Peds proctor Review

A nurse is providing teaching to the parents of a preschooler who has heart failure and a new prescription for digoxin. Which of the following instructions should the nurse include in the teaching? A. Use kitchen teaspoons to measure the medication B. Brush child's teeth after giving medication C. Double the next dose if the child misses a dose D. Repeat the dose if the child vomits.

B. Brush child's teeth after giving medication Helps prevent tooth decay

A nurse is monitoring the oxygen saturation level of an infant using pulse oximetry. The nurse should secure the sensor to which of the following areas on the infant? A. Wrist B. Great toe C. Index finger D. Heel

B. Great toe (place on great toe with a fitted sock)

A nurse is teaching a school age child and their parent about postoperative care following cardiac catherization. Which of the following instructions should the nurse include? A. Stay home from school for 1 week following procedure B. Follow a diet that is low fiber for 1 week C. Wait 3 days before taking a tub bath D. Apply a pressure dressing to the site for 3 days

C. Wait 3 days before taking a tub bath A child should keep site clean and dry at least for 3 days to reduce risk of infection NOT D, apply a pressure dressing for 3 days because the pressure dressing is removed the day after procedure and apply a new adhesive bandage strip daily

A community health nurse is assessing an 18 month old toddler in a community day care. Which of the following findings should the nurse identify as a potential indication of physical neglect? A. Resists having an axillary temp taken B. Exhibits withdrawal behavior when their parents leave C. Has multiple bruises on their knees D. Poor personal hygiene

D. Poor personal hygiene

A nurse is reviewing the dietary choices of an adolescent who has iron deficiency anemia. The nurse should identify which of the following menu items has the highest amount of nonheme iron? A. 1/2 cup whole milk B. 1 cup of orange juice C. 1/2 cup of raisins D. 1 cup raw carrots

C. 1/2 cup of raisins

A charge nurse is preparing to make a room assignment for a newly admitted school age child. Which of the following considerations is the nurse's priority? A. Length of stay B. Treatment schedule C. Disease process D. Self care ability

C. Disease process

A nurse is planning care for a school age child who has a tunneled central venous access device. Which of the following interventions should the nurse include in the plan? A. use sterile scissors to remove the dressing from the site B. Irrigate each lumen weekly with 10mL of 0.9% sodium chloride solution when not in use C. Access the site using a noncoring angled needle D. Use a semipermeable transparent dressing to cover the site.

D. Use a semipermeable transparent dressing to cover the site.

A nurse is caring for a school age child who has diabetes mellitus and was admitted with a diagnosis of diabetic ketoacidosis. When performing the respiratory assessment, which of the following findings should the nurse expect? A. Deep respirations of 32/min B. Shallow respiratory of 10/min C. Paradoxic respirations of 26/min D. Periods of apnea lasting for 20 sec

A. Deep respirations of 32/min Kussmaul respirations (deep and rapid respirations are the body's attempt to eliminate excess carbon dioxide and achieve homeostasis)

A nurse is assessing the pain level of a 3 year old toddler. Which of the following pain assessment scale should the nurse use? A. FACES B. Numeric C. CRIES D. Visual analog

A. FACES

A nurse in an emergency department is assessing a toddler who has Kawasaki disease. Which of the following findings should the nurse expect? (SATA) A. Increased temp B. Gingival hyperplasia C. Xerophthalmia D. Bradycardia E. Cervical lymphadenopathy

A. Increased temp (acute illness associated with fever that is unresponsive to antipyretics) C. Xerophthalmia (Ophthalmic manifestation including reddening of conjunctiva and dryness of the eyes (xerophthalmia) E. Cervical lymphadenopathy (Enlarged cervical nodes on one side of the neck that are nontender) Kawasaki disease (KD), is a acutte febrile illness characterized by inflammation of blood vessels throughout the body

A nurse is assessing an adolescent who received a sodium polystyrene sulfonate enema. Which of the following findings indicates effectiveness of the medication? A. Report an absence of nausea and vomiting B. Reports experiencing an onset of loose stool within 15 min of administration C. Serum potassium level 4.1 D. Blood pressure 86/52

C. Serum potassium level 4.1 Sodium polystyrene enema is used to treat hyperkalemia by exchanging sodium ions for potassium ions in the intestines. Therefore, a potassium level within the expected reference range of 3.4 to 4.7 indicated effectiveness of

A nurse is planning care for a newly admitted school aged child who has generalized seizure disorder. Which of the following interventions should the nurse plan to include? A. Ensure that a padded tongue blade is at the child's bedside B. Allow the child to play video games on a tablet computer C. Allow the child to take a tub bath independently D. Ensure the oxygen source is functioning in the child's room.

D. Ensure the oxygen source is functioning in the child's room.

Hemophilia A Exhibit questions about anticipated and contraindicated provider prescriptions -Administer factor VIII -Apply ice pack to the affected joints -Administer morphine PRN pain -Perform passive range of motion -Elevate the affected joints

****Anticipated**** -Administer factor VIII -Apply ice pack to the affected joints -Administer morphine PRN pain -Elevate the affected joints ****Contra**** -Perform passive range of motion (it can increase bleeding into the joint)

A nurse is providing discharge teaching to the parent of a 6 month old infant who is postoperative following hypospadias repair with a stent placement. Which of the following instructions should the nurse include in the teaching? A. You may bathe your infants in an infants bathtub when you go home B. Apply hydrocortisone cream to your infants penis daily C. You should clamp your infants stent twice daily. C. You should clamp your infants stent twice daily D. Allow the stent to drain directly into your infants diaper

D. Allow the stent to drain directly into your infants diaper

A nurse is teaching the guardian of a 6 month old infant about teething. Which of the following statements should the nurse make? A. Your baby might pull at their ears when they are teething B. Rub your baby's gum with an aspirin to decrease discomfort C. Place a beaded teething necklace around your baby's neck D. Your baby's upper middle teeth will erupt first.

A. Your baby might pull at their ears when they are teething

A nurse is receiving change of shift report for four children. Which of the following children should the nurse assess first? A. A toddler who has a concussion and an episode of forceful vomiting? B. An adolescent who has infective endocarditis and reports having a headache C. An adolescent who has placed into halo traction 1 hr ago and reports pain as 6 on a scale of 0 to 10 D. A school aged child who has acute glomerulonephritis and brown colored urine.

A. A toddler who has a concussion and an episode of forceful vomiting?

A nurse is caring for school ages child who has primary nephrotic syndrome and is taking prednisone. Following 1 week of treatment, which of the following manifestations indicates to the nurse that the medication is effective? A. Decreased edema B. Increased abdominal girth C. Decreased appetite D. Increased protein in the urine

A. Decreased edema

A nurse is teaching the parents of a toddler who has cognitive impairment about toilet training. Which of the following instructions should the nurse include in the teaching? A. Scold your child when they have a toileting accident B. Award your child with a sticker when they sit on the potty chair C. Play your child's favorite song while teaching them to use the potty chair D. Teach multiple steps of the skills at the same time

B. Award your child with a sticker when they sit on the potty chair

A nurse is planning an educational program to teach parents about protecting their children from sunburns. Which of the following instructions should the nurse plan include? A. Allow your children to play outside during the hours between 10:00am and 2:00pm B. Choose a waterproof sunscreen with a minimum SPF of 15 C. Dress your child in loose weave polyester fabric prior to sun exposure D. Reapply sunscreen every 4 hours.

B. Choose a waterproof sunscreen with a minimum SPF of 15

A nurse in an emergency department is caring for school age child who has epiglottitis. Which of the following actions should the nurse take? A. Obtain a throat culture from the child B. Monitor the childs oxygen saturation C. Put a warm mist humidifier in the child's room D. Place the child in the supine position.

B. Monitor the child's oxygen saturation

A nurse is assessing a 6 month old infant during a well child visit. Which of the following findings should the nurse report to the provider? A. Presence of a central incisor tooth B. Presence of strabismus C. Presence of an open anterior fontanel D. Presence of external cerumen

B. Presence of strabismus (Crossing of the eyes typically disappears at 3 to 4 months. If not corrected early it can lead to blindness.

A nurse is providing discharge teaching to a guardian of a toddler who had a lower leg cast applied 24 hrs ago. The nurse should instruct the guardian to report which of the following findings to the provider? A. Cap refill less than 2 sec B. Restricted ability to move the toes C. swelling of the casted foot when leg is dependent D. Pedal pulse +3 bilateral

B. Restricted ability to move the toes It's a neurovascular compromise and requires immediate notification to provider. Perm muscle damage and tissue damage can occur in just a few hours.

A nurse is admitting an infant who has intussusception. Which of the following findings should the nurse expect? (SATA) A. Steatorrhea B. Vomiting C. Lethargy D. Constipation E. Weight gain

B. Vomiting (Due to obstruction) C. Lethargy (D/T severe pain leading to exhaustion and decreased nutritional intake) Intussusception is a form of bowel obstruction in which one segment of intestine telescopes inside of another S/S: Bloody stool, mucus filled, red jelly like diarrhea, weight loss

A nurse is caring for a 1 month old infant who is breastfeeding and requires a heel stick. Which of the following actions should the nurse take to minimize the infants pain? A. Use manual lancet to obtain the heel blood sample B. Apply an ice pack to the infants heel prior to obtaining the sample C. Allow the mother to breastfeed while the sample is being obtained D. Apply topical lidocaine cream prior to obtaining the sample.

C. Allow the mother to breastfeed while the sample is being obtained

A school nurse is caring for a child following a tonic clonic seizure. Which of the following actions should the nurse take first? A. Check the child for a head injury B. Observe for oral bleeding C. Check the child's respiratory rate D. Observe for extremity weakness.

C. Check the child's respiratory rate

A nurse is assessing a school aged child who has an infratentorial brain tumor. Which of he following findings should the nurse identify as a manifestation of increased intracranial pressure? A. Hypotension B. Reports insomnia C. Difficulty concentrating D. Tachycardia

C. Difficulty concentrating Other S/S: Hypertension Bradycardia

A nurse is assessing an 8 year old child who has early indications of shock. After establishing an airway and stabilizing the child's respirations, which of the following actions should the nurse take next? A. Insert an indwelling urinary catheter B. Measure weight and height C. Initiate IV access D. Maintain ECG monitoring.

C. Initiate IV access When using ABC the next best thing is establishing IV access to maintain the child's circulatory volume.

A nurse is caring for a newly admitted school aged child who has hypopituitarism. Which of the following medications should the nurse expect the provider to prescribe? A. Desmopressin B. Luteinizing hormone releasing hormone C. Recombinant growth hormone D. Levothyroxine

C. Recombinant growth hormone Recombinant growth hormone injections are used to treat hypopituitarism, which inhibits cell growth and results in growth failure. -Desmopressin is antidiuretic -LHRH is used for precocious puberty to slow down growth -Levothyroxine is used for hypothyroid

A nurse is discussing organ donation with the parent of a school age child who has sustained brain death due to bicycle crash. Which of the following actions should the nurse take first? A. Inform the parents that written consent is required prior to organ donation B. Provide written information to the parents about organ donation C. Ask the provider to explain misconceptions of organ donation to the parents D. Explore the parents feelings and wishes regarding organ donation

D. Explore the parents feelings and wishes regarding organ donation

A nurse is caring for a preschooler who has congestive heart failure. The nurse observes wide QRS complexes and peaked T wave on the cardiac monitor. Which of the following prescriptions should the nurse clarify with the provider? A. Furosemide B. Captopril C. Regular Insulin D. Potassium chloride

D. Potassium chloride Patient is having congestive heart failure. The patient is having manifestations of hyperkalemia and administering potassium will increase manifestations.

A nurse is caring for a school age child who has peripheral edema. The nurse should identify that which of the following assessments should be performed to confirm peripheral edema? A. Palpate the dorsum of the child's feet B. Weight the child daily using the same scale C. Assess the child's skin turgor D. Observe the child for periorbital swelling

A. Palpate the dorsum of the child's feet Peripheral edema is swelling of lower extremities or hands.

A nurse is caring for an infant who is receiving IV fluids for the treatment of Tetralogy of Fallott and begins to have a hypercyanotic spell. Which of the following actions should the nurse take? A. Place the infant in a knee chest position B. Administer a dose of meperidine IV C. Discontinue administration of IV fluids D. Apply oxygen at 2 L/min via nasal cannula.

A. Place the infant in a knee chest position

A nurse is planning developmental activities for a newly admitted 10 year old child who has neutropenia. Which of the following actions should the nurse plan to take? A. Provide the child with a book about adventures B. Arrange frequent visits from family members and peers C. Give the child a large piece puzzle D. Use puppets to entertain the child

A. Provide the child with a book about adventures

A nurse is creating a plan of care for a newly admitted adolescent who has bacterial meningitis. How long should the nurse plan to maintain the adolescent in droplet precaution? A. Until the adolescent is afebrile B. For 7 days following admission to the facility C. Until the adolescent has a negative blood culture D. For 24hrs following initiation of antimicrobial therapy.

D. For 24hrs following initiation of antimicrobial therapy.

A nurse is planning an educational program for school age children and their parents about bicycle safety. Which of the following information should the nurse plan to include? A. The child should be able to stand on the ball of their feet when sitting on the bike. B. The child should ride their bike 2 feet to the side of the other bike riders. C. The child should wear dark colored clothing with fluorescent stripes when riding at night D. The child should ride the bike facing traffic when it is necessary to ride in the street.

A. The child should be able to stand on the ball of their feet when sitting on the bike.

A nurse is providing dietary teaching to the guardian of a school age child which has cystic fibrosis. Which of the following statement should the nurse make? A. You should offer your child high protein meals and snacks throughout the day B. You should decrease your childs dietary fat intake to less than 10% of their calorie intake C. You should restrict your childs calorie intake to 1,200 per day D. You should give your child a multivitamin once weekly.

A. You should offer your child high protein meals and snacks throughout the day

A nurse in an emergency department is assessing a 3 month old infant who has rotavirus and is experiencing acute vomiting and diarrhea. Which of the following manifestations should the nurse identify as an indication that the infant has moderate to severe dehydration? A. Heart rate 124/min B. Increase tear production C. Sunken anterior fontanel D. Capillary refill 2 seconds

C. Sunken anterior fontanel Not A. HR 124/min because the Expected HR is 106 to 168 Not D. Cap refill 2 seconds. because the expected range is less than 3

A nurse is performing hearing screening for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? A. an 18 month old toddler who has unintelligible speech B. A 3 month old infant who has an exaggerated startle response C. A 4 year old preschooler who prefers playing with others rather than alone D. An 8 month old infant who is not yet making babbling sounds.

D. An 8 month old infant who is not yet making babbling sounds.

A nurse is providing discharge to the parents of a 3 month old infant following a cheiloplasty. Which of the following instructions should the nurse include? A. Clean your babys sutures daily with a mixture of chlorhexidine and water B. Expect your baby to swallow more than usual over the next few days C. Inspect your babys tongue for white patches using a tongue depressor every 8 hrs D. Apply a thin layer of antibiotic ointment on your baby's suture line daily for the next 3 days.

D. Apply a thin layer of antibiotic ointment on your baby's suture line daily for the next 3 days. Cheiloplasty is lip surgery.

A nurse is providing anticipatory guidance to the parent of a toddler. Which of the following expected behavior characteristics of toddlers should the nurse include? A.Controls impulsive feelings B. Understands right from wrong C. Easily separates from parents for long periods of time D. Expresses likes and dislikes

D. Expresses likes and dislikes

A nurse is teaching a group of parents about infectious mononucleosis. Which of the following statements by a parent indicates an understanding of the teaching? A. "Mononucleosis is caused by an infection with Epstein Barr virus" B. "Mononucleosis is a bacterial infection requiring 14 day of antibiotics" C. "A Monospot is a throat culture used to diagnose mononucleosis D. "Children who get mononucleosis will need to refrain from sports for 6 months"

A. "Mononucleosis is caused by an infection with Epstein Barr virus" It's not D. refrain from sports for 6 months because it should say 4 weeks or until splenomegaly has resolved.

A nurse is creating a plan of care for a preschooler who has Wilms tumor and is scheduled for surgery. Which of the following interventions should the nurse include? A. Avoid palpating the abdomen when bathing the child before surgery B. Refrain from auscultating the child's bowel sounds during the postoperative assessment C. Encourage the child to play with the other children on the unit prior to surgery D. Explain to the child that their pain will be managed after the surgery

A. Avoid palpating the abdomen when bathing the child before surgery The movement of the tumor before surgery can cause the cancer cells to spread to other sites.

A nurse is caring for a 10 year old child following a head injury. Which of the following findings should the nurse identify as an indication that the child is developing diabetes insipidus? A. Urine specific gravity 1.045 B. Sodium 155 C. Blood glucose 45 D. Urine output 35mL/hr

B. Sodium 155 ( a child with a head injury can develop diabetes insipidus as a result of pituitary hypofunction leading to a deficiency of antidiuretic hormones.) ----------------- RATTIONALES A. Urine specific gravity range is 1.005 to 1.030 and 1.045 is above expected range. A child w/ DI is more likely to have diluted urine and be below range C. blood glucose range is 70 to 110. 45 is below range and in DI it is expected to have a normal range D. urine output of 35ml/hr is within the expected range of 33 to 58mL/hr. In DI they are expected to have polyuria.

A nurse is planning care to address nutritional needs for a preschooler who has cystic fibrosis. Which of the following interventions should the nurse include in the plan? A. Administer pancreatic enzymes 2 hrs after meals B. Discontinue the use of pancreatic enzymes if steatorrhea develops C. Limit fluid intake to 750 mL per day D. Increase fat content in the child's diet to 40% of total calories

D. Increase fat content in the child's diet to 40% of total calories A child with CF is unable to properly digest fats d/t fibrosis of pancreas and limited secretions of pancreatic enzymes. ------------------ Rationales A. pancreatic enzymes should be administered within 30 min of meals to replace enzymes that are lost B. If a CF patient develops steatorrhea, the dosage of pancreatic enzymes need to be increased C. Never restrict fluids

A nurse is creating a plan of care for a school-age child who has varicella. Which of the following interventions should the nurse include? A. Maintain the child's room temp at 80F B. Prepare the child for a lumbar puncture? C. Administer aspirin to the child for a temp greater than 38.3 C (101F) D. Initiate airborne precautions for the child

D. Initiate airborne precautions for the child Varicella (chicken pox) is spread through droplet in the air.