crusted. Explanation: Chickenpox lesions are infectious until they crust.

Congenital hypothyroidism

decreased t3 and t4 and increase in TSH. These babies will have a puffy face, large protruding tongue, dull expression, short thick neck, hoarse cry and rarely cry "good babies"

When the physician looks in a child's mouth during a sick-visit exam, the mother exclaims: "Her tongue is bright red! It was not like that yesterday." The physician would most likely order which medication based on the probable diagnosis of scarlet fever? a) Steroids to decrease the inflammation b) Penicillin to prevent acute glomerulonephritis c) Erythromycin to prevent the spread to siblings d) Acetaminophen to decrease the throat pain

A "strawberry tongue" is a classic sign of scarlet fever. Penicillin is prescribed to prevent the complications of acute glomerulonephritis and rheumatic fever associated with beta-hemolytic group A streptococcal infections

Which of the following is a symptom of neonatal sepsis? a) Bradycardia b) Hyperglycemia c) Hypertension d) Increased urine output

Bradycardia Correct Explanation: Symptoms of neonatal sepsis are bradycardia or tachycardia, hypotension, decreased urine output, and hypoglycemia.

What accurately depicts the hemodynamic changes that occur in the body within the first 24 to 48 hours after a burn? a) Hematocrit and WBC counts decrease b) Hematocrit and WBC counts elevate c) Hematocrit increases and WBC count decreases d) Hemoglobin and WBC counts decrease

Correct response: Hematocrit and WBC counts elevate Explanation: In the first 24 to 48 hours after a burn, the hematocrit will often be elevated secondary to fluid loss and the WBC may also be elevated as an acute-phase reaction, which later could indicate infection. (less)

Administering thyroid pill

Crush in a small spoon. Add a few drops of water, breast milk, or formula to the spoon and mix. Do no mix with large amounts of liquid. -give aprox thirty minutes before feeding. -soy products, calcium and iron supplements prevent absorption. Should not give w/i 4 hrs of thyroid medication administration

The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe? a) Edema with wet blistering skin b) Reddened and leathery skin c) Edema with dry or waxy-looking skin d) Peeling skin with escha

Edema with wet blistering skin Explanation: Partial-thickness burns are very painful and edematous and have a wet appearance or the presence of blisters. Full-thickness burns appear red, edematous, leathery, dry, or waxy and may display red or charred skin (eschar)

The nurse working in the burn unit is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to which of the following? a) Hypovolemic shock b) Wound care c) Curling's ulcer d) Graft placement

Hypovolemic shock Correct Explanation: Hypovolemic shock is the major manifestation in the first 48 hours in massive burns. As extracellular fluid pours into the burned area, it collects in enormous quantities, which dehydrates the bod

Which of the following is a late effect of congenital syphilis? a) Jaundice b) Anemia c) Perforated hard palate d) Osteochondritis

Perforated hard palate Explanation: Late effects of congenital syphilis include a perforated hard palate, saber shins, and hearing loss. Early effects include jaundice, anemia, and osteochondritis

A young child has just been admitted to the emergency department with a burn that encompasses the dermis and the underlying dermis. The mother wants to know what kind of treatment will be prescribed for the child. The nurse bases her response on her knowledge that treatment will be prescribed based on the degree of the burn, and this child has a: a) Second-degree burn. b) Third-degree burn. c) Fourth-degree burn. d) First-degree burn.

Second-degree burn. Correct Explanation: The burn described in the stem of this question is a second-degree burn. A first-degree burn would only involve the epidermis, and a third-degree burn would involve nerve endings as well as destruction of the epidermis and dermis. A fourth-degree burn would extend even deeper into the fat layer.

One method of preventing communicable diseases in children is to administer vaccines to stimulate the development of antibodies. Which of the following best describes what occurs in the child when vaccines are given? a) The child develops an active immunity. b) The child becomes a carrier of the disease. c) The child becomes a host for the disease. d) The child develops a passive immunity.

The child develops an active immunity. Correct Explanation: When a vaccine is given, active immunity occurs which then stimulates the development of antibodies to destroy infective agents without causing the disease.

The nurse is caring for a child hospitalized with pertussis. Which nursing intervention would be the highest priority for this child? a) The nurse will monitor caloric intake. b) The nurse will encourage bed rest. c) The nurse will administer oxygen. d) The nurse will administer antibiotics.

The nurse will administer oxygen. Correct Explanation: The major complication of pertussis (whooping cough) is pneumonia and respiratory complications. Oxygen, bed rest, and monitoring for airway obstruction are nursing interventions. The highest priority is administering oxygen to maintain adequate oxygenation of cells

A 7-year-old is diagnosed as having type 1 diabetes. One of the first symptoms usually noticed by parents when this illness develops is

loss of weight Lack of insulin reduces the ability of body cells to use glucose; this leads to starvation of cells and loss of weight as an early symptom.

During an assessment, a child exhibits an audible high-pitched inspiratory noise. The nurse documents this as: a) rales. b) tympany. c) stridor. d) wheeze

stridor. Correct Explanation: Stridor is a high-pitched, readily audible inspiration noise that indicates an upper airway obstruction. A wheeze is a high-pitched sound heard on auscultation, usually on expiration. It is due to obstruction in the lower trachea or bronchioles. Rales are crackling sounds heard on auscultation when the alveoli become fluid filled. Tympany is a sound heard with percussion over an air-filled area

The nurse is collecting data on an adolescent admitted with a diagnosis of a sexually transmitted infection. The child has a hard, red, painless lesion on his penis. The nurse recognizes the lesion as a chancre, which is a sign of: a) gonorrhea. b) genital herpes. c) chalmydial infection. d) syphilis.

syphilis. Explanation: The cardinal sign of the primary stage of syphilis is the chancre, which is a hard, red, painless lesion at the point of entry of the spirochete. This lesion can appear on the penis, the vulva, or the cervix

The most common cause of acute bronchiolitis is: a) prenatal complications. b) bacterial infection. c) hereditary factors. d) viral infection.

viral RSV

Choice Multiple question - Select all answer choices that apply. A child has just been diagnosed with whooping cough (pertussis). Which of the following interventions does the nurse expect for this condition? (Select all that apply.) a) A 10-day course of erythromycin or azithromycin b) Only one large meal per day c) Increased protein intake d) Exercise to promote expectoration of mucus e) Seclusion from cigarette smoke and dust f) Bed rest

Bed rest • Seclusion from cigarette smoke and dust • A 10-day course of erythromycin or azithromycin Explanation: Children with pertussis are maintained on bed rest until the paroxysms of coughing subside. Urge parents to keep them secluded from environmental factors, such as cigarette smoke and dust, and to avoid strenuous activity as these initiate coughing episodes. Nutrition may become a problem if the child is constantly coughing and vomiting. As a rule, frequent small meals are vomited less than larger meals so should be encouraged. A full 10-day course of erythromycin or azithromycin may be prescribed as these drugs have the potential to shorten the period of communicability and may shorten the duration of symptoms. Increased protein intake is not indicated for this condition.

What is a complication of cystic fibrosis? a) Crohn disease b) Pneumothorax c) Kidney disease d) UTI

Pneumothorax Correct Explanation: A pneumothorax is a complication of cystic fibrosis. A rupture of the subpleural blebs through the visceral pleura takes place. There is also a high reoccurrence rate and incidence increases with age

The nurse is caring for a 7-year-old boy who has just had a tonsillectomy. Which intervention is least appropriate for this child? a) Providing fluids by straw b) Placing the child on his side c) Discouraging the child from coughing d) Applying an ice collar

Providing fluids by straw Correct Explanation: Providing fluids by straw may cause trauma to the surgical site and should be avoided. Applying an ice collar, if ordered, helps relieve pain. Placing the child on his side, until he is fully awake, facilitates safe drainage of secretions. The child should be discouraged from coughing, clearing his throat, and blowing his nose to avoid trauma to the surgical site

A nurse practitioner suspects that a child has scarlet fever based on which assessment finding? a) Red, strawberry tongue b) Severity of the sore throat c) White exudate on the tonsils d) An enanthematous rash

Red, strawberry tongue Explanation: The characteristic assessment finding that distinguishes scarlet fever from other disorders is the appearance of the red, strawberry tongue. Sore throat, an enanthematous and exanthematous rash, and white exudate on the tonsils are also seen with scarlet fever, but it is the strawberry tongue that helps to confirm the diagnosis.

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102° F (38.9° C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect? a) Diphtheria b) Community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA) c) Scarlet fever d) Pertussis

Scarlet fever Correct Explanation: Scarlet fever typically is associated with a sore throat, fever greater than 101° F (38.9° C), and the characteristic rash on the face, trunk, and extremities that looks like sunburn but feels like sandpaper. CAMRSA is typically manifested by skin and tissue infections. Diphtheria is characterized by a sore throat and difficulty swallowing but fever is usually below 102°F . Airway obstruction is apparent. Pertussis is characterized by cough and cold symptoms that progress to paroxysmal coughing spells along with copious secretions

A young child has just been admitted to the emergency department with a burn that encompasses the dermis and the underlying dermis. The mother wants to know what kind of treatment will be prescribed for the child. The nurse bases her response on her knowledge that treatment will be prescribed based on the degree of the burn, and this child has a: a) Third-degree burn. b) Second-degree burn. c) First-degree burn. d) Fourth-degree burn.

Second-degree burn. Explanation: The burn described in the stem of this question is a second-degree burn. A first-degree burn would only involve the epidermis, and a third-degree burn would involve nerve endings as well as destruction of the epidermis and dermis. A fourth-degree burn would extend even deeper into the fat layer

The nurse is caring for a child admitted with partial thickness burns. What is most characteristic of this type of burn? a) Blisters appear b) Skin is red and edematous c) Muscle damage occurs d) Pain is minimal

a

The nurse is collecting data on a 4-year-old child admitted to the burn unit. The nurse is concerned about the possibility of the child going into hypovolemic shock. Which of the following data would the nurse recognize as an indication that this may be occurring? a) The child is complaining of intense pain. b) The child's face is bright red in color. c) The child's apical pulse is 140 bpm. d) The child's blood pressure is 128/86.

he child's apical pulse is 140 bpm. Correct Explanation: Hypovolemic shock is the major manifestation in the first 48 hours in massive burns. Symptoms of shock are low blood pressure, rapid pulse, pallor, and often considerable apprehension. Intense pain is seldom a major factor.

As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies what as characteristic of full thickness burns? a) Skin appearing wet with significant pain b) Skin that is leathery and dry with some numbness c) Skin that is reddened, dry, and slightly swollen d) Skin with blistering and swelling

Skin that is leathery and dry with some numbness Correct Explanation: Full thickness burns may be very painful, numb, or pain-free in some areas. They appear red, edematous, leathery, dry, or waxy and may display peeling or charred skin. Superficial burns are painful, red, dry, and possibly edematous. Partial thickness and deep partial thickness burns are very painful and edematous and have a wet appearance or blisters

Choice Multiple question - Select all answer choices that apply. Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Select all that apply. a) Removing ticks by rubbing them away from the skin with a credit card. b) Contacting the health care provider if there is any area of inflammation that might be a bite. c) Dressing the child in dark clothing when going outdoors. d) Wearing protective clothing when playing in wooded areas. e) Inspecting the skin closely for ticks after the child plays in wooded areas.

• Wearing protective clothing when playing in wooded areas. • Inspecting the skin closely for ticks after the child plays in wooded areas. • Contacting the health care provider if there is any area of inflammation that might be a bite. Explanation: The nurse should teach the parents to have the child wear protective clothing and dress the child in light clothing when playing in wooded areas or going outdoors. The parents should inspect the child's skin closely for ticks after being outside in wooded areas and if any ticks are found, remove them with a tweezer, not rub them with a credit card. The parents also should be instructed to contact their health care provider if they notice any area of inflammation that might be a tick bite.

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings? a) Lymphadenopathy b) Koplik spots c) Nits d) Slapped cheek appearance

Correct response: Koplik spots Explanation: Koplik spots are bright red spots with blue-white centers appearing primarily on the buccal mucosa and indicate rubeola (measles). They are often described as tiny grains of white sand surrounded by red rings. Lymphadenopathy is used to document enlargement of the lymph nodes. Slapped cheek appearance refers to the erythematous flushing associated with fifth disease. Nits refer to the adult eggs of pediculosis

It is summer time, and the mother of a 6-year-old boy tells the nurse that the mosquitoes in their neighborhood are terrible this year. She says she has heard of cases of West Nile virus in the area and asks the nurse what she can do to protect her son from it. Which of the following should the nurse recommend to the mother? a) Drain any standing water in the yard b) Instruct the son to stay inside from 11 am to 3 pm c) Have the son dress in light-colored clothing d) Avoid using mosquito repellants that contain DEET

Drain any standing water in the yard Correct Explanation: Parents can help prevent the spread of West Nile disease by adhering to the "5D's": Instruct children to stay inside between Dusk and Dawn (not 11 am to 3 pm) when mosquitoes are most prevalent. Drain standing water so there are few opportunities for mosquitoes to breed. Dress should include long pants and long sleeves when outside (not light-colored clothing). Apply mosquito repellant that contains DEET (use a concentration not over 30% and apply only once a day. Don't place it on children's hands so they don't ingest it or use with infants under 2 months of age

Which of the following is a true statement regarding measles? a) Rarely is contagious. b) The incubation period is 8 to 12 days. c) It is transmitted by the fecal-oral route. d) Peak outbreaks are in the summer.

The incubation period is 8 to 12 days. Correct Explanation: The typical incubation period is 8 to 12 days. Outbreaks peak in the winter and spring. It is highly contagious and is transmitted by airborne suspended drop

The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? a) "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." b) "The immunities that the infant is born with are not for the same diseases they will be immunized against." c) "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." d) "Infants are unable to develop antibodies to protect them from diseases so they must be immunized."

The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." Correct Explanation: During fetal life, the mother's antibodies cross the placenta, giving the fetus a temporary immunity against certain diseases. This immunity is present at birth and decreases during the first year of life. In the meantime, the infant begins developing antibodies to fight against pathogens and disease. In addition, during the first year of life immunizations are started to help the infant develop protection against certain diseases

Choice Multiple question - Select all answer choices that apply. A nurse is preparing a presentation for a local mothers' group about common viral infections associated with a rash during childhood. When describing rubella, what information would the nurse include? Select all that apply. a) Incubation period usually ranges from 16 to 18 days. b) The infection is communicable for a week before to a week after the rash appears. c) The disease most often occurs during late summer and early fall. d) The rash typically begins on the trunk and spreads to the face. e) Any itching with the rash is usually mild

• Incubation period usually ranges from 16 to 18 days. • The infection is communicable for a week before to a week after the rash appears. • Any itching with the rash is usually mild. Explanation: Rubella has an incubation period ranging from 12 to 23 days, but usually 14 days. It is communicable for 7 days before the rash to 7 days after the onset of the rash. Itching is usually mild. It occurs most commonly during late winter and early spring and the rash typically begins on the face and spreads down the neck, trunk, and extremities

Choice Multiple question - Select all answer choices that apply. A child is diagnosed with bronchiolitis. Which of the following would the nurse expect to include in the child's plan of care? Select all that apply. a) Pulse oximetry monitoring b) Fluid and electrolyte replacement c) Chest physiotherapy d) Oxygen therapy e) Bronchodilator therapy

• Oxygen therapy • Pulse oximetry monitoring • Fluid and electrolyte replacement Explanation: Humidified oxygen is used for infants who demonstrate oxygen desaturation of less than 90% (Schuh, 2011). Continuous pulse oximetry is recommended for infants in acute distress. Nutritional care for the infant with bronchiolitis includes supportive fluid and electrolyte replacement. Chest physiotherapy has not be found to be helpful. Bronchodilators and corticosteroids have limited effects on a child with bronchiolitis

Choice Multiple question - Select all answer choices that apply. The nurse is assessing a child with a varicella infection. The nurse would be alert for which of the following as a possible complication? a) Pneumonia b) Encephalitis c) Scarlet fever d) Scarring e) Secondary bacterial infections

• Scarring • Pneumonia • Encephalitis • Secondary bacterial infections Correct Explanation: The most common complication of varicella is secondary bacterial infection caused by the child scratching the lesions. Other complications include pneumonia, scarring, and encephalitis. Scarlet fever is a complication associated with group A streptococcal infections