PED Final Questions
A school health nurse is screening for scoliosis. What assessment findings should the nurse look for? (Select all that apply.) a. uneven shoulders and hips b. a one-sided rib hump c. prominent scapula d. lordosis e. pain
a, b, c
A nurse is caring for a preschooler who has muscular dystrophy. For which of the following findings should the nurse assess? (Select all that apply.) a. purposeless, involuntary, abnormal movements b. spinal defect and sac-like protrusion c. muscular weakness in lower extremities d. unsteady, wide based or waddling gait e. upward slant to the eyes f. Gower's sign
c, d, f
Which of the following statements by the mother of a child with osteogenesis imperfecta demonstrates to the nurse understanding of safety measures needed to prevent injury? a. I will use my hands to gently turn her in the bed b. I will use a wrinkle-free lift sheet to reposition her c. I will pad her floor with plenty of soft throw rugs d. I will confine clutter to just one section of her bedroom floor e. I will gently spank her when she misbehaves
b
A nurse is assessing a child after a fractured femur. Signs that compartment syndrome is occurring are: (Select all that apply.) a. pink, warm extremity b. pain not relieved by pain medication c. dorsalis pedis pulse present d. prolonged capillary re-fill time with paresthesia
b, d
A newborn's failure to pass meconium within the first 24 to 48 hours after birth may indicate all of the following conditions EXCEPT: a. cystic fibrosis b. Hirschpring's disease c. imperforate anus d. intussusception
d
A nurse is doing a postoperative assessment on an infant who has just had a ventriculoperitoneal shunt placed for hydrocephalus. Which assessment would indicate a malfunction in the shunt? a. incisional pain b. movement of all extremities c. negative Brudzinki's sign d. bulging fontanel
d
A nurse performs triage in a pediatric orthopedic clinic. Which of the following should the nurse recognize as a symptom of slipped capital femoral epiphysis (SCFE)? a. intense knee pain while at rest b. presence of a limp in a younger school-aged child c. painful external rotation of the affected leg d. pain in the hip of a preadolescent child
d
The Glasgow Coma Scale is used to measure neurological functioning. Which of the following criteria would indicate the lowest level of functioning for an infant or young child? a. confused b. irritable, cries c. eyes open only to pain d. no response to painful stimuli
d
Which of the following statements by a teenager with a seizure disorder should indicate to the nurse that she has understood client teaching regarding her extended-release carbamazepine (Tegretol) medication? a. I know I need extra exposure to sunshine while I am taking Tegretol b. I will take my tegretol with grapefruit juice c. for maximum absorption, I will take my tegretol on an empty stomach d. I will be careful not to crush my Tegretol pill, because I might get too much medication at once
d
A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following are appropriate home care instructions? (Select all that apply.) a. sleep on a firm mattress b. use cold compresses for join pain c. take ibuprofen (Motrin) on an empty stomach d. take frequent rest periods throughout the day e. perform range of motion exercises when inflammation has subsided
a, d, e
An 8-year-old boy with Duchenne muscular dystrophy (DMD) is being seen in the clinic for a routine health visit. A high-priority nursing diagnosis for this patient is: a. risk for falls related to break down of muscles b. risk for infection related to altered immune systems c. risk for impaired skin integrity related to loss of sensation d. risk for corneal injury related to eye inflammation (uveitis)
a
An infant diagnosed with hypertrophic pyloric stenosis is admitted with history of vomiting for several days. Which nursing diagnosis should be the priority? a. deficient fluid volume related to prolonged vomiting b. ineffective airway clearance related to impaired swallowing c. imbalance nutrition: less than body requirements related to prolonged vomiting d. disorganized infant behavior related to loss of body fluids from vomiting
a
Care for an infant with osteogenesis imperfecta should include: a. support the trunk and extremities when moving b. traction care c. cast care d. post spinal surgery care
a
Congenital myelomeningocele (meningomyelocele) is commonly associated with which of the following conditions? a. hydrocephalus b. microcephaly c. cranial suture overlap d. anencephaly (absence of major portion of the brain, skull and scalp)
a
Health promotion/disease prevention is an important role for nurses to prevent spina bifida. It would be most important for the nurse to explain that women of childbearing age should: a. taking folic acid supplements during pregnancy b. be immunized for rubella and rubeola c. avoid pregnancy after age of 35 d. not have children with a man who also carries the spina bifida genetic trait
a
The nurse has completed discharge teaching for the family of a child diagnosed with Legg-Calve-Perthes disease. The nurse knows further teaching is needed about the condition if the family states, a. we're glad this will only take about six weeks to correct b. we understand swimming is a good sport for Legg-Calve-Perthes c. we know to watch for areas on the skin the brace may rub d. we understand that abduction of the affected leg is important
a
The nurse in the newborn nursery is doing the admission assessment on a neonate. Developmental dysplasia of the hip (DDH) should be suspected when the nurse observes: a. asymmetry of the gluteal and thigh fat folds b. trendelenburg sign c. telescoping of the affected limb d. lordosis
a
The pediatric nurse understands that first-line medication therapy for tonic-clonic status epilepticus, with prolonged or repetitive seizures, is/are: a. diazepam or lorazepam b. fosphenytoin or phenytoin c. phenobarbital d. propofol and ketamine
a
When assessing a newborn with cleft lip, the nurse should be alert that which of the following will most likely be compromised? a. sucking ability b. respiratory status c. locomotion d. GI function
a
Which assessment finding should lead the nurse to suspect esophageal atresia in an infant? a. excessive drooling b. hypotonicity c. abdominal distention d. excessive crying
a
Which statement would reassure the nurse that the parents understand the teaching regarding their 4-year-old with genu valgum? a. this is a normal developmental issue that will improve as the child grows b. casting will be needed to correct the deformity c. the deformity is a manifestation of arthritis and osteoporosis d. this deformity was caused by a vitamin d deficiency
a
infants are more susceptible to brain injury during a shaking episode because: a. an infants brain has higher water content and less myelination and is easily compressed within the skull during a shaking episode b. an infants skill is more rigid and has fontanels that open with bleeding when shaking occurs c. an infants head is smaller in relation to body size, and the blood vessels stretch when shaking occurs d. an infants brain has less water content, more myelination occurring and more brain cells than an adult brain
a
A child with a mild traumatic brain injury is being sedated with a mild sedative so that pain and anxiety are minimized. The nurse should (Select all that apply): a. place a continuous pulse oximetry monitor on the child b. place the child in a room near the nurses station c. allow for several visitors to remain at the child's bedside d. use soft restraints if the child becomes confused e. use sedation around the clock to decrease agitation
a, b
A child has sustained a traumatic brain injury and is being monitored in the pediatric intensive-care unit. The nurse is using the Glasgow Coma Scale to assess the child. What will the nurse be assessing for this scale? Select all that apply. a . eye opening b. verbal response c. motor response d. head circumference e. pulse oximetry
a, b, c
A nurse is preparing an educational session with parents of newborns. Which of the following should be included in the teaching in relation to the differences seen in newborns and their gastrointestinal system? (Select all that apply). a. safe and successful oral feeding in the neonate is dependent on the proper development of sucking and swallowing and their coordination with breathing b. newborns get more gas in the abdomen c. new borns have decreased peristalsis d. newborns have smaller stomach capacity e. new borns have faster movement of contents through the alimentary canal
a, b, d, e
Which of the following foods are allowed on the ketogenic diet? a. bacon b. avocado c. pastry d. breakfast cereal e. beef hot dog f. heavy cream g. green beans h. cottage cheese
a, b, e, f, g, h
Which of the following nursing interventions are appropriate for a child with muscular dystrophy? (Select all that apply.) a. suggest swimming as a good exercise for this child b. provide resources to the parents related to developmental norms for the child's age c. teach the family proper body mechanics d. immunize the child on the recommended schedule e. encourage the child to perform as much self care as possible
a, c, d ,e
A nurse is discharging an infant after a pyloric stenosis repair. Which statement by the mother would indicate the need for further instructions prior to discharge? a. I should fold the diaper down so it does not irritate the incision b. if my infant vomits, I should hold feedings for 6 hours c. I should call the doctor if my infants temperature rises above 101 degrees d. my infants incision will need to be observed for redness, swelling, or discharge
b
A nurse is evaluating the pin sites of a child with an external fixator. The nurse is least concerned with: a. redness and inflammation b. serous drainage c. pain at pin site d. purulent drainage e. pain and tenderness over the affected area of the bone
b
An 8-month-old is admitted for severe diarrhea. Which of the following would be a significant finding for this child? a. absent bowel sounds b. depressed anterior fontanel c. pale yellow urine d. increased turgor manifested by smooth, taut, shiny, skin that cannot be grasped and raised
b
An infant has just returned from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. The nurse should: a. call the physician to report the edema b. elevate the legs on pillows c. apply a warm, moist pack to the feet d. encourage movement of toes
b
The pediatric nurse is caring for a neonate with congenital clubfoot. The child has a cast to correct the defect. Before discharge, what should the nurse tell the parents? a. the cast will be removed in 6 weeks b. a new is needed every week c. a short leg cast is applied when the baby is ready to walk d. the cast will be removed when the baby begins to crawl e. a foot abduction brace is applied after the first week of casting
b
Which situation should alert the school nurse that a child requires additional assessment for Legg-Calvé-Perthes disease? a. a 7 year old girl complaining of muscle spasms in her calf b. a 7 year old boy who is limping and states that his hip hurts c. a 10 year old boy with a fever and complaints of knee pain d. a 16 year old girl with swollen knees and ankles who is limping
b
Which type of medication is most commonly used to treat juvenile arthritis? a. glucocorticoids (prednisone) b. non-steroidal anti-inflammatory drugs (NSAIDS) c. disease-modifying anti rheumatic drugs (DSMARDs) d. biologic response modifiers (immunimodulators)
b
A nurse is obtaining a history on an 18-month old child with diarrhea. Which of the following questions might help to identify the cause of this condition? (Select all that apply). a. has the child taken ibuprofen in the past week b. does the child have any food sensitivities? c. has the child traveled recently? d. has the child been on antibiotics recently? e. do any other family members have diarrhea
b, c, d, e,
A nurse is caring for a child hospitalized for osteomyelitis of the left lower extremity. Which of the following interventions should be included in the child's plan of care? (Select all that apply.) a. avoid administration of opioid analgesics for pain b. administrer intravenous antibiotics c. encourage increased fluid intake d. assess for rising ESR levels, which indicate healing e. assess the child for signs of infection f. ambulate three times daily, to prevent clots
b, c, e
The nurse is teaching family members how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip. The nurse should include in the parental education to: a. apply lotion or powder to minimize skin irritation b. put clothing over the harness for maximum effectiveness of the device c. check at least two or three times a day for red areas under the straps d. place a diaper over the harness, preferable using a thing superabsorbent disposable diaper
c
What notable sign may indicate increased intracranial pressure in an infant? a. excessive voiding b. bulging fontanel c. high-pitched cry d. minimal lover extremity movement
c
Which intervention should the nurse include in care of an infant following surgical repair of a cleft lip? a. position the infant in the prone position for feeding to avoid aspiration b. use a special feeding device with shorter nipples c. administer pain medication as ordered d. let the infant touch the suture lines as a means of self-comfort
c
Which of the following patients should the nurse suspect to have pyloric stenosis? a. an 11 month old with sausage shaped abdominal mass b. a 7 month old with choking episodes and green tinged emesis c. a five-week old infant with projectile vomiting d. a 2-year old with a harsh cough
c
Which question would be most helpful in obtaining a nursing history from the mother of an infant with suspected intussusception? a. Is your child eating normally? b. How often has your child been vomiting c. what do your child's stools look like d. when did your child last urinate
c
which of the following is the best indicator of brain function in a child with a moderate brain injury? a. pupil response b. vital signs c. level of consciousness d. gross motor strength
c
In examining a child's pupils: 1.. Size, shape, and symmetry of both pupils should be the same 2. Each pupil should constrict briskly when a light is shined into the eyes. 3. Each pupil should have consensual light reflex. True or false?
true
The Glasgow Coma Scale assesses how the brain functions as whole and not as individual parts. The scale assesses three major brain functions: eye opening, motor response, and verbal response. A completely normal child will score 15 on the scale overall. Using the scale consistently in the healthcare setting allows healthcare providers to share a common language and monitor for trends across time. True or false?
true
excess spitting up or forceful vomiting
GERD
Infants less than 1 year of age who present with apnea, seizures, lethargy, respiratory difficulty, coma, or death should be suspected of: a. maltreatment b. physical abuse c. shaken baby syndrome d. child neglect
c
The ketogenic diet is used to treat: a. autism b. cerebral palsy c. epilepsy d. hydrocephalus
c
A newborn infant is diagnosed with tracheoesophageal fistula (TEF). The nurse assesses the infant, knowing that a typical finding in this disorder is: a. slowed reflexes b. cyanosis, coughing, and choking c. diaphragmatic breathing d. passage of large amounts of frothy stool
b
olive-shaped mass in the upper right quadrant
hypertrophic pyloric stenosis
painless swelling extended toward the scrotum
inguinal hernia
stool of red current jelly consistency
intussusception
A fracture to the epiphyseal plate of a child's left arm occurs. What complication may result? a. early-onset osteoporosis b. reduced further growth c. stenosis d. juvenile arthritis
b
A nurse is caring for a child who has an arm cast. Which of the following is an early sign of altered neurovascular function? a. decreased capillary refill b. pain, dramatically out of proportion for the severity of injury c. inability to detect pulse distal to the cast d. inability to move distal extremity e. the arm is cool to the touch (the same temperature as the local environment)
b
failure to pass meconium in newborns
Hirschsprung's disease
A nurse is caring for a preschooler who walks but has difficulty keeping up with peers. The nurse is assessing the preschooler for possible right developmental dysplasia of the hip (DDH). Which of the following assessments should the nurse use to assess for DDH? a. Barlow test b. Trendelenburg sign c. manipulation of right food and ankle d. Ortolani test
b
A child is being prepared for immediate surgery due to risk of life-threatening respiratory distress. Which of the following gastrointestinal illness is a priority consideration for this problem? a. gastroesophageal reflux b. diaphragmatic hernia c. umbilical hernia d. cleft palate e. inguinal hernia
b
A 14-year-old female will receive a Milwaukee brace to correct scoliosis with a 24 degree curve. Reviewing her discharge instructions, the nurse recognizes that the client has received adequate teaching when she says she will: a. wear the brace all day and remove it only to bathe b. put the brace on a minimum of one hour, three times per day c. wear the brace after school and at night d. take off the brace if her skin gets sore or starts to break down
a
A child has experienced a sprain of the right ankle. The school nurse should: a. apply ice to the extremity b. apply a warm, moist pack to the extremity c. perform passive range of motion to the extremity d. lower the extremity to below the level of the heart
a
A child is admitted with gastroenteritis from suspected rotavirus. To prevent the spread of this disease, the nurse should: a. observe enteric contact precautions b. administer antibiotics as soon as possible c. single-bag all linens d. use an alcohol-based hand rub to prevent spread of pathogens
a
A child must wear a brace for correction of scoliosis. The nursing diagnosis that should be included in this child's plan of care is: a. risk for impaired skin integrity b. risk for delayed development c. risk for activity intolerance d. risk for decreased cardiac output e. risk for disuse syndrome
a
A child with a known seizure disorder is hospitalized for an unrelated procedure. After walking the child back from the restroom, the nurse notes tonic-clonic movements. Which action should the nurse take first? a. note the time b. ease the child to the floor c. clear the area of objects and pad the head d. roll the child to side-lying position to protect the airway
a
A nurse is preparing to administer low-dose erythromycin (E.E.S.) to a 6-year-old child. In reviewing this medication, the nurse understands that the mechanism of action is to: a. accelerate gastric emptying b. block gastric acid secretion c. coat stomach lining d. neutralize gastric acid e. treat gastrointestinal infection
a
A child with acid reflux is given metoclopramide (Reglan). A family member asks why the child is receiving this medication. What is the best response by the nurse? a. this medication improves the child's GERD symptoms, by blocking gastric acid secretion b. this medication helps prevent acid reflux by clearing food out of the stomach more quickly c. this medication coats the stomach lining, thereby protecting the stomach from excess gastric acid d. this medication restores the pH balance in the stomach, by neutralizing stomach acid
b
A 15-year-old wrestler who suffered a concussion after being thrown on his head during a match was seen in the emergency room for assessment and observation. After providing the parent with discharge instructions about post-concussion syndrome, the nurse knows that the parents have understood the instructions if they state they: a. will keep an eye on the child when he wrestles in a meet tomorrow b. plan to speak with his teachers about the injury c. should call their primary physician for an antiemetic prescription if he has any vomiting d. will check him every four hours during the night and have him bend his head to his chest
b
A 2-year-old starts to have a tonic-clonic seizure while in a crib in the hospital. The child's jaws are clamped. The most important nursing action at this time is to: a. place a padded tongue blade between the child's jaws b. stay with the child and observe the respiratory status c. prepare the suction equipment d. restrain the child to prevent injury
b
A 4-year-old child with a head injury is demonstrating difficulty swallowing and talking. Which cranial nerve might be adversely affected with this head injury? a. abducens b. vagus c. trigeminal d. accessory
b
A child has been diagnosed with epilepsy and is on daily phenytoin (Dilantin). Client education should include: a. fluid intake b. good dental hygiene c. a decrease in vitamin D intake d. taking the medication with milk
b
A child is being discharged after surgery for a myelomeningocele (meningomyelocele) repair. Before discharge, the nurse works with the parents to establish a catheterization schedule to prevent urinary tract infection. With what frequency should the nurse instruct the parents to catheterize the child? a. every 1-2 hours b. every 3-4 hours c. every 6-8 hours d. every 10-12 hours
b
An important nursing intervention when caring for an infant with a myelomeningocele (meningomyelocele) in the preoperative stage should be to: a. place infant supine to decrease pressure on the sac b. apply a heat lamp to facilitate drying and toughening of the space c. measure head circumference every shift to identify developing hydrocephalus d. apply a diaper to prevent contamination of the sac
c
A 7-year-old child has been admitted with a diagnosis of appendicitis. The nurse should expect to see which of the following lab results for this child? a. serum glucose 140 mg/dl b. serum creatinine 5.2 mg/dl c. serum leukocytes 22,000/microliter d. serum hemoglobin 7.7 g/dl
c
A child with myelomeningocele (meningomyelocele), corrected at birth, is now 5 years old. What is a priority nursing diagnosis for a child with corrected spina bifida at this age? a. dysfunctional gastrointestinal motility b. ineffective peripheral tissue perfusion c. impaired urinary retention d. impaired comfort
c
A nurse is caring for a child who has just received a cast. Which of the following considerations is important in providing care for this child? a. apply powder to the inside edges of the cast to help decrease moisture b. when handling the cast in the first 24 hours, use finger tips c. assess the casted extremity every 15-30 minutes the first two hours after cast application d. give the child a blunt object to help with the itching under the cast e. to decrease irritation, put lotion on the skin
c
A nurse notes blue sclerae during a newborn assessment. The infant should be checked for: a. anemia b. juvenile idiopathic arthritis c. osteogenesis imperfecta d. muscular dystrophy e. hypoxia of tissue f. elevated bilirubin
c
After striking his head on a tree while falling from a ladder, a 17-year-old male is admitted to the emergency department. He is unconscious and his pupils are nonreactive. Which intervention would be the most dangerous for the client? a. give him a barbiturate b. place him on mechanical ventilation c. perform a lumber puncture d. elevate the head of his bed
c
A 4-year-old child is being evaluated for hydrocephalus. An early indication of hydrocephalus in this child would be: a. bulging fontanels b. rapid enlargement of the head c. shrill, high-pitched cry d. early morning headache
d
A child has been admitted to the hospital with osteomyelitis. Which statement should the nurse understand as correct for this medical diagnosis? a. cultures should be done immediately after the first dose of antibiotics infuse b. antibiotics are ineffective against this virus c. penicillin is the antibiotic of choice d. antibiotic therapy should continue for 3-6 weeks
d
A child has just returned from surgery after spinal-fusion surgery. The nurse should check for signs of: a. increased intracranial pressure b. seizure activity c. impaired pupillary response during neurological checks d. impaired, color, sensitivity and movement to lower extremities
d
A child with gastroesophageal reflux disease (GERD) is prescribed omeprazole (Prilosec) to treat this condition.The pediatric nurse understands that the mechanism of action of omeprazole (Prilosec) is which of the following? a. this medication causes food to leave the stomach faster, decreasing the reflux of gastric contents into the esophagus b. the medicament inhibits histamine at the H2 receptors in the parietal cells of the gastric mucosa and leads to a reduction in secretion of gastric acid c. this medication binds to the surface of the gastrointestinal tract, creating a physical barrier that protects the gastrointestinal tract from stomach acid d. this medication binds to the proton pump, inhibiting acid secretion by the parietal cells of the stomach lining
d
A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses by the nurse appropriately addresses the mother's question? a. the pavlik harness is used for children with scoliosis, not hip dysplasia b. the pavlik harness is used for school aged children c. the pavlik harness cannot be used for your child because her condition is too severe d. the pavlik harness is used for infants less than 6 months of age
d
A nurse is educating a family about the type of fracture their 8-year-old son has experienced. Which of the following would be an accurate way to explain a closed fracture of the radius to the family? a. One in which a wound through the overlying soft tissues communicates with the site of the break b. one of the borns in the leg is broken incompletely, like a green twig c. one of the bones in the arm broke completely and penetrated the skin d. one of the bones in the arm broke completely and penetrated the skin e. one of the bones in the leg is crushed and broken into little pieces
d
A nurse is preparing a child for a barium enema. For which of the following conditions would this plan of care be appropriate? a. gastrochisis b. pyloric stenosis c. appendicitis d. intussusception
d
A school nurse is evaluating a child who hurt her leg in gym class. The nurse believes it is a muscle strain, but is still going to refer her to her pediatric nurse practitioner. Which instruction should the child follow until she is seen by the PNP? a. increase motion to the extremity quickly to increase circulation b. try to walk on it, even if she experiences pain c. go back to gym class and participate d. apply ice for 15 minutes at a time
d
The school nurse is performing musculoskeletal screening examinations for students in the fifth grade class. The nurse notes that a student's shoulders are at different heights—one shoulder blade is more prominent than the other. The student also has a raised, prominent hip and an uneven waist. These findings may indicate: a. Torticollis b. Kyphosis c. Lordosis d. Scoliosis
d
Which assessment finding would be most likely found on an infant diagnosed with Hirschsprung's disease? a. scaphoid abdomen (sunken, concave abdomen) b. cyanosis of distal extremities c. hyperactive reflexes d. weight less than normal for height and age
d
Which intervention should NOT be included in the preoperative plan of care for an infant with gastroschisis or omphalocele? a. administer intravenous fluids b. care for the infant in a radiant warmer c. assess the signs of other congenital anomalies d. push the abdominal content back into the abdomen
d
Which of the following instructions should be provided to parents of an infant with gastroesophageal reflux? a. feed every 4 to 5 hours to prevent overfeeding b. place in a seated position for 10 minutes after feedings c. burp every 3 to 4 ounces with feeding d. elevate the head of the crib
d
Which of the following nursing interventions is most effective in relieving joint stiffness and muscle spasm in a 10-year-old girl with juvenile arthritis? a. provide support to flexed joints with pillows and pads b. position her on her abdomen for several times a day c. massage the inflamed joints with creams and oils d. assist her with heat application and ROM exercises
d
Brain death is the same as persistent vegetative state. True or false?
false