Peds Final Exam
The nurse is caring for a 4-year-old admitted with Varicella. Which of the following activities is most appropriate for this child?
Putting a puzzle together
The nurse is interviewing a parent of a 9-month-old infant during a well-baby visit. Which statement by the parent causes the nurse concern about infant safety?
"He loves to crawl and get his toys out of a big plastic storage bag on the floor in his room."
Parents of a child who experienced a moderately severe allergic reaction while playing outside. The parents ask the nurse what they can do to help if it happens again. Which response by the nurse is the most appropriate?
"I will teach you how to use an Epi-Pen."
The nurse is reinforcing teaching with the parents of a child who has a strep throat infection about preventing disease transmission. Which of the following instructions indicates that the teaching was effective?
"I'll discard his toothbrush and buy a new one.
The parents of a school-aged child with growth hormone deficiency ask the nurse how long their son will need to administer injections for his delayed growth. Which of the following responses is the most appropriate?
"Injections should be administered until there is evidence of epiphyseal (growth plate) closure.
The nurse is caring for a 6-year-old child with congestive heart failure. Which of the following statements is the most appropriate to encourage the child to take deep breaths?
"Let's play a game of blowing cotton balls across the table."
The nurse is reinforcing discharge instructions with the parent of a child who has cystic fibrosis. Which of the following statements by the parent indicates a correct understanding of the child's needs?
"My child needs to wash her hands well before eating."
The school nurse is talking to a 13-year-old female. Which of the following statements is the most concerning?
"None of the kids at my school like me, and I don't like them either."
The nurse is providing care to a child with cystic fibrosis. Which of the following would not be an appropriate intervention for this child?
A low calorie diet
The pediatric nurse is oated to the newborn nursery. The nurse is feeding a baby and the baby has a cyanotic episode. The nurse noties the primary health care provider. The nurse suspects the baby has which of the following congenital heart defects?
Tetralogy of Fallot
The nurse in a pediatric office is performing physical assessments on multiple patients. Which patient must the nurse report to the medical provider?
The 3-year-old patient with a history of prematurely closed fontanels who has a headache.
The school nurse monitors a child 3 weeks after the child was diagnosed with mononucleosis. The nurse should intervene if which of the following is observed?
The child plays soccer during recess. *epstein barr
The nurse is caring for a child with Kawasaki's disease. What is the primary reason that providing nursing care to this child is challenging?
The child's irritability.
The nurse is preparing to administer insulin to a child with diabetes. Which of the following syringes is the most appropriate?
If you regularly inject half units of insulin, you can get a 3/10 cc, short needle syringe with half-unit markings. This is ideal for young children who manage their ..
Match the name and severity of the retraction to the appropriate number. mild mild intermediate Severe
Mild-subcostal Mild -Substernal Intermediate -Intercostal Severe - Supraclavicular
The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse that they will be back to visit at 6 pm. When the child asks the nurse when his parents are coming back, which response by the nurse is best?
"They will be here after dinner."
Parents of a child admitted with respiratory distress are concerned because the child won't lie down and wants to squat while playing with a toy. Which response by the nurse is the most appropriate?
"This position helps keep the airway open
The nurse is providing teaching about age-appropriate activities to the parents of a 2-year-old. Which of the following statements by the parents indicates a need for further teaching?
"To promote physical activity we are going to sign our child up for a soccer team."
The nurse is assessing an adolescent patient in the emergency department after she was sexually assaulted at a party. The patient refuses to give her parent's contact information and states, "They will kill me when they find out that I went to the party." What response by the nurse is most appropriate?
"We have to report this event to the authorities."
Following parental teaching, the nurse is evaluating the parents' understanding of environmental control for their child's asthma management. Which statement by the parents' indicates appropriate understanding of the teaching?
"We will replace the carpet in our child's bedroom with tile."
A nurse is assessing an adolescent patient. Which statement by the nurse is most likely to enhance communication with the patient?
"What concerns do you have about your health?"
The nurse is caring for a child who weighs 16 kg. What is the expected daily fluid intake for the child? Round to the nearest whole number.
1300 10 kg= 1000 mL 6 kg x 50 mL= 300 mL Total 1300 mL
The pediatric nurse is assigned 4 clients. Which patient should the nurse see first?
18-month-old admitted for treatment of Bronchiolitis with supraclavicular retractions and a respiratory rate of 54 breaths per minute.
The nurse is caring for a child who weighs 38 pounds. Which of the following values represents an expected hourly output for this child?
35 mL 1-3 mL/kg 38lb=17.27 kg x 1 mL= 17.27 mL/hr 17.27 kg x 3 mL= 51.81 mL/hr
The nurse has just received shift report on four pediatric patients. Which patient should the nurse see FIRST?
A 13-year-old admitted for treatment of endocarditis with new onset anxiety and chest pain.
The community health nurse visits a child care center. Which of the following findings indicates the need for state education?
A 2-month-old is sleeping in a crib on his stomach. Causes SIDS
The nurse admits a child with Tetralogy of Fallot to the unit. Which nursing diagnosis for this child is the most appropriate?
Activity Intolerance
The nurse is preparing to administer a liquid medication to a 10-month-old infant who is crying. Which of the following interventions reduces the risk of aspiration when administering the medication?
Administer the medication with an oral syringe placed along-side the infant's tongue with the infant is sucking on a pacifier. uses sucking reflex
The nurse is caring for a child with Kawasaki disease. When caring for the child the nurse would anticipate which of the following interventions in the plan of care?
Administration of gamma globulins and aspirin.
During adolescence, experimentation and risk-taking behavior are common. Adolescents frequently don't identify the link between their actions and the consequences. Which of the following statements provide the best rationale for this behavior?
Adolescents have a tendency to feel indestructible and immune to consequences that others may experience.
The nurse is teaching the parent of a type 1 diabetic preschool-age client about management of the disease. Which teaching point is appropriate for the nurse to include in this session?
Allowing the client to choose which finger to stick for glucose testing
The nurse is caring for a child that is currently NPO following a procedure. The primary medical provider writes an order to resume an appropriate diet advancing as appropriate. Which of the following choices would the nurse offer to the child first?
Apple juice - Clear liquids first
The nurse is caring for a preschooler with hand, foot and mouth disease. Which of the following would be the most appropriate intervention for this child?
Apple juice and mashed potatoes
The nurse is assessing an infant during a well-baby visit in the family practice clinic. During the assessment, the nurse asks the mother several routine questions regarding the infant's progress, the mother does not verbally respond but nods her head. The nurse notes the mother is looking at her cell phone. Which action by the nurse is most appropriate in this situation?
Ask the mother if she could please put the phone down and discuss her infant's progress
The nurse in a pediatric clinic is assessing a female adolescent who is 15 years of age. When the nurse performs a reproductive health assessment, the patient states, "I have never had anything but safe sex." Which approach does the nurse take next?
Ask the patient to define "safe sex."
The nurse is caring for an infant with heart failure. The nurse is assessing the quality of the peripheral pulses. Which site is the nurse palpating?
Brachial For infants
The school nurses is teaching a health class. The nurse instructs the students that which of the following is the initial indication of puberty? Select the initial indication of puberty for each gender. Female: Male:
Breast development Testicular enlargement
The nurse is caring for a 3-month-old infant with copious nasal secretions, grunting, and brief episodes of hypoxia. These clinical manifestations are associated with which of the following respiratory alteration?
Bronchiolitis
The clinic nurse is providing education about treatment for several pediatric conditions. Match the treatment with the medical diagnosis. Each treatment should be used (none should be used twice). Varicella Lyme Disease Tinea Corpis Acne
Chicken Pox- 1-2 weeks of oatmeal baths From ticks - 14 days antibiotic therapy Athletes feet - 20 weeks of isotretinoin therapy
The nurse is caring for a hospitalized 18-month-old child. Which of the following lunches is the most appropriate for this child?
Chicken nuggets and baked tater tots
After receiving change of shift report, which client should the nurse assess first?
Child after tonsillectomy swallowing frequently.
The nurse is evaluating the motor development of a preschooler at age 5 years. Which assessment finding is essential in order for the child to be considered ready for preschool?
Continent of urine and stool while awake.
Which of the following activities would be the most appropriate for a child recovering from rheumatic fever?
Drawing
The nurse is caring for a child with type I diabetes. Which of the following should the nurse include in discharge instructions regarding hypoglycemia?
Drink 4 ounces of fruit juice.
The nurse is caring for a toddler with croup. Which clinical manifestation should the nurse report to the primary health care provider immediately?
Drooling
Align the developmental milestone to the appropriate cognitive stage of development. Concrete Operations Formal Operations Sensorimotor Preoperational
Egocentricity diminishes - Discovers though senses Develops abstract thinking - thoughts based on perceptions rather than logic Discovers though senses - Develops abstract thinking Thoughts are based on perceptions rather than logic
The nurse is caring for a child in the emergency department experiencing wheezing. Place the following nursing interventions in PRIORITY order from first to last.
Elevate the head of the bed Place the child on continuous pulse oximetry monitoring Assess lung sounds Administer the bronchodilator medication Administer steroid medication Reassure the family you will check on the child frequently
The nurse is planning care for a 10-year-old child who will be hospitalized for an extended period of time. Which action should the nurse include in the plan of care?
Encourage the child to complete school work.
The school nurse is developing a teaching session for children in middle school. The nurse has determined that the greatest need for the overall health of the children is promotion of healthy foods. Which intervention is most likely to be effective?
Engage the students in healthy choices with food prep sessions.
The nurse is caring for an infant on oxygen therapy. The infant is on a continuous oxygen saturation monitor (pulse oximetry). The monitor alarms and indicates a value of 89%. Which of the following should the nurse do FIRST?
Ensure proper placement of the sensor probe.
The nurse is obtaining data for a routine assessment of the 8-month-old patient. Which of the following should the nurse collect during the assessment? Select all that apply.
Enter length and weight in the growth chart. Update the immunization record in the chart. Enter height and weight in the growth chart Measure the head circumference and record results.
The nurse is providing care to a hospitalized 1-year-old patient. The unit protocol requires infants to remain on the unit and wear a child abduction sensor at all times. The grandparents become angry about this because they want to take the infant outside for "some fresh air." What is the appropriate action by the nurse?
Explain to the grandparents that this is a required safety measure to prevent infant abduction throughout the hospital.
The clinic nurse receives a call from the parent of a child with type 1 diabetes. The parent is concerned about the child's therapeutic regimen since the child has a fever and decreased intake. Which of the following interventions is the priority for the nurse to include in the conversation?
Monitor your child's urine for ketones every 3-4 hours.
Which of the following nursing interventions is a priority when providing nursing care to an infant with a congenital heart defect?
Feeding small amounts frequently
Which of the following nursing interventions is a priority when providing nursing care to an infant with a congenital heart defect?
Feeding small amounts frequently Rationale: Babies with congenital heart disease typically do best when fed more often and on a demand schedule. They tend to tire quickly during the feeding, so frequent feedings tend to work well.
A parent reports that her school-age child has had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which of the following does the nurse suspect based on the parent's description?
Fifth disease (erythema infectiosum)
The nurse concludes a series of parenting classes on the topic of tantrums and discipline. Which comment by an attending parent causes the nurse concern?
He is content playing and then suddenly screams for no reason."
The nurse is providing education to the parents of a newborn diagnosed with a congenital heart defect. Which intervention is not appropriate for the newborn?
Holding newborn upright at a 90 degrees during feedings.
The nurse is developing a health fair for elementary school children. Which of the following would be appropriate topics for this population? Select all that apply.
How to prevent the u with hand washing How to choose and eat healthy foods How to recognize suicidal thoughts Play that promotes physical activity.
Which nursing diagnosis is priority for an infant with acute bronchiolitis due to respiratory syncytial virus (RSV)?
Ineffective Airway Clearance
The pediatric nurse educator is providing an educational in-service about pediatric growth and development to pediatric medical-surgical nurses. Which of the following statements should the nurse educator include in the learning event?
Infancy and adolescence are periods of rapid growth
The nurse is working in the pediatric clinic. A client comes into the clinic with a temperature of 102 degrees Fahrenheit, chapped lips, peeling skin on the hands and feet and a bright red tongue. The nurse anticipates the child will be diagnosed with which of the following medical conditions?
Kawasaki disease
The experienced nurse is teaching a new graduate nurse about the differences between hyperglycemia and hypoglycemia. For each symptom, identify if it is a clinical manifestation of hypoglycemia or hyperglycemia.
Ketones -Hyperglycemia (ketoacidosis) Diaphoresis -Hypoglycemia (Altered mental, confuse) Chills- Hypoglycemia (low sugar makes you cold) Rapid Respiration -hyperglycemia (high blood sugar makes your heart beat fast.
A child with type I diabetes presents to the emergency department unconscious. According to the client's mother, the child went to two birthday parties over the weekend and consumed a few pieces of birthday cake. What complication of diabetes is most likely in this case?
Metabolic ketoacidosis
During examination of a toddler's extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which of the following?
Normal because the lower back and leg muscles are not yet well developed
The elementary school nurse is promoting nutrition for the school-age population at the health fair. Which of the following is the most common nutrition concern in this age group?
Obesity
The nurse is preparing to perform an assessment on a toddler hospitalized for dehydration. Place the following steps in order from what the nurse would perform first to last when assessing the child.
Observe the child's skin color and general appearance Count the respirations Obtain the apical heart rate Unfasten the childs to view the perineal area and buttocks
The nurse is collecting data from a child and notices several bruises. Which of the following is the most appropriate action by the nurse?
Obtain a detailed history.
The nurse is teaching the parents of an infant about the transition from breast milk or formula to solid foods during infancy. Which of the following information should the nurse provide to the parents?
Once solid foods are introduced, they should be introduced one at a time, every 3-4 days.
Two children are playing in a hospital playroom together. One is playing with a doll while the other is with a large plastic truck. The mother of one of the children wants to know why the children are not playing together. The nurse explains to the mother this is what type of play?
Parallel play
The nurse is caring for a 6 month old infant who has been ordered clear liquids by mouth. Which of the following should the nurse select for the infant?
Pediatric oral electrolyte solution
The nurse is assessing a toddler with a history of congenital heart defect repaired at birth. Which clinical manifestation would be the most concerning?
Periorbital edema
The nurse is caring for an adolescent with suicidal ideation. Which of the following is the priority intervention for this child?
Place the child on 1:1 monitoring
The nurse is caring for a 14-month-old child on contact precautions. Which of the following is the most appropriate toy for the RN to provide to the child?
Plastic toy vacuum from the play room.
The nurse is developing interventions for a transgender adolescent based on the nursing diagnosis Decreased self-esteem related to transgender identity as evidenced by statements of feeling "worthless, different, and alone." What would be the most appropriate intervention based on the nursing diagnosis?
Provide information on resources and support groups for patient and family.
The nurse is caring for a child 24 hours after a tonsillectomy. Which of the following is an appropriate intervention for this child?
Provide pediatric electrolyte solution to drink.
The nurse is teaching the mom of a 2-year-old how to administer ear drops. Which of the following indicates understanding of the teaching?
Pull the pinna back and down to administer the drops
The nurse is admitting a child with autism spectrum disorder. Which of the following is the best nursing intervention for this child?
Reduce noxious environmental stimuli
A 3-year-old has been hospitalized for 3 days. He has started sucking his thumb and asking to be spoon fed his meals. This is an example of which of the following?
Regression
The nurse is providing care for a preschooler who is 5 years of age. The patient is hospitalized for treatment of a broken femur from a fall. Which behavior by the caregiver is of most concern to the nurse?
Remains adamant about staying with the child at all times Sign for possible abuse
The nurse is evaluating the language skills of a 2-year-old patient. Which assessment finding causes the nurse to suspect a developmental delay?
Repeats sounds but not words said by the nurse
The nurse is creating a plan of care for a child newly diagnosed with type 1 diabetes. Which of the following is the priority nursing diagnosis for this child?
Risk for Unstable Blood Glucose related to potential episodes of hypoglycemia and diabetic ketoacidosis Rationale: This can kill the patient the patient (1st physiological)
A community center is offering classes taught by pediatric nurses on summer safety for toddlers and preschoolers. Which topics will the nurses include in the teaching plan? Select all that apply
Safety near swimming areas Bicycle safety for riders or passengers Safety related to flotation devices Danger of leaving child unattended in a car Dangers of toys being left in a pool
The nurse is caring for a child with cystic fibrosis. Which of the following clinical manifestations are expected? Select all that apply
Steatorrhea Tenacious mucus production Cough
The nurse in the clinic is providing teaching to a child prescribed isotretinoin for acne. Which of the following should the nurse instruct the child to report immediately? Select all that apply.
Suicidal thoughts Violent behavior Acutane -use birth control
A school-aged child is prescribed methylphenidate for attention deficit hyperactivity disorder. Which of the following instructions will the nurse include in the teaching?
Take the medication early in the morning
A toddler recently diagnosed with a chronic condition is being discharged home on a maintenance medication. After the nurse teaches the family how to administer the medication, which of the following, by the mother demonstrates an understanding of how to properly administer the medication?
The mother draws up the medication in the syringe and administers to the child.
Which action, by the parents of a 16-month-old, indicate that they understand how to best minimize separation anxiety during their child's hospitalization?
The parents take turns staying with the child throughout the hospitalization.
A new mother is worried about a "soft spot" on the top of her newborn infant's head. The nurse informs her that this is a normal physical finding. Which phrase would the nurse include in the education?
This is the anterior fontanel, it will close between 12 to 18 months of age.
The nurse is preparing an 8-year-old patient for a cancer protocol that has a significant amount of risk. The parents have provided informed consent for this trial, but the patient has refused to partake in this research. What is the most appropriate course of action for this situation?
Treatment is canceled until the patient assents.
According to Erikson's theory of psychosocial development, identify the task the patient needs to accomplish before successfully mastering the state of development and progressing to the next one: Identity vs Role Confusion Industry vs Inferiority Trust vs Mistrust Autonomy vs Shame and Doubt Initiative vs guilt
Trust vs Mistrust- basic care and needs Autonomy vs shame & doubt - Initiative vs versus guilt - Enter school and have a sense of achievement Industry versus Inferiority- offices choices Identity versus Role Confusion- Experimentation and preoccupied with appearance
The nurse is obtaining data for a routine assessment of the 8-month-old patient. Which of the following should the nurse collect during the assessment? Select all that apply.
Update the immunization record in the chart. Enter length and weight in the growth chart. Enter height and weight in the growth chart. Measure the head circumference and record results
The nurse is teaching the parents of an infant with diaper dermatitis methods to reduce the irritation. Which of the following should not be included in the teaching session?
Use commercial baby wipes.
The nurse is teaching a mother and 10 year old patient who has asthma how to use a spacer attached to the handheld inhaler. Which of these provides the rationale for using a spacer?
Using a spacer ensures more medication is delivered to the lungs.
A mother brings her toddler to the clinic. The nurse notes the child has fluid-fluid-filled vesicles, honey colored crusts, and reddened areas around the mouth and axillae. The nurse should include which of the following statements when teaching the mother? Select all that apply
Wash your hands before and after applying the topical antibiotic. Your child has a bacterial infection that can be treated with topical antibiotics.
The nurse is caring for a child that is not toilet trained. The primary health care provider has ordered the measurement of intake and output. Which of the following is the most appropriate method to accurately assess output?
Weigh the diapers after each diaper change.
