pediatrics week week 13 chapters 22,26,and 28
A 2-month-old breastfed infant is receiving oral rehydration solution for acute diarrhea. What instructions should the nurse give the mother about breastfeeding? 1 To continue breastfeeding 2 To supplement breastfeeding with water 3 To stop breastfeeding until the diarrhea has ceased for 24 hours 4 To express breast milk and dilute it with sterile water before feedings
1
A father brings his 5-year-old son to the clinic because he has recently lost a lot of weight. He reports to the nurse that the boy is always hungry, thirsty, and complaining that he has to use the bathroom. What disorder is best described by these symptoms? 1 Diabetes mellitus 2 Addison disease 3 Cushing syndrome 4 Pheochromocytoma
1
A nurse assesses that the newborn has frothy saliva, cyanosis, oxygen desaturation, and unexplained episodes of apnea. Which surgical treatment will be beneficial for the child? 1 Thoracotomy 2 Kasai procedure 3 Nissen fundoplication 4 Fredet-Ramstedt procedure
1
An adolescent patient reports constipation, weight gain, and low mood. The patient also feels cold in warm weather. Most of the adolescents in the community have similar symptoms. What does the nurse tell the patient to include in the diet? 1 Iodized salt 2 Iron-fortified milk 3 Essential fatty acids 4 Essential amino acids
1
An infant is found to have malrotation of the intestine. What is the therapeutic management to reverse this condition? 1 Surgery to remove the affected area 2 Holding feedings until bowel sounds are present in all four quadrants 3 Nothing-by-mouth status until the intestine rotates back into normal position 4 Beginning breastfeeding to help the intestine rotate back into normal position
1
During the summer, many children are more physically active. What changes in the management of the child with type 1 diabetes mellitus should be expected as a result of more exercise? 1 Increased food intake 2 Decreased food intake 3 Decreased risk of insulin shock 4 Increased risk of hyperglycemia
1
The child with testicular dysfunction has undergone surgery. The nurse is teaching the parents about interventions to prevent complications after surgery. Which statement of the parent indicates the need for further teaching? 1 "I should give my child a tub bath every day." 2 "I should monitor the appearance of child's testes." 3 "I should ensure that the child does not go out to play." 4 "I should ensure that my child does not lift heavy things."
1
The laboratory reports of a patient indicate that the patient has hypoalbuminemia and proteinuria. Upon physical examination, the nurse finds that the patient has a pleural effusion, a distended abdomen, and generalized edema. Which complication should the nurse expect in the child? 1 Nephrotic syndrome 2 Acute glomerulonephritis 3 Hemolytic uremic syndrome 4 Acute urinary tract infection
1
The nurse finds that a child has excessive hair growth, a pendulous abdomen, red abdominal striae, ecchymosis, fat deposits on the upper back, and a moon-shaped face. Based on these, which laboratory value should the nurse assess first? 1 Potassium 2 Calcium 3 Sodium 4 Phosphorus
1
The nurse is caring for a child with hepatitis A. What is the main mode of transmission of this disease? 1 Fecal-oral route 2 Parenteral route 3 Breastfeeding 4 Transplacental blood
1
The nurse is discussing home care with the mother of a 6-year-old child with hepatitis A. What should the discharge teaching plan include? 1 Teaching infection-control measures to family members 2 The importance of bedrest until 1 week after the icteric phase 3 The need for the child not to return to school until 3 weeks after the icteric phase 4 Reassurance for the mother that hepatitis A cannot be transmitted to other family members
1
The nurse is planning care for a child with recently diagnosed diabetes insipidus. Which nursing intervention should be planned? 1 Encouraging the child to wear medical identification 2 Discussing with the child and family ways to limit fluid intake 3 Teaching the child and family how to do required urine testing 4 Reassuring the child and family that diabetes insipidus is usually not a chronic or life-threatening illness
1
The nurse is preparing a 3-year-old child for the examination of the urethra and taking a urine sample. What strategy should the nurse use while preparing the child? 1 Demonstrate and explain the procedure on a doll. 2 Explain the urinary system and procedure to the child. 3 Show pictures of the urinary system and the procedure. 4 Ask the parents to explain the procedure to the child.
1
The nurse is providing nutritional counseling to a patient who presented with severe diarrhea, fistulas, weight loss, and severe growth retardation. Which statement by the patient indicates effective learning? 1 "I should consume a high-protein diet." 2 "It's OK to drink coffee sometimes." 3 "I should avoid high-calorie foods." 4 "I should avoid iron supplements."
1
The nurse is reviewing the laboratory reports of a patient and notices a urine specific gravity of 1.030. What should the nurse interpret from this finding? 1 The patient has dehydration. 2 The patient has renal disease. 3 The patient has diabetes mellitus. 4 The patient has metabolic alkalosis
1
The nurse is reviewing the urinalysis results of a 12-hour sample of urine of a patient. The nurse finds that the creatinine level in the urine is significantly reduced. What does the nurse interpret from this? 1 The glomerular filtration rate (GFR) is reduced. 2 The patient has excess protein metabolism. 3 The patient is in a state of hypovolemic shock. 4 The patient has a urinary tract infection
1
The nurse suspects that the child has delayed growth. The nurse does not have serial height and weight records to assess the child's growth. What action does the nurse take? 1 Asks about the child's growth as compared to siblings. 2 Asks the parents about the child's allergy status. 3 Asks about the child's height and weight at birth. 4 Asks about the child's weight as compared to the siblings.
1
Type 1 diabetes mellitus has just been diagnosed in a teenage boy who is actively involved in sports. What important instruction should the nurse include in the teaching plan? 1 Because exercise can lower the blood glucose level, blood glucose needs to be closely monitored. 2 Because exercise can increase the blood glucose level, blood glucose needs to be closely monitored. 3 Because exercise can increase the blood glucose level, additional insulin should be taken before physical activity. 4 Because exercise can lower the blood glucose level, additional insulin should be taken before physical activity.
1
What accounts for the increased incidence of bacteriuria in females? 1 Lower urinary tract 2 Higher urinary tract 3 Higher intake of fluids 4 Frequent emptying of the bladder
1
What care must the nurse take when obtaining abdominal measurements for a child with Hirschsprung disease? 1 Mark the point of measurement on the abdomen with a pen. 2 Obtain abdominal circumference just above the umbilicus. 3 Obtain and document the measurement once a day. 4 Remove the tape after each measurement is recorded.
1
What does management of the child with a peptic ulcer often include? 1 Proton pump inhibitors 2 Milk at frequent intervals 3 Coping with stress and adjusting to chronic illness 4 Antacids 1 and 3 hours before meals and at bedtime
1
What explanation does the nurse give the parents of a child scheduled for treatment of chordee? 1 "It is a surgical release of the fibrous band from the penis." 2 "It is a surgical closure of the inguinal defect in the abdomen." 3 "It is a surgical lengthening of the urethral opening for better urination." 4 "It is a surgical correction to allow a direct stream of urination to prevent infections."
1
What is an appropriate breakfast for the hospitalized child who has celiac disease? 1 Eggs, turkey bacon, fruit 2 Cheerios, low-fat milk, fruit 3 Pancakes, eggs, turkey bacon 4 Eggs, turkey bacon, toast, low-sugar orange juice
1
What is the current treatment for end-stage renal disease? 1 Dialysis and transplantation 2 Limited sodium and water intake 3 None available 4 Restriction of protein intake below the reference daily intake (RDA)
1
What is the primary form of dehydration in children? 1 Isotonic dehydration 2 Osmolar dehydration 3 Hypotonic dehydration 4 Hypertonic dehydration
1
What levels of thyroid hormone (TH) and thyroid-stimulating hormone (TSH) characterize primary congenital hypothyroidism? 1 Low level of circulating TH, raised level of TSH at birth 2 Low level of circulating TH, low level of TSH at birth 3 Low level of circulating TH, normal level of TSH at birth 4 High level of circulating TH, increased level of TSH at birth
1
Which physiologic alteration is characterized by destruction of pancreatic beta-cells that produce insulin? 1 Type 1 diabetes 2 Type 2 diabetes 3 Gestational diabetes 4 Impaired glucose tolerance
1
Which statement best describes Hirschsprung disease? 1 The colon has an aganglionic segment. 2 It results in frequent evacuation of solids, liquids, and gas. 3 There is a passage of excessive amounts of meconium in the neonate. 4 It results in excessive peristaltic movements within the gastrointestinal tract.
1
Which type of diarrhea is associated with antibiotic therapy? 1 Acute diarrhea 2 Chronic diarrhea 3 Chronic nonspecific diarrhea 4 Intractable diarrhea of infancy
1
While waiting for the administration of air pressure to reduce an intussusception, the child passes a normal brown stool. What is the most appropriate nursing action? 1 Notifying the health care provider immediately 2 Decreasing the rate of intravenous fluids 3 Measuring the abdominal girth 4 Administering prescribed prophylactic antibiotics
1
What conditions place an infant at risk for increased fluid requirements? Select all that apply. 1 Burns 2 Surgery 3 Tachypnea 4 Diabetic ketoacidosis 5 Congestive heart failure
1, 3, 4
Parents have brought their child in to the clinic for a well-child visit. They express some concern that the child seems to have short stature. The nurse needs to determine if the cause is familial short stature or constitutional growth delay. What steps does the nurse take to evaluate the growth curve? Select all that apply. 1 Determine the child's absolute height. 2 Assess the child's height velocity. 3 Determine the child's cognitive development. 4 Determine the child's weight-to-height ratio. 5 Determine the child's motor development.
1,2,4
The nurse is caring for a newborn admitted to the nursery with a cleft lip and palate. What preoperative nursing care goals should the nurse set with this patient and family? Select all that apply. 1 The infant will be prepared for surgery. 2 The infant will receive optimal hydration and nutrition. 3 The family will be prepared for the home needs of the child. 4 The family will cope with the impact of an infant with a defect. 5 The infant will experience no trauma and minimal or no pain after the procedure.
1,2,4
The nurse is monitoring an infant for water intoxication. Which actions may lead to water intoxication? Select all that apply. 1 Providing intravenous (IV) fluid replacement 2 Administering tap water enema 3 Using milk to pacify the infant 4 Administering 0.45% sodium chloride 5 Feeding concentrated formulas
1,2,4
What are the early clinical manifestations of acute adrenocortical insufficiency? Select all that apply. 1 Diarrhea 2 Headache 3 Nuchal rigidity 4 Weak, rapid pulse 5 Increased irritability
1,2,5
What factors contribute to infants' having a greater and more rapid water loss than adults? Select all that apply. 1 Infants lose a large amount of fluid at birth. 2 Infants are less likely than adults to become febrile. 3 Infants maintain more extracellular fluid than do adults. 4 Infants have the same amount of intracellular fluid as adults. 5 Infants with acute illnesses retain extracellular fluid more than adults do
1,3
A child is on hormone replacement therapy for panhypopituitarism. What instructions does the nurse give to the child's parents? Select all that apply. 1 Provide same age-appropriate responsibilities as the child's siblings. 2 Provide responsibilities that would be appropriate for a younger child. 3 Encourage the child to wear medical identification at all times. 4 Encourage the child to participate in group activities with peers. 5 Keep the child away from other children, because they will bully the child.
1,3,4
Urinalysis of a patient with type 1 diabetes mellitus shows ketones, glucose, and high concentrations of H+ ions. On examination the nurse finds that the patient's skin is dry, radial artery pulse is weak, and the level of consciousness is decreased. What measures are taken by the nurse? Select all that apply. 1 Administer potassium supplements. 2 Administer amitriptyline (Elavil). 3 Administer insulin. 4 Administer IV fluids. 5 Administer furosemide (Lasix)
1,3,4
What interventions must the nurse perform for the child after an uncomplicated appendectomy? Select all that apply. 1 Irrigate the wound with saline. 2 Cover the wound with tape. 3 Listen for bowel sounds. 4 Encourage intake of ice chips. 5 Ensure complete bed rest.
1,3,4
The nurse is assessing a child with delayed growth. Which questions does the nurse include in the assessment while interviewing the parents? Select all that apply. 1 "Tell me about diseases in your family." 2 "What behavioral therapies is the child undergoing now?" 3 "What kind of developmental issues did the child have?" 4 "Have there been changes in the child's appetite?" 5 "What kind of medications does the child take?"
1,3,4,5
While reviewing the laboratory reports of a pregnant patient who is at 40 weeks of gestation, the nurse finds that the patient has reduced secretion of the hormone oxytocin. What would be the consequences if treatment is delayed? Select all that apply. 1 Delayed labor 2 Dehydration 3 Reduced blood pressure 4 Reduced milk ejection from the breasts 5 Reduced contraction of small blood vessels
1,4
The nurse is assessing a child for pituitary hyperfunction. Which assessment findings does the nurse recognize as an effect of hyperpituitarism? Select all that apply. 1 Overgrowth of the long bones 2 Absence of sexual maturation 3 Delayed dentition and tooth loss 4 Malocclusion of teeth in enlarged jaw 5 Thickened, deeply creased skin
1,4,5
The nurse is aware of the need to maintain water balance in infants. Which infants would the nurse expect to have an increased need for water replacement? Select all that apply. 1 The infant in the radiant warmer 2 An infant with oliguric renal failure 3 The infant with congestive heart failure 4 An infant receiving phototherapy 5 The febrile infant who is vomiting
1,4,5
The nurse is teaching an adolescent with newly diagnosed type I diabetes ways to minimize discomfort with insulin injections. Which recommendations are helpful in minimizing injection discomfort? Select all that apply. 1 Do not reuse needles. 2 Inject insulin when it is cold. 3 Flex or tense the muscle during injection. 4 Remove all bubbles from the syringe before the injection. 5 Do not move the direction of the needle-syringe during insertion or withdrawal.
1,4,5
The nurse understands that the long-term management of a child with a cleft lip often involves several types of treatment. What are those treatments? Select all that apply. 1 Speech therapy 2 Treatment of chronic pain 3 Treatment of serial infections 4 Orthodontics and prosthodontics 5 Placement of pressure-equalization tubes
1,4,5
What assessment findings does the nurse recognize as a complication of chronic renal failure (CRF)? Select all that apply. 1 Decreased erythropoietin 2 Seizure due to uremia 3 Water intoxication 4 Osseous deformities 5 Growth failure
1,4,5
Calculate the target height of a boy whose father is 175 cm tall and whose mother is 160 cm tall. Record your answer using a whole number. ________ cm
175+160+13 / 2 = 174cm
A child has a nasogastric (NG) tube after surgery for acute appendicitis. What is the purpose of the NG tube? 1 Maintain electrolyte balance 2 Prevent abdominal distention 3 Prevent the spread of infection 4 Maintain an accurate record of output
2
A child's parents report that the child is urinating frequently and in large amounts. A urinalysis also reveals a high specific gravity and a high osmolality. Based on this result, which test should the nurse assess? 1 Chest x-ray results 2 Blood glucose levels 3 Serum potassium level 4 Liver function tests
2
A diabetic child who is treated with insulin is trembling and sweating profusely. The nurse learns that the child has skipped lunch. What should the nurse do? 1 Administer a glucagon injection. 2 Give the child 3 to 6 oz of orange juice. 3 Give the child an insulin injection immediately. 4 Ignore the symptoms, because they are normal findings.
2
A nurse is caring for a 6-month-old infant who has been brought to the clinic with a moderate fever and foul-smelling watery stools for the past 2 days. What is the most common cause of diarrhea in children of this age group? 1 Shigella 2 Rotavirus 3 Salmonella 4 Escherichia coli
2
A patient with gastrointestinal Helicobacter pylori is prescribed triple-drug therapy of bismuth, clarithromycin, and metronidazole as first-line treatment. Which condition does the nurse expect to be present in the patient? 1 Acute appendicitis 2 Peptic ulcer disease 3 Meckel diverticulum 4 Hirschsprung disease
2
A previously healthy 10-year-old boy is hospitalized because he has experienced weight gain over the past several days, generalized edema, and irritability. With what condition are these clinical manifestations associated? 1 End stage renal disease 2 Nephrotic syndrome 3 Acute glomerulonephritis 4 Hemolytic uremic syndrome
2
A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solution (ORS). The child's mother calls the clinic nurse because the child is also occasionally vomiting. What should the nurse recommend? 1 Alternating ORS and carbonated drinks 2 Continuing to give ORS frequently in small amounts. 3 Bringing the child to the hospital for intravenous fluids 4 Instituting nothing-by-mouth status for the child for 8 hours and resuming ORS if the vomiting subsides
2
An 8-week-old infant is brought to the clinic. The infant's parents tell the nurse that the baby was thriving and doing well with only a mild amount of jaundice at birth but report that over the past several days the baby has become increasingly irritable and has started passing dark yellow urine and is having difficulty gaining weight. The nurse notices jaundice in the baby's sclerae. With what condition are these clinical manifestations associated? 1 Liver disease 2 Biliary atresia 3 Acute hepatitis 4 Peptic ulcer disease
2
An adolescent who has been consuming a low-sodium diet for a long period is at risk for: 1 Water excess 2 Hyponatremia 3 Hypernatremia 4 Water depletion
2
The imbalance of which hormone causes symptoms of warm, moist skin; protruding eyeballs; difficulty breathing; and heat intolerance? 1 Insulin 2 Thyroid hormone 3 Parathyroid hormone 4 Antidiuretic hormone
2
The largest percentage of childhood hyperthyroidism is caused by: 1 Poor diet 2 Graves disease 3 Hashimoto disease 4 Hypoparathyroidism
2
The nurse is assessing a child with a urinary tract infection (UTI). On speaking to the parents about the child, the nurse concludes that the patient has a persistent UTI. What statement made by the parents would have led the nurse to this conclusion? 1 "Our child has pain in the lower abdominal area and also presents with a fever." 2 "Our child has had this problem in spite of taking antibiotics prescribed earlier." 3 "Our child gets cured and symptoms begin again within a month's time." 4 "Our child's blood report revealed that the infection has spread in the blood."
2
The nurse is caring for a child hospitalized with acute adrenocortical insufficiency. The acute phase seems to be over when ascending flaccid paralysis occurs. What is the most appropriate nursing action? 1 Preparing the family for the child's death 2 Reassuring the family that this condition is temporary 3 Reassuring the family that flaccid paralysis is not problematic 4 Preparing the family for the long-term consequences of paralysis
2
The nurse is caring for a child who had an appendectomy following a ruptured appendix and peritonitis. Which intervention does the nurse perform first for the child with risk for infection? 1 Listen for bowel sounds and bowel activity. 2 Monitor wound status, integrity, and type of dressing. 3 Maintain nasogastric (NG) tube gastric decompression. 4 Monitor temperature, blood pressure, and pulse oximeter.
2
The nurse is caring for a child with Crohn disease (CD). What is a distinctive characteristic of CD? 1 Inflammation is limited to the distal colon and rectum. 2 Inflammation results in stiffening of the bowel wall. 3 The most dangerous form is toxic megacolon. 4 Rectal bleeding is common in these patients.
2
The nurse is caring for a child with a peptic ulcer, who has been prescribed omeprazole. What is the effect of this drug on the child? 1 Protects the ulcerated mucosal layer 2 Inhibits hydrogen ion pump in parietal cells 3 Neutralizes gastric acid 4 Inhibits the growth of microorganism
2
The nurse is caring for a child with acute adrenocortical insufficiency. Which nursing intervention must be executed first in the acute phase of adrenal crisis? 1 Provide emotional support to the parents. 2 Institute precautions to prevent seizures. 3 Ensure rapid administration of IV fluids. 4 Offer small quantities of oral fluids.
2
The nurse is collecting a urine sample for culture from a child who has undergone surgery and has an indwelling urinary catheter in place. What should the nurse keep in mind while collecting the sample? 1 The nurse should avoid taking the urine sample from a catheter. 2 The nurse should use aseptic techniques while collecting the sample. 3 The nurse should store the sample for 2 hours before sending it to the lab. 4 The nurse should obtain the parents' consent before collecting the sample.
2
The nurse is reviewing the cystourethrography results of a child with urinary tract infection. Cystourethrography results reveal that the child has vesicoureteral reflex. What complication could be associated with this finding? 1 The child is unlikely to respond to any kind of antibiotics. 2 The child is at risk for the development of pyelonephritis. 3 The child is susceptible to have infection spread in the blood. 4 The child is prone to anatomic variations in the renal system.
2
The nurse is reviewing the medical record of a patient who presents with a tumor in an enlarged sella turcica and enlargement of the paranasal sinuses with a normal bone age and a diagnosis of acromegaly. What should the nurse expect to find in the assessment? 1 Recessed jaw 2 Enlarged jaw 3 Lack of facial hair 4 Hypoglycemia
2
The parents of a child who is on growth hormone replacement therapy are not satisfied with the outcome of the treatment, because the child's height is not increasing. The child is still shorter than school peers. What is the most appropriate action of the nurse? 1 Increase the dose of growth hormone to the child. 2 Reassure the parents and set realistic expectations. 3 Change the route of administration of growth hormone. 4 Advise the parents to feed the child a high-protein diet.
2
What action must the nurse take when feeding the child with inflammatory bowel disease? 1 Provide bran or a high-fiber diet. 2 Provide mouth care before eating. 3 Encourage three large meals a day. 4 Offer slightly spicy foods for taste.
2
What are the cardinal signs of diabetes insipidus? 1 Vascular anomalies 2 Polyuria and polydipsia 3 Hypotension and dehydration 4 Dehydration and diminished urine output
2
What are the clinical manifestations of juvenile hypothyroidism? 1 Sleepiness, dry skin, diarrhea 2 Dry skin, sparse hair, slowed growth 3 Diarrhea, dry skin, decelerated growth 4 Constipation, dry skin, enlarged thryoid
2
What are the clinical manifestations of juvenile hypothyroidism? 1 Sleepiness, dry skin, diarrhea 2 Dry skin, sparse hair, slowed growth 3 Diarrhea, dry skin, decelerated growth 4 Constipation, dry skin, enlarged thyroid
2
What does the nurse recognize as a nursing intervention that is contraindicated for children, especially infants with acute diarrhea? 1 Bathing 2 BRAT diet 3 Breastfeeding 4 Rehydration solution
2
What finding in a child undergoing continuous ambulatory peritoneal dialysis requires immediate attention? 1 Clear dialysate draining from the child 2 Cloudy dialysate draining from the child 3 Instillation of solution into the peritoneal cavity 4 Surgically implanted indwelling catheter tunneled subcutaneously and sutured into place
2
What findings are commonly observed in the child who is in the acute phase of acute glomerulonephritis? 1 Hematuria and ketosis 2 Hematuria and proteinuria 3 Increased serum complement 4 Positive cultures of the pharynx for streptococci
2
What is a common characteristic of acute peptic ulcer disease in neonates? 1 Usually stress ulcers 2 Usually gastric ulcers 3 Usually duodenal ulcers 4 Usually associated with Helicobacter pylori
2
What is one appropriate nursing intervention for a child with nephrotic syndrome on bedrest? 1 Restraining the child as necessary 2 Adjusting activities to the child's tolerance level 3 Discouraging the parents from holding the child 4 Performing passive range-of-motion exercises once a day
2
What manifestation in the infant does the nurse associate with hypertrophic pyloric stenosis? 1 Abdominal pain 2 Projectile vomiting 3 Edema at the extremities 4 Distended lower abdomen
2
What should the nurse interpret from the findings in this infant's laboratory results? 1 The infant has dehydration. 2 The infant has renal disease. 3 The infant requires a high-protein diet. 4 The infant requires antibiotic therapy
2
What should the nurse teach the parents about reducing the risk for transmitting bacteria via food? 1 Keep food out of the refrigerator for 3 hours before cooking. 2 Wash hands with hot, soapy water after contact with raw meat. 3 Cook all dishes made with ground meat until pale pink inside. 4 Wash vegetables that cannot be peeled in running water.
2
When discharging an infant with short-bowel syndrome home on parenteral nutrition (PN) and gastrostomy feedings the nursing care should include: 1 Teaching the family how to calculate caloric needs 2 Recognition of signs of central venous catheter infections 3 Preparation of the family to increase the PN solution when enteral feedings are advanced 4 Securing the PN and gastrostomy tubing under the diaper to lessen the risk of dislodgement
2
Which diet is most appropriate for the child with celiac disease? 1 Salt-free 2 Low-gluten 3 Phenylalanine-free 4 High-calorie, low-protein, low-fat
2
Which factor does the nurse associate with chronic diarrhea in a child? 1 Urinary tract infection 2 Lactose intolerance 3 Antibiotic therapy 4 Laxative use
2
Which statement best describes Cushing syndrome? 1 Treatment involves replacement of cortisol. 2 It is caused by excessive production of cortisol. 3 The major clinical features are exophthalmia and pigment changes. 4 Diagnosis is suspected with findings of hypotension, hyperkalemia, and polyuria.
2
The nurse is caring for a child with transient renal failure due to dehydration. The child continues to experience oliguria even after fluid volume restoration. In which order does the nurse perform the interventions in the child's plan of care? 1. Administer prescribed diuretic therapy. 2. Provide adequate volume replacement. 3. Insert Foley catheter into the bladder. 4. Monitor intake of fluid, potassium, and sodium.
2, 1, 3 ,4
An infant with neurologic impairment and delay is receiving several medications, including a proton pump inhibitor. Which of these medications are proton pump inhibitors? Select all that apply. 1 Ranitidine 2 Omeprazole 3 Pantoprazole 4 Glycopyrrolate 5 Bethanechol
2,3
The nurse is caring for a child who is referred for radioisotope imaging of the renal system using the DTPA (diethylenetriamine pentaacetic acid) radioisotope. The nurse is explaining the procedure to the parents. What information given by the nurse is appropriate? Select all that apply. 1 "A contrast dye would be injected into the arteries of the child." 2 "The child may need to be catheterized for this procedure." 3 "This test will help to locate any obstruction in the urinary tract." 4 "This test would help determine the filtering ability of the kidney." 5 "This test would determine whether the renal blood vessels are obstructed.
2,3,4
A nurse is caring for an infant with a suspected urinary tract infection (UTI). What clinical manifestations does the nurse, drawing on knowledge of UTIs, expect to note? Select all that apply. 1 Jaundice 2 Vomiting 3 Swelling of the face 4 Persistent diaper rash 5 Failure to gain weight
2,4,5
What are some clinical manifestations of gastroesophageal reflux in infants? Select all that apply. 1 Heartburn 2 Spitting up 3 Chronic cough 4 Failure to thrive 5 Excessive crying and arching of the back
2,4,5
A 3-month-old child presents with sudden acute abdominal pain. The child is having episodes of screaming and drawing knees to her chest followed by periods of comfort. The parent tells the nurse the child's stool looked like red jelly. What do these clinical manifestations suggest? 1 Omphalocele 2 Gastroschisis 3 Intussusception 4 Anorectal malformations
3
A 5-year-old child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to the child's parents, as a priority action, that the child be evaluated for which condition? 1 School phobia 2 Emotional causes 3 Urinary tract infection 4 Structural defects of the urinary tract
3
A 6-year-old child with acute kidney injury is being transferred out of the intensive care unit. Which child, in light of this diagnosis, is the most appropriate roommate for this child? 1 6-year-old child with pneumonia 2 4-year-old child with gastroenteritis 3 5-year-old child with a fractured femur 4 7-year-old child who has undergone surgery for a ruptured appendix
3
A child presents to the pediatric office with incontinence and strong-smelling urine. For what condition should the child be evaluated? 1 Sexual abuse 2 Nephritic syndrome 3 Urinary tract infection 4 Structural defect of the urinary tract
3
A child with testicular torsion is scheduled to undergo anorchiopexy surgery. Which condition would this procedure correct? 1 Protrusion of abdominal contents into scrotum 2 Urethral opening at the dorsal side of the penis 3 Undescended testes through the inguinal canal 4 The inability to retract the distal foreskin over the glans penis
3
A patient underwent surgical treatment in which a segment of intestine was anastomosed to the resected porta hepatis. Which medication present in the patient's prescription will help to stimulate bile flow? 1 Digoxin 2 Loperamide 3 Phenobarbital 4 Ursodeoxycholic acid
3
A patient with nephrotic syndrome is receiving prednisone therapy. On a follow-up visit, the nurse finds that the child's condition shows no improvement. Which other therapy would the nurse expect to be most beneficial for the patient? 1 Diuretic therapy 2 Antibiotic therapy 3 Immunosuppresive therapy 4 Nonsteroidal antiinflammatory drug (NSAID) therapy
3
A stool specimen from a child with diarrhea shows the presence of eosinophils. With what condition is this finding associated? 1 Enzyme deficiency 2 Fat malabsorption 3 Parasitic infection 4 Bacterial gastroenteritis
3
An 8-year-old child comes to the clinic with a history of constipation and malnourishment. Her parents say that her stools look like ribbons and smell strong. The nurse notes visible peristalsis and abdominal distension. With what condition are these clinical manifestations associated? 1 Dehydration 2 Constipation 3 Hirschsprung disease 4 Inflammatory bowel disease
3
An infant presents with hypospadias, micropenis, and no palpable gonads. How should the nurse document these findings? 1 Atrophy 2 Cushing syndrome 3 Ambiguous genitalia 4 Adrenal insufficiency
3
External defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to ensure what? 1 Acceptance of hospitalization 2 Prevention of separation anxiety 3 Development of normal body image 4 Prevention of urinary tract complications
3
In what form of dehydration is rapid fluid replacement contraindicated? 1 Hypotonic 2 Isotonic 3 Hypertonic 4 Rapid fluid replacement is indicated in all forms of dehydration.
3
Infection with which bacterial pathogen that results in acute diarrhea has the highest incidence in infants? 1 Giardia 2 Shigella 3 Salmonella 4 Campylobacter
3
Nephrotic syndrome is a clinical state that includes hypoalbuminemia, hyperlipidemia, and what? 1 Creatine and edema 2 Uric acid and edema 3 Proteinuria and edema 4 Blood urea nitrogen and proteinuria
3
The intravenous pyelogram results of the patient indicate a urinary obstruction. Which treatment will be beneficial for the patient? 1 Orchiopexy 2 Circumcision 3 Nephrostomy 4 Renal transplantation
3
The nurse is assessing a 7-year-old girl with precocious puberty who is taking a monthly injection of a synthetic analogue of luteinizing hormone-releasing hormone leuprolide acetate (Lupron Depot). When should treatment be discontinued? 1 When growth slows 2 When breast development occurs 3 At a chronologically appropriate time 4 When the targeted adult height is obtained
3
The nurse is caring for a 10-year-old boy with nephrotic syndrome. What are the objectives of therapeutic management for this child? 1 Decreasing intravascular fluid volume, preventing infection, and minimizing complications related to therapies 2 Reducing excretion of urinary protein, enhancing fluid retention in the tissues, treating infection, and minimizing complications related to therapies 3 Reducing excretion of urinary protein, reducing fluid retention in the tissues, preventing infection, and minimizing complications related to therapies 4 Increasing excretion of urinary protein, reducing fluid retention in the tissues, preventing infection, and minimizing complications related to therapies
3
The nurse is caring for a 5-year-old child who has acute diarrhea. What is the first line of treatment for this condition? 1 Clear liquids 2 Adsorbents such as kaolin and pectin 3 Orally administered rehydration solutions 4 Antidiarrheal medications such as paregoric
3
The nurse is caring for a child with minimal-change nephrotic syndrome (MCNS). Which nursing intervention in the plan of care is most important? 1 Providing adequate skin care 2 Keeping the child warm and dry 3 Monitoring fluid retention continuously 4 Formulating a nutritionally adequate diet
3
The nurse is caring for an infant with celiac disease. Why does the nurse expect the child to be prescribed a wheat-free diet at all times? 1 To avoid constipation 2 To avoid formation of fecalith 3 To prevent villous atrophy 4 To prevent fecal impaction
3
The nurse is reviewing assessment findings for a child with severe dehydration. Which assessment finding does the nurse associate with severe dehydration? 1 The skin has decreased turgor. 2 The child has slight tachypnea. 3 The capillary refill is 5 seconds. 4 The child has little tears when crying.
3
The nurse is reviewing the clinical manifestations of a child. What finding does the nurse recognize as a manifestation of acute poststreptococcal glomerulonephritis (APSGN)? 1 Decreased blood pressure 2 Abdominal swelling or ascites 3 Cloudy, smoky brown urine 4 Facial edema absent during the day
3
The nurse is teaching a 2-year-old's parent about necessary dietary restrictions needed to manage celiac disease. Which statement made by the parent indicates effective learning? 1 "I should include oats in my child's breakfast daily." 2 "I should provide rye bread in my child's daily diet." 3 "I should provide a bowl of rice in my child's lunch and dinner." 4 "I should include two slices of wheat bread in my child's daily diet."
3
The nurse should recognize that when a child develops diabetic ketoacidosis (DKA), treatment will be instituted as described in which of the following statements? 1 DKA is best treated at home 2 DKA is best treated at a practitioner's office or clinic 3 Immediate treatment is required because DKA is a life-threatening situation 4 No treatment is required, because DKA is an expected outcome of type 1 diabetes mellitus
3
The parent of a child undergoing continuous ambulatory peritoneal dialysis tells the nurse the solution draining from the child is cloudy. What is the most appropriate response by the nurse to the parent's statement? 1 The bag should be changed. 2 Clean the area around the catheter. 3 Notify the practitioner immediately. 4 The solution is expected to be cloudy.
3
The urinary reports of a patient show gross discoloration of the urine associated with the presence of red blood cells and hemoglobin. The nurse anticipates acute glomerulonephritis in the patient. Which other findings should the nurse correlate with blood test reports of the patient? 1 Hypolipidemia 2 Hyperproteinemia 3 Increase in serum creatinine levels 4 Decrease in blood urea nitrogen levels
3
Vesicoureteral reflux will most likely lead to which condition? 1 Hypotension 2 Incontinence 3 Recurrent kidney infections 4 Increased renal arterial perfusion
3
What are common clinical manifestations of acute poststreptococcal glomerulonephritis? 1 Edema, increased urine volume, hypotension 2 Edema, decreased urine volume, hypotension 3 Edema, decreased urine volume, hypertension 4 Edema, increased urine volume, hypertension
3
What does the care of a newborn with a cleft lip and palate before surgical repair include? 1 Little or no sucking 2 Gastrostomy feedings 3 Alternative feeding systems 4 Placing the infant in a near-horizontal position for feedings
3
What is an essential medical intervention for an infant born with symptomatic congenital diaphragmatic hernia? 1 Bag-mask ventilation 2 Early bottle- or breastfeeding 3 Immediate endotracheal intubation 4 Positioning the head lower than the abdomen
3
What is the best method of assessing dehydration in a toddler? 1 Assessing the fontanels 2 Weighing the child daily at different times 3 Accurate measurements of fluid intake and output 4 Checking the intravenous infusion site for signs of infiltration
3
What is the current treatment option for children with type 1 diabetes? 1 Diet only 2 Oral agents 3 Insulin and diet 4 Diet and oral agents
3
What is the most common of the postinfectious renal diseases in childhood? 1 Obstructive neuropathy 2 Nephrotic syndrome 3 Acute glomerulonephritis 4 Hemolytic uremic syndrome
3
What should the nurse consider when providing support to a family whose infant has just been found to have biliary atresia? 1 Death usually occurs by 6 months of age. 2 The prognosis for full recovery is excellent. 3 Liver transplantation may be needed eventually. 4 Children with surgical correction live normal lives.
3
Which condition does the nurse suspect in a patient with anxiety and mental depression, who has facial muscle spasms elicited by tapping the facial nerve in the region of the parotid gland and carpopedal spasm? 1 Thyrotoxicosis 2 Hyperthyroidism 3 Hypoparathyroidism 4 Lymphocytic thyroiditis
3
Which factor predisposes an infant to fluid imbalances? 1 Lower metabolic rate 2 Decreased surface area 3 Immature kidney function 4 Decreased daily exchange of extracellular fluid
3
Which inflammatory bowel disease is characterized by inflammation limited to the colon and rectum? 1 Celiac disease 2 Crohn disease 3 Ulcerative colitis 4 Meckel diverticulum
3
Which is an advantage of continuous cycling peritoneal dialysis (CCPD) or continuous ambulatory peritoneal dialysis (CAPD) for adolescents who require dialysis? 1 Hospitalization is only required several nights per week. 2 Dietary restrictions are no longer necessary. 3 Adolescents can carry out procedures themselves. 4 Insertion of catheter does not require surgical placement.
3
Which manifestation helps the nurse to identify hyperglycemia in a child with diabetes mellitus (DM)? 1 Presence of paleness or pallor 2 Shallow normal respirations 3 Presence of acetone breath 4 Excessive sweating
3
The parents of a child who is on a long-term steroid therapy are worried about the child's appearance. The child has gained a lot of weight and has excessive hair growth. The nurse finds that the child has moon face, pendulous abdomen, and red abdominal striae. What does the nurse tell the parents of the child? Select all that apply. 1 Give the drug in the evening. 2 Give the drug daily without fail. 3 Give the drug on alternate days. 4 Reduce the drug dose. 3 Give the drug in the early morning
3,5
While reviewing laboratory reports, the nurse finds that the posterior lobe of the patient's pituitary gland is damaged. Which hormones are likely to be imbalanced if this part of the pituitary gland is not functioning properly? Select all that apply. 1 Insulin 2 Prolactin 3 Oxytocin 4 Growth hormone 5 Antidiuretic hormone
3,5
A 17-year-old with type 1 diabetes mellitus tells the school nurse about recently starting to drink alcohol with friends on weekends. What is the most appropriate intervention by the nurse? 1 Tell the adolescent not to drink alcohol 2 Ask the adolescent about the reasons for drinking alcohol 3 Recommend counseling so the adolescent understands the serious consequences of alcohol consumption 4 Teach the adolescent about the effects of alcohol on type 1 diabetes mellitus and how to prevent problems associated with alcohol intake
4
A diabetic patient is on twice-daily dosing of rapid-acting and intermediate-acting insulin. The child is admitted for dose adjustment of intermediate-acting insulin required to be administered in the evening. Which blood sugar level readings of the patient are taken into consideration? 1 Postprandial blood sugar level after lunch 2 Random blood sugar levels of the same day 3 Random blood sugar levels of the previous day 4 Morning fasting blood sugar levels of the same day
4
A nurse caring for a neonate immediately after birth notices an excessive amount of frothy mucus coming from the child's nose and mouth. What condition does the nurse suspect? 1 Cleft lip 2 Cleft palate 3 Biliary atresia 4 Tracheoesophageal fistula
4
A toddler is hospitalized with acute kidney injury resulting from severe dehydration. For what complication should the nurse assess the child? 1 Hypotension 2 Hypokalemia 3 Hypernatremia 4 Water intoxication
4
Constipation has recently become a problem for a school-age boy who just started attending a new school. What is the most likely cause of his constipation? 1 Puberty 2 Allergies 3 High-fiber diet 4 Fear of using bathrooms at school
4
The nurse assesses a neonate immediately after birth. What is one clinical sign/symptom of tracheoesophageal fistula? 1 Jaundice 2 Absence of sucking 3 Bile-stained vomitus 4 An excessive amount of frothy saliva in the mouth
4
The nurse is caring for a child weighing 8 kg with minimal dehydration following acute diarrhea. What intervention should the nurse execute to replace the fluid lost due to diarrhea? 1 Administer Ringer lactate intravenously 2 Allow the child to have fruit juices orally 3 Provide undiluted lactose-free formula 4 Give 90 mL oral rehydration solution (ORS)
4
The nurse is caring for a patient with pheochromocytoma. The nurse checks the patient's blood pressure, respiratory rate, and blood glucose levels, and palpates the adrenal mass to note its measurements. Which of the actions performed by the nurse needs correction? 1 Checking the blood pressure of the patient 2 Checking the respiratory rate of the patient 3 Measuring the blood glucose levels in the patient 4 Palpating the mass to note its measurements in the patient
4
The nurse is educating an adolescent female about proper hygiene and necessary care to prevent urinary tract infections. What should the nurse include in the teaching plan? 1 The importance of urinating two times a day 2 The importance of limiting water intake to 5 ounces a day 3 The importance of wearing nylon underwear instead of cotton 4 The importance of wiping the perineum from the front to the back
4
The nurse is providing discharge instructions to the parents of a 5-year-old child with gastroesophageal reflux. What information should the nurse give the parents about the administration of a protein pump inhibitor? 1 The medication may be stopped once the symptoms have resolved. 2 If the medication is working, the parents should notice immediate results. 3 The medication should be given 60 minutes before breakfast so the peak plasma concentration occurs with mealtimes. 4 If the medication is given twice a day, the second best time for administration is 30 minutes before the evening meal.
4
The nurse is providing discharge teaching to the parents of the child who had a urinary tract infection (UTI). The nurse tells the parents, "Always ask the child if he needs to use the bathroom. You should not let your child hold it for a long time." What is the reason for the nurse to give this advice to the parents? 1 It would reduce the blood supply of the kidneys. 2 It would cause severe abdominal pain in the child. 3 It would inhibit the process of urine formation. 4 It would increase the chances of another infection.
4
The parents of a 1-month-old infant bring the child to the clinic because the infant has been projectile vomiting 30 minutes after feeding. The parent describes the vomit as stale milk. On assessment the nurse palpates an olivelike mass. What condition do these clinical manifestations characterize? 1 Gastroschisis 2 Hiatal hernia 3 Umbilical hernia 4 Hypertrophic pyloric stenosis
4
The parents report that their child has excessive urination, thirst, hunger, irritability, fatigue, flushed skin, headache, blurred vision, and dry skin. The child is diagnosed with type 1 diabetes mellitus. Based on this diagnosis, what should the nurse include in the plan of care? 1 Assess the feet for open sores. 2 Obtain a urine dipstick for bacteria. 3 Administer corticosteroids to decrease inflammation. 4 Monitor capillary blood glucose levels before meals and at bedtime.
4
What complication can result when a child ingests an excessive volume of electrolyte-free water? 1 Dehydration 2 Hyperkalemia 3 Hyponatremia 4 Water intoxication
4
What endocrine disorder can result from prolonged steroid therapy? 1 Goiter 2 Addison disease 3 Diabetes mellitus 4 Cushing syndrome
4
What is the best method for assessing control of diabetes? 1 Urine testing 2 Patient logbooks 3 Self-monitoring of blood glucose 4 Glycosylated hemoglobin (hemoglobin A1c) testing
4
What progressive inflammatory process causes both intrahepatic and extrahepatic bile duct fibrosis? 1 Jaundice 2 Cirrhosis 3 Hepatitis 4 Biliary atresia
4
What should dietary management of a child with inflammatory bowel disease include? 1 High-fiber foods 2 Low-calorie foods 3 Low-protein foods 4 Vitamin supplements
4
What should the nurse interpret from the laboratory findings below? 1 The patient has an uncomplicated urinary tract infection. 2 The patient has obstructive uropathy. 3 The patient has acute glomerulonephritis. 4 The patient has hemolytic uremic syndrome.
4
What should the nurse teach the parents of an infant with cleft lip (CL) about feeding? 1 Avoid breastfeeding; provide bottle feeds. 2 Use bottles with a narrow base nipple. 3 Feed the infant in the supine position. 4 Provide cheek support when feeding.
4
When evaluating the extent of an infant's dehydration, the nurse should recognize which symptoms of severe dehydration? 1 Tachycardia, decreased tears, 5% weight loss 2 Normal pulse and blood pressure, intense thirst 3 Irritability, moderate thirst, normal eyes and fontanels 4 Tachycardia, parched mucous membranes, sunken eyes and fontanels
4
Which finding is most often observed with destruction of the pancreatic beta cells? 1 Increased insulin secretion in the body 2 Decreased growth hormone in the body 3 Increased serum thyroxin levels in the body 4 Decreased blood glucose levels in the body
4
Which statement made by the child indicates the need for further education about how to manage newly diagnosed type 1 diabetes mellitus? 1 "I should check my blood glucose levels before meals and at bedtime." 2 "It is important to rotate the injection sites to prevent tissue damage." 3 "I should check my blood glucose and ketones every 3 hours when I am sick." 4 "I can eat cake and candy as long as I give myself extra insulin to compensate."
4
The nurse is reviewing the medical records of four different patients. Which patient requires a change in the treatment plan? 1 Patient A 2 Patient B 3 Patient C 4 Patient D
4 patient D
The nurse is teaching the parents of preschoolers about preventing urinary tract infections (UTIs). What strategies should the nurse instruct the parents to use to prevent UTIs? Select all that apply. 1 "Give cranberry juice to your children on a regular basis." 2 "Put a diaper on your child overnight." 3 "Do not allow your children to urinate in public toilets." 4 "Encourage your children to drink 6 to 8 glasses of water each day." 5 "Ensure that your children evacuate their bowels regularly."
4,5
