Peds Final Exam

The nurse has performed client teaching to a 15-year-old boy with Crohn disease, and his parents, regarding the cobblestone lesions in his small intestine. Which comment by the family indicates learning occurred? a. "I have to be careful because I am prone to not absorbing nutrients." b. "I have a lot of diarrhea every day because of how my small intestine is damaged." c. "I may end up with a colectomy because the disease is continuous from the beginning to the end of my intestines." d. "It's unusual for someone my age to get Crohn disease."

a. "I have to be careful because I am prone to not absorbing nutrients."

Which statement by the nurse accurately describes the term phenotype? a. "The individual's outward appearance" b. "The genetic makeup of an individual" c. "The somatic cells of an individual" d. "Only the homozygous genes outwardly expressed"

a. "The individual's outward appearance"

The nurse is educating parents of an toddler with Down syndrome. What would the nure include in the teaching plan? a. Have the child's thyroid function tested regularly b. Use a heating pad if the child reports neck pain c. The child should be meeting milestones the same as typical peers d. Plan to see a dentist when the child is in preschool to screen for extra teeth eruptions

a. Have the child's thyroid function tested regularly

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage tube patency? a. Monitor output. b. Allow tubes to dangle freely to encourage flow. c. Maintain fluid restriction. d. Provide a low-sodium diet.

a. Monitor output

What occurs in the gastrointestinal system of the child with Hirschsprung disease? a. There is a partial or complete mechanical obstruction in the intestine. b. There is a severe narrowing of the lumen of the pylorus. c. There is an invagination or telescoping of one portion of the bowel into a distal portion. d. There is a relaxed sphincter in the lower portion of the esophagus.

a. There is a partial or complete mechanical obstruction in the intestine.

A child with inflammatory bowel disease is started on an anti-inflammatory medication. Which item would the nurse teach the child/parent about being on this type of medication? Select all that apply. a. Use sunscreen and protective clothing while outside. b. Increase folic acid intake. c. Drink adequate fluids to avoid crystallization of sulfa in urine. d. Administer the medication just after meals to avoid GI irritation. e. Take the medication between meals to increase absorption.

a. Use sunscreen and protective clothing while outside.

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? a. prepare the infant for surgery b. medicate the infant with analgesics c. change the infant's diet to lactose-free d. assist in doing a barium enema procedure on the infant

a. prepare the infant for surgery

Biliary ____________ is an absence of some or all of the major biliary ducts, resulting in obstruction of bile flow.

atresia

Pervasive devlopmental disorder is another name for ______________________

autism spectrum

A client's mother asks the nurse, "When should my daughter have a pelvic examination?" Which response by the nurse is most appropriate? a. "A pelvic examination is not necessary until pregnancy." b. "A pelvic exam is necessary at 18 to 20 years of age." c. "A pelvic exam is necessary for girls in puberty." d. "As her mother, it is your choice when she should have a pelvic exam."

b. "A pelvic exam is necessary at 18 to 20 years of age."

A nurse is performing postoperative care on a child with a ureteral stent. Which intervention will help manage bladder spasms? a. Allow tubes to dangle freely to encourage flow. b. Encourage high fluid intake c. Increase low-fat foods. d. Apply antibiotic ointment to tube site.

b. Encourage high fluid intake

The nurse is examing a child with fetal alcohol syndrome (FAS). Which assessment finding should the nurse expect? a. Macrocephaly b. Low nasal bridge with short upturned nose c. Clubbing of fingers d. Short philtrum with thick upper lip

b. Low nasal bridge with short upturned nose

Purging is self-induced vomiting or evacuation of the ______________

bowel

The nurse is reviewing the health records for several children at a health clinic. Which child would the nurse expect to be newly diagnosed with an inborn error of metabolism? a. An adolescent male b. A female toddler c. A preschool male d. A newborn female

d. A newborn female

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? a. Surgery b. Upper endoscopy c. Endoscopic retrograde cholangiopancreatography d. Barium enema

d. Barium enema

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a. Sausage-shaped mass in the upper mid abdomen b. Perianal fissures and skin tags c. Abdominal pain and irritability d. Hard, moveable "olive-like mass" in the upper right quadrant

d. Hard, moveable "olive-like mass" in the upper right quadrant

The nurse is examing a 2 year old girl with VATER association. Which sign or symptom should be noted? a. Use of hearing aid b. Underdevekioed kabua c. Cleft in the iris d. History of corrective surgery for anal atresia

d. History of corrective surgery for anal atresia

The nurse is examining an 8 year old boy with chromosomal abnormalities. Which sign or symptom suggests the body has Angelman syndrome? a. Palpation discloses reduced muscular tonicity b. Observation reveals moonlike round face c. History shows surgery for cleft palate repair d. Observation shows jerky ataxic movement

d. Observation shows jerky ataxic movement

The nurse is caring for a teenager diagnosed with acute pancreatitis. Which order would the nurse question? a. NPO b. Nasogastric tube placed to suction c. Serum amylase levels d. PO pain management

d. PO pain management

Desmospressin is a medication commonly used to treat nocturnal

enuresis

Urodynamic studies measures the urine ____________ during micturition.

flow

Oral candidiasis is a ________________ infection of the oral mucosa.

fungal

The _________________ of an organism is its entire hereditary information encoded in the DNA.

genome

A creatinine (serum) clearance test is used to diagnose impaired ________________ function

glomerular

When a child receives different genes from the mother and father for the same trait, the child's genes are ____________________ and usually the dominant gene will be expressed.

heterozygous

Profuse menstrual bleeding

menorrhagia

A nurse is caring for a child with intellectual challenge. The medical chart indicates an IQ of 37. the nurse understands that the degree of disability is classifed as:

moderate

A disorder in which an adult meets her own psychological needs by having an ill child is known as _______________

munchausen

The physical appearance, or ___________________, is the expression of a dominant gene or two recessive genes.

phenotype

Vomiting is a reflex with three different phases. The first phase is the prodromal period, the second phase is ______________ , and the third phase is vomiting.

retching

Cytotoxic drugs cause bone marrow ______________

supression

Human chorionic gonadotropin is used to precipitate __________________ descent

testicular

Chronic diarrhea is diarrhea that lasts for more than ______________ weeks.

2

Bladder capaacity of the newborn is _____________

30 ml

For diagnosis of attention deficit/hyperactivity disorder (ADHD), the symptoms of impulsivity and hyperactivity begin before 7 years of age and must persist longer than ______________ months.

6

Significant decrease in urinary output

Oliguria

How will the urine appear after a bladder augmentation is done?

Should contain mucous

Trisomy 21 is a disorder caused by __________________ or an error in cell division during meiosis.

nondisjunction

Many times genes for the same trait have two or more _______________ or versions that may be expressed

alleles

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? a. Necrotizing enterocolitis b. Short-bowel/short-gut syndrome c. Intussusception d. Volvulus with malrotation

c. Intussusception

A _________________ is a long, continuous strand of DNA that carries gnetic information.

chromosome

Severe generalized edema

anasarca

Burns that appear in a ________________ or glove pattern are highly suspicious of inflicted burns.

stocking

To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take? a. Allow the child to ask questions about the procedure. b. Use an authoritarian manner to gain control. c. Do not allow the child to see the spoon approach the mouth. d. Use a repetitive series of movements.

d. Use a repetitive series of movements.

Close blood relationship, referred to as _________________, is a risk factor for genetic disorders.

cosanguinity

A 5-year-old child with acute renal failure develops hyperkalemia. When reviewing client orders for an antidote, which medication would the nurse select? a. Nifedipine b. Labetalol c. Furosemide d. Polystyrene sulfonate

d. Polystyrene sulfonate

The nurse is planning the discharge instructions for the parents of a 1-month old infant who has had a curcimcision completed. Which information should be included in the education provided? a. Use petroleum jelly on the ehad of the penis for the first 2 weeks after the procedure. b. Report any bleeding to the physician c. Reduce any bleeding to the physician d. Report redness or swelling on the penile shaft

d. Report redness or swelling on the penile shaft

A nurse is caring for a 12 year old girl recently diagnosed with end stage renal disease. The nurse is discussing dietary restrictions with the girl's mother. Which response indicates a need for further teaching? a. My daughter can eat what she wants when she is hooked ot the maching b. My daughter must avoid high sodium food c. She needs to restrict her potassium intake d. She can eat whatever she wants on dialysis days

d. She can eat whatever she wants on dialysis days

The nurse is discussing the treatment of congenital aganglionic megacolon with the caregivers of a child diagnosed with this disorder. Which statement is the best explanation of the treatment for this diagnosis? a. "The treatment for the disorder will be a surgical procedure." b. "Your child will be treated with oral iron preparations to correct the anemia." c. "We will give enemas until clear and then teach you how to do these at home." d. "Your child will receive counseling so the underlying concerns will be addressed."

a. "The treatment for the disorder will be a surgical procedure."

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD? a. A classroom with a plan of study that is followed each day b. A classroom with windows facing a playground c. A classroom in which children self-select their activities d. A classroom with tables and chairs rather than individual desks

a. A classroom with a plan of study that is followed each day

The nurse is conducting a physical examination of an 18-month-old with suspected intussusception. Which finding would the nurse identify as the hallmark of this condition? a. A sausage-shaped mass in the upper midabdomen b. skin tags c. Abdominal pain and guarding d. Skin tenting

a. A sausage-shaped mass in the upper midabdomen

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? a. Barium enema b. Surgery c. Upper endoscopy d. Endoscopic retrograde cholangiopancreatography

a. Barium enema

A nurse is assessing a child diagnosed with Sturge-Weber syndrome. What finding would the nurse expect to find when assessing the skin? a. Port wine stain b. Café-au-lait spots c. Tumors d. Pigmented nevi

a. Port wine stain

A nurse is assessing an infant who has been vomiting and experiencing diarrhea. Which findings would indicate to the nurse that the infant is experiencing severe dehydration? Select all that apply . a.Sunken fontanels b.Bradycardia c. Cool mottled extremities d. Pink moist oral mucosa e. Slightly decreased urine output

a. Sunken fontanels b. Bradycardia c. Cool mottled extremities

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? a. The VCUG will rule out vesicoureteral reflux. b. The VCUG will detect if the infection is gone. c. The VCUG will rule out kidney stones. d. The VCUG will prevent further complications of the urinary tract infection (UTI).

a. The VCUG will rule out vesicoureteral reflux.

The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which complications that signal refeeding syndrome? a. Cardiac arrhythmias, confusion, seizures b. Orthostatic hypotension and hypothermia c. Hypthermia and irregular pulse d. Bradycardia with ectopy and seizures

a. Cardiac arrhythmias, confusion, seizures

The labor and delivery nurse is caring for a mother who has demonstrated polyhydramnios upon delivery. The newborn displays copious, frothy bubbles of mucus in the mouth and nose, as well as drooling. The nurse is concerned that the infant has what disorder? a. Esophageal atresia b. Omphalocele c. Gastroschisis d. Hiatal hernia

a. Esophageal atresia

A nurse taking a health history of a newborn notes that there is a maternal history of polyhydramnios. What GI condition might this history precipitate? a. Esophageal atresia (EA) b. Cleft palate c. Pyloric stenosis d. Hernia

a. Esophageal atresia (EA)

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is mostaccurately related to the diagnosis of pyloric stenosis? a. A partial or complete intestinal obstruction occurs. b. A thickened, elongated muscle causes an obstruction at the end of the stomach. c. There are recurrent paroxysmal bouts of abdominal pain. d. In this disorder the sphincter that leads into the stomach is relaxed.

b. A thickened, elongated muscle causes an obstruction at the end of the stomach.

The nurse is inspecting a newborn wit trisomy 18. Which findings should the nurse expect? Select all that apply. a. Very small head b. Extra fingers or toes c. Major heart problem d. Webbed fingers and toes e. Low-placed ears

b. Extra fingers or toes d. Webbed fingers and toes e. Low-placed ears

The nurse is assessing a newborn boy. Which findings indicate the possibility of neurofibromatosis? Select all that apply. a. History shows a grandparent had neurofibromatosis b. Measurment shows a slightly larger head size c. Inspection discloses several cafe au lait spots on the trunk d. Observation reveals freckles on the lower extremities e. Assessment reveals abnormal curvature of the spine.

b. Measurment shows a slightly larger head size c. Inspection discloses several cafe au lait spots on the trunk e. Assessment reveals abnormal curvature of the spine.

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a. Explosive diarrhea b. Projectile vomiting c. Severe abdominal pain d. Frequent urination

b. Projectile vomiting

Which assessment finding would suggest that a child's postoperative feeding schedule following pyloric stenosis surgery should be slowed? a. Flatulence b. Vomiting c. Semiformed bowel movements d. Falling asleep at each feeding

b. Vomiting

The nurse is conducting a follow-up visit for a 13 year old girl who has been treated for pelvic inflammatory disease. which remark indicates a need for further teaching? a. "I should be tested for other sexually transmitted diseases." b. "douching is not necessary and can cause bacteria to flourish." c. " I cannot have sex again until my partner is treated." d. " My partner needs to be treated with antibiotics."

c. " I cannot have sex again until my partner is treated."