404 Final Exam Review

B. Rheumatic Fever

A 10 YO CHILD IS RECOVERING FROM A SEVERE SORE THROAT. THE PARENT STATES THAT THE CHILD COMPLAINS OF CHEST PAIN. THE NURSE OBSERVES THAT THE CHILD HAS SWOLLEN JOINTS, NODULES ON THE FINGERS AND A RASH ON THE CHEST. THE LIKELY CAUSE IS ____________. A. Measles B. Rheumatic Fever C. Flu D. Candida Albicans

B. Pulses

A 10 year old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess what???

B. Decreased wheezing

A 10-YEAR-OLD CHILD WITH ASTHMA IS TREATED FOR ACUTE EXACERBATION IN THE EMERGENCY DEPARTMENT. THE NURSE CARING FOR THE CHILD SHOULD MONITOR FOR WHICH SIGN, KNOWING THAT IT INDICATES A WORSENING OF THE CONDITION? A. Warm, dry skin B. Decreased wheezing C. Pulse rate of 90 beats/minute D. Respirations of 18 breaths/minute

C. Bone marrow biopsy

A 4- year old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are benign performed on the child because acute lymphocytic leukemia is suspected. The nurse understands that which diagnostic study should confirm this diagnosis??? A. Platelet count B. Lumbar Puncture C. Bone marrow Biopsy D. White blood cell count

C. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time"

A 6-YEAR-OLD CHILD WITH LEUKEMIA IS HOSPITALIZED AND IS RECEIVING COMBINATION CHEMOTHERAPY. LABORATORY RESULTS INDICATE THAT THE CHILD IS NEUTROPENIC, AND PROTECTIVE ISOLATION PROCEDURES ARE INITIATED. THE GRANDMOTHER OF THE CHILD VISITS AND BRINGS A FRESH BOUQUET OF FLOWERS PICKED FROM HER GARDEN AND ASKS THE NURSE FOR A VASE FOR THE FLOWERS. WHICH RESPONSE SHOULD THE NURSE PROVIDE TO THE GRANDMOTHER? A. "I have a vase in the utility room, and I will get it for you B. "I will get the vase and wash it well before you put the flowers in it" C. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time D. "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible

C. Kawasaki's disease

A CHILD WHO HAS REDDENED EYES WITH NO DISCHARGE; RED, SWOLLEN, AND PEELING PALMS/SOLES OF FEET; DRY, CRACKED LIPS; AND A "STRAWBERRY TONGUE" MOST LIKELY HAS___________ A. Legioinnaires' Disease B. Acute glomerunephritis C. Kawasaki's displease D. Babesiosis

D. Let the mother hold the child and direct the cool mist over the child's face

A CHILD WITH LARYNGOTRACHEOBRONCHITIS (CROUP) IS PLACED IN A COOL MIST TENT. THE MOTHER BECOMES CONCERNED BECAUSE THE CHILD IS FRIGHTENED, CONSISTENTLY CRYING AND TRYING TO CLIMB OUT OF THE TENT. WHICH IS THE MOST APPROPRIATE NURSING ACTION? A. Tell the mother that the child must stay in the tent. B. Place a toy in the tent to make the child feel more comfortable. C. Call the health care provider and obtain a prescription for a mild sedative. D. Let the mother hold the child and direct the cool mist over the child's face.

D. Checks the amount of urine output

A HEALTH CARE PROVIDER PRESCRIBES AN INTRAVENOUS (IV) SOLUTION OF 5% DEXTROSE AND HALF-NORMAL SALINE (0.45%) WITH 40 MEQ OF POTASSIUM CHLORIDE FOR A CHILD WITH HYPOTONIC DEHYDRATION. THE NURSE PERFORMS WHICH PRIORITY ASSESSMENT BEFORE ADMINISTERING THIS IV PRESCRIPTION? A. Obtains a weight B. Takes the temp C. Takes the BP D. Checks the amount of urine output

D. Eat a small box of raisins or drink a cup of orange juice before soccer practice

A SCHOOL-AGE CHILD WITH TYPE 1 DIABETES MELLITUS HAS SOCCER PRACTICE THREE AFTERNOONS A WEEK. THE SCHOOL NURSE PROVIDES INSTRUCTIONS REGARDING HOW TO PREVENT HYPOGLYCEMIA DURING PRACTICE. WHICH SHOULD THE SCHOOL NURSE TELL THE CHILD TO DO? A. Eat twice the amount normally eaten at lunchtime B. Take half the amount of prescribed insulin on practice days C. Take the prescribed insulin at noontime rather than in the morning D. Eat a small box of raisins or drink a cup of orange juice before soccer practice

A. Congenital Heart Defect

A child born with Down syndrome should be evaluated for which associated cardiac manifestation?

B. The vaccine cannot be given at that visit Rationale.: The nurse should not give the vaccine. The varicella vaccine is not usually administered prior to one year of age

A mother requests that her child receive the varicella vaccine at the 9 month well-child checkup. The nurse tells the mother of the following

B. Turn the child to the side

AFTER A TONSILLECTOMY, A CHILD BEGINS TO VOMIT BRIGHT RED BLOOD. THE NURSE SHOULD TAKE WHICH INITIAL ACTION? A. Maintain NPO status B. Turn the child to the side C. Administer the prescribed antiemetic D. Notify the health care provider

D. If the infant has clenched first after 3 months *clenched fist should disappear around 4-6W

The parent of an infant asks the nurse what to watch for to determine if the infant has CP. Which is the nurse's best response?

C. Conjunctival Hyperemia (red eyes)

ON ASSESSMENT OF A CHILD ADMITTED WITH A DIAGNOSIS OF ACUTE-STAGE KAWASAKI DISEASE, THE NURSE EXPECTS TO NOTE WHICH CLINICAL MANIFESTATION OF THE ACUTE STAGE OF THE DISEASE? A. Cracked lips B. Normal appearance C. Conjunctival hyperemia D. Desquamation of the skin

C. May children with CP have normal intelligence

The parent of an infant with CP asks the nurse if the infant will be mentally retarded. Which is the nurse's best response??

D. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination"

THE CLINIC NURSE IS PROVIDING INSTRUCTIONS TO A PARENT OF A CHILD WITH CYSTIC FIBROSIS REGARDING THE IMMUNIZATION SCHEDULE FOR THE CHILD. WHICH STATEMENT SHOULD THE NURSE MAKE TO THE PARENT? A. "The immunization schedule will need to be altered." B. "The child should not receive any hepatitis vaccines." C. "The child will receive all the immunizations except for the polio series." D. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

D. Foul-smelling ribbon-like stools

THE CLINIC NURSE REVIEWS THE RECORD OF AN INFANT AND NOTES THAT THE HEALTH CARE PROVIDER HAS DOCUMENTED A DIAGNOSIS OF SUSPECTED HIRSCHSPRUNG'S DISEASE. THE NURSE REVIEWS THE ASSESSMENT FINDINGS DOCUMENTED IN THE RECORD, KNOWING THAT WHICH SYMPTOM MOST LIKELY LED THE MOTHER TO SEEK HEALTH CARE FOR THE INFANT? A. Diarrhea B. Projectile vomiting C. Regurgitation of feedings D. Foul-smelling ribbon-like stools

B. The child consistently tilts the head to see

THE DAY CARE NURSE IS OBSERVING A 2-YEAR-OLD CHILD AND SUSPECTS THAT THE CHILD MAY HAVE STRABISMUS. WHICH OBSERVATION MADE BY THE NURSE INDICATES THE PRESENCE OF THIS CONDITION? A. The child has difficulty hearing B. the child consistently tilts the head to see C. The child does not respond when spoken to D. the child consistently turns the head to hear

B. The child is leaning forward, with the chin thrust out

THE EMERGENCY DEPARTMENT NURSE IS CARING FOR A CHILD DIAGNOSED WITH EPIGLOTTITIS. IN ASSESSING THE CHILD, THE NURSE SHOULD MONITOR FOR WHICH INDICATION THAT THE CHILD MAY BE EXPERIENCING AIRWAY OBSTRUCTION? A. The child exhibits nasal flaring and bradycardia. B. The child is leaning forward, with the chin thrust out. C. The child has a low-grade fever and complains of a sore throat. D. The child is leaning backward, supporting himself or herself with the hands and arms.

C. Encourage the child to drink liquids. Rationale: Remember that it isn't always DKA, they could just be dehydrated, and you need to see if they are symptomatic

THE MOTHER OF A 6-YEAR-OLD CHILD WHO HAS TYPE 1 DIABETES MELLITUS CALLS A CLINIC NURSE AND TELLS THE NURSE THAT THE CHILD HAS BEEN SICK. THE MOTHER REPORTS THAT SHE CHECKED THE CHILD'S URINE AND IT WAS POSITIVE FOR KETONES. THE NURSE SHOULD INSTRUCT THE MOTHER TO TAKE WHICH ACTION?

B. Side-lying

THE NURSE IS PREPARING TO CARE FOR A CHILD AFTER A TONSILLECTOMY. THE NURSE DOCUMENTS ON THE PLAN OF CARE TO PLACE THE CHILD IN WHICH POSITION? A. Supine B. Side-lying C. High Fowler''s D. Trendelenburg's

D. Bright red blood and mucus in the stools

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? A. Watery diarrhea B. Ribbon-like stools C. Profuse projectile Vomiting D. Bright red blood and mucus in the stools

D. Thicken the feedings by adding rice cereal to the formula

THE NURSE PROVIDES FEEDING INSTRUCTIONS TO A PARENT OF AN INFANT DIAGNOSED WITH GASTROESOPHAGEAL REFLUX DISEASE. WHICH INSTRUCTION SHOULD THE NURSE GIVE TO THE PARENT TO ASSIST IN REDUCING THE EPISODES OF EMESIS? A. Provide less frequent, larger feedings B. Burp the infant less frequently during feedings. C. Thin the feedings by adding water to the formula D. thicken the feedings by adding rice cereal to the formula

A. Rice

THE NURSE PROVIDES HOME CARE INSTRUCTIONS TO THE PARENTS OF A CHILD WITH CELIAC DISEASE. THE NURSE SHOULD TEACH THE PARENTS TO INCLUDE WHICH FOOD ITEM IN THE CHILD'S DIET? A. Rice B. Oatmeal C. Rye toast D. Wheat bread

A. Ventricular Septal Defect (VSD0 B. Right ventricular hypertrophy D. Pulmonic Stenosis F. Overriding Aorta

Tetralogy of fallout involves which defects? SATA

C. Play alongside one another but not actively with one another

The mother of a 2 year old child has arranged a play date with the neighbor and her child who is the same age. During the play date, the two mothers should expect that the children will do which of the following?

B. I give the iron and multivitamin in the morning 6-oz bottle Rationale: Medications should never be mixed in a large amount of food or formula because the parent cannot be sure that the child will take the entire feeding. Also, formula decreases the absorption of iron

The mother of an 11 month old with iron deficiency anemia tells the nurse that her infant is currently taking iron and a multivitamin. Which statement made by the mother should be of concern to the nurse??

D. Remove excess clothing and blankets from the child

The nurse has just administered ibuprofen (Motrin) to a child with a temp of 38.8 C (102 F). The nurse should also take which action? A. Withhold oral fluids for 8 hours B. Sponge the child with cold water C. Plan to administer salicylate (aspirin) in 4 hours D. Remove excess clothing and blankets from the child.

B. the transplant will not cure the child of CF but will allow the child to have a longer life

The parent of a child with cystic fibrosis is excited about the possibility of the child receiving a double lung transplant. What should the parent understand???

C. My child will grow up and need to learn to do things independently

The parent of a young child with CP brings the child to the clinic for a checkup. Which parent's statement indicates an understanding of the child's long-term needs?

D. The nurse answers their questions briefly, listens to their concerns and is available later after they've process information Rationale: The nurse's best intervention is to let the parents express their concerns and fears. The nurse should be available if the parents have any other concerns or questions or if they just need someone with whom to talk.

The parents of a 5-week old have just been told that their child has cystic fibrosis. The mother had a sister who died of CF when she was 19 years of age. The parents are sad and ask the nurse about the current life expectancy. What is the nurse's best response

B. Hypertension

WHAT ASSOCIATED MANIFESTATION MIGHT THE NURSE OCCASIONALLY FIND IN A CHILD DIAGNOSED WITH WILMS TUMOR? A. Atrial Fibrillation B. Hypertension C. Endocarditis D. Hyperlipidemia

A, B, D, E

WHICH OF THE FOLLOWING CAN BE MANIFESTATIONS OF LEUKEMIA IN A CHILD? SELECT ALL THAT APPLY. A. Leg pain B. Fever C. Excessive weight gain D. Bruising E. Enlarged lymph nodes

A, B, C

WHICH OF THE FOLLOWING MEASURES SHOULD THE NURSE IMPLEMENT TO HELP WITH THE NAUSEA AND VOMITING FROM CHEMOTHERAPY? SELECT ALL THAT APPLY. A. Give an antiemetic 30 minutes prior to the start of therapy B. Continue the antiemetic as ordered until 24 hours after the chemotherapy is complete C. Remove food that has a lot of odor D. Keep the child on a NPO status E. Wait until the nausea begins to start the antiemetic

B, C, D

WHICH SPECIFIC NURSING INTERVENTIONS ARE IMPLEMENTED IN THE CARE OF A CHILD WITH LEUKEMIA WHO IS AT RISK FOR INFECTION? SELECT ALL THAT APPLY. A. Maintain the child in a semiprivate room B. reduce exposure to environmental organisms C. Use strict aseptic technique for all procedures D. Ensure that anyone entering the child's room wears a mask E. Apply firm pressure to a needle stick area for at least 10 minutes

C. I will give him the aspirin that is ordered for pain and inflammation Side Note: Limit any manipulation of the joint, no hot or cold temps, NSAID is the first line

WHICH STATEMENT BY THE MOTHER OF A CHILD WITH RF SHOWS SHE HAS GOOD UNDERSTAND OF THE CARE OF HER CHILD? A. I will apply heat to his swollen joints to promote circulation B. I will have him do gentle stretching exercise to prevent contractures C. I will give him the aspirin that is ordered for pain and inflammation D. I will apply cold packs to his swollen joints to reduce pain

D. Full Fontanels, poor feeding, rapid head growth

Which are early signs and symptoms of hydrocephalus in infants A. Confusion, headache, diplopia B. Rapid head growth, poor feeding, confusion C. Papilledema, irritability, headache D. Full fontanels, poor feeding, rapid head growth