peds 3
A nurse is reviewing a CSF analysis for a client who has suspected meningitis. Which of the following findings should the nurse identify as indicating viral meningitis? (SATA) a. negative gram stain b. normal glucose content c. cloudy color d. decreased WBC e. normal protein content
a, b, e
A nurse is caring for an adolescent who has a closed head injury. Which of the following findings are indications of increased intracranial pressure? a. report headache b. alteration in pupillary response c. increased motor response d. increased sleeping e. increased sensory response
a,b,d
You are educating a family on the use of rectal diazepam (Valium) for management of prolonged seizures at home while caring for their 2-year old. Which of the following instructions is essential for the nurse to teach the parents? Monitor for an allergic reaction to the medication Monitor her level of sedation Gradually reduce the dosage as the seizure stops Watch for a fever indicating an infection
level of sedation
Chris is performing an exam on a 9-year old male who presents with tachycardia and tacypnea. He anticipates which of the following as most helpful in evaluating the extent of his hypoxia? A.Pulmonary function test B.Pulse oximetry C.Peak expiratory flow D.Chest X-ray
pulse ox
A child who is hospitalized with cystic fibrosis often refuses to let the nurse perform some nursing interventions. What is the most effective method by which the nurse can continue the care management without interruption? Develop a daily schedule of events with the child. Perform the interventions even if the child resists. Avoid waking up the child to perform any activities. Use a little force to make the child allow the activities
schedule
A patient is severely dehydrated. The nurse is aware to monitor for which associated electrolyte imbalance? Increased iron Increased calcium Increased potassium Decreased blood urea nitrogen
increased potassium
A 6-year-old male presents to the ER with father. He is anxious, speaking with a whisper, and is sitting up with a forward neck thrust. Which of the following would be least appropriate during you exam? Provide 100% oxygen Inspect the throat Auscultate the lungs Have him lean forward
inspect the throat
Dr. Kapri is preparing a lecture on head injuries in children. While reviewing the information with her students she is pleased when they expressed an understanding by stating that which of the following is the most common type of skull fracture in children? Depressed Basilar Diastatic Linear
linear
A nurse is assessing a child who has myopia. Which of the following findings should the nurse expect ? a. headaches b. photophobia c. difficulty reading d. difficulty focusing close on objects e. poor school performance
a, c,e
Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath? 1. Prednisone. 2. Singulair (montelukast). 3. Albuterol. 4. Flovent (fluticasone).
3
Which should the nurse instruct children to do to stop the spread of influenza in the classroom? 1. Stay home if they have a runny nose and cough. 2. Wash their hands after using the restroom. 3. Wash their hands after sneezing. 4. Have a flu shot annually.
3
A nurse is caring for a child who just experience a generalized seizure. Which of the following is the priority action for the nurse to take? a. maintain the child in a side-lying position b. loosen the child's restrictive clothing c. reorient the child to the environment d. not the time and characteristics of the child's last seizure
a.
A nurse is teaching the parent of an infant who has down syndrome. Which of the following statements by the parent indicates an understanding of the teaching? a. i should expect him to have frequent diarrhea b. i should place a cool mist humidifier in the room c. I should avoid the use of lotion on his skin d. i should expect him to grow faster in length than other infants
b
A nurse is developing an in-service about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreases the incidence of bacterial meningitis in children (SATA) a. IPV b. CPV c. DTaP d. HiB e. TIV
b, d
A nurse is planning to perform a peripheral vision test on a child. Which of the following actions should the nurse take? a. place the child 10 ft away from a snellen char b. show a set of cards to the child one at a time c. cover the childs eye while performing the test on the other eye d. have the child focus on an object while performing the test
d.
A nurse is reviewing the medical record of a newborn who has NEC. Which of the following findings is a risk for NEC? a. nacrosomia b. transient tachypnea of the newborn c. maternal gestational hypertension d. gestational age of 36 weeks
d.
You are providing discharge instructions for a 6-year-old girl who has a diagnosis of Group A Streptococcus. Which of the following would be your least priority when providing education? A. Using a cool mist humidifier at home B. Administration of antibiotics and duration C.Encouraging fluids at home D. Discarding the toothbrush
d.
An adolescent male reported to his camp nurse that he has a headache and a stiff neck. Which of the following signs and symptoms would alert the nurse that he may have bacterial meningitis? Frequent urination Sunset eyes Fixed and dilated pupils Sunlight is "too bright"
sunlight is too bright
You are educating the parents of a child who have a recent diagnosis of hypothyroidism. Which of the following symptoms should you include? A. Nervousness B. Heat Intolerance C. Smooth velvety skin D. Weight Gain
weight gain
The parent of a 4-month-old with cystic fibrosis (CF) asks the nurse what time to begin the child's first chest physiotherapy (CPT) each day. Which is the nurse's best response? 1. "Thirty minutes before feeding the child breakfast." 2. "After deep-suctioning the child each morning." 3. "Thirty minutes after feeding the child breakfast." 4. "Only when the child has congestion or coughing."
1
The parent of a child with influenza asks the nurse when the child is most infectious. Which is the nurse's best response? 1. "Twenty-four hours before and after the onset of symptoms." 2. "Twenty-four hours after the onset of symptoms." 3. "One week after the onset of symptoms." 4. "One week before the onset of symptoms."
1
Which would be an early sign of respiratory distress in a 2-month-old? 1. Breathing shallowly. 2. Tachypnea. 3. Tachycardia. 4. Bradycardia.
2
Joan asked her nurse about her thoughts on immunizing her 8-month-old son against the flu. Which of the following responses would be most appropriate? "She cannot have the vaccine until she is 12months old"" She will most likely receive a dose the next time she is scheduled for her routine vaccines" "The vaccine has many side effects, so she wouldn't get any at this time" "She should get the vaccine because she is older than 6 months"
6 months
What is the most appropriate nursing intervention for a child after tonsillectomy? A. Watching for continuous swallowing B. Applying warm compresses to the throat C.Encouraging gargling to reduce discomfort D.Positioning the child on the back for sleeping
A.
While obtaining a history from caregivers of a 4 month old diagnosed with congenital hypothyroidism. You inform them that which of the following would be a common finding? a. it is difficult to keep the child awake b.the skin is pink and healthy c.the child is active and playful d.the child is above normal growth rate
A.
a nurse in the emergency room is assessing a child following a motor vehicle crash. The child is unresponsive, has spontaneous respirations of 22/min, and has a laceration on his forehead that is bleeding. Which of the following nursing actions should the nurse take first? a. stabilize the childs neck b. clean the child's laceration with soap and water c. implement seizure precautions for the child d. initiate IV access
A.
A parent rushes her 9-month old after finding him face down in the bathtub. The mother stated that she left the bathroom to grab his favorite toy. Which of the following would be your priority assessment? Vital Signs Airway, breathing, and circulation Pupil response Level of consciousness
ABC
A nurse's assessment of a mechanically ventilated patient includes which basic ongoing assessments? A.Assessing skin color B. Assessing capillary refill C.Assure displacement of tube D.Assessing level of consciousness E>Observing chest rise and fall for symmetry
ALL BESIDES C
You are the clinical nurse expert in the endocrine department. You prepared a teaching plan for an 11 year old female with hyperthyroidism. Which of the following should you have included in the plan? a. A description of the surgical procedure to remove an anterior pituitary tumor b. Education on how to administer injections of growth hormone c. An explanation of the radioactive iodine procedure d. A visual instruction on how to give DDAVP intranasally
C
A nurse monitors a patient in metabolic acidosis for what expected compensation? A.Stridor B.Crackles C.Kussmaul breathing D.Cheyne Stokes breathing
C.
Children with congenital adrenal hyperplasia can experience a crisis when sick. Which of the following findings would lead you to suspect that your patient is experiencing an acute adrenal crisis? A.Hypernatremia B.Bradycardia C.Hypertension D.Hyperkalemia
D.
A nurse is assessing a child who has a concussion which of the following findings should the nurse expect? a. amnesia b. systemic hypertension c. bradycardia d. respiratory depression e. confusion
a,c,d,e
A nurse is caring for a client who has suspected meningitis and has a decreased level of consciousness. Which of the following actions is appropriate? a. place the client on NPO b. Prepare the client for a liver biopsy c. Position the client dorsal recumbent d. put the client in a protective environment
a (prevent aspiration)
A nurse is caring for a child who is taking mannitol for cerebral edema. Which of the following adverse effects should the nurse monitor the child for and report to the provider? a. bradycardia b. weight loss c. confusion d. constipation
c
A child with a respiratory tract infection is having bouts of vomiting and refuses oral fluids. What advice should the nurse give to the family to promote hydration? "Give thick fruit juice to provide high calorie intake." "Force the child to drink fluids to maintain hydration level." "Offer the child's favorite beverages to promote hydration." "Give oral fluids at fixed intervals even if the child is sleeping."
fav bev
Holly is caring for a child who is being treated for Reyes Syndrome. She is in the acute stage of her illness. Holly's priority assessments should focus on which of the following? Presence of protein in the urine Indications of increased intracranial pressure An increase in the blood glucose level A decrease in the liver enzymes
increased ICP
A premature infant is about to be discharged home. The neonatologist orders palivizumab before discharge. What is the purpose of this medication? To prevent secondary bacterial infection To decrease toxicity of antiviral agents To prevent respiratory syncytial virus (RSV) infection To make isolation of the infant with RSV unnecessary
prevent RSV
You are working at a local school and notice a 5-year-old girl who has experienced a febrile seizure. Which of the following would be a priority? Protecting her from harm during the seizure Loosening her clothing to ensure a patent airway Using a tongue blade to pry open her jaw Hyper-extending the girl's head while placing her on her side
protecting her from harm
You are providing a respiratory exam on a pediatric patient who was admitted to your unit. Which of the following would be a first indicator of respiratory illness? Irregular breathing that is unlabored A bluish tinge to the lips Increasing lethargy Rapid Shallow breathing
rapid shallow breaths
Brian prepared a presentation for his colleagues about preventative vaccines at his local primary care office. He is discussing the causes of meningitis and notes that there is a variety of organisms. Which of the following would he highlight as the most common cause of meningitis in newborns? Neisseria Meningitides Streptococcus group B Streptococcus pneumoniae Haemophilus Influenzae type B
strep B
A nurse is providing teaching to the parent of a child who is to have an ECG. Which of the following responses should the nurse include in the teaching? a. decaffeinated beverages should be offered on the morning to the procedure b. do not wash your child's hair the night before the procedure c. withhold all the foods the morning of the procedure d. give your child an analgesic the night before the procedure
a.
John is working in his local ER and is assessing a 6 year old girl with pharyngitis. He would least likely expect to see which of the following during his assessment? A. Working Hard to Breathe B. Difficulty Swallowing C.Sore throat and headache D> Rash on the abdomen
working hard to breathe
Which child with asthma should the nurse see first? 1. A 12-month-old who has a mild cry, is pale in color, has diminished breathsounds, and has an oxygen saturation of 93%. 2. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezingbilaterally, and has an oxygen saturation of 93%. 3. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with anoxygen saturation of 92%. 4. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright,and has an oxygen saturation of 93%
1
Which is the nurse's best response to a parent who asks what can be done at home to help a child with upper respiratory infection (URI) symptoms and a fever get better? 1. "Give your child small amounts of fluid every hour to prevent dehydration." 2. "Give your child Robitussin at night to reduce his cough and help him sleep." 3. "Give your child a baby aspirin every 4 to 6 hours to help reduce the fever." 4. "Give your child an over-the-counter cold medicine at night."
1.
A school-age child has been diagnosed with nasopharyngitis. The parent is concerned because the child has had little or no appetite for the last 24 hours. Which is the nurse's best response? 1. "Do not be concerned; it is common for children to have a decreased appetite during a respiratory illness." 2. "Be sure your child is taking an adequate amount of fluids. The appetite should return soon." 3. "Try offering the child some favorite food. Maybe that will improve the appetite." 4. "You need to force your child to eat whatever you can; adequate nutrition essential"
2
A child is complaining of throat pain. Which statement by the mother indicates that she needs more education regarding the care and treatment of her daughter's pharyngitis? 1. "I will have my daughter gargle with salt water three times a day." 2. "I will offer my daughter ice chips several times a day." 3. "I will give my daughter Tylenol every 4 to 6 hours as needed." 4. "I will ask the nurse practitioner for some amoxicillin.
4
The nurse is reviewing discharge instructions with the parents of a child who had a tonsillectomy 24 hours ago. The parents tell the nurse that the child is a big eater, and they want to know what foods to give the child for the next 24 hours. What is the nurse's best response? 1. "The child's diet should not be restricted at all." 2. "The child's diet should be restricted to clear liquids." 3. "The child's diet should be restricted to ice cream and cold liquids." 4. "The child's diet should be restricted to soft foods."
4
A nurse is assessing a toddler for possible hearing loss. Which of the following findings are indications of a hearing impairment? a. uses monotone speech b. speaks loudly c. repeats sentences d. appears shy e. is overly attentive to the surroundings
a,b,d
One of the goals for children with asthma is to prevent respiratory tract infection because infections do what? Increase sensitivity to allergens Lessen effectiveness of medications Encourage exercise-induced asthma Can trigger an episode or aggravate an asthmatic state
can trigger asthma
What assessment finding is most expected with a stable patient with cystic fibrosis? Clubbing Clear chest x-ray Cheyne Stokes breathing Supraclavicular retractions
clubbing
A nurse is caring for a 4 month old infant who has meningitis. Which of the following findings is associated with a diagnosis? a. decreased anterior fontanel b. constipation c. presence of the rooting reflex d. High-pitched cry
d
A 3-year old female is brought to the emergency department by her mother because she developed a barking cough in the middle of the night. Your assessment leads you to suspect that she is experiencing croup because of which of the following symptoms? Petechial rash High Fevers Inspiratory Stridor Toxic Appearance
inspiratory stridor
A 4-year-old child is brought to the emergency department. The child exhibits a "froglike" croaking sound on inspiration, is agitated, and is drooling. The child insists on sitting upright. What is the priority action by the nurse? Make the child lie down and rest quietly. Auscultate the child's lungs and make preparations for placement in a mist tent. Examine the child's oropharynx and report the assessment to the health care provider. Notify the health care provider immediately and be prepared to assist with a tracheostomy or intubation.
notify & trach
Who is at the highest priority to receive the flu vaccine? 1. A healthy 8-month-old who attends day care. 2. A 3-year-old who is undergoing chemotherapy. 3. A 7-year-old who attends public school. 4. An 18-year-old who is living in a college dormitory.
1.
How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is 1. Not compliant with taking her vitamins. 2. Not compliant with taking her enzymes. 3. Eating too many foods high in fat. 4. Eating too many foods high in fiber.
2
Which laboratory result will provide the most important information regarding the respiratory status of a child with an acute asthma exacerbation? 1. CBC. 2. ABG. 3. BUN. 4. PTT.
2
A nurse is caring for a school-age client who possibly has reye's syndrome. Which of the following is a risk factor for developing reye syndrome? a. recent history of infectious cystitis caused by candida b. recent history of bacterial otitis media c. recent episode of gastroenteritis d. recent episode of haemophilus infulenza meningitis
c.
A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? (SATA) a. LOC b. appearance of daydreaming c. dropping held objects d. falling to the floor e. having a piercing cry
a, b, c,
A nurse is teaching a group of parents about the risk factors for seizures. Which of the following factors should the nurse include all the teaching? a. febrile episodes b. hypoglycemia c. sodium imbalances d. low serum lead levels e. presence of diptheria
a, b, c,
A nurse is reviewing treatment options with the parent of a child who has worsening seizures. Which of the following treatment options should the nurse include in the following? a. vagal nerve stimulator b. additional anti-epileptic medication c. corpus callostomy d. focal resection e. radiation therapy
a, b, c, d
A nurse is providing preconception teaching with a client who has PKU. Which of the following information should the nurse include in the teaching? a. follow a low-phenlylalanine diet once pregnancy is confirmed b. the client will undergo testing a phenylalanine levels one to two times per week throughout pregnancy c. increase intake of dietary proteins prior to conception d. the client will require a cesarean section during birth due to the likelihood of having a fetus with macrosomia
b
A nurse is assessing a newborn who has congenital hypothyroidism. Which of the following findings should the nurse expect? a. hypertonicity b. cool extremities c. short neck d. tachycardia e. hyperreflexia
b,c
A nurse is caring for a child who has ICP, which of the following actions should the nurse take? a. suction the endotracheal tube every 2 hours b. maintain a quiet environment c. use two pillows to elevate the head d administer the stool softner e. maintain body alignment
b,d,e
A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and is to undergo phototherapy. Which of the following actions should the nurse include in the plan of care? a. reposition the newborn every 4 hours b. lotion the newborns skin twice per day c. check the newborn's temperature every 8 hours d. remove the newborn's eye mask during feedings
d
A child's parent asks the nurse what treatment the child will need for the diagnosis of strep throat. Which is the nurse's best response? 1. "Your child will be sent home on bedrest and should recover in a few days without any intervention." 2. "Your child will need to have the tonsils removed to prevent future strep infections." 3. "Your child will need oral penicillin for 10 days and should feel better in a few days. "4. "Your child will need to be admitted to the hospital for 5 days of intravenous antibiotics."
3
Which statement by the parents of a toddler with repeated otitis media indicates they need additional teaching? 1. "If I quit smoking, my child may have a decreased chance of getting an ear infection." 2. "As my child gets older, he should have fewer ear infections, because his immune system will be more developed." 3. "My child will have fewer ear infections if he has his tonsils removed." 4. "My child may need a speech evaluation."
3
You are the nurse caring for a patient who had a recent diagnosis of hyperpituitarism. Which of the following treatments would you expect to perform? a. give desmopressin acetate inhaled b. give 1 mg/kg/ day of methimazole c. inject octreeiode acetate d. administer glipizide orally
C.
A nurse is teaching a group of parents about responsible manifestations of down syndrome. Which of the following findings should the nurse include in the teaching? a. a large head with bulging fontanels b. larger ears that are set back c. protruding abdomen d. broad, short feet and hands e. hypotonia
c,d,e
Which should be included in instructions to the parent of a child prescribed amoxicillin to treat an ear infection? 1. "Continue the amoxicillin until the child's symptoms subside." 2. "Administer an over-the-counter antihistamine with the antibiotic." 3. "Administer the amoxicillin until all the medication is gone." 4. "Allow your child to administer his own dose of amoxicillin."
c.