Pedi Question
A 13-year-old boy is hospitalized for a femur fracture. He was hit by a car while he and his friends were racing bikes near a major intersection. The child's parents are concerned about his judgment. The nurse should tell the parents that the behavior is: A. Typical of young teens. B. Related to hormonal surges during adolescence. C. An isolated incident and will not likely happen again. D. Related to teen rebellion.
A
A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse's best response is: A. "Your mommy and daddy will be back after your nap." B. "Your mommy and daddy will be back at 6:00 p.m." C. "Your mommy and daddy will be back later this evening." D. "Your mommy and daddy will be back in 3 hours."
A
A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately? A. Administer a bolus of normal saline. B. Administer a bolus of D10W. C. Administer a bolus of normal saline with 5% dextrose added to the solution. D. Offer the child an oral rehydrating solution such as Pedialyte.
A
A 5-year-old has been diagnosed with pseudohypertrophic muscular dystrophy. Which nursing intervention would be appropriate? A. Discuss with the parents the potential need for respiratory support. B. Explain that this disease is easily treated with medication. C. Suggest exercises that will limit the use of muscles and prevent fatigue. D. Assist the parents in finding a nursing facility for future care.
A
A young child hospitalized with asthma is ready for discharge. A home nebulizer is ordered by the physician. In order to obtain the nebulizer, a referral should be made to which staff member? A. Case manager. B. Nurse manager. C. Materials management staff. D. Child life staff.
A
Parents are told by the genetic counselor that they have a 1:4 probability of having a second child with cystic fibrosis (CF). They already have one child who is affected. The parents state their risk is lower now than when they had the previous child. What should the nurse tell the parents about the 1:4 probability? A. Each pregnancy is an independent event. B. The probability of having another child with CF is twice as likely as it was when they had the first child. C. The probability of having a healthy child is twice as likely with this pregnancy. D. The probability of miscarrying is greater now than with the previous pregnancy.
A
The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find?A. Maternal polyhydramnios. B. Pregnancy lasting more than 38 weeks. C. Poor nutrition during pregnancy. D. Alcohol consumption during pregnancy.
A
The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response? A. "Thirty minutes before feeding the child breakfast." B. "After deep-suctioning the child each morning." C. "Thirty minutes after feeding the child breakfast." D. "Only when the child has congestion or coughing."
A
The parents of a preschooler diagnosed with muscular dystrophy are asking questions about the course of their child's disease. Which should the nurse tell them? A. "Muscular dystrophies usually result in progressive weakness." B. "The weakness that your child is having will probably not increase." C. "Your child will be able to function normally and not need any special accommodations." D. "The extent of weakness depends on doing daily physical therapy."
A
What can a nurse do to reinforce a 5-year-old's intellectual initiative when he asks about his upcoming surgery? A. Answer the child's questions about his upcoming surgery in simple terms. B. Provide the child with a book that has vivid illustrations about his surgery. C. Tell the child he should wait and ask the doctor his questions. D. Tell the child that she will answer his questions at a later time.
A
Which method is the most effective way to present an educational program on abstinence to adolescents? A. Use peer-led programs that emphasize the consequences of unprotected sexual contact. B. Teach students methods to resist peer pressure. C. Offer students the opportunity to care for a simulator infant for 1 week. D. Offer statistics, pamphlets, and films discussing the consequences of unprotected sexual contact.
A
Which outcome would indicate effective case management for a child with moderate to severe asthma? A. The child attends school regularly with few absences for the year. B. The child is able to tolerate a regular diet without constipation or diarrhea. C. The family does not fill prescriptions for prophylactic inhaled steroids. D. The child does not utilize the peak flowmeter when cared for at home.
A
Which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication? A. "I should administer two quick puffs of the albuterol inhaler using a spacer." B. "I should always use a spacer when administering the albuterol inhaler." C. "I should be sure that my child is in an upright position when administering the inhaler." D. "I should always shake the inhaler before administering a dose."
A
Which will help a school-aged child with muscular dystrophy stay active longer? A. Normal activities, such as swimming. B. Using a treadmill every day. C. Several periods of rest every day. D. Using a wheelchair upon getting tired.
A
What does the therapeutic management of cystic fibrosis (CF) patients include? Select all that apply. A. Providing a high-protein, high-calorie diet. B. Providing a high-fat, high-carbohydrate diet. C. Encouraging exercise. D. Minimizing pulmonary complication. E. Encouraging medication compliance.
A,C,D,E
Which child may need extra fluids to prevent dehydration? Select all that apply. A. 7-day-old receiving phototherapy. B. 6-month-old with newly diagnosed pyloric stenosis. C. 2-year-old with pneumonia. D. 2-year-old with full-thickness burns to the chest, back, and abdomen. E. 13-year-old who has just started her menses.
All of the ABOVE
A 16-year-old is having a discussion with the nurse about the teen's recent diagnosis of lupus. In explaining the child's prognosis, the nurse uses the knowledge that adolescents are: A. Preoccupied with thoughts of the here and now. B. Able to understand and imagine possibilities for the future. C. Capable of thinking only in concrete terms. D. Overly concerned with past events and relationships.
B
A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development?A. Fax the teen's teacher, and have her send in his homework. B. Encourage the teen's friends to visit him in the hospital. C. Encourage the teen's grandparents to visit frequently. D. Tell the teen he is free to use his phone to call or text friends.
B
A 9-year-old girl builds a clubhouse in her backyard. She hangs a sign outside her clubhouse that says "No boys allowed" printed on it. The child's parents are concerned that she is excluding their neighbor's son, and they are upset. What should the school nurse tell the child's parents? A. Her behavior is cause for concern and should be addressed. B. Her behavior is common among school-age children. C. Her feelings about boys will subside within the next year. D. They should have their daughter speak with the school counselor.
B
How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is A. Not compliant with taking her vitamins. B. Not compliant with taking her enzymes. C. Eating too many foods high in fat. D. Eating too many foods high in fiber.
B
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? A. "I give the iron and multivitamin at the same time each morning." B. "I give the iron and multivitamin in the morning 6-oz bottle." C. "I give the iron and multivitamin 2 hours before I feed the morning bottle." D. "I give the iron and multivitamin in oral syringes toward the back of the cheek."
B
The nurse is instructing a new breastfeeding mother in the need to provide her premature infant with an adequate source of iron in her diet. Which statement reflects a need for further education of the new mother? A. "I will use only breast milk or an iron-fortified formula as a source of milk for my baby until she is at least 12 months old." B. "My baby will need to have iron supplements introduced when she is 4 months old." C. "I will need to add iron supplements to my baby's diet when she is 2 months old." D. "When my baby begins to eat solid foods, I should introduce iron-fortified cereals to her diet."
B
The nurse knows that teaching was successful when a parent states which of the following are early signs of muscular dystrophy? A. Increased muscle strength. B. Difficulty climbing stairs. C. High fevers and tiredness. D. Respiratory infections and obesity.
B
The parent of a child with cystic fibrosis (CF) is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? A. The transplant will cure the child of CF and allow the child to lead a long and healthy life. B. The transplant will not cure the child of CF but will allow the child to have a longer life. C. The transplant will help to reverse the multisystem damage that has been caused by CF. D. The transplant will be the child's only chance at surviving long enough to graduate college.
B
To obtain an adolescent's health information, the nurse should: A. Interview the adolescent using direct questions. B. Gather information during a casual conversation. C. Interview the adolescent only in the presence of the parents. D. Gather information only from the parents.
B
Which child can be discharged without further evaluation? A. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea in the past 12 hours. B. A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet. C. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased urine output. D. A 10-year-old who has just returned from a Scout camping trip and has had several episodes of diarrhea.
B
Which foods would the nurse recommend to the mother of a 2-year-old with anemia? A. 32 oz of whole cow's milk per day. B. Meats, eggs, and green vegetables. C. Fruits, whole grains, and rice. D. 8 oz of juice, three times per day.
B
Which is the nurse's best response to parents who ask what impact asthma will have on the child's future in sports? A. "As long as your child takes prescribed asthma medication, the child will be fine." B. "The earlier a child is diagnosed with asthma, the more significant the symptoms." C. "The earlier a child is diagnosed with asthma, the better the chance the child has of growing out of the disease." D. "Your child should avoid playing contact sports and sports that require a lot of running."
B
Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation? A. CBC. B. ABG. C. BUN. D. PTT.
B
Which stressor is common in hospitalized toddlers? Select all that apply. A.. Social isolation. B. Interrupted routine. C. Sleep disturbances. D. Self-concept disturbances. E. Fear of being hurt.
B,C,E
A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? A. Urinalysis obtained by bagged specimen. B. Urinalysis obtained by sterile catheterization. C. Analysis of serum electrolytes. D. Analysis of cerebrospinal fluid.
C
An adolescent has a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet? A. Parents and their dietary choices. B. Cultural background C. Peers and their dietary choices. D. Television and other forms of media influence.
C
An adolescent has a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet? A. Parents and their dietary choices. B. Cultural background. C. Peers and their dietary choices. D. Television and other forms of media influence.
C
The best method to explain a procedure to a hospitalized preschool-age child is to: A. Show the child a pamphlet with pictures showing the procedure. B. Have the 5-year-old next door tell the 4-year-old about the experience. C. Demonstrate the procedure on a doll. D. Show the child a video of the procedure
C
The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? A. Administer Imodium as needed. B. Administer Kaopectate as needed. C. Continue breastfeeding per routine. D. The infant may return to day care 24 hours after antibiotics have been started.
C
The nurse is giving discharge instructions to the parent of a 1-month-old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states: A. "I will give my baby feedings through the GT but place liquid medications in the corner of the mouth to be absorbed." B. "I will flush the GT with 2 ounces of water after each feeding to prevent the GT from clogging." C. "I will clean the area around the GT with soap and water every day." D. "I will place petroleum jelly around the GT if any redness develops."
C
The nurse should tell the parents of a child with Duchenne (pseudohypertrophic) muscular dystrophy that some of the progressive complications include: A. Dry skin and hair, hirsutism, protruding tongue, and mental retardation. B. Anorexia, gingival hyperplasia, and dry skin and hair. C. Contractures, obesity, and pulmonary infections. D. Trembling, frequent loss of consciousness, and slurred speech.
C
The parent of a 5-year-old states that the child has been having diarrhea for 24 hours, vomited twice 2 hours ago, and now claims to be thirsty. The parent asks what to offer the child because the child is refusing Pedialyte. Select the nurse's most appropriate response. A. "You can offer clear diet soda such as Sprite and ginger ale." B. "Pedialyte is really the best thing for your child, who, if thirsty enough, willeventually drink it." C. "Pedialyte is really the best thing for your child. Allow your child some choice in the way to take it by offering small amounts in a spoon, medicine cup, or syringe." D. "It really does not matter what your child drinks as long as it is kept down. Try offering small amounts of fluids in medicine cups."
C
Which action is a developmentally appropriate method for eliciting a 4-year-old's cooperation in obtaining the blood pressure? A. Have the child's parents help put on the blood pressure cuff. B. Tell the child that if he sits still, the blood pressure machine will go quickly. C. Ask the child if he feels a squeezing of his arm. D. Tell the child that measuring the blood pressure will not hurt.
C
Which child with asthma should the nurse see first? A. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%. B. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 93%. C. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with an oxygen saturation of 92%. D. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright, and has an oxygen saturation of 93%.
C
Which nursing action would help foster a hospitalized 3-year-old's sense of autonomy? A. Let the child choose what time to take the oral antibiotics. B. Allow the child to have a doll for medical play. C. Allow the child to administer her own dose of Keflex (cephalexin) via oral syringe. D. Let the child watch age-appropriate videos.
C
Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath? A. Prednisone. B. Singulair (montelukast). C. Albuterol. D. Flovent (fluticasone).
C
A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the time. The nurse's best response to the child's parents who are concerned about this behavior is that the child is in the: A.Detachment phase of separation anxiety, which is normal for children during hospitalization. B. Despair stage of separation anxiety, which is normal for children during hospitalization. C. Bargaining stage of separation anxiety, which is normal for children during hospitalization. D. Protest stage of separation anxiety, which is normal for children during hospitalization.
D
According to developmental theories, which important event is essential to the development of the toddler? A. The child learns to feed self. B. The child develops friendships. C. The child learns to walk. D. The child participates in being potty-trained.
D
The parents of a 5-week-old have just been told that their child has cystic fibrosis (CF). 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 projected life expectancy. What is the nurse's best response?A. "The life expectancy for CF patients has improved significantly in recent years." B. "Your child might not follow the same course that the mother's sister did." C. "The physician will come to speak to you about treatment options." D. The nurse answers their questions briefly, listens to their concerns, and is available later after they've processed the information.
D
The parents of a 6-year-old who has a new diagnosis of asthma ask the nurse what to do to make their home a more allergy-free environment. Which is the nurse's best response? A. "Use a humidifier in your child's room." B. "Have your carpet cleaned chemically once a month." C. "Wash household pets weekly."D. "Avoid purchasing upholstered furniture."
D
Which statement accurately describes how the nurse should approach an 11-year-old to do a physical assessment? A. Ask the child's parents to remain in the room during the physical exam. B. Auscultate the heart, lungs, and abdomen first. C. Explain that the physical exam will not hurt. D. Explain what the nurse will be doing in basic understandable terms.
D
C
How can the nurse best facilitate the trust relationship between infant and parents while the infant is hospitalized? The nurse should: A. Encourage the parents to remain at their child's bedside as much as possible. B. Keep parents informed about all aspects of their child's condition. C. Encourage the parents to hold their child as much as possible. D. Advise the parents to participate actively in their child's care.