pediatrics midterm:
A varsity high-school wrestler presents with a "rug burn" type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? a-tinea cruris b- MRSA c-impetigo d-tinea versicolor
b
In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder? a-Hemophilia b-Asthma c-rheumatoid arthritis d-Otitis media
b
The nurse is caring for a child who has tinea corporis. The child weighs 18 lb 11 oz. The medication order reads: griseofulvin 85 mg PO every day. Griseofulvin is supplied as 125 mg/5 mL. How many milliliters will the nurse administer? Round to the nearest tenth.
19.9
A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply. 1-Reduced platelet levels 2-Elevated erythrocyte sedimentation rate (ESR) 3-Reduced hemoglobin levels 4-Negative C reactive protein levels 5-Reduced white blood cell count
3, 2
A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? a-gallop and rales b-blood pressure discrepancies in the extremities c-right ventricular hypertrophy on ECG d-heart murmur
d
1. The nurse is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? A: "I will use Vaseline or Crisco to moisturize my child's skin." B: "A hot bath will soothe my child's itching when it is severe." C: "I will buy cotton rather than wool or synthetic clothing for my child." D: "I will apply a small amount of the prescribed cream after the bath."
B
A varsity high-school wrestler presents with a "rug burn" type of rash on his shoulder that is not healing as expected, despite use of triple antibiotic cream. Two other wrestlers on his team have a similar abrasion. What infection should the nurse be most concerned about, based on the history? A; tinea cruris B;MRSA C; impetigo D; tinea versicolor
B
The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? A: Administer griseofulvin with a fatty meal. B: Institute contact isolation precautions. C: Apply topical antibiotic cream. D: Apply topical antifungal cream.
D
1. Compared with adults, why are infants and children at an increased risk for infection and communicable diseases? a- The infant has had limited exposure to disease and is losing the passive immunity acquired from maternal antibodies. b- The infant demonstrates an increased inflammatory response. c- Cellular immunity is not functional at birth. d- Infants have an increased risk for infection until they receive their first set of immunizations.
a
4. The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention? a-Administer pain medication every 3 hours intravenously until pain is controlled. b-Perform passive range of motion of the arm and leg to maintain function. c-Try acetaminophen for pain first, moving up to opioids only if needed. d-Use narcotic analgesics and warm compresses as needed to control the pain.
a
A mother, who is HIV positive, is distraught when she learns that her 6-month-old baby is also human immunodeficiency virus (HIV) positive. The child had undergone open heart surgery as a newborn and had received numerous blood transfusions. The nurse recognizes that the mostlikely means of transmission of the disease to this child was: a- placental spread during pregnancy b-blood transfusion products contaminated with the virus c- the mother kissing the baby on the forehead d- breastfeeding
a
An infant born to a mother who was HIV positive was tested at birth and found to be negative. The infant is scheduled for follow-up testing. Which test would the nurse expect to be performed? a- Polymerase chain reaction (PCR) test b- Enzyme-linked immunosorbent assay (ELISA) c- Platelet count d- CD4 counts
a
When developing the plan of care for a child in pain, the nurse identifies appropriate strategies aimed at modifying which factor influencing pain? a-Gender b-Cognitive level c-Previous pain experiences d-Anticipatory anxiety
d
A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the mother would indicate the teaching was successful? a- "I should not cover the area with plastic wrap after applying the cream." b- "I should use the highest-potency steroid cream I can find." c- "I need to shake the preparation before using it." d- "I should apply the medicine at bedtime and rinse it off in the morning."
a
Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem? a-previous streptococcal throat infection b-history of open heart surgery at 5 years of age c-playing too much soccer and not getting enough rest d-exposure to a sibling with pneumonia
a
The nurse is caring for a child brought to the emergency department after an animal bite. Which action will the nurse perform first? a-Ask if the animal was provoked prior to the bite. b-Assess the child's height, weight, and temperature. c-Administer rabies vaccine and rabies immune globulin. d-Question the child about malaise, pain, and hydrophobia.
a
The nurse is caring for a child diagnosed with hydronephrosis. Which manifestation is consistent with complications of the disorder? a-Hypertension b-Hypotension c-Hypothermia d-Tachycardia
a
The nurse is caring for a child with Down syndrome. What should the nurse's focus be? a-Teaching hygiene skills to the child in order to increase self-esteem b-Screening for anomalies and teaching about prevention of respiratory infection c-Finding opportunities to increase socialization for the child and family d-Expecting walking at age 1 year and toilet training completion at age 2 years
a
The nurse is caring for an infant exposed to HIV. The polymerase chain reaction (PCR) test was negative at birth. The nurse tells the mother that the child should be tested again at what age? a- 4 to 7 weeks b- 8 to 10 weeks c- 2 to 3 months d- 12 months
a
Which of these strategies would be the first choice in attempting to maximize function in a child with muscular dystrophy? a-Long leg braces b-Motorized wheelchair c-Manual wheelchair d-Walker
a
An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? Select all that apply. a-Burning b-Photosensitivity c-Dryness d-Flu-like symptoms e-Headache
a, b, c
x The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply. The parents state, a- "We should postpone immunizing our 5-year-old since there has been contact with the infection." b- The parents remove their personal protective equipment (PPE) at the door before exiting, then wash their hands. c- The parents wear a respiratory mask when entering their child's room. d- The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." e-The parents state, "We will be sure to finish any antibiotic if our child is sent home with a prescription."
a, d
A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome? a- Instances of Down syndrome in the family greatly increases the risk for the baby also having Down syndrome. b- Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg. c- Down syndrome occurs only in females, and there is no risk as the baby is male. d-Children with Down syndrome are usually born to older mothers.
b
A 6-month-old infant is admitted to the hospital with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. The priority nursing intervention would be: a-Educate the family on ways to prevent bacterial meningitis. b-Initiate appropriate isolation precautions and begin intravenous antibiotics. c-Assess the infant's fontanels. d-Encourage the mother to hold the infant and feed her.
b
The nurse is caring for a 2-year-old with myelomeningocele. When teaching about care related to neurogenic bladder, what response by the parent would indicate that additional teaching is required? a-"Routine catheterization will decrease the risk of infection from urine staying in the bladder." b- "I know it will be important for me to catheterize my child for the rest of her life." c-"I will make sure that I always use latex-free catheters." d-"I will wash the catheter with warm soapy water after each use."
b
The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is due to a desire to avoid going to school. What is the best advice by the nurse? a:Refer the girl to a psychologist for evaluation of school phobia related to chronic illness. b: Administer a warm bath every morning before school. c: Give the child her prescribed NSAIDs 30 minutes before getting out of bed. d: Allow her to stay in bed some mornings if she wants.
b
The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is due to a desire to avoid going to school. What is the best advice by the nurse? a-Refer the girl to a psychologist for evaluation of school phobia related to chronic illness. b-Administer a warm bath every morning before school. c-Give the child her prescribed NSAIDs 30 minutes before getting out of bed. d-Allow her to stay in bed some mornings if she wants.
b
The nurse is caring for a child with Turner syndrome admitted to the unit for treatment of a kidney infection. What characteristics associated with this syndrome may the nurse expect to find upon assessment? a-Microcephaly, polydactyly b-Low-set ears, cleft lip c-Short stature, webbed neck d-Gynecomastia, taller than average
b
The nurse is providing presurgical care for a newborn with myelomeningocele. Which action is the central nursing priority? a- Maintain infant's body temperature b- Prevent rupture or leaking of cerebrospinal fluid c- Maintain infant in prone position d- Keep lesion free from fecal matter or urine
b
The nurse is teaching about skin care for atopic dermatitis. Which statement by the parent indicates that further teaching may be necessary? a-"I will use Vaseline or Crisco to moisturize my child's skin." b-"A hot bath will soothe my child's itching when it is severe." c-"I will buy cotton rather than wool or synthetic clothing for my child." d-"I will apply a small amount of the prescribed cream after the bath."
b
The public health nurse has been asked to provide information to local child care centers on controlling the spread of infectious diseases. What is the best information the nurse can provide? a: The etiology of common infectious diseases b: Proper handwashing techniques c: The physiology of the immune system d: Why children are at a higher risk of infection than adults
b
A 5-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate initial nursing intervention? a-Attempt to calm the infant by placing him in his mother's lap and offering him a bottle. b-Alert the physician or nurse practitioner to the situation and ask for an order for a stat chest x-ray. c-Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure. d-Bring the emergency equipment to the room and begin bag-valve-mask ventilation.
c
A 7-year-old child with cerebral palsy has been admitted to the hospital. Which information is most important for the nurse to obtain in the history? a-Age that the child learned to walk b-Parents' expectations of the child's development c-Functional status related to eating and mobility d-Birth history to identify cause of cerebral palsy
c
A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment? a-Assess for pallor, fatigue, and tachycardia. b-Monitor for fever. c-Assess for bruising or bleeding. d-Determine intake and output.
c
The nurse is caring for a child in the emergency department who was bitten by the family dog, who is fully immunized. What is the priority nursing action? a-Administer rabies immunoglobulin. b-Refer the child to a counselor. c-Assess the depth and extent of the wound. d-Administer a tetanus booster.
c
The nurse is caring for a child with cerebral palsy who requires a wheelchair to attain mobility. Which intervention would help the child achieve a sense of normality? a-Encourage follow-through with physical therapy exercises. b-Restrict the child to a special needs classroom. c-Encourage after-school activities within the limits of the child's abilities. d-Ensure the school is aware of the child's capabilities.
c
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history? a- The child has a sibling with the same diagnosis. b-The child had a congenital heart defect. c-The child recently had an ear infection. d-The child is being treated for asthma.
c
The nurse is observing a group of 2- and 3-year-olds in a play group. Which behavior noted in one of the children indicates to the nurse that the child may have autism spectrum disorder (ASD)? a- After another child takes a toy, the child cries and stomps his feet. b- A child playing in the kitchen area pretends to pour a glass of milk and repeats this over and over. c- While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack. d- A child flips the light switch off and on until the caregiver asks her to stop and join the other children in playing.
c
A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would be the priority nursing intervention related to prevention of injury? a-Remove the child from his bed. b-Place a tongue blade in the child's mouth. c-Restrain the child. d-Place the child on his side and opening his airway.
d
A 4-month-old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse? a-"It's too early to know; we have to wait until the infant has symptoms." b-"Since the mother is so ill, it's likely the child is also infected with HIV." c-"The ELISA test is positive, so the child is definitely infected." d-"The PCR test is positive; this indicates HIV infection, which may or may not progress to AIDS."
d
A 4-month-old infant born to an HIV-infected mother is going into foster care because the mother is too ill to care for the child. The foster mother wants to know if the infant is also infected. What is the best response by the nurse? a: "It's too early to know; we have to wait until the infant has symptoms." b: "Since the mother is so ill, it's likely the child is also infected with HIV." c: "The ELISA test is positive, so the child is definitely infected." d: "The PCR test is positive; this indicates HIV infection, which may or may not progress to AIDS."
d
A boy with Duchenne muscular dystrophy is admitted to the pediatric unit. He has an ineffective cough. Lung auscultation reveals diminished breath sounds. What is the priority nursing intervention? a-Apply supplemental oxygen. b- Notify the respiratory therapist. c-Monitor pulse oximetry. d-Position for adequate airway clearance.
d
A child with leukemia has the following AM laboratory results: Hgb 8.0, Hct 24.2, WBC 8,000, platelets 150,000. What is the priority nursing assessment? a-Monitor for fever. b-Assess for bruising or bleeding. c-Determine intake and output. d-Assess for pallor, fatigue, and tachycardia.
d
A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse? a- "All fevers should be treated to prevent seizures." b-"Antipyretics should be used with any rise in temperature. They can help change the course of the infection." c-"Give your child aspirin when her fever is above 38°C (100.4°F)." d-"In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication."
d
A mother calls the clinic because her 2-year-old daughter has a rectal temperature of 37.8°C (100°F). She wonders how high a fever should be before she should give medications to reduce it. What is the best response by the nurse? a; "All fevers should be treated to prevent seizures." b;"Antipyretics should be used with any rise in temperature. They can help change the course of the infection." c; "Give your child aspirin when her fever is above 38°C (100.4°F)." d;"In a normal healthy child, if your child is not uncomfortable, fevers less than 39°C (102.2°F) do not require medication."
d
The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be mostappropriate for the nurse to suggest? a- Avoid chocolate and greasy foods. b- Wash the face with abrasive soaps three times a day. c- Pop the pimples to make them go away. d- Wash the face twice a day with a mild soap then pat dry.
d
The nurse is caring for a child with ADHD. Which behavior would the nurse not expect the child to display? a-moody, morose behavior with pouting b-interruption and inability to take turns c-forgetfulness and easy distractibility d-excessive motor activities and fidgeting
d
The nurse is caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes? a-"I will stop the enzymes if my child is receiving antibiotics." b-"I will decrease the dose by half if my child is having frequent, bulky stools." c-"Between meals is the best time for me to give the enzymes." d-"The enzymes should be given at the beginning of each meal and snack."
d
The nurse is caring for an infant girl in an outpatient setting. The infant has just been diagnosed with developmental dysplasia of the hip (DDH). The mother is very upset about the diagnosis and blames herself for her daughter's condition. Which response best addresses the mother's concerns? a- "There are simple noninvasive treatment options." b- "Your daughter will likely wear a Pavlik harness." c- "Don't worry; this is a relatively common diagnosis." d- "This is not your fault and we will help you with her care and treatment."
d
The nurse is caring for an infant on the pediatric unit who has a very red rash in the diaper area, with red lesions scattered on the abdomen and thighs. What is the priority nursing intervention? a-Administer griseofulvin with a fatty meal. b- Institute contact isolation precautions. c-Apply topical antibiotic cream. d-Apply topical antifungal cream.
d
The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a- Sausage-shaped mass in the upper mid abdomen b-Perianal fissures and skin tags c-Abdominal pain and irritability d-Hard, moveable "olive-like mass" in the upper right quadrant
d