PEDS 2
The physician has asked you to run D5NS at maintenance for a child that weighs 12kg. What will be the hourly rate of the maintenance IV fluids?
44 Using the 4-2-1 method for a child weighing 12kg: 4 x 10 = 40 2 x2 = 4 40 + 4 = 44ml/hr
A 6-year-old child is hospitalized with increased intracranial pressure after a head trauma. An intracranial pressure monitor has been inserted. Current vital signs and intracranial pressure are as follows. Calculate the child's cerebral perfusion pressure. Temperature: 3.7 Pulse: 104 Respiratory rate: 22 Blood pressure with MAP: 108/62 MAP 77 Intracranial pressure: 26
51 CPP is calculated by subtracting the ICP from the MAP. (MAP) 77 - (ICP) 26 = 51
A preschool age child believes there are monsters in his bedroom at night. The parent asks the nurse for suggestions to handle the child's fears. The nurse determines the parent understood the teaching if the parent states: A) "I will keep a night-light on in the child's bedroom at night" B) "I will notify my child's physician since fears are unusual at this age" C) "I will tell my child that monsters do not exist" D) "I will explain to my child why these fears are illogical"
A) "I will keep a night-light on in the child's bedroom at night"
Parents ask the nurse when their child with chickenpox will no longer be contagious. The nurse states: A) "When all the lesions are crusted over" B) "Once the rash develops the child is no longer contagious" C) "24 hours after beginning antibiotics" D) "When there is no longer a fever"
A) "When all the lesions are crusted over"
A child is opening his eyes spontaneously, with no verbal response, and withdrawing in response to pain. His Glasgow Coma Score would be: A) 9 B) 7 C) 10 D) 8
A) 9 Eye opening response = 4 points for spontaneous eye opening Verbal response = 1 point for no verbal response Motor response = 4 points for withdrawal to painful stimuli Total score = 9 points
Erikson's theory of psychosocial development in the Preschooler is? A) Initiative vs. Guilt B) Trust vs. Mistrust C) Industry vs. Inferiority D) Autonomy vs. Shame/Doubt
A) Initiative vs. Guilt
An infant has been diagnosed with Respiratory Syncytial Virus (RSV) and is in respiratory distress. All of the following are signs of respiratory distress EXCEPT: A) Symmetrical chest rise on inspiration B) Retractions C) Nasal flaring D) Head bobbing
A) Symmetrical chest rise on inspiration
Important nursing interventions when caring for a child who is experiencing a tonic-clonic seizure include: SELECT ALL THAT APPLY A) Have someone remain with the child during the seizure B) Restrain the child to prevent thrashing C) Move hazardous obstacles out of the way to prevent injury D) Time the length of the seizure activity E) Place a tongue blade between the teeth
A;C;D A) Have someone remain with the child during the seizure C) Move hazardous obstacles out of the way to prevent injury D) Time the length of the seizure activity
The parent of a toddler asks the nurse for suggestions on dealing with temper tantrums. The nurse recommends: A) Punish the child B) Explain to the child why this behavior is wrong C) Tell the child that big boys and girls don't have temper tantrums D) Ensure the child is safe and ignore the behavior
D) Ensure the child is safe and ignore the behavior
A child is diagnosed with mononucleosis and the nurse will be teaching the parent about treatment for mononucleosis. The nurse plans to include in the teaching: A) The child should not have candy, soda, and concentrated sweets since the primary treatment is a steroid B) The child should eat a low fat, low salt diet until labs have returned to normal C) Have the child take the prescribed antibiotics until they are gone D) Expect the child to feel fatigued and allow the child extra rest
D) Expect the child to feel fatigued and allow the child extra rest
A child is diagnosed with periorbital cellulitis. The nurse should prepare the child and family to expect the treatment to include: A) Eye drops B) Corrective lenses (glasses) C) Long-term corticosteroid therapy D) Intravenous antibiotic therapy
D) Intravenous antibiotic therapy
A 10-year-old boy on a bicycle has been hit by a car in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action should be: A) Take the child's blood pressure B) Check the child's scalp and back for bleeding C) Place the child on his side D) Stabilize the child's neck and spine
D) Stabilize the child's neck and spine
A nurse is teaching parents of toddlers about normal growth and development. The nurse includes in the developmental teaching that toddlers are learning to: A) play interactively with other children B) trust their caregivers C) fear strangers D) exert their will by frequently saying no
D) exert their will by frequently saying no
An infant is being admitted with a suspected botulism infection. In the intake interview the nurse asks the parents if the infant has had: A) exposure to ill children such as at daycare B) the recommended immunizations for age C) a recent viral infection D) exposure to honey
D) exposure to honey
Cerebral edema and increased intracranial pressure are suspected in a child. The nurse anticipates an order to administer: A) An IV fluid bolus B) A narcotic such as morphine sulfate C) An antibiotic D) hypertonic saline or mannitol
D) hypertonic saline or mannitol
The pediatric nurse incorporates Erikson's developmental theory into the plan of care for a hospitalized toddler by: A) giving the toddler complex craft projects to complete and display in the room B) allowing the child to spend time at the playroom without his parent C) ensuring the child's needs are met quickly and consistently D) providing finger foods so the child can feed himself
D) providing finger foods so the child can feed himself
The pediatric nurse prioritizes assessments and care for a hospitalized infant with the knowledge that a cardiac arrest in an infant is almost always preceded by: A) sepsis B) trauma C) shock D) respiratory arrest
D) respiratory arrest
A nurse teaches the parents of an infant with nasopharyngitis to call their physician if the infant: A) Has clear nasal drainage B) Starts pulling on one or both ears C) Has a cough D) Sleeps poorly
B) Starts pulling on one or both ears
Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? A) fever B) Tachypnea with retractions C) Pale skin color D) oxygen saturation level of 96%
B) Tachypnea with retractions
The pediatric nurse received report and will be caring for four patients: Patient 1 is a 6-year-old who had an appendectomy 2 days ago Patient 2 is an infant receiving IV fluids to treat moderate dehydration Patient 3 is an infant with bronchiolitis and tachypnea on oxygen therapy Patient 4 is a toddler with short bowel syndrome who is ready to be discharged home with TPN and gastrostomy feedings. The nurse prioritizes care and chooses to assess first: A) The 6-year-old post appendectomy B) The infant with bronchiolitis C) The infant with dehydration D) The toddler with short bowel syndrome
B) The infant with bronchiolitis
A child fell from a tree and has been diagnosed with a basilar skull fracture. The nurse assesses the child and immediately calls the provider to report: A) bruising and mild swelling around the eyes B) clear drainage from the nose and ears which tests positive for glucose C) bruising behind the ears D) the child complains of headache 4 out of 10 on the faces scale
B) clear drainage from the nose and ears which tests positive for glucose
The nurse explains to parents that peanuts are a poor choice for a snack food for their toddler. The nurse's rationale is: A) peanuts are low in nutritive value B) peanuts can be easily aspirated C) peanuts are high in sodium D) peanuts are hard to digest
B) peanuts can be easily aspirated
The nurse is closely monitoring a child who is unconscious after a fall. The nurse notices the child suddenly developed a fixed and dilated pupil. The nurse interprets this as: A) Eye trauma B) An expected finding C) An excess of sedation medications D) A medical emergency
D) A medical emergency
You are taking care of a 5 year old child admitted for respiratory distress. You walk into the patient's room at the beginning of your shift and find him unresponsive. What will be your priority interventions in the order you would do them? A) Tap and shout asking the patient "are you ok?", check for breathing and a pulse, if no pulse or respirations hit the code blue button and begin CPR B) Leave the patient to go find help then start CPR C) Open the airway, give 2 rescue breaths D) Start compressions because it was probably a cardiac issue that left him unresponsive
A) Tap and shout asking the patient "are you ok?", check for breathing and a pulse, if no pulse or respirations hit the code blue button and begin CPR
A child fell and hit his forehead on cement. A CT scan was done which shows a contusion under the forehead (frontal) and also under the back (occipital) bones of the head. The nurse interprets this as: A) The coup and contrecoup injury sites B) Inconsistent with a single fall and abuse must be suspected C) A basilar skull fracture D) A neurosurgical emergency
A) The coup and contrecoup injury sites
When assessing a toddler the nurse notices one of the child's eyes drifts off in a different direction. The nurse asks the parents if the child has ever been tested for: A) amblyopia B) hyperopia C) nystagmus D) myopia
A) amblyopia
A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally? A) pancreatic enzymes B) anti-inflammatory agents C) bronchodilators D) recombinant human DNase
A) pancreatic enzymes
A child is is receiving the following medications for asthma. The nurse explains the actions of the different medications to the child and family. MATCH THE MEDICATION TO ITS ACTION OR USE: A) IV steroids B) albuterol C) Singulair/montelukast (leukotriene receptor antagonist) D) QVar or Flovent (inhaled steroid)
A) works systemically to suppress inflammation during an exacerbation B) bronchodilator to be used as rescue inhaler C) once a day pill for asthma control D) locally acting anti-inflammatory effect to reduce frequency and severity of attacks
A child is admitted with suspected influenza infection and is placed in droplet and contact isolation. To follow proper isolation technique the nurse will: SELECT ALL THAT APPLY A) wash or gel hands when entering and exiting the room B) wear a gown and gloves when in the room C) put the child in a room with negative air flow D) wear a mask when in the room E) either provide a single-patient stethoscope for the child or clean the stethoscope after using it on the child
A;B;D;E A) wash or gel hands when entering and exiting the room B) wear a gown and gloves when in the room D) wear a mask when in the room E) either provide a single-patient stethoscope for the child or clean the stethoscope after using it on the child
An infant is admitted with suspected meningitis and a lumbar puncture (LP) is performed. The nurse reviews the LP results. The nurse knows bacterial meningitis is indicated by: SELECT ALL THAT APPLY A) Decreased glucose B) Cloudy CSF C) Elevated protein D) Increased erythrocytes (RBCs) E) Decreased leukocytes (WBCs)
A;B;C A) Decreased glucose B) Cloudy CSF C) Elevated protein
A 3-year-old child is being discharged home from day surgery after a tonsillectomy. In the discharge teaching the nurse includes: SELECT ALL THAT APPLY A) Observe for and notify the doctor if the child is swallowing frequently. B) Administer analgesics and an ice collar as needed for pain. C) Avoid red and brown fluids and juices. D) Encourage frequent, vigorous gargling. E) Resume a regular diet as soon as possible.
A;B;C A) Observe for and notify the doctor if the child is swallowing frequently. B) Administer analgesics and an ice collar as needed for pain. C) Avoid red and brown fluids and juices.
The nurse is teaching the parent of a child with pediculosis capitis (head lice) about treatment for the infestation. The nurse includes in the teaching: SELECT ALL THAT APPLY A) "Thoroughly vacuum your house" B) "Wash your child's hair with a pediculicide shampoo" C) "Wash the child's bedding and clothing and dry in a hot dryer" D) "Boil for 10 minutes or replace combs, brushes, and hair accessories" E) "Continue the oral medication until it is all gone"
A;B;C;D
A child has inflamed conjunctiva with itchy eyes and watery discharge. As the nurse, you recognize this as which type of conjunctivitis? A) Bacterial conjunctivitis B) Fungal conjunctivitis C) Viral conjunctivitis D) Allergic conjunctivitis
D) Allergic conjunctivitis
A toddler with fever, headache, nausea, photophobia, and nuchal rigidity is being admitted to the hospital with suspected bacterial meningitis. The nurse prioritizes care and plans to implement first: A) Administer ondansetron (Zofran) for nausea B) Administer IV antibiotics C) Offer a clear liquid diet D) Administer acetaminophen (Tylenol) for fever and discomfort
B) Administer IV antibiotics
An appropriate nursing intervention when caring for a toddler with a viral upper respiratory tract infection and elevated temperature of 100.1F (37.8C) is: A) Have the child wear heavy clothing to prevent chilling B) Give small amounts of favorite fluids frequently to prevent dehydration C) Encourage food intake to maintain caloric needs D) Give a hot water bath to reduce fever
B) Give small amounts of favorite fluids frequently to prevent dehydration
A teenager has suffered from a traumatic brain injury two days ago. Which would be concerning to you as the bedside nurse? A) If the patient tells you they have a headache. B) If the patient suddenly becomes bradycardic, hypertensive, and is having irregular respirations. C) If the patient throws up after their first meal since the injury. D) If the patient becomes tachycardic, blood pressure is within normal limits, and respirations are normal.
B) If the patient suddenly becomes bradycardic, hypertensive, and is having irregular respirations.
The parents of a toddler ask the nurse for suggestions in dealing with their toddler's negativism. The nurse recommends: A) Explaining to the child the rationale behind a request B) Offering the child choices when possible C) Helping the child to see things from another person's perspective D) Repeating the request as many times as necessary for the child to comply
B) Offering the child choices when possible
A nurse is teaching parents about ways to prevent/treat accidental poisoning. The nurse includes in the teaching: SELECT ALL THAT APPLY A) Transfer toxic liquids to uninteresting plain white or brown bottles B) Know the number of the nearest poison control center C) Keep toxic substances in an out-of-reach cabinet with a child safety lock D) Use child-proof caps on medications E) Administer syrup of ipecac immediately after an ingestion
B;C;D B) Know the number of the nearest poison control center C) Keep toxic substances in an out-of-reach cabinet with a child safety lock D) Use child-proof caps on medications
The nurse teaches parents of toddlers about near-drowning/submersion injury. The nurse includes in the teaching: A) Limit bath water to a few inches so the child cannot drown in it. B) With proper treatment most children who have had a near drowning episode will improve and recover over time. C) A toddler can drown in a bucket of water or a toilet. D) Infants and toddlers should be taught to swim so they will be safe around pools.
C) A toddler can drown in a bucket of water or a toilet.
A child has been diagnosed with acute streptococcal pharyngitis. The nurse tells the child and parent that the child can return to school: A) As long as no rash develops B) When coughing spells resolve C) After taking antibiotics for 24 hours D) When the parotid glands are no longer swollen
C) After taking antibiotics for 24 hours
The nurse is auscultating the breath sounds of a child with asthma. The nurse is most concerned by assessment findings of: A) Expiratory wheezes B) A frequent dry cough C) No wheezes and no audible air movement in the lungs D) Inspiratory wheezes
C) No wheezes and no audible air movement in the lungs
A nurse is teaching parents of toddlers about febrile seizures. The nurse plans to include in the teaching: A) Toddlers who experience a febrile seizure will usually develop a seizure disorder B) Antipyretic medications should be given with caution if a child has a history of febrile seizure C) Seek medical attention if a febrile seizure occurs and lasts greater than 5 minutes. D) A febrile child should be placed in a cold bath
C) Seek medical attention if a febrile seizure occurs and lasts greater than 5 minutes.
The mother of a toddler yells, "Help, my child is chocking on a wheel from his toy car." A nurse nearby rushes to help. The nurse determines the toddler has a life-threatening airway obstruction if: A) The child is gagging B) The child is crying C) The child cannot speak D) The child is coughing
C) The child cannot speak
A child tells the nurse his eyes hurt. The nurse notes red conjunctiva with thick purulent drainage. The nurse knows these signs are consistent with: A) viral conjunctivitis B) allergic conjunctivitis C) bacterial conjunctivitis D) foreign body (such as sand) in the eyes
C) bacterial conjunctivitis
The nurse is planning care for a child with severe croup symptoms who is suspected of having epiglottitis. The nurse includes in the plan of care: A) collect a throat culture B) obtain a sputum culture C) do NOT use a tongue blade to assess the airway D) assess frequently for increasing cough
C) do NOT use a tongue blade to assess the airway
A toddler has had several incidences of pneumonia and is lagging behind on the growth chart. The child is tested for Cystic Fibrosis (CF) and is positive. The nurse teaches the parents about the disease. The nurse explains the the main characteristic of CF is: A) abnormal formation of the cilia in the lungs and villi in the intestines B) chronic inflammation of the GI system and frequent refluxing of GI contents causing aspiration pneumonia C) increased viscosity of exocrine gland secretions D) chronic inflammation of the lungs making the child susceptible to pneumonia and impaired growth
C) increased viscosity of exocrine gland secretions
A nurse is teaching parents of toddlers about toilet training. The nurse teaches the parents that all of the following can be helpful EXCEPT: A) Read books to the child about potty training to help reinforce desired behaviors. B) Praise the child for successes C) scold the child for accidents D) Have the child try to use the toilet after meals
C) scold the child for accidents
The nurse is teaching the parents of a child with a VP shunt about potential serious complications. The nurse recommends seeking medical care immediately if the parents notice: SELECT ALL THAT APPLY A) Redness and heat along the track of the shunt B) Headache, nausea and vomiting possibly from increased intracranial pressure C) The shunt palpable on the side of the scalp under the skin D) High fever and possible shunt infection E) Shunt malfunction causing abdominal irritation
C;D;E C) The shunt palpable on the side of the scalp under the skin D) High fever and possible shunt infection E) Shunt malfunction causing abdominal irritation ?
The nurse teaches the parent of a child with asthma about the disease. The nurse explain that the heightened airway reactivity of asthma is characterized by: SELECT ALL THAT APPLY A) Fluid filled alveoli B) Increased mucus production C) Contraction of the smooth muscle around the bronchi D) Laryngeal tracheal edema E) Inflammation within the bronchial lumen
E) Inflammation within the bronchial lumen ??
A hospitalized 2-year child remains unconscious after a head injury. The nurse obtains the following vital signs. TIME 0800 TEMP: 37 PULSE: 116 RR: 25 B/P: 88/64 O2: 99% 0900 TEMP: 37.6 PULSE: 104 RR: 22 B/P: 98/58 O2: 100% 1000 TEMP: 37.4 PULSE: 95 RR: 20 B/P: 106/52 O2: 98% The nurse should: A) notify the doctor that the heart rate has increased B) notify the doctor that the systolic blood pressure has increased C) document the vital signs and do nothing else since they are within normal limits for age D) notify the doctor that the respirations have decreased E) notify the doctor that the vital signs have changed even though the results remain within normal limits for age
E) notify the doctor that the vital signs have changed even though the results remain within normal limits for age
