PEds Exam 4 review

Which description of a stool is characteristic of intussusception? Ribbon-like stools Hard stools positive for guaiac "Currant jelly" stools Loose, foul-smelling stools

"Currant jelly" stools

A child who weighs 37 pounds needs a dose of lidocaine prior to cardioversion for ventricular tachycardia. What dose does the nurse prepare to administer? Write your answer using a whole number. _____ mg

17

Before giving a dose of digoxin the nurse checked an infant's apical heart rate and it was 114 beats/minute. What should the nurse do next? A. Administer the dose as ordered. b. Hold the medication until the next dose. c. Wait and recheck the apical heart rate in 30 minutes. d. Notify the physician about the infant's heart rate.

A. Administer the dose as ordered.

The nurse is assessing a child for epiglottitis. What findings are consistent with this condition? (Select all that apply.) Drooling Dysphagia Dysphonia Distressed inspiratory efforts Decreased oxygenation

Drooling Dysphagia Dysphonia Distressed inspiratory efforts

Which statement is characteristic of acute otitis media (AOM)? The etiology is unknown. Permanent hearing loss often results. It can be treated by intramuscular (IM) antibiotics. It is treated with a broad range of antibiotics.

It is treated with a broad range of antibiotics.

Which classification of drugs is used to relieve an acute asthma episode? Short-acting beta2-adrenergic agonist Inhaled corticosteroids Leukotriene blockers Long-acting bronchodilators

Short-acting beta2-adrenergic agonist

What is an expected outcome for the parents of a child with encopresis? The parents will give the child an enema daily for 3 to 4 months. The family will develop a plan to achieve control over incontinence. The parents will have the child launder soiled clothes.

The family will develop a plan to achieve control over incontinence.

What is the nurse's first action when planning to teach the parents of an infant with a CHD? a. Assess the parents' anxiety level and readiness to learn. b. Gather literature for the parents. c. Secure a quiet place for teaching. d. Discuss the plan with the nursing team.

a. Assess the parents' anxiety level and readiness to learn.

For which problem should the child with chronic otitis media with effusion be evaluated? a. Brain abscess b. Meningitis c. Hearing loss d. Perforation of the tympanic membrane

c. Hearing loss

Therapeutic management of the child with acute diarrhea and dehydration usually begins with clear liquids. IV solutions while the child is NPO. oral rehydration solution (ORS). antidiarrheal medications.

oral rehydration solution (ORS).

Therapeutic management of most children with Hirschsprung disease is primarily daily enemas. low-fiber diet. permanent colostomy. surgical removal of the affected section of the bowel

surgical removal of the affected section of the bowel

A parent of a child with asthma asks if his child can still participate in sports. What response by the nurse is best? "Children with asthma are usually restricted from physical activities." "Children can usually play any type of sport if their asthma is well controlled." "Avoid swimming because exhaling underwater is dangerous for people with asthma." "Even with good asthma control, I would advise limiting the child to one athletic activity per school year."

"Children can usually play any type of sport if their asthma is well controlled."

What is the best response by the nurse to a mother asking about the cause of her infant's bilateral cleft lip? "Did you use alcohol during your pregnancy?" "Does anyone in your family have a cleft lip or palate?" "This defect is associated with intrauterine infection during the second trimester." "The prevalent of cleft lip is higher in Caucasians."

"Does anyone in your family have a cleft lip or palate?"

. A baby is scheduled for abdominal surgery for hypertrophic pyloric stenosis and has an NG tube to intermittent suction. When the family asks why the child has the tube, what response by the nurse is best? "The nasogastric tube decompresses the abdomen and decreases vomiting." "We can keep a more accurate measure of intake and output with the tube." "The tube is used to decrease postoperative diarrhea." "The nasogastric tube makes the baby more comfortable after surgery."

"The nasogastric tube decompresses the abdomen and decreases vomiting."

What is an appropriate statement for the nurse to make to parents of a child who has had a barium enema to correct an intussusception? "I will call the physician when the baby passes his first stool." "I am going to dilate the anal sphincter with a gloved finger to help the baby pass the barium." "Your baby can't have anything to eat or drink until bowel function returns." "Add cereal to the baby's formula to help him pass the barium.

"Your baby can't have anything to eat or drink until bowel function returns."

The nurse getting an end-of-shift report on a child with status asthmaticus should question which intervention? Administer oxygen by nasal cannula to keep oxygen saturation at 100%. Assess intravenous (IV) maintenance fluids and site every hour. Notify provider for signs of increasing respiratory distress. Organize care to allow for uninterrupted rest periods.

Administer oxygen by nasal cannula to keep oxygen saturation at 100%.

The nurse caring for a child with suspected appendicitis should question which order from the physician? Keep patient NPO. Start IV of D5/0.45 normal saline at 60 mL/hr. Apply K-pad to abdomen prn for pain. Obtain CBC on admission to nursing unit.

Apply K-pad to abdomen prn for pain.

Which assessment finding should the nurse expect in an infant with Hirschsprung disease? "Currant jelly" stools Constipation with passage of foul-smelling, ribbon-like stools Foul-smelling, fatty stools Diarrhea

Constipation with passage of foul-smelling, ribbon-like stools

The nurse is caring for an infant with bronchopulmonary dysplasia (BPD) who has RSV. Which treatment measure does the nurse prepare to provide? Pancreatic enzymes Cool humidified oxygen Erythromycin intravenously Intermittent positive pressure ventilation

Cool humidified oxygen

Which type of croup is always considered a medical emergency? Laryngitis Epiglottitis Spasmodic croup Laryngotracheobronchitis (LTB)

Epiglottitis

What is a common trigger for asthma attacks in children? Febrile episodes Dehydration Exercise Seizures

Exercise

What explanation should the nurse give to the parent of a child with asthma about using a peak flow meter? It is used to monitor the child's breathing capacity. It measures the child's lung volume. It will help the medication reach the child's airways. It measures the amount of air the child breathes in.

It is used to monitor the child's breathing capacity.

Which order should the nurse question when caring for a 5-year-old child after surgery for Hirschsprung disease? Monitor rectal temperature every 4 hours. Assess stools after surgery. Keep the child NPO until bowel sounds return. Maintain IV fluids at ordered rate.

Monitor rectal temperature every 4 hours.

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. What action by the nurse is most appropriate? Prepare to administer a bronchodilator. Give ordered antibiotics on time. Provide oxygen via face tent. Assess the airway for a foreign body.

Prepare to administer a bronchodilator.

An infant's parents ask the nurse about preventing OM. What should be recommended? a. Avoid tobacco smoke. b. Use nasal decongestant .c. Avoid children with OM. d. Bottle feed or breastfeed in supine position.

a. Avoid tobacco smoke.

A nurse is caring for four infants. Which one should the nurse assess first? a. a. Nasal flaring b. Respiratory rate of 55 breaths/min c. Irregular respiratory pattern d. Abdominal breathing

a. Nasal flaring

5-year-old child is brought to the emergency department with copious drooling and a croaking sound on inspiration. Her mother states that the child is very agitated and only wants to sit upright. What action by the nurse takes priority? a. Prepare intubation equipment and call the provider. b. Examine the child's oropharynx and call the provider. c. Obtain a throat culture for respiratory syncytial virus (RSV). d. Obtain vital signs and listen to breath sounds.

a. Prepare intubation equipment and call the provider.

An infant has laryngomalacia. What assessment finding correlates with this condition? a. Stridor b.High-pitched cry c. Nasal congestion d. Spasmodic cough

a. Stridor

Which CHD results in increased pulmonary blood flow? a. Ventricular septal defect b. Coarctation of the aorta c. Tetralogy of Fallot d. Pulmonary stenosis

a. Ventricular septal defect

What intervention should be included in the plan of care for an infant with the nursing diagnosis of excess fluid volume related to congestive heart failure? a. Weigh the infant every day on the same scale at the same time. b. Notify the physician when weight gain exceeds more than 20 g/day. c.Put the infant in a car seat to minimize movement. d. Administer digoxin as ordered by the physician.

a. Weigh the infant every day on the same scale at the same time.

A beneficial effect of administering digoxin is that it a. decreases edema. b. decreases cardiac output. c. increases heart size. d. increases venous pressure.

a. decreases edema.

a nurse is teaching a parent of an infant about gastrointestinal reflux disease. which of the following should the nurse include in the teaching (SATA) a. offer frequent feedings b. thicken formula with rice cereal c. use a bottle with a one-way valve d. position baby upright after feedings e. use a wide-based nipple for feedings

a. offer frequent feedings b. thicken formula with rice cereal d. position baby upright after feedings

a nurse is assessing an infant who has hypertrophic pyloric stenosis. which of the following findings should the nurse expect? (SATA) a. projectile vomiting b. dry mucus membranes c. currant jelly stools d. sausage-shaped abdominal mass e. constant hunger

a. projectile vomiting b. dry mucus membranes e. Constant hunger

The nurse expects the initial plan of care for a 9-month-old child with an acute otitis media infection to include a. symptomatic treatment and observation for 48 to 72 hours after diagnosis. b. an oral antibiotic, such as amoxicillin, five times a day for 7 days. c. pneumococcal conjugate vaccine. d. myringotomy with tympanoplasty tubes

a. symptomatic treatment and observation for 48 to 72 hours after diagnosis.

What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well? a. Recheck the infant's blood pressure. b. Alert the provider c. Withhold oral feeding. d. Increase the oxygen rate.

b. Alert the provider

The nurse is providing home care instructions to the parents of an infant being discharged after repair of a bilateral cleft lip. Which instructions should the nurse include? (Select all that apply.) a. Acetaminophen (Tylenol) should not be given to your infant. b. Feed your infant in an upright position. c. Place your infant prone for a period of time each day. d. Burp your child frequently during feedings. e. Apply antibiotic ointment to the lip as prescribed.

b. Feed your infant in an upright position. d. Burp your child frequently during feedings. e. Apply antibiotic ointment to the lip as prescribed.

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? a. Wheezing is heard audibly. b. It has a harsh, barky cough. c. It is bacterial in nature. d. The child has a high fever.

b. It has a harsh, barky cough.

Which statement best describes patent ductus arteriosus? a. Patent ductus arteriosus involves a defect that results in a right-to-left shunting of blood in the heart. b. Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. c. Patent ductus arteriosus is a stenotic lesion that must be surgically corrected at

b. Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close.

7. The nurse assessing a premature newborn infant auscultates a continuous machinery- like murmur. What action by the nurse is most appropriate? a. Educate parents on daily low-dose aspirin regime. b. Prepare to administer indomethacin. c. Administer next dose of enalapril early. d. Position infant in the knee-chest position.

b. Prepare to administer indomethacin.

The nurse discovers a heart murmur in an infant 1 hour after birth. What does the nurse know about when fetal shunts close in the neonate? a. When the umbilical cord is cut b. Within several days of birth c. Within a month after birth d. By the end of the first year of life

b. Within several days of birth

a nurse in an outpatient facility is caring for an infant who has manifestations of acute otitis media. which of the following factors places the infant at risk for otitis media (SATA) a. breastfeeding without formula supplementation b. attends daycare 4 days per week c. immunizations are up to date d. history of cleft palate repair e. parents smoke cigarettes outside

b. attends daycare 4 days per week d. history of cleft palate repair e. parents smoke cigarettes outside

Which strategy is appropriate when feeding the infant with congestive heart failure? a. Continue the feeding until a sufficient amount of formula is taken. b. limit feeding time to no more than 30 minutes. c. Always bottle feed every 4 hours. d. Feed larger volumes of concentrated formula less frequently.

b. limit feeding time to no more than 30 minutes.

a nurse is caring for an infant who is postoperative following cleft lip and palate repair. which of the following actions should the nurse take a. remove the packing in the mouth b. place the infant in an upright position c. offer a pacifier with sucrose d. assess the mouth with a tongue blade

b. place the infant in an upright position

a nurse is caring for a child who has Hirschsprung's disease. which of the following actions should the nurse take? a. encourage a high fiber, low portion, low calorie diet b. prepare the family for surgery c. place an NG tube for decompression d. initiate bed rest

b. prepare the family for surgery

a nurse is assessing an infant. which of the following findings are clinical manifestations of acute otitis media (SATA) a. decreased pain in the supine positions b. rolling head side to side c. loss of appetite d. increase sensitivity to sound e. crying

b. rolling head side to side c. loss of appetite e. crying

When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure? a. The right arm b. The left arm c. All four extremities d. Both arms while the child is crying

c. All four extremities

The nurse is admitting a child who has been diagnosed with Kawasaki disease. What is the most serious complication for which the nurse should assess in Kawasaki disease? a. Cardiac valvular disease b. Cardiomyopathy c. Coronary aneurysm d. Rheumatic fever

c. Coronary aneurysm

Which intervention for treating croup at home should be taught to parents as possibly helpful? a. Have a decongestant available. b. Have the child sleep in a dry room. c. Take the child outside. d. Give the child an antibiotic at bedtime.

c. Take the child outside.

A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if which conditions occur? (Select all that apply.) a. Respiratory rate of 36 at rest b. Appetite slowly increasing c. Temperature above 37.7° C (100° F) d. New, frequent coughing e. Turning blue or bluer than normal

c. Temperature above 37.7° C (100° F) d. New, frequent coughing e. Turning blue or bluer than normal

Which statement made by a parent indicates understanding of restrictions for a child after cardiac surgery? a. "My child needs to go to bed early for a few weeks." b. "My son is really looking forward to riding his bike next week." c. "I'm so glad we can attend religious services as a family this coming Sunday." d. "I am going to keep my child out of day care for 6 weeks."

d. "I am going to keep my child out of day care for 6 weeks."

Which statement suggests that a parent understands how to correctly administer digoxin? a. "I measure the amount I am supposed to give with a teaspoon." b. "I put the medicine in the baby's bottle." c. "When she spits up right after I give the medicine, I give her another dose." d. "I give the medicine at 8 in the morning and evening every day."

d. "I give the medicine at 8 in the morning and evening every day."

The nurse is caring for a child with Kawasaki disease. The child weighs 33 pounds. When initiating aspirin therapy, what dose does the nurse prepare to administer? a. 75 mg orally once a day b. 81 mg orally twice a day c. 200 mg three times a day d. 375 mg orally four times a day

d. 375 mg orally four times a day

A nurse is assigned to care for an infant with an unrepaired tetralogy of Fallot. What should the nurse do first when the baby is crying and becomes severely cyanotic? a. Place the infant in a knee-chest position. b. Administer oxygen. c. Administer morphine sulfate. d. Calm the infant.

d. Calm the infant.

8. What is an expected assessment finding in a child with coarctation of the aorta? a. Orthostatic hypotension b. Systolic hypertension in the lower extremities c. Blood pressure higher on the left side of the body d. Disparity in blood pressure between the upper and lower extremities

d. Disparity in blood pressure between the upper and lower extremities

Which intervention should be included in the nurse's plan of care for a 7-year-old child with encopresis who has cleared the initial impaction? a. Have the child sit on the toilet for 30 minutes when he gets up in the morning and at bedtime. b Increase caffeine in the child's diet to promote bowel elimination. c. Use a Fleet enema daily. d. Give the child a choice of beverage to mix with a laxative.

d. Give the child a choice of beverage to mix with a laxative.

Nursing care for the child in congestive heart failure includes which of the following activities? a. Counting the number of saturated diapers b. Putting the infant in the Trendelenburg position c. Removing oxygen while the infant is crying d. Organizing care to provide rest periods

d. Organizing care to provide rest periods

The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for which of the following? a. Sore throat b. Elevated blood pressure c. Desquamation of the fingers and toes d. Tender, warm, inflamed joints

d. Tender, warm, inflamed joints

For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E1? a. To decrease inflammation b. To control pain c. To decrease respirations d. To improve oxygenation

d. To improve oxygenation

a nurse is caring for a toddler who has acute otitis media. which of the following is the priority action for the nurse to take? a. provide emotional support to the family b. educate the family on care of the child c. prevent clinical complications d. administer analgesics

d. administer analgesics

A common, serious complication of rheumatic fever is a. seizures. b. cardiac dysrhythmias. c. pulmonary hypertension. d. cardiac valve damage.

d. cardiac valve damage.

The postoperative care plan for an infant with surgical repair of a cleft lip includes a clear liquid diet for 72 hours. nasogastric feedings until the sutures are removed. elbow restraints to keep the infant's fingers away from the mouth. rinsing the mouth after every feeding.

elbow restraints to keep the infant's fingers away from the mouth.