Peds Exam 2 Practice Questions

The nurse is performing an admission assessment on a 2 year old child diagnosed with nephrotic syndrome. Which finding from the physical assessment is most characteristic of nephrotic syndrome? a. Increased urinary output b. Hypertension c. Facial edema d. Bright red blood in the urine

c

A nurse is reviewing data for four children. Which of the following children should the nurse assess first? a. A 10-year-old child who has sickle cell anemia who reports severe chest pain b. A 4-year-old child who has asthma and a PCO2 of 37 mm Hg c. A four-year-old who has strep throat and a temperature of 38.4° C (101.1 F) d. An 7 year old child with a ventricular septal defect whose urine specific gravity is 1.016

a

The nurse is caring for a child with hemophilia A who has developed hemarthrosis in the knee joint. What is the priority nursing intervention? a. Intravenous infusion of Factor VIII b. Range of motion exercises c. Administration of acetaminophen for pain relief d. Assessment of the child's response to hospitalization

a

The nurse is working in the triage department of a pediatric emergency room. Which client deserves the highest priority? a. A child who has hemophilia A who is vomiting after a head injury b. A child with iron deficiency anemia whose mother reports that he ingested a small amount of play-doh c. A child with Sickle Cell disease who comes in with an injured knee from a soccer game d. A child who has been having frequent nosebleeds (epistaxis) for 2 days.

a

Which instruction is appropriate for a parent caring for a child with a urinary tract infection? a. "The child should have plenty of fluid, but avoid beverages that contain caffeine" b. "Many children find bubble baths comforting and they help your child thoroughly clean the area around the urethra." c. "Boys have a greater risk than girls of developing urinary tract infections, so you should watch your son carefully for signs that he has one." d. "You should give your child the antibiotic until symptoms subside."

a

The nurse is teaching an adolescent female with iron deficiency anemia about foods high in iron. The nurse knows that the teaching has been effective if the girl reports that she will eat which foods? Select all that apply. a. Kale b. Black beans c. Beef d. Fortified Cereal e. Milk

a, b, c, d

The nurse is caring for a child with Hemophilia A. The child has sustained a fall with possible head injury. Which signs and symptoms require immediate intervention? Select all that apply. a. Two or more incidents of vomiting b. Nuchal rigidity c. Severe headache d. Changes in level of consciousness e. Bruising to the scalp

a, c, d

The nurse is attending a child's softball game when one of the players gets hit with a foul ball in the nose. The child is experiencing epistaxis (nosebleed). What does the nurse do? Select all that apply. a. Apply pressure to the nares with a clean tissue b. Position the child in a supine position with one rolled up towel under the head c. Tilt the child's head foreward slightly d. Encourage the child to blow the nose forcefully while bleeding is occurring e. Apply an ice pack across the bridge of the nose

a, c, e

The nurse is working with a child who is in sickle cell crisis. Treatment and nursing care for this child include which actions? Select all that apply. a. Administering oxygen b. Promoting exercise and activity c. Administering analgesics (pain relievers) d. Administering platelets e. Maintaining fluid intake

a, c, e

A nurse caring for an infant with dehydration is educating a parent about oral fluid replacement. The mother states that she does not have Pedialyte and asks if apple juice is an acceptable alternative. How should then nurse answer this parent's question? a. "Apple juice causes dental caries in infants with teeth." b. "Apple juice does not contain electrolytes that your child lost from vomiting and diarrhea." c. "Apple juice is acceptable, but only if you mix it with an equal amount of water." d. "If you don't have oral rehydration solution (Pedialyte), you may use bottled water instead."

b

A nurse is providing teaching about dietary recommendations to the parents of a toddler who has iron deficiency anemia. Which of the following dietary recommendations should the nurse include as a food that enhances iron absorption when consumed with nonheme iron? a. Bell Peppers b. Lentils and black beans c. Diluted Iced Tea d. Whole Milk

b

A school-aged child develops a nosebleed (epistaxis). Which action should the nurse take? a. Keep the child flat and apply pressure to the bridge of the nose. b. Sit the child upright and apply pressure to the sides of the nose. c. Elevate the head of the bed slightly and apply pressure to the forehead. d. Turn the child's head to the side and press on the nasal ridge.

b

An 8-year-old client presents with sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the child's health history, the nurse learns that the child had strep throat 9 days ago. Which condition does the nurse suspect? a. Urinary tract infection b. acute glomerulonephritis c. Renal Agenesis d. Polycystic kidney disease

b

The nurse is caring for a 12 month-old child with iron deficiency anemia and teaching the parents about liquid iron supplements because the child is unable to swallow pills or chew tablets. Which statement indicates that the parents require further teaching? a. "I will not offer milk for at least two hours after I give this medication." b. "I will place the liquid in the front of the mouth right near the gum line." c. "I will shake the bottle well and measure the dose carefully" d. "I will encourage fiber and fluids to avoid constipation."

b

The nurse is caring for a newborn with hypospadias. The parents are questioning why their son can not have a circumcision. What is the best explanation the nurse can offer? a. "Hypospadias is the absence of foreskin. The child will not need a circumcision." b. "The surgeons will need the foreskin to repair the defect." c. "The cosmetic result will be diminished if you do the procedure now." d. "There is increased incidence of bleeding at the circumcision site when the newborn has hypospadias."

b

The nurse is caring for a child with acute glomerulonephritis who has just undergone a renal biopsy. Which interventions should be part of the child's plan of care to prevent complications of the procedure? Select all that apply. a. High calorie, low protein diet immediately post-op b. Strict Bedrest c. Pressure dressing over the site d. Hemodialysis e. CBC 6 hours post-op and in the am

b, c, e

The nurse is assessing a toddler for signs and symptoms of iron-deficiency anemia. Which assessment findings support this diagnosis? Select all that apply. a. Joint pain and fever b. Pale conjunctiva and mucous membranes c. Excessive bruising and bleeding after minor injuries d. Fatigue and listlessness e. Brittle, spoon-shaped nails

b, d, e

The nurse is caring for a child with Hemophilia A. The child is scheduled for wisdom tooth extraction. Which of the following orders should the nurse anticipate for this client prior to surgery to control bleeding? a. Platelets b. DDAVP c. Packed Red Blood Cells d. Antibiotics

b.

A 4-month-old infant is found to have decreased hemoglobin and hematocrit. Which is the most likely cause of anemia in this child? a. Sickle cell disease b. Inadequate breastfeeding c. Inadequate iron intake of the mother in the last trimester of pregnancy d. Thalassemia

c

A child diagnosed with hemophilia A presents with warm, swollen, painful joints. Which action will the nurse take first? a. Apply ice to the affected areas b. Assess the client's urine and stool for blood c. Prepare to administer factor replacement medication d. Administer acetaminophen

c

An infant with bladder exstrophy is awaiting surgical repair. What is the priority nursing intervention for this child? a. Teaching the parents to change the soiled diapers frequently b. Apply petroleum jelly on a gauze square to the affected area c. Keep the bladder moist and covered with a sterile, nonadherent plastic covering d. Bathe the child in a tub and use a soft washcloth to cleanse the bladder with soap and water.

c

The nurse receives the shift report of multiple pediatric clients. Which pediatric client will the nurse see first? a. a child with a history of hypertension and a current blood pressure of 130/90 mm Hg b. an infant whose parents report difficulty feeding with a temperature of 100.1°F (38°C) c. A child with tetralogy of Fallot squatting quietly in a corner d. A child with coarctation of the aorta with complaints of nasal congestion and mild cough.

c

A newborn is diagnosed with tetralogy of Fallot. The pediatric cardiologist remarks that there is an over-riding PDA, and orders prostaglandin to keep the ductus arteriosis from closing. What is the nurse's most appropriate action after receiving this order? a. Explain to the parents that the right to left shunting in the PDA will compensate for pulmonic stensosis and prevent congestion in the lungs. b. Question the physician's order c. Advocate for the administration of indomethacin d. Explain to the parents that keeping the ductus arterosis open will make sure that some oxygenated blood will circulate

d

A nurse is caring for a 12 year-old child who has been admitted to the hospital with sickle cell crisis. The nurse observes that the child suddenly appears confused and uncoordinated with right-sided weakness, slurred speech. The client is also reporting a severe headache and double vision. The nurse immediately contacts the provider to report that the patient may be experiencing which condition? a. Reye Syndrome b. Hypoxia from decreased hemoglobin c. Opioid intoxication d. Cerebrovascular accident (CVA)

d

A two-month old has been brought to the emergency department with projectile vomiting, decreased urine output, lethargy, and irritability. The parents report that the infant was previously healthy. The nurse observes peristaltic waves in the abdomen and sunken fontanelles. Which order should the nurse anticipate? a. Histamine-2 blockers b. Oral rehydration with Pedialyte c. Administration of an enema d. IV fluids, strict I & O and NPO for surgery

d

An infant is born, the umbilical cord is clamped, and the newborn takes its first breath. What is the next event in transition from fetal to newborn circulation? a. Systemic blood pressure decreases and blood flow through the inferior vena cava increases b. Closure of the ductus arteriosis c. The ductus venosus becomes a ligament in the liver d. Pulmonary resistance decreases and blood flow to the lungs increases

d

Parents are told that their infant has a heart defect with a left-to-right shunt. What is the best way for the nurse to explain this type of shunting to the parents? a. This type of shunting causes a decrease of blood to the brain. b. This type of shunting causes an increase of blood to the systemic circulation. c. This type of shunting causes a decrease of blood to the lungs. d. This type of shunting causes an increase of blood to the lungs.

d

The nurse is caring for an 8-year-old child hospitalized with nephrotic syndrome. Which nursing intervention would be appropriate for this child? a. Measure the abdominal girth weekly b. Test urine for ketones daily c. Administer acetaminophen as ordered for temperature greater than 100.3 F d. Weigh the child daily on the same scale

d

The nurse is working in a pediatric emergency department and is assigned to four clients. Which client should the nurse see first? a. A school-age child with a history of epilepsy who is post-ictal following a tonic-clonic seizure 2 hours ago. b. A toddler with anemia who has eaten a handful of dog food c. A preschooler with asthma who has a temperature of 100.3 and a cough d. An adolescent with Sickle Cell Disease who is complaining of chest pain, fever, and shortness of breath

d

The parents of a three month old infant report that their child vomits after every feeding and appears to be in pain when vomiting. The provider diagnoses GERD. Which intervention represents accurate teaching to the parents? a. "You should provide larger, more frequent feedings to the infant to minimize the amount of episodes your child experiences." b. "You can start offering solid foods such as bananas or cereal to the infant's formula." c. "You should discontinue breastfeeding and offer feedings with pre-digested formula." d. "Keep the infant in an upright position for 30 minutes after feeding."

d

Which finding is typically present in acute glomerulonephritis but absent in nephrotic syndrome? a. Edema b. Proteinuria c. Oliguria d. Hematuria

d

Which laboratory finding is expected in nephrotic syndrome? a. Decreased Blood Urea Nitrogen (BUN) b. Increased serum albumin c. Elevated AST & ALT d. Proteinuria

d