practice questions

A child is undergoing hemodialysis. The child should be monitored closely for: Select all that apply. 1. Migraines. 2. Hypotension. 3. Infections. 4. Fluid overload. 5. Shock.

2, 3, 5

A child has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS). The clinical manifestations will include which of the following? 1. Massive proteinuria, hypoalbuminemia, and edema 2. Hematuria, bacteriuria, and weight gain 3. Urine-specific gravity decreased and urinary output increased 4. Gross hematuria, albuminuria, and fever

1

A child in renal failure has hyperkalemia. The nurse plans to instruct the child and her parents to avoid which foods? 1. Carrots and green, leafy vegetables 2. Spaghetti and meat sauce with breadsticks 3. Hamburger on a bun and cherry gelatin 4. Chips, cold cuts, and canned foods

1

A four-year-old has acute glomerulonephritis (AGN) and is admitted to the hospital. The priority nursing diagnosis for this child would be: 1. Risk for injury related to hypertension. 2. Altered growth and development related to a chronic disease. 3. Risk for infection related to hypertension. 4. Fluid volume excess related to decreased plasma filtration.

1

A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. What would the nurse expect to see on this child's lab results? 1. Hyponatremia 2. Hypocalcemia 3. Hyperglycemia 4. Hypernatremia

1

Assessment of a 2-year-old by a nurse in the Emergency Department reveals the following: edema, hematuria, hypertension, and oliguria. Which of the following would the nurse assess as the most likely cause of these symptoms? 1. Acute renal failure 2. Urinary tract infection 3. Vesicoureteral reflux 4. Bladder exstrophy

1

Following an outbreak of chicken pox in the school, the school nurse is concerned that children are at risk for Reye syndrome. The nurse sends home letters reminding the parents not to administer aspirin and describes the initial symptoms of Reye syndrome which are: 1. Nausea, vomiting, and confusion. 2. Headache, vomiting, and seizures. 3. Sore throat, moist respirations, and cough. 4. Fever, rash, and photophobia.

1

The nurse has received a child from the emergency department with a diagnosis of decreased level of consciousness secondary to increased intracranial pressure. Which physician's order would the nurse question? 1. Passive range-of-motion exercises 2. Oxygen at 2L nasal cannula to keep saturation above 95% 3. Hourly vital signs and neuro checks 4. Elevate head of bed 30 degrees

1

The nurse is doing an assessment on a four-month-old infant. Which assessment finding would the nurse consider abnormal? 1. The posterior fontanel is open. 2. The infant has good head control when held upright. 3. The infant is able to roll only from abdomen to back. 4. The anterior fontanel is open and soft.

1

The nurse is planning care for a child with bacterial meningitis. What is the priority nursing diagnosis? 1. Impaired gas exchange 2. Infection, risk for 3. Anxiety (parental) 4. Acute pain

1

When the home health nurse visits the home of a 10-month-old child, she observes the environment for risks for injury to the child. Which observation will the nurse discuss with the mother? 1. The mother leaves the filled mop bucket on the floor while in another room. 2. The mother turns all pan handles to the back of the stove. 3. The mother fills the bath tub before bringing the baby into the bathroom. 4. When riding in a car, the child is in a car seat in the middle of the back seat.

1

A child has been diagnosed with a basilar skull fracture. The nurse should monitor this child for: 1. Periorbital ecchymosis. 2. Subdural hematoma. 3. Protruding bone. 4. Epidural hematoma.

1 "raccoon eyes"

In caring for a hospitalized eight-year-old child with myelodysplasia, the nurse should remember to: Select all that apply. 1. Expect the child to have normal intelligence. 2. Use latex precautions. 3. Allow the child to do her own self-catheterization. 4. Ensure that the child has a low-fiber diet. 5. Encourage the child to shift positions hourly when in her wheelchair.

1, 2, 3, 5

The surgeon is discussing plans for orchiopexy with the parents of an infant born with cryptorchidism. The parents are overwhelmed and do not hear much of the discussion. The nurse will clarify the surgeon's explanation by discussing that the risk of undescended testes include: Select all that apply. 1. Sperm production will be affected after puberty. 2. Abdominal testes are subject to injury. 3. Abdominal testes have a higher risk of developing cancer. 4. Hormonal production will be affected. 5. The testes are at greater risk of torsion.

1, 2, 3, 5

The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes mellitus how to minimize pain with insulin injections. Which interventions to minimize pain will the nurse include in the teaching? Select all that apply. 1. Do not reuse needles. 2. Remove all bubbles from the syringe before injecting. Ball, Child Health Nursing, 3/E Copyright 2014 by Pearson Education, Inc. 3. Have the child flex the muscle during injection. 4. Inject insulin when it is cold. 5. Do not change the direction of the needle during insertion or withdrawal.

1, 2, 5

The school nurse has noticed an increase in the number of children in the school being diagnosed with type 2 diabetes. Which changes could the nurse implement at school to help reduce students' risk for developing type 2 diabetes? Select all that apply. 1. Increase the amount of daily physical activity. 2. Meet with all parents and explain the risk that is associated with obesity. 3. Test each child's urine monthly. 4. Teach the parents to avoid administering aspirin to their children. 5. Work with the cafeteria to decrease the amount of fat in the foods served.

1, 2, 5

The nurse is providing information to a teenager newly diagnosed with diabetes and his parents. The nurse teaches them that the signs of diabetic ketoacidosis (DKA) include: Select all that apply. 1. Change in mental status. 2. Tachycardia. Ball, Child Health Nursing, 3/E Copyright 2014 by Pearson Education, Inc. 3. Fruity breath odor. 4. Rapid, shallow respirations. 5. Abdominal pain.

1, 3, 5

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following? 1. Bacteriuria and increased specific gravity 2. Hematuria and proteinuria 3. Proteinuria and decreased specific gravity 4. Bacteriuria and hematuria

2

A child with nephritic syndrome is severely edematous. The primary health care provider has placed the child on bed rest. An important nursing intervention for this child would be to: 1. Monitor BP every 30 minutes. 2. Reposition the child every two hours 3. Limit visitors. 4. Encourage fluids.

2

A child with nephrotic syndrome is placed on corticosteroids. The nurse should educate the family about which side effects of corticosteroids? 1. Impaired balance 2. Moon face 3. Decreased appetite 4. Hair loss

2

A seven-year-old with a head injury is hospitalized after losing consciousness when he was hit in the head with a bat at baseball practice. The child was not wearing a helmet. The last set of vital signs showed heart rate 48, BP 148/74, respiratory rate 28 and irregular. The nurse suspects that these vital signs are: 1. A sign that this child has a spinal cord injury. 2. A sign of increased intracranial pressure. 3. Typical for a sleeping child at this age. 4. A sign that the child's condition is improving.

2

Following a hypospadias repair, the 10-month-old child returns from the operating room with a urethral stent. It is now four hours since the child's surgery. Which assessment finding should be reported to the surgeon? 1. The infant has bloody urine. 2. The infant has voided one time since returning from surgery. 3. The infant seems to be having bladder spasms that respond favorably to anticholinergic medications. 4. Double diapering the infant has resulted in the stent being free from stool contamination.

2

Which issue is important to discuss when educating a family about nocturnal enuresis? 1. Limit daytime fluids. 2. Have the child double-void before going to bed. 3. Administer laxatives daily. 4. Refer the child to counseling immediately

2

A four-year-old girl has been treated for three urinary tract infections (UTI) in the last two years. Which instructions can the nurse give to the mother to help reduce the child's risk of acquiring another UTI? Select all that apply. 1. Wear only nylon underwear for better air flow. 2. Teach the child to wipe from front to back. 3. Encourage the child to take long baths by allowing the child bubbles and toys in the tub. 4. Encourage the child to drink additional fluids throughout the day. 5. Plan potty breaks every two hours throughout the day.

2. 4. 5

A 12-year-old has been selected to be a cheerleader for her middle school. This child has been recently diagnosed with type 1 diabetes. In teaching this child's mother about care for her child, the nurse wants the mother to understand that with increased physical activity, the child will need: 1. Decreased food intake. 2. Increased doses of insulin. 3. Increased food intake. 4. Decreased doses of insulin.

3

A baby is born with bladder exstrophy. Immediate care for this infant will include which intervention? 1. Measuring intake and output 2. Inserting a Foley catheter 3. Covering the defect with sterile plastic wrap 4. Palpating the bladder mass to ensure urine is expelled

3

A teenager has arrived in the emergency department (ED) with confusion. The physician suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 76l5 mg/dL. The nurse expects that this teen has which symptoms? 1. Tachycardia, dehydration, and abdominal pain 2. Sweating, photophobia, and tremors 3. Dry mucous membranes, blurred vision, and weakness 4. Dry skin, shallow rapid breathing, and dehydration

3

Which sets of symptoms are characteristic of a preschool-age child with a urinary tract infection? 1. Headache, hematuria, and vertigo 2. Foul-smelling urine, elevated blood pressure, and hematuria 3. Urgency, dysuria, and fever 4. Severe flank pain, nausea, and headache

3

The nurse is caring for a nine-month-old who just returned from the PACU after a shunt placement for hydrocephalus. Which of the physician's orders would the nurse question? 1. Vital signs and neuro checks hourly 2. Small, frequent formula feedings 3. Elevate head of bed 4. Daily head circumference

3 HOB should be flat so CSF drainage is not too rapid

The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which of the physician's orders should the nurse question? 1. Neurological checks hourly 2. Insert urinary catheter and measure output hourly. 3. NPH insulin IV at 0.1 units/kg per hour 4. Stat serum electrolytes

3 NPH is never given IV

A child is admitted to the hospital with a diagnosis of "rule out" urinary tract infection. A clean-catch urine specimen is submitted to the lab. When the results return, the nurse evaluates the findings. Which finding would the nurse question? 1. 2+ White blood cells 2. 1+ red blood cells 3. Urine appearance: cloudy 4. Specific gravity: 1009

4

A child is scheduled for a kidney transplant. The nurse has completed the preoperative teaching to prepare the child and parents for the surgery and postoperative considerations. Which statement indicates that the parents understand the process involved with a kidney transplant? 1. "We're happy our child won't have to take any more medicine after the transplant." 2. "We understand our child won't be at risk anymore for catching colds from other children at school." 3. "We'll be glad we won't have to bring our child in to see the doctor again." 4. "We know it's important to see that our child takes prescribed medications after the transplant."

4

A child weighing 18.2 kg with a history of diabetes insipidus has been admitted to the hospital. Which of the physician's orders would the nurse question? 1. Stat electrolytes 2. Urine specific gravity with each void 3. DDAVP (desmopressin) PO 4. Restrict oral fluids to 500 mL every 24 hours.

4

A child with a history of seizures arrives in the emergency department in status epilepticus. What is the nurse's initial action? 1. Take vital signs. 2. Establish an intravenous line. 3. Perform rapid neurological assessment. 4. Maintain patent airway.

4

A young child admitted to the pediatric unit has fever, irritability, and vomiting. The physician suspects bacterial meningitis. The nurse would expect the cerebrospinal fluid (CSF) to show: 1. Decreased protein count. 2. Clear, straw-colored fluid. 3. Positive for RBCs. 4. Decreased glucose level.

4

The teacher is speaking to the school nurse about one of the girls in the fifth grade. The girl has always been a good student but lately seems to be daydreaming a lot. The teacher says, "Sometimes when I ask her a question, she will just stare at me for 15 seconds, then blink and ask me to repeat the question. What do you think is going on with her?" Based on this data, the nurse will suspect: 1. The girl has a crush on a boy in the class. 2. The girl has increased intracranial pressure. 3. The child may have had a head injury. 4. The girl is experiencing absence seizures.

4

The nurse is caring for a hospitalized three-year-old admitted with a history of syndrome of inappropriate antidiuretic hormone (SIADH). He has just received his breakfast tray. Which food should the nurse remove from his tray? 1. Oatmeal 2. Yogurt 3. Biscuit 4. Cantaloupe

4 SIADH needs fluid restriction- melons contain significant fluid volume

A baby just born with a meningomyelocele is to have surgery in the morning. The nurse knows the care of this newborn includes: 1. Applying a diaper to prevent contamination of sac. 2. Positioning the newborn in a side-lying position. 3. Encouraging the mother to hold the newborn, because she will not be able to pick him up after surgery. 4. Positioning the newborn in a prone position.

4 keeps pressure off of the sac

The mother brings her five-month-old infant to the clinic for a well-child visit. The mother tells the nurse that the baby's father had febrile seizures when he was an infant. The mother says she is concerned her baby will have a febrile seizure and wants to know what she should do to prevent it. The nurse explains: Select all that apply. 1. That the baby has no more risk of febrile seizures than any other baby. 2. When the infant has a fever, the mother should give the baby dose-appropriate aspirin. 3. That the baby should be sponged with cold water. 4. The mother should increase the child's fluid intake. 5. That after the tepid bath, the child should be patted dry.

4, 5

A toddler is having a tonic-clonic major motor seizure. What should the nurse do first? a) Check the child's breathing b) Place a tongue blade in the child's mouth c) Remove objects from the child's surroundings d) Restrain the child

a

A nurse is assigned to care for an 8 year old child with a diagnosis of a basilar skull fracture. The nurse reviews the physician's orders and contacts the physician to question which order? a) Obtain daily weight b) NP suctioning as needed c) Provide clear liquid diet d) Maintain a patent intravenous line

b

A nurse is caring for an infant with hydrocephalus. Preoperatively, a priority nursing intervention is to: a) Test the urine for protein b) Reposition the infant frequently c) Provide a stimulating environment d) Obtain a blood pressure every 30 minutes.

b

A lumbar puncture is performed on a child suspected of having bacterial meningitis and cerebral spinal fluid (CSF) is obtained for analysis. A nurse reviews the results of the CSF analysis and determines that which of the following results would verify the diagnosis? a) Clear CSF, elevated protein, and decreased glucose levels b) Clear CSF, decreased pressure, and elevated protein level c) Cloudy CSF, elevated protein and decreased glucose levels d) Cloudy CSF, decreased protein and decreased glucose levels

c

A newborn undergoes surgery to repair a myelomeningocele. To detect increased intracranial pressure (ICP) as early as possible, the nurse should stay alert for which post-operative finding? a) Decreased urine output b) Increased heart rate c) Bulging fontanels d) Sunken eyeballs

c

When assessing a toddler, age 18 months, the nurse should nurse should interpret which of the following as a sign of a neurologic dysfunction? a) Positive gag reflex b) Positive tonic neck reflex c) Negative plantar grasp d) Positive corneal reflex

c

A child is diagnosed with Reye's Syndrome. A nurse develops a nursing care plan for the child that includes which intervention in the plan? Select all that apply. a) Assessing hearing loss b) Monitoring urine output c) Changing body position every two hours d) Providing a quiet atmosphere with dimmed lighting

d

A nurse develops a plan of care for a child at risk for generalized tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents which items to be placed at the child's bedside? a) Emergency cart b) Airway and tracheotomy set c) Oxygen with a tracheotomy set d) Suctioning equipment and oxygen

d

A nurse is caring for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which of the following should be included in the plan of care? a) Maintain enteric (contact) precautions b) Maintain neutropenic precautions c) No precautions are required as long as antibiotics have been started d) Maintain respiratory isolation precautions for at least 24 hours after initiation of antibiotics.

d