Peds Exam 7

A child has been diagnosed with meningococcal meningitis. Which of the following isolation techniques is appropriate?

Isolation precautions for at least 24 hours after the initiation of antibiotics.

A nurse is collecting data about a child who has been admitted to the hospital with a diagnosis of seizures. The nurse checks for causes of the seizure activity by:

Obtaining a history regarding factors that may precipitate seizure activity

Following surgery to repair spina bifida, the nurse would immediately report which of the following symptoms to the nurse in charge that might indicate increased intracranial pressure:

Vomiting

A child is experiencing a tonic-clonic seizure. Which of the following interventions would be appropriate for the nurse to perform?

Pad the side rails

The nurse is assisting the healthcare provider with a lumbar puncture of a small child. The nurse will monitor which of the following during the procedure?

Respiratory status The nurse would monitor the respiratory status of the child during the procedure. Respiratory obstruction is a risk when the neck is flexed. The other vital signs would be monitored before the beginning of the procedure.

The nurse is preparing the child for a lumbar puncture and places the child in this position:

Side-lying with knees flexed or Seated with back curved

A nurse is instructing parents about treatment for and giving general information about chickenpox. The parents would like to know how to prevent spreading the disease. The nurse would inform the parents that:

The child will be contagious until all lesions are crusted

A nurse notes that several of the clients on the unit have ear infections. Most of the children are very young. Children are more prone to ear infections than adults because:

The eustachian tube in infants is straighter and shorter than that in older children and adults.

The nurse is caring for a 2-year-old child with an ear infection who requires the administration of antibiotic ear drops. The nurse observes the mother administering the ear drops to the child. Which of the following observations, if made by the nurse, indicates that the mother is performing the procedure correctly?

The mother pulls the ear down and back when administering the ear drops.

An infant had been diagnosed with otitis media twice in the last 4 months. The parents inquire about ways to prevent the recurrence. the nurse responds with which of the following interventions:

The nurse asks if the parents smoke; and if so, advises them to stop

A new nurse is caring for a child with a foreign body in the ear canal. You know that the health care provider has not seen the child yet, so you would assess the situation and intervene if the new nurse performs which of the following actions?

Uses an otoscope to check for perforation Flush with warm water.

You need to administer 250mg of Amoxicillin to a child in the hospital. You have on hand 500mg per 5mL. How much Amoxicillin do you administer?

2.5mL

The nurse is caring for an infant with a diagnosis of hydrocephalus and is monitoring the infant for signs of increased intracranial pressure (ICP). The nurse suspects increased ICP if which of the following is noted?

A bulging anterior fontanel

The nurse is providing instructions to the parents of an infant with a ventriculoperitoneal shunt. The nurse plans to include which of the following instructions?

Call the healthcare provider if the infant has a high-pitched cry.

The nurse giving instructions for acute conjunctivitis would teach parents to:

clear dried exudate with warm soaks and then remove from inner to outer canthus.

In caring for a 3 year old with a head injury, the nurse would report the probability of increasing intracranial pressure based on the assessment of:

decrease in pulse. increase BP

The priority nursing intervention for a 4-year-old child with cerebral palsy is designed to:

encourage the child to ambulate independently and keep them mobile if able.

The nurse explains that febrile seizures:

occur when the temperature rises quickly.

A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds. After a generalized tonic-clonic seizure, the nurse would expect that the child might be:

sleepy.

A nurse is initiating seizure precautions on a new admit from the ER and places these items at the bedside:

suction equipment and oxygen

You have a child on an IV for hydration and there is no electricity he is getting a bolus of 150 ml over 1 hour and the drip factor on your IV set is 60 drops per mL. What drip rate do you set your IV at (how many drops per minute)?

150 drops per minute

A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. This behavior is characteristic of which type of seizure?

Absence

Parents bring their 6-year-old child to the emergency department. While explaining the history of the current issue, the parents report the following problem: Their child was playing normally, then suddenly quit talking, assumed a blank expression, and displayed flickering eye lids. The event lasted about 20 seconds. The nurse realizes that the child has likely experienced:

Absence seizure

The nurse is caring for a child following a surgical repair of strabismus. Which of the following interventions would be most appropriate?

Allow parents to remain with the child if the eyes must remain covered The parents should be allowed to remain with the child if the eyes are to be covered. This will decrease anxiety. The surgery does not involve the internal structures of the eye, so there are no activity restrictions.

A nurse is collecting data on an 11 month old infant. Which of the following clinical manifestations is indicative of a central nervous system infection?

Buldging fontanel

What clinical manifestations are suggestive of hydrocephalus in a neonate?

Bulging fontanelle, dilated scalp veins

Which of the following lab results would verify the diagnosis of bacterial meningitis?

Cloudy cerebrospinal fluid with high protein and low glucose levels

A child needs to receive an antibiotic by intravenous administration. Which of the following precautions should be followed when administering an IV to children?

Compatibility between medication and fluid should be checked

Which additional congenital malformation is expected in 80% of infants with a myelomeningocele?

Hydrocephalus

The nurse is assisting in providing an educational session to new mothers regarding the methods that will decrease the risk of recurrent otitis media in infants. Which of the following statements, if made by a mother in the group, indicates that teaching has been successful?

I need to feed the baby in an upright position.

The nursing care of an infant with spina bifida would include which of the following interventions: (Select all that apply)

Pre OP Position child on abdomen Placing moist, sterile dressings on the sac Protection of the sac from urine and feces Post OP Place child on abdomen 10-14 days Monitor VS Observing for signs of bleeding and infection

A child is admitted to the emergency department with a head injury. The nurse makes an assessment and will record which of the following baseline data on admission.: (Select all that apply)

Pupil size Level of consciousness Complete vital signs

When speaking to young parents, the nurse states that lead poisoning is one of the most common preventable health problems affecting children. When lead levels exceed the amount that can be absorbed by the bones, it leads to:

anemia.

The nurse is planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes would include:

avoiding getting water in the ears.

The healthcare provider is treating a child with meningitis with a course of antibiotic therapy. The nurse assures the parents that the child will be out of isolation when:

the antibiotics have been initiated for 24 hours.

The school nurse would suspect strabismus when the child:

covers one eye to read the chalkboard.

The nurse instructs parents about the signs of otitis media, which include:

fever, irritability, pulling on ear.

The mother brings the child to the nurse because of exposure to varicella. The nurse explains that early signs of the disease are:

general malaise. Early signs of varicella will develop during the prodromal period and are mainly low-grade fever, malaise, and anorexia. Lesions do not appear until later.

The nurse is creating a teaching plan that includes the long-term administration of phenytoin (Dilantin) would state that:

gums should be massaged regularly to prevent hyperplasia.

An adolescent who has epilepsy has just had a generalized seizure and collapsed in the school nurse's office. The nurse should call 911 if the student:

has a seizure lasting more than 5 minutes.

A common cause of sensorineural hearing loss include:

mycin drugs

The nurse explains that a common treatment for amblyopia is:

patching the good eye to force the brain to use the affected eye.

When assessing a child for classical signs of meningeal irritation, the nurse records:

positive Brudzinski's Kernig's signs photophobia.

A child is diagnosed with meningitis and is in isolation the healthcare provider has ordered Rocephin 1 Gram every 12 hours. The child weighs 44 pounds and the dosage for a pediatric client with meningitis is recommended that the initial therapeutic dose be 100 mg/kg (not to exceed 4 grams). Thereafter, a total daily dose of 100 mg/kg/day (not to exceed 4 grams daily) is recommended. The daily dose may be administered once a day (or in equally divided doses every 12 hours). Is this a safe dose and if yes how much will you administer if you have 250mg per mL?

yes it is a safe dose and you would administer 4mL