Exam 3 Pediatrics

The nurse is taking a health history of a child with suspected acute post-streptococcal glomerulonephritis. Which response would alert the nurse to a confirmed risk factor for this condition?

"He just got over a head cold with laryngitis."

The nurse is taking a health history of a toddler with a suspected congenital defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells

"He likes to stop and squat wherever he walks."

The nurse is providing discharge teaching to the parents of an 18-month-old toddler who has dehydration as a result of acute diarrhea. Which of the following statements by the parent indicate an understanding of the teaching?

"I will monitor child's number of wet diapers."

The mother of a 3-week-old infant old brings her daughter in for an evaluation. During the visit, the mother tells the nurse that her baby is spitting up after feedings. Which response by the nurse would be most appropriate?

"Infants this age commonly spit up."

A nurse is providing instruction to the parent of a school-aged child who has otitis externa. Which of the following instructions should the nurse include to help prevent re-occurrence of the infection?

"Use a mixture of vinegar and alcohol."

A 3-month old female has been brought to the hospital by the parents. The infant is very lethargic, has a weak cry and a recent history of poor feeding. The parent indicates that the symptoms "seem to happen all at once". She had put the baby down for a nap and when the baby didn't wake up after its usual 2 hour nap the mother went in and noted that the baby had a purplish rash and was lying with his back extremely arched. The infant cried out when the mother picked him up

Bacterial Meningitis

A nurse is assessing a preschooler who has heart failure. Which of the following manifestations should the nurse expect?

Bradycardia

The nurse is providing teaching to the parents of a preschooler with heart failure and is to begin to take Digoxin twice daily. Which of the following instructions should the nurse include in the teaching.

Brush the child's teeth after taking the Digoxin.

A five-year-old patient is admitted to the unit for treatment of rheumatic fever. What labs does the nurse anticipate will be ordered by the physician? (Select all that apply)

C-reactive protein Erythrocyte Sedimentation Rate

A 8-year-old girls who had a previous throat infection and was referred by her family provider to a pediatric cardiologist for suspected rheumatic fever. The nurse explains to the parents a common, serious complication of rheumatic fever is?

Cardiac valve damage

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color?

Cola colored

An admission nursing assessment of the child would reveal which of the following prodromal manifestations of ruebola?

Coryza, cough, conjuctivitis

A 12-year-old girl who is short for her age comes in the ER complaining of pain in the umbilical region, losing weight, low grade fever, diarrhea, loss of appetite. The nurse taking in the patients history suspects she might have?

Crohns Disease

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would document the stool's appearance most likely as which of the following?

Currant jelly-like

A 5-year-old male is being admitted to the pediatric Unit. The mother states that the child has a cough that produces thick tenacious mucous and has frequent frothy, greasy, foul smelling stools. The likely diagnosis the nurse would expect for this child would be?

Cystic Fibrosis

A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as which of the following?

Epispadias

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which of the following would the nurse incorporate into the presentation as the most common cause?

Escherichia coli

A nurse is admitting a child with cystic fibrosis. Which of the following medications should the nurse anticipate including in the plan of care. Select all that apply.

Fat-soluble vitamins Tobramycin Albuterol Dornase alfa

A nurse is creating a plan of care for a newly admitted adolescent who has bacterial meningitis. How long should the nurse plan to keep the adolescent in droplet precautions?

For 24 hours after the initiation of an antimicrobial therapy

The nurse is assessing a school-age child immediately postoperative following a perforated appendix repair. Which of the following findings should the nurse expect?

Absence of perstalsis

The nurse is creating a plan of care for an infant with nephrotic syndrome with 3+ pitting edema. Which of the following interventions should the nurse include in the plan?

Administer corticosteroids to the toddler

The nursing is providing teaching to the parents of a toddler about the administration of prescribed eye drops and eye ointment. Which of the following instructions should the nurse include in the teaching?

Administer eye drops 3 minutes before the eye ointment.

A nurse is preparing an adolescent for a lumbar puncture. Which of the following actions should the nurse take?

Apply topical analgesic cream 1-2 hours prior to scheduled puncture.

The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for promoting healing and preventing further skin breakdown?

Applying a barrier/healing cream or paste on skin

A child with Kawasaki disease is admitted to the pediatric unit. The nurse is reviewing the MAR and would expect to find which of the following medications. (Select all that apply)

Gama Globulin Aspirin Warfarin

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, which of the following would the nurse most likely find?

Hard, moveable, olive-shaped mass in the right upper quadrant

The nurse is creating a plan of care for an infant with a epidural hematoma due to a skull fracture. Which the following actions should the nurse include in the plan of care?

Implement seizure precautions as a safety measure.

In planning care for an asthmatic child, the nurse recognizes a priority goal is to prevent respiratory tract infections. Why is this goal important?

Infection can trigger an episode or aggravate asthmatic state.

The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care?

Maintaining the intravenous (IV) fluid rate as ordered

Cystic fibrosis may affect one system or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations?

Mechanical obstruction caused by increased viscosity of exocrine gland secretions

A 4-year-old child is brought to the emergency department by his father. The child has a "froglike" croaking sound on inspiration, is agitated, and is drooling. The child insists on sitting upright. The father states that the child has not been eating or drinking but little sips. What is the priority nursing action?

Notify the healthcare provider immediately and be prepared to assist with a tracheostomy or intubation.

The school nurse is assessing a school-aged child's blood pressure while he is seated in a chair. The child starts to experience a tonic-clonic seizure. Which of the following actions should the nurse take first?

Place the child in a side-lying position on the floor.

A 16-month-old child diagnosed with Kawasaki disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. The nurse should do which of the following first?

Place the toddler in a quiet environment.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis?

Projectile vomiting

A nurse is reviewing the medical record of a child and finds that the child has a grade II murmur. After auscultating the child's heart sounds, the nurse would document this murmur as which of the following?

Soft and easily heard

A nurse in an emergency department is performing a physical assessing on a two-week-old male infant. Which of the following manifestations is the priority for the nurse to report to the provider?

Substernal retractions

A 2-month-old is brought into the ED by her mother. The mother indicates that the infant has not been breastfeeding very well and is worried. The nurse explains that this young infant is experiencing moderate dehydration? The nurse would tells the mother to watch for which sign of moderate dehydration in her young infant?

Sunken fontanels

A 7-year-old male has come to the hospital with paroxysmal coughing, barrel chested, and manifests clubbing of the fingers. His mother says his skin tastes salty. Diagnostic confirmation for Cystic Fibrosis is achieved by performing a

Sweat Chloride Test

A 15-year-old boy comes to the emergency department accompanied by his parents. The boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states "it's a 12." Further assessment reveals a blue-black swelling on the affected side. The nurse suspects testicular torsion and immediately notifies the physician because:

The condition is a surgical emergency

Jason an 8-year-old male patient is being admitted to the Isolation Unit. When caring for the child with Kawasaki disease, the nurse should know which information regarding therapeutic management?

Therapeutic management includes administration of gamma globulin and high aspirin

A 5-year-old child is brought to the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward, refusing to lay down. Acute epiglottitis is suspected. The nurse would avoid what action:

Throat culture

A nurse is providing pediatric cardiac education to a group of nursing students. Which of the following is considered a mixed cardiac defect (mixed blood flow)?

Transposition of the great arteries

A nurse is caring for an infant with a peripheral IV line. When preparing to discontinue the fluids and remove the IV catheter which of the following actions should the nurse plan to take? Move the steps in order to the box on the right placing them in the order of performance. Use all steps.

Turn off the Pump Occlude the IV tubing Remove the tape securing the catheter Apply over the insertion site

The mother of a 20-month-old tells the nurse that the child has a barking cough at night. The child's temperature is 37ºC (98.6ºF). The mother states the child is not having difficulty breathing. Which education provided by the nurse is appropriate for this patient?

trying a cool-mist vaporizer at night and watching for signs of difficulty breathing

Princess a 10-year-old female had a tonsillectomy and is now returning to her room after postop. The nurse is explaining to her father what signs and symptoms to watch for after surgery. Which choice below would be included in the parents postoperative education for a child following a tonsillectomy?

watch for continuous swallowing.

A nurse in a provider's office is caring for a school-age child with varicella. The parent asks the nurse when her child will no longer be contagious. Which of the following responses should the nurse make?

"When your child's lesions are crusted over (approximately six days)."

A nurse is providing dietary teaching to the parent of a school-aged child who has cystic fibrosis. Which of the following statements should the nurse make?

"You should offer your child high protein meals and snacks throughout the day."

The nurse is determining maintenance fluid requirements for a child who weighs 25 kg. How much fluid would the child need per day?

1,600 mL

A nurse is preparing to administer ibuprofen 5mg/kg every 6 hours prn for temperatures above 38.0 C (100.5 F) to an infant that weighs 17.6 Lb. The infant has a temperate of 38.4 C (101.2 F). Available is ibuprofen liquid 100mg/5mL. How many mL should the nurse administer to the infant per dose? round to the nearest whole number. Use a leading 0 if it applies.

2

Zack is a 4-year-old admitted to the Day Surgery Unit for an outpatient procedure. Which explanation regarding the cardiac catheterization is appropriate for a preschool child?

When the procedure is done, you will have to keep your leg straight for at least 4 hours.

The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What is the most appropriate initial nursing action?

apply direct pressure above catheterization site

A 7-year-old boy with cystic fibrosis is a patient on the Pulmonary Unit. He is scheduled for bronchial postural drainage twice daily. When is the most appropriate times to perform bronchial postural drainage?

at least one hour before meals and at bedtime.