Peds Test 1

A nurse is caring for a child who has epiglottitis. Which of the following actions should the nurse take? A. Obtain a throat culture B. Monitor oxygen saturation C. Use a warm mist humidifer in the childs room D. Place the child in the supine position

B. Monitor oxygen sturation Monitoring oxygen saturation is necessary to determine if the child is responding to treatment.

A nurse is assessing a 3-year-old child at a well-child visit. Which of the following findings should the nurse report to the provider? A. Blood pressure 88/46 mm Hg B. Respirations 30/min C. Urine specific gravity 1.018 mEq/L D. Heart Rate 110/min

B. Respirations 30/min

A nurs is planning care for a child who has glomerulonephritis and is edematous. Which of the following activities should be part of the plan of care? A. Monitor weight weekly B. Restrict sodium intake C. Administer IV bolus of 0.9% sodium chloride D. Maintain bed rest.

B. Restrict sodium intake A nurse should restrict sodium in a child who has glomerulonephritis and is edematous

A nurse is preparing an inservice on child maltreatment for a group of newly licensed nurses. Which of the following should the nurse include as a manifestation of physical abuse? A. Recurrent urinary tract infections B. Symmetric burns of the lower extremities C. Growth failure D. Lack of subcutaneous fat

B. Symmetric burns of the lower extremities The nurse should include in the teaching that symmetric burns of the lower extremities are a manifestation of physical abuse.

A nurse is performing a monthly assessment for a child who is taking methylhenidate. Which of the following is a manifestation that indicates an adverse effect of the medication? A. Mouth Ulcers B. Weight loss C. Tachypnea D. Oliguria

B. Weight loss

A nurse is caring for a school aged child who was diagnosed with asthma and reports chest pain. Which of the following actions should the nurse take first? A. Administer albuterol B. Apply oxygen C. Auscultate breath sounds D. Notify the provider

C. Auscultate breath sounds

A nurse is assessing a 4-year-old child. Which of the following developmental milestones should the nurse expect? A. Identifies right from left hand B. Uses a utensil to spread butter C. Cuts a shape using scissors D. Draws a stick figure with seven body parts

C. Cuts a shape using scissors A 4-year-old child should be able to use scissors to cut out a shape.

A nurse at an urgent care clinic is performing an admission assessment on a child. Which of the following should the nurse recognize as an early manifestation of pertussis? A. Inflamed throat with exudate B. Purulent eye drainage C. Dry, hacking cough D. Koplik spots on buccal mucosa

C. Dry, hacking cough A dry, hacking cough is an early manifestation of pertussis.

A nurse is caring for a child who is postoperative following a tonsillectomy. Which of the following should the nurse recognize as a sign of hemmorrhage? A. Decreased Pulse Rate B. Increased blood pressure C. Frequent swallowing D. Dark brown emesis

C. Frequent swallowing

A school-age child who was treated for a streptococcal throat infection is being admitted to the hospital with a diagnosis of acute rheumatic fever. Which of the following nursing interventions is appropriate? A. Limit sodium intake B. Restrict visitors C. Maintain bed rest D. Avoid salicylates

C. Maintain bed rest

A nurse is providing postoperative care to a 13 month old toddler following cleft palate repair. Which of the following interventions is appropriate for the nurse to take? A. Avoid the use of elbow restraints on the client B. Maintain the client in a supine position C. Prevent the client from using a pacifier D. Provide the client with a regular diet at time of discharge.

C. Prevent the client from using a pacifier A pacifier provieds only non-nutritive sucking, can damage suture line and poses risk for infection

A nurse is planning care for a toddler who has a serum lead level of 4 mcg/dL. Which of the following is an appropriate action for the nurse to take? A. Instruct the parents to decrease the calcium in their toddler's diet B. Prepare the toddler for chelation therapy. C. Schedule the toddler for a yearly re-screening. D. Refer the family to a child protective services.

C. Schedule the toddler for a yearly re-screening.

A nurse is caring for an adolescent undergoing a lumbar puncture. Which of the following results would confirm a diagnosis of bacterial meningitis? A. Decreased CSF pressure B. Decreased WBC's C. Increased protein D. Increased glucose

C. increased protein

A nurse is auscultating the lungs of a child who has pneumonia. listen to the audio clip below and identify the following sounds and the nurse is hearing and should document in clients medical record.

Crackles

A nurse is caring for an infant who is postoperative pyloric stenosis repair. Which of the following is an appropriate action for the nurse to take? A. Educate the parent about gastrostomy care B. Maintain stomach decompression with nasogastric suction. C. Thicken the infant's formula with rice cereal. D. Monitor the infant following feedings for vomiting.

D. Monitor the infant following feeding for vomiting

A school nurse is assessing a preschool-age child. Which of the following findings should the nurse identify as a potential finding of physical neglect? A. Mismatched clothing B. Separation anxiety C. Bruises on her shins D. Poor personal hygiene

D. Poor personal hygiene Poor personal hygiene in preschoolers is a sign of physical neglect, because children at this age are still dependent on their parents for hygiene needs.

A nurse is caring for an infant who has respiratory syncytial virus (RSV) and is in a mist tent. Which of the following actions should the nurse implement for infection control?

Have a designated stethoscope in the room. Contact precautions are implemented for RSV. Placing a designated stethoscope in the room will prevent transmission from one client to another.

A school nurse is developing a plan of care for a student who is newly diagnosed with juvenile idiopathic arthritis (JIA) Wich of the following should the nurse include in the plan?

Monitor students for presence of communicable diseases. Childhood illnesses can exacerbate JIA; therefore, it is important for the nurse to limit the child's exposure to communicable diseases.

A nurse is providing teaching to the parent of child who has impetigo. Which of the following instructions should the nurse include in the teaching?

Remove crust after soaking with 1:20 Burow's solution.

A nurse is planning to assess a 2-month-old infant who has pulmonary stenosis. Identify the area where a systolic ejection murmur can be heard the loudest?

The nurse should auscultate at the 2nd intercostal space at the left sternal boarder to hear the systolic ejection murmur the loudest

A hospice nurse is visiting a parent on the 1-year anniversary of death of his child from leukemia. Which of the following reactions by the parent would indicate to the nurse the need for bereavement counseling referral?

The parent has not returned to work. This is a symptom of complicated grief reaction, and should indicate to the nurse that a referral for bereavement counseling is appropriate.

A nurse is caring for a 3-year-old child who was administered pain medication. Which of the following pain scales is appropriate for measuring the client's response to the medication? A. Oucher B. Numeric C. Visual analog D. Word-graphic

A. Oucher This is the correct scale to use for a 3-year-old child.

A nurse is caring for a child who has a new diagnosis of Lyme disease. Which of the following findings is a manifestation of stage 1 of this disease? A. Skin rash B. Deafness C. Memory loss D. Encephalopathy

A. Skin Rash A skin rash is a maniffestation of stage 1 Lyme disease.

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should teach the parent to apply which of the following to the affected area? A. Zinc ocide B. Antibiotic ointment C. Talcum powder D. Antiseptic solution

A. Zinc oxide

A nurse is teaching an adolescent who has a new diagnosis of infectious mononucleosis. Which of the following client statements indicates an understanding of the teaching?

B. "I should take ibuprofen for me headaches." Treatments of infectious mononucleosis consist of symptom management. Acetomeniphen and Ibuprophen manage pain.

A nurse is performing a urine dipstick test on a child who has nephrotic syndrome. Which of the following results should the nurse expect? A. 1+ nitrates B. 4+ protein C. 3+ ketones D. 2+ blood

B. 4+ protein

A nurse is assessing a child who has appendicitis with possible perforation. The nurse should identify which of the following as a manifestation of peritonitis? A. Hyperactive bowel sounds B. Abdominal distention C. Bradycardia C. Polyuria

B. Abdominal distention Abdominal distention is a manifestation of peritonitis.

A nurse is caring for a child who has partial-thickness burns on more than 40% of his body. Which of the following fluids prescribed by the provider should the nurse administer to the child in the first 24 hours? A. 5% dextrose B. Lactated Ringer's C. Albumin D. Plasmalyte

B. Lactated Ringer's Crystalloid solutions, such as lactated Ringer's, minimize the fluid shift in the early state of burn recovery.

The mother of an adolescent tells a nurse that she argues frequently with her daughter about playing music while studying. Which of the following is an appropriate response for the nurse to make?

" Consider letting her make her own choice about listening to music while studying" This is an appropriate statement. It provides age-appropriate guidance to the parent by suggesting a technique that will address the developmental needs of the adolecent.

A nurse is teaching an adolescent about how to manage tinea pedis. Which of the following statements from the client indicates and understanding of the teaching?

"I should wear sandals as much as possible."

A nurse is providing discharge teaching to the parent of an 18 month old toddler who experienced dehydration. Which of the following statements by the parent should indicate to the nurse an understanding of the teaching?

"I will monitor my child's number of wet diapers." Monitorying the number of wet diapers per day is the appropriate way for the parent to monitor adequate output and hydration status.

A nurse is teaching a parent of a child who has pediculosis. Which of the following statements from the parent indicates an understanding of the teaching?

"I will need to remove the nits after treatment."

A nurse is working with a toddler who has cerebral palsy and is having trouble with verbal communication. Which of the following strategies should the nurse plan to use to promote effective communication (select all that apply) A. Use pictures and objects when talking to the child B. Encourage the child to move his lips and tongue when eating C. Speak to the child in a louder voice D. Allow the child time to articulate at his own pace. E. Discourage the child's use of voice-assistive equipment

A. B. (this will facilitate speach development) D.

A nurse in a pediatric unit is caring for a preschool-age child who has acute lymphocytic leukemia and severe stomatitis. Which of the following should the nurse include in the child's plan of care? A. Help the child bursh her teeth gently with a soft sponge toothbursh. B. Administer oral viscous lidocaine. C. Clean the child's mouth frequently with lemon glycerin swabs D. Have the child swish with a hydrogen peroxide solution.

A. Help the child brush her teeth gently with a soft sponge toothbursh.

A nurse is caring for a 6-year-old child who is receiving chemotherapy. Which of the following lab values should the nurse report to the provider? A. Hemoglobin 9.0 g/dL B. WBC count 9,500/mm 3 C. Hematocrit 40% D. Platelet count 300,000/mm3

A. Hemoglobin 9.0g/dL

During observation of children playing on a pediatric unit, a nurse notes a child begin to stare into space and grunt. The child's extremities then begin to extend stiffly. In what order should the nurse perform the steps listed below?

1. The child should be first lowered to the floor to prevent injury from falling. 2. Next, the nurse should place a pillow under the child's head to prevent injury. 3. Third, the nurse should loosen restrictive clothing to facilitate breathing efforts 4. Lastly, the child's mouth should be assessed for injuries that may have occurred during the seizure.

A nurse is preparing to administer cefazolin 25 mg/kg IV bolus to a school-age child who weighs 55 lb. Available is cefazolin injection 330 mg/mL. How many mL should th enurse administer per dose?

1.9 mL

A nurse is caring for a child who has nephrotic syndrome. Which of the following assessments should the nurse perform to confirm peripheral edema? A. Palpating dorsum of feet B. Weighing the child daily C. Measuring the child's skin turgor D. Observing for periorbital swelling

A. Palpating dorsum of feet

A nurse is caring for a toddler who has a foreign body aspiration. Which of the following is an appropriate action for the nurse to take? A. Prepare for an endoscopy B. Perform chest percussion C. Administer a bronchodilator D. Obtain a sputum culture.

A. Prepare for an endoscopy An endoscopy is used diagnostically and therapeuticaly to remove an aspired foreign body; therefore preparing for an endoscopy is an appropriate action for the nurse to take.

A nurse is assessing a 6-month old infant at a well-infant visit. Which of the following findings should the nurse report to the provider? A. Presence of strabismus B. Presence of corneal light reflex C. Presence of open anteriror fontanel D. Presence of cerumen

A. Presence of strabismus The nurse should report this finding to the provider. Strabismus disappears at 3-4 months of age.

A nurse is caring for a school-age-child who has heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan of care? A. Provide small, frequent meals B. Schedule time in the play room for the child C. Weigh the child weekly D. Perform hygiene activities for the child.

A. Provide small frequent meals

A nurse is caring for a child following surgery for an acute perforated appendix. Which of the following is an expected finding in the immediate postoperative period? A. Purulent nasogastric drainage B. Absence of peristalsis C. Pain at McBurney's point D. A WBC count of 6,000/mm3

B. Absence of peristalsis

A nurse is teaching a parent of a child who is receiving IV famotidine. The nurse should tell the parent that which of the following is an adverse effect of famotidine? A. Diaphoresis B. Bruising C. Hypotension D. Hyperkalemia

B. Bruising

A nurse is educating the parents of a toddler who will be discharged with a lower leg cast. The nurse should instruct the family that which of the following findings is important to report to the provider? A. Pruritus underneath the cast B. Inability to move the toes C. Swelling of the toes when the leg is dependent Toes that feel warm to the touch

B. Inability to move the toes An inability to move the toes is a sign of neurovascular damage and requires immediate notification to the provider.

A charge nurse is preparing a room assignment for a school-age child. Which of the following is the most important consideration when planning a room assignment? A. Length of stay B. Disease process C. Treatment schedule D. Self-care ability

B. Disease Process

A nurse is providing education to the family of a child who has juvenile idiopathic arthritis. Which of the following should the nurse include in the teaching? A. Limit the movement of large joints. B. Encourage the child to perform independent self-care C. Provide the child with a soft mattress D. Administer NSAIDs on an empty stomach.

B. Encourage the child to perform independent self-care It is important to encourage the child to perform independent self-care to minimize pain while maximizing mobility.

A nurse is caring for a child who has nephrotic syndrome. Which of the following findings is associated with this diagnosis? A. Constipation B. Hyperalbuminuria C. Weight loss D. Hypervolemia

B. Hyperalbuminuria

A nurse is caring for a preschool-age child who has been receiving IV fluids via a peripheral IV catheter. When preparing to remove the IV fluids and catheter, which of the following steps should the nurse perform first? A. Remove the tape. B. Turn off the pump C. Occlude the tubing. D. Apply pressure over the insertion site.

B. Turn off the pump This is the first step the nurse should take to remove a peripheral IV line.

A nurse is caring for a newborn who has a large sacral myelomeningocele. Prior to surgery, the nurse should prevent potential complications by: A. maintaining the newborn in a supine position. B. securing the newborn's diaper loosely C. keeping the newborn's legs abducted with a pad between the knees D. convering the newborn's unrepaired sac with a dry, adherent dressing

C. Kepping the newborn's legs abducted with a pad between the knees

A nurse is caring for a child who is newly prescribed methotrexate. Which of the following should the nurse obtain prior to administering the first dose? A. Arterial blood gases B. HbA1c C. Liver function tests D. Serum uric acid level

C. Liver function tests The nurse should obtain baseline liver function tests prior to the initial administration of this medication to rule out hepatic insufficiency.

A nurse is caring for a child who is in Bryant traction. Which of the following is an appropriate action for the nurse to take? A. Change the child's position every 2 hours B. Clean the pin sites with chlorhexidine solution every 4 hours C. Maintain the hips at a 90 degree angle to the body. D.Ensure that the head of the bed is maintained at a 45 degree angle.

C. Maintain the hips at a 90 degree angle to the body. Bryant traction is a 90 degree skin traction with the child's buttock slightly raised off the bed. Therefore this is an appropriate action for the nurse to take.

A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? A. Weight loss B. Bradycardia C. Peripheral edema D. Elevated blood pressure

C. Peripheral edema The nurse should expect peripheral edema due to systemic venous compression.

A nurse is planning care for a child following the application of a halo brace. Which of the following interventions should the nurse include in the plan of care? A. Apply pressure to the device when repositioning. B. Perform active range of motion of the head and neck. C. Adjust the device when bathing D. Provide pin site care.

D. Provide pin site care. Providing pin site care is an appropriate intervention to include in the plan of care.

A nurse is discussing food choices with the parent of a child who has celiac disease. Which of the following foods offered to the child by the parents is appropriate? A. White bread B. Oatmeal muffin C. Barley soup D. Rice pudding

D. Rice Pudding

A nurse is caring for a school-age child who is admitted with a poorly controlled seizure disorder. Which of the following should the nurse include in the plan of care? A. Place a padded tongue blade at the child's bedside. B. Maintain a well-lit room. C. Keep the head of the bed flat. D. Have oxygen available.

D. Have oxygen available

A nurse is providing teaching about growth hormone injections to the mother of a child who has growth hormone deficiency. Which of the following should the nurse include in the teaching? A. Administer the injections intradermally B. Sore reconstituted medication at room temperature C. Give the medication three times daily D. Have serum calcium levels drawn periodically

D. Have serum calcium levels drawn periodically The nurse should teach that serum calcium levels are drawn periodically while receiving growth hormones

A nurse is assessing a 7-month-old infant. Which of the following findings should the nurse report to the provider? A. inability to pull up from sitting to standing B. Inability to crawl on hands and knees C. Inability to respond to simple verbal commands D. Inability to babble one-syllable sounds

D. Babbleing one-syllable sounds this is developmentally appropriate for a 6-month old infant ; therefor the nurse should report this to the provider.

A nurse is assessing a toddler who has diarrhea. Which of the following findings should alter the nurse to worsening dehydration? A. Increased blood pressure B. Elastic skin turgor C. Urine output of 45 mL/hr D. Decreased tear production

D. Decreased tear production A decrease in tear production is a manifestation that indicates worsening dehydration.

A nurse is admitting a 4-month-old infant who has heart failure to the cardiac unit. which of the following findings is the highest priority? Temp: 37.5 HR: 70/min Resps: 30/min Birth weight: 3.2 kg (7lb) Current weight 6.3 kg (14lb) 3 episodes of vomiting 6 wet diapers in 24 hours Consumed 2 oz concentrated formula q4h Digoxin 0.5 mccg PO Q12H Furosemide 20 mg PO Q12 H

Three episodes of vomiting The greatest risk to this infant is digoxin toxicity. Three episodes of vomiting may indicate digoxin toxicity.

A nurse is providing discharge teaching about car seat use to the mother of a 6-month-old infant. Which of the following actions by the mother indicates a need for further teaching?

Using a blanket as padding underneath the infant while traveling This action by the mother indicates a need for additional teaching. Padding placed underneath the infant can compress and create space between the infant and the harness.