Pediatrics Quiz #6
22. A 12-month-old with a history of hydrocephalus and ventriculoperitoneal shunt (VP) placement is brought to the ED by his mother who states that he refuses to eat, is afebrile but not extremely fussy, and does not play with any of his toys. The diagnostic evaluation for this child will most likely include: a. urinary catheterization b. upper GI series c. skull radiographs d. head CT
d
3. A nurse is caring for a child who is suspected of having Legg-Calve-Perthes disease. The nurse should prepare the child for which of the following diagnostic procedures? a. Bone biopsy b. Genetic testing c. MRI d. Radiographs
d
5. A nurse is caring for an infant who has myelomeningocele. Which of the following actions should the nurse include in the preoperative plan of care? a. Assist the mother with cuddling the infant. b. Assess the infant's temperature rectally c. Place the infant in a supine position d. Apply a sterile, moist dressing on the sac
d
5. Which of the following nursing observations would usually indicate pain in a comatose child? a. increased flaccidity b. increased oxygen saturation c. Decreased blood pressure d. Increased agitation
d
1. Which of the following are measures of UTI prevention? a. Good perineal hygiene b. Avoiding constipation c. Emptying the bladder frequently and completely d. all of the above
d. all of the above
3. Clinical manifestations of urinary tract infection in infancy include all but which of the following? a. fever b. poor feeding c. frequent urination d. anemia
d. anemia
17. Fosphenytoin may be given IV to treat childhood seizures instead of phenytoin because the former drug: a. is compatible with glucose and saline solutions b. has fewer complications c. may be given IM d. may be administered at a faster rate e. may involve all of the above
e
20. A 6-year-old child is seen in the urgent care unit for a history of seizures at home. He begins to have seizures in the urgent care unit that last more than 5 minutes. IV access has not been successful. The nurse caring for this child is knowledgeable that which medications may be given to stop the child's seizures? a. IM phenytoin b. Rectal diazepam c. Buccal midazolam d. a and c e. b and c
e
15. In general, during the oliguric phase of acute renal failure, which electrolytes are withheld? a. sodium b. potassium c. chloride d. a and b only e. all of the above
e. all of the above
21. Clinical manifestations of hydrocephalus in children older than 18 months include: a. headache b. irritability c. lethargy d. vomiting e. a, b, and d f. all of the above
f
A nurse is assessing a child who has chronic renal failure. Which of the following findings should the nurse expect? A. Flushed face B. Hyperactivity C. Weight gain D. Delayed growth
D. Delayed growth
A nurse is planning care of a child who has a urinary tract infection. Which of the following should the nurse include? A. Administer an antidiuretic B. Restrict fluids C. Evaluate the child's self-esteem D. Encourage frequent voiding
D. Encourage frequent voiding
5. Acute glomerulonephritis is most likely to be suspected when the child presents with the clinical manifestations of: a. normal BP, generalized edema, and oliguria. b. edema, hematuria, and oliguria c. fatigue, elevated serum lipid levels, and elevated serum protein levels. d. temperature elevation, circulatory congestion, and normal creatinine serum levels.
b. edema, hematuria, and oliguria
4. For the child with nephrosis, one aim of the therapy is to reduce: a. excretion of urinary protein b. excretion of fluids c. serum albumin levels d. urinary output
a. excretion of urinary protein
13. The most immediate threat to life of the child with acute kidney injury is: a. hyperkalemia b. anemia c. hypertensive crisis d. cardiac failure from hypovolemia
a. hyperkalemia
8. Clinical manifestations of nephrotic syndrome include: a. hyperlipidemia, hypoalbuminemia, edema, and proteinuria b. hematuria, hypertension, periorbital edema, and flank pain c. oliguria, hypocholesterolemia, and hyperalbuminemia d. hematuria, generalized edema, hypertension, and proteinuria.
a. hyperlipidemia, hypoalbuminemia, edema, and proteinuria
*2. A nurse is caring for a 10-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse report to the provider? a. Serum BUN 8 mg/dL b. Serum creatinine 1.3 mg/dL c. Blood pressure 100/74 d. Urine output 550 mL in 24 hours
b
1. In a child with hypopituitarism, the growth hormone levels are usually: a. elevated after 20 minutes of strenuous exercise b. elevated 45 to 90 minutes after the onset of sleep c. below normal after being stimulated pharmacologically. d. below normal at birth
b
1. The most common solid tumor in children and the second most common childhood cancer is: a. Wilms tumor b. brain tumor c. osteosarcoma d. Ewing sarcoma
b
11. Which of the following test, which yields immediate results, is particularly useful in diagnosing congenital adrenal hyperplasia? a. Chromosome typing b. Pelvic ultrasound c. Pelvic X-ray d. Testosterone level
b
13. Secondary problems from bacterial meningitis are most likely to occur in the: a. school-aged child. b. infant under 2 months of age c. Infant over 2 months of age. d. Child with H. influenzae meningitis
b
13. The primary pathologic defect in children with type 1 DM is: a. insulin resistance in which the body fails to use insulin properly. b. destruction of pancreatic beta cells resulting in absolute insulin deficiency
b
15. The type of seizure, also known as the petit mal seizure, that occurs more often in children between the ages of 4 and 12 years is the: a. generalized seizure b. absence seizure c. atonic seizure d. jackknife seizure
b
16. Glycosylated hemoglobin is an acceptable method to: a. diagnose diabetes mellitus b. assess the control of diabetes c. assess oxygen saturation of the hemoglobin d. determine blood glucose levels most accurately
b
2. A nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include? a. Structure interventions according to the toddler's chronological age. b. Evaluate the toddler's need for an evaluation of hearing ability c. Monitor the toddler's pain level routinely using a numeric rating scale. d. Provide total care for daily hygiene activities
b
22. Problems of adjustment to diabetes are most likely to occur when it is diagnosed in: a. infancy b. adolescence c. the toddler years d. the school-age years
b
3. The earliest indicator of improvement or deterioration in neurologic status is: a. motor activity b. level of consciousness c. reflexes d. vital signs
b
5. A nurse is assessing a preschool-age child for developmental dysplasia of the hip. Which of the following assessments should the nurse include? a. Barlow test b. Trendelenburg sign c. Manipulation of foot and ankle d. Ortolani test
b
7. The most important nursing observation following head trauma is assessment of the child's: a. head for bruises or lacerations b. level of consciousness c. neurological status d. vital signs
b
8. A common cause of secondary hyperparathyroidism is: a. maternal hyperparathyroidism b. chronic renal disease c. adenoma d. renal ricketsa
b
8. Epidural hemorrhage is less common in children under 2 years of age than in adults because: a. the middle meningeal artery is embedded in the bone surface of the skull until approximately 2 years of age. b. fractures are less likely to lacerate the middle meningeal after in children less than 2 years of age. c. separation of the dura from bleeding is more likely to occur in children than adults d. there is an increased tendency for the skull to fracture in children less than 2 years of age.
b
9. Pheochromocytoma is a tumor characterized by: a. secretion of insulin b. secretion of catecholamines c. adrenal crisis d. myxedema
b
9. The outcome of craniocerebral trauma: a. depends on the extent of the injury and the complications b. has a prognosis more favorable for children than for adults c. shows more than 90% of children with concussions or simple linear fractures recover without symptoms after the finical period d. all of the above.
b
5. A nurse is caring for a child who is in skeletal traction. Which of the following actions should the nurse take? (SATA). a. Remove the weights to reposition the client. b. Assess the child's position frequently c. Assess pin sites every 4 hours d. Ensure the weights are hanging freely e. Ensure the rope's knot is in contact with the pulley
b,c,d
*1. A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect (SATA). a. Dipstick protein of 1+ b. Edema in the ankles c. Hyperlipidemia d. Weight loss e. Anorexia
b,c,e
*5. A nurse is caring for a child who has post streptococcal glomerulonephritis (APSGN). Which of the following manifestations should the nurse expect? (SATA). a. Frothy urine b. periorbital edema c. Ill appearance d. Decreased creatinine e. hypertension
b,c,e
4. A nurse is assessing a child who has Legg-Calve-Perthes disease. Which of the following findings should the nurse expect. (SATA). a. Longer affected leg b. hip stiffness c. intense pain d. limited ROM e. Limp with walking
b,d,e
17. The manifestation of chronic kidney disease that probably has the most detrimental social consequences for the developing child is: a. anemia b. growth restriction c. bone demineralization d. septicemia.
b. growth restriction
12. The primary manifestation of acute kidney injury is: a. edema b. oliguria c. metabolic acidosis d. weight gain and proteinuria
b. oliguria
6. The nurse is caring for the child with acute glomerulonephritis would expect to: a. enforce complete bed rest. b. weigh the child daily c. perform peritoneal dialysis d. ensure a diet low in protein
b. weigh the child daily
10. The epidemiology of bacterial meningitis has changed in recent years because of the: a. diphtheria, pertussis, and tetanus vaccine b. rubella vaccine c. Haemophilus influenzae type B vaccine d. Hepatitis B Vaccine
c
12. Definitive treatment for pheochromocytoma consists of: a. surgical removal of the thyroid b. administration of potassium c. surgical removal of the tumor d. administration of beta blockers
c
17. The most common acute complication of diabetes that a young child may encounter is: a. retinopathy b. ketoacidosis c. hypoglycemia d. hyperosmolar nonketotic coma
c
2. A nurse is completing preoperative teaching with an adolescent client who is schedule to received spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching? a. "You will go home the same day of surgery." b. "You will have minimal pain." c. "You will need to received blood." d. "you will not be able to eat until the day after your surgery."
c
2. The best time to administer a growth hormone replacement injection is: a. midmorning b. at the afternoon nap c. at bedtime d. before breakfast
c
2. The sign which can be used to indicate increased intracranial pressure in the infant but not the older child is: a. projectile vomiting b. headache c. bulging fontanel d. pulsating fontanel
c
21. The nurse is teaching 15-year-old Mario about the management of type 1 DM. The management of type 1 DM for the prevention of complications is based on: I. a daily insulin regimen II. a periodic insulin regimen III. blood glucose self-monitoring IV. a regular exercise regimen V. a balanced diet VI. limited physical exercise a. I, III, and IV b. II, IV, and V c. I, III, IV, and V
c
4. Which of the following would be most important when caring for a child during a seizure? a. intervene to halt the seizure b. restrain the child c. protect the child from injury d. place a solid object between the teeth
c
6. Parents of a child with precocious puberty need to know that: a. dress and activities should be aligned with the child's sexual development b. heterosexual interest will usually be advanced c. the child's mental age is congruent with the chronologic age d. overt manifestations of affection represent sexual advances
c
6. The activity that has been shown to increase intracranial pressure is: a. using earplugs to eliminate noice b. gentle range-of-motion exercises c. suctioning d. osmotherapy and sedation
c
4. A nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? (SATA). a. Purposeless, involuntary, abnormal movements b. spinal defect and saclike protrusion c. muscular weakness in lower extremities d. Unsteady, wide-based or waddling gait e. Upward slant to the eyes
c, d
11. the most frequent cause of transient acute renal failure in infants and children is: a. nephrotoxic agents b. obstructive uropathy c. dehydration d. burn shock
c. dehydration
10. Renal injury, acquired hemolytic anemia, central nervous system symptoms, and thrombocytopenia are characteristic clinical manifestations of the disorder known as: a. minimal-change nephrotic syndrome b. Wilms tumor c. hemolytic-uremic syndrome d. vesicoureteral reflux
c. hemolytic-uremic syndrome
16. Which of the following manifestations would not be an expected finding in the child with acute renal failure? a. anemia b. hypertension c. hypernatremia d. cardiac failure with pulmonary edema
c. hypernatremia
14. The drug therapy used for the removal of elevated serum potassium is a. furosemide b. vasopressin c. ion exchange resin d. calcium gluconate
c. ion exchange resin
9. When teaching the family of a child with nephrotic syndrome about prednisone therapy, the nurse includes the information that: a. corticosteroid therapy begins after BUN and serum creatinine elevation b. prednisone is administered orally in a dosage of 4 mg/kg of body weight c. steroid therapy will occur over several weeks and restarted if a relapse occurs d. the drug is discontinued as soon as the urine is free from protein
c. steroid therapy will occur over several weeks and restarted if a relapse occurs
*4. A nurse is assessing a child who has chronic renal failure. Which of the following findings should the nurse expect? a. flushed face b. hyperactivity c. weight gain d. delayed growth
d
1. A nurse is caring for a child who is in a plaster spica cast. Which of the following actions should the nurse take? a. Use a heat lamp to facilitate dying. B. avoiding turning the child until the cast is dry c. Assist the client with crutch walking after the cast is dry d. Apply moleskin to the edges of the cast
d
1. 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 should the nurse make? a. "The Pavlik harness is used for children with scoliosis, not hip dysplasia." b. "The pavlik harness is used for school-age 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
10. The parents of a child who has Addison disease should be instructed to: a. use extra hydrocortisone only for crises. b. discontinue the child's cortisone if side effects develop c. decrease the cortisone dose during times of stress. d. report signs of adrenal insufficiency to the physician
d
14. Which of the following types of meningitis is self-limiting and least serious? a. meningococcal meningitis b. tuberculosis meningitis c. H. influenzae meningitis d. nonbacterial (aseptic) meningitis
d
15. What are characteristics often seen in type 1 DM: a. abrupt onset b. child is often underweight c. low to no serum insulin levels d. all of the above
d
16. The risk factors associated with recurrence of epilepsy include: a. polytherapy b. abnormal electroencephalogram (EEG) c. frequent seizures on anti epileptic medication d. all of the above
d
18. Exercise for the child with diabetes mellitus: a. is restricted to non contact sports b. may require a decreased intake of carbohydrate c. may necessitate an increased insulin dose d. may require an increased intake of carbohydrate
d
18. Risk factors for febrile seizures include: a. family history of febrile seizures b. viral infections c. family history of epilepsy d. a and b e. all of the above
d
A nurse is caring for a child who has post streptococcal glomerulonephritis (APSGN). Which of the following manifestations should the nurse expect? (SATA) A. Frothy urine B. Periorbital edema C. Ill appearance D. Decreased creatinine E. Hypertension
B. Periorbital edema C. Ill appearance E. Hypertension
A nurse is caring for a 10-year-old child who has acute glomerulonephritis. Which of the following findings should the nurse report to the provider. A. Serum BUN 8 mg/dL B. Serum creatinine 1.3 mg/dL C. Blood pressure 100/74 mm Hg D. Urine output 550 mL in 24 hr
B. Serum creatinine 1.3 mg/dL
A nurse is assessing a child who has a urinary tract infection. Which of the following are manifestations of urinary tract infections (SATA) A. Night sweats B. Swelling of the face C. Pallor D. Pale-colored urine E. Fatigue
B. Swelling of the face C. Pallor E. Fatigue
A nurse is caring for an infant who has obstructive uropathy. Which of the following findings should the nurse expect (SATA). A. Decreased urine flow B. Urinary tract infection C. Metabolic alkalosis D. Concentrated urine E. Hydroenphrosis
B. Urinary tract infection E. Hydroenphrosis
A nurse is caring for a male infant who has an epispadias. Which of the following findings should the nurse expect (SATA). A. Bladder exstrophy B. Inability to retract foreskin C. Widened pubic symphysis D. Broad, spade-like penis E. Pain
A. Bladder exstrophy C. Widened pubic symphysis D. Broad, spade-like penis
A nurse is caring for an infant who has ambiguous genitalia. Which of the following actions should the nurse take? (SATA) A. Prepare the child for surgery B. Obtain a detailed family history. C. Gather supplies for a circumcision. D. Refer the family for genetic counseling. E. Explain the need for chromosomal analysis
A. Prepare the child for surgery B. Obtain a detailed family history. D. Refer the family for genetic counseling. E. Explain the need for chromosomal analysis
A nurse is caring for a 10-year-old child who has nephrotic syndrome. Which of the following findings should the nurse report to the provider? A. Serum protein 5.0 g/dL B. Hgb 14.5 g/dL C. Hit 40% D. Platelet 200,000 mm^3
A. Serum protein 5.0 g/dL
3. A nurse is caring for a child who sustained a fracture. Which of the following actions should the nurse take (SATA). a. Place a heat pack on the site of injury. b. Elevate the affected limb. c. Assess neuromuscular status frequently d. Encourage ROM of the affected limb e. Stabilize the injury
B, C, E
A nurse is teaching a parent of a child who has a urinary tract infection. Which of the following should the nurse include in the teaching (select all that apply) A. Wear Nylon underpants B. Avoid bubble baths C. Empty bladder completely with each void D. Provide information about manifestations of infection. E. Wipe perineal area back to front
B. Avoid bubble baths C. Empty bladder completely with each void D. Provide information about manifestations of infection.
2. A nurse is teaching a group of parents about fractures. Which of the following information should the nurse include in the teaching? a. "Children need a longer time to heal from a fracture than an adult." b. "Epiphyseal plate injuries can result in altered bone growth." c. "A greenstick fracture is a complete break in the bone." d. "Bones are unable to bend, so they break."
B. CORRECT: Detection and early treatment is crucial for an epiphyseal plate injury to prevent altered bone growth.
A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect (SATA) A. Dipstick protein of 1+ B. Edema of the ankles C. Hyperlipidemia D Weight loss E. Anorexia
B. Edema of the ankles C. Hyperlipidemia E. Anorexia
A nurse is caring for a child who has enuresis. Which of the following is a complication of enuresis? A. Urinary tract infections B. Emotional problems C. Urosepsis D. Progressive kidney disease
B. Emotional problems
A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take? A. Prepare the child for surgery. B. Explain to the parents that the issue will self-resolve. C. Retract the foreskin and cleanse several times daily. D. Refer the family to genetic counseling.
B. Explain to the parents that the issue will self-resolve. p156
7. the most common cause of thyroid disease in children and adolescents is: a. Hashimoto disease (lymphocytic thyroiditis). b. Graves disease c. goiter d. thyrotoxicosis
B. Graves disease
A nurse is assessing an infant who has a suspected urinary tract infection. Which of the following are anticipated findings (SATA). A. Increase in hunger B. irritability C. Decrease in urination D. Vomiting E. Fever
B. irritability D. Vomiting E. Fever
18. Which of the following is included in dietary regulation of the child with chronic kidney disease? a. Restricting protein intake below the recommended daily allowance b. Dietary protein intake is limited only to the reference daily intake (Recommended Dietary Allowance [RDA] for the child's age. c. Restricting potassium when creatinine clearance falls below 50 mL/min d. Giving vitamin A, E, and K supplements
b. Dietary protein intake is limited only to the reference daily intake (Recommended Dietary Allowance [RDA] for the child's age.
*3. A nurse is caring for a 10-year-old child who has nephrotic syndrome. Which of the following findings should the nurse report to the provider? a. Serum protein 5.0 g/dL b. Hgb 14.5 g/dL c. Hct 40% d. Platelet 200,000 mm
a
11. The most common mode of transmission for bacterial meningitis is: a. vascular dissemination of an infection elsewhere. b. direct implantation from an invasive procedure c. direct extension from an infection in the mastoid sinuses d. direct extension from an infection in the nasal sinuses.
a
19. When a child has a febrile seizure, it is important for the parents to know that the child will: a. probably not develop epilepsy. b. most likely develop epilepsy c. most likely develop neurological damage d. usually need tepid sponge baths to control fever
a
1. A nurse is caring for a child who has cerebral palsy. Which of the following medications should the nurse expect to administer to treat painful muscle spasms? (SATA). a. Baclofen b. Diazepam c. Oxybutynin d. Methotrexate e. Prednisone
a, b
4. A nurse is caring for a child who has a fracture. Which of the following are manifestations of a fracture? (SATA). a. crepitus b. edema c. pain d. fever e. Ecchymosis
a, b, c, e
3. A nurse is caring for school-age child who has juvenile idiopathic arthritis. Which of the following home care instruction should the nurse include in the teaching? (SATA) a. Provide extra time for completion of ADLs b. Use cold compresses for joint pain c. Take ibuprofen on an empty stomach d. remain home during periods of exacerbation e. Perform range-of-motion exercises.
a, e
22. A child, age 12, had a renal transplant 5 months ago. He now presents to the outpatient clinic with fever, tenderness over the graft area, decreased urinary output, and a slightly elevated blood pressure. The nurse's priority at this time is to: a. Recognize that the child is probably undergoing acute rejection and to notify the physician immediately. b. Recognize that this is an episode of increased inflammation within the donor kidney because the child has probably been noncompliant with his immunosuppressant drugs. c. Obtain urine for culture and sensitivity and a blood count to quickly identify the child's infection before alerting the physician. d. Recognize that the child is in chronic rejection and that no present therapy can halt the progressive process.
a. Recognize that the child is probably undergoing acute rejection and to notify the physician immediately.