Peds Test 5

Pataasin ang iyong marka sa homework at exams ngayon gamit ang Quizwiz!

When an infant with pyloric stenosis is admitted to the hospital, which of the following should the nurse do first? 1. Weigh the infant. 2. Begin an intravenous infusion. 3. Switch the infant to an oral electrolyte solution. 4. Orient the mother to the hospital unit.

1. Weigh the infant.

A neonate is fed 20 mL of formula every three hours by orogastric lavage. At the beginning of this feeding, the nurse aspirates 15 mL of gastric residual. Which action by the nurse is the most appropriate? 1. Withhold the feeding and notify the healthcare provider. 2. Replace the residual and continue with the full feeding. 3. Replace the residual but only give 5 mL of the feeding. 4. Withhold the feeding and check the residual in three hours.

1. Withhold the feeding and notify the healthcare provider.

our sick children with type 1 diabetes have been admitted to the hospital. Which child is most at risk of developing hypoglycemia? The child with: 1. bacterial sepsis. 2. intussusception. 3. jaundice. 4. chickenpox.

1. bacterial sepsis.

After teaching the mother of an infant with pyloric stenosis about the disease, which of the following, if stated by the mother as a cause, indicates effective teaching? 1. "An enlarged muscle below the stomach sphincter." 2. "A telescoping of the large bowel into the smaller bowel." 3. "A result of giving the baby more formula than is necessary." 4. "A result of my baby taking the formula too quickly."

1. "An enlarged muscle below the stomach sphincter."

Which of the following should the nurse assess in a newborn diagnosed with an anorectal malformation? Select all that apply. 1. Abdominal distension. 2. Loose stools. 3. Vomiting. 4. Meconium in the urine. 5. Meconium stools.

1. Abdominal distension. 3. Vomiting. 4. Meconium in the urine.

Which of the following would most likely alert the nurse to the possibility that a preschooler is experiencing moderate dehydration? 1. Absence of tear formation. 2. Decreased urine specific gravity. 3. Deep, rapid respirations. 4. Diaphoresis.

1. Absence of tear formation.

A school-age child visits a school nurse with complaints of dizziness and shaking. The nurse confirms that the child has a history of type 1 diabetes mellitus when the child becomes diaphoretic and begins to faint. What should be the nurse's first action? 1. Administer an injection of glucagon. 2. Activate EMS. 3. Squeeze glucose gel into the cheek. 4. Test the child's blood sugar.

1. Administer an injection of glucagon.

A 2-month-old infant with a cleft lip is transferred to the pediatric floor immediately following surgical repair of the defect. Which of the following interventions should the nurse perform? 1. Assess placement of the elbow restraints. 2. Assess placement of the gastrostomy tube. 3. Monitor the child for signs of hypokalemia. 4. Monitor the child for passage of tarry stools.

1. Assess placement of the elbow restraints.

A child is admitted with a tentative diagnosis of shigella. The nurse should do which of the fol- lowing? Select all that apply. 1. Assess the child for nausea and vomiting. 2. Collect a stool specimen for white blood cells (WBCs). 3. Place the child on strict isolation. 4. Monitor the child for signs and symptoms of dehydration. 5. Initiate an intake and output record.

1. Assess the child for nausea and vomiting. 2. Collect a stool specimen for white blood cells (WBCs). 4. Monitor the child for signs and symptoms of dehydration. 5. Initiate an intake and output record.

A 3-month-old child is being assessed in the emergency department. The child's laboratory results are: potassium 5.5 mEq/L and sodium 150 mEq/L. Which of the following is most likely the etiology of the child's results? 1. Baby is consuming concentrated formula that is not diluted with water. 2. Child has a cardiac defect. 3. Child has gastroenteritis. 4. Parent fed the baby large quantities of plain water on a hot summer day.

1. Baby is consuming concentrated formula that is not diluted with water.

Which of the following measures would be most effective in helping the infant with a cleft lip and palate to retain oral feedings? 1. Burp the infant at frequent intervals. 2. Feed the infant small amounts at one time. 3. Place the end of the nipple far to the back of the infant's tongue. 4. Maintain the infant in a lying position while feeding.

1. Burp the infant at frequent intervals.

Which of the following instructions should the nurse expect to include in the discharge teaching plan for the parent of an infant who has had an inguinal herniorrhaphy? 1. Change diapers as soon as they become soiled. 2. Apply an abdominal binder. 3. Keep the incision covered with a sterile dressing. 4. Restrain the infant's hands.

1. Change diapers as soon as they become soiled.

Which teaching tips should be included when instructing parents on hydrocortisone administration? Select all that apply. 1. Maintain prescribed administration times. 2. Never discontinue medication abruptly. 3. Injections might be necessary when unable to take by mouth. 4. Lower doses are needed during illness. 5. Keep an emergency kit with the child at all times.

1. Maintain prescribed administration times. 2. Never discontinue medication abruptly. 3. Injections might be necessary when unable to take by mouth. 5. Keep an emergency kit with the child at all times.

A nurse is providing education to 4 sets of parents whose children have been diagnosed with type 1 diabetes. The nurse should provide follow-up education to the parents who state that they will perform which of the following actions? 1. Parents of a 2-year-old: "We will have our daughter prick her finger for each glucose testing." 2. Parents of a 5-year-old: "We will give our daughter a code word that she will say when she feels a hypoglycemic episode developing." 3. Parents of a 9-year-old: "We will monitor our daughter as she draws up and administers her insulin injections." 4. Parents of a 17-year-old: "We will allow our daughter to take responsibility for all of her own diabetic care."

1. Parents of a 2-year-old: "We will have our daughter prick her finger for each glucose testing."

The nurse, who is assessing the blood gas results of a young child in the emergency department, notes that the Pco2 is elevated and that the pH is low. The nurse will check to see if the child's body has attempted to compensate for the disturbance by doing which of the following? 1. Raising the serum bicarbonate levels 2. Raising the serum oxygen levels 3. Raising the serum carbonic acid levels 4. Raising the serum potassium levels

1. Raising the serum bicarbonate levels

A child has been diagnosed with Hirschsprung's disease. Which of the following findings would the nurse expect the parents to report in the child's history? Select all that apply. 1. Ribbon-like stools 2. Chronic constipation 3. Black and tarry stools 4. Distended abdomen 5. Delayed meconium passage

1. Ribbon-like stools 2. Chronic constipation 4. Distended abdomen 5. Delayed meconium passage

The nurse provides home care instruction to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1. Rice 2. Oatmeal 3. Rye toast 4. Wheat bread

1. Rice

When developing the postoperative plan of care for an adolescent who has undergone an appendectomy for a ruptured appendix, in which of the following positions should the nurse expect to place the client during the early postoperative period? 1. Side-lying position on the right. 2. Side-lying position on the left. 3. Lithotomy position. 4. Supine.

1. Side-lying position on the right.

A one-month-old baby has been admitted to the pediatric unit with a diagnosis of pyloric stenosis. Which of the following assessments is highest priority for the nurse to report to the baby's primary health-care provider? 1. Sunken fontanel 2. Undigested emesis 3. Apical heart rate of 156 bpm 4. Serum potassium of 3.6 mEq/dL

1. Sunken fontanel

An infant is to be discharged after surgery for intussusception. In developing the discharge teaching plan, the nurse should tell the mother? 1. The infant will experience a change in the normal home routine. 2. The infant can return to the prehospital routine immediately. 3. The infant needs to ingest more calories at home than what was consumed in the hospital. 4. The infant will continue to experience abdominal cramping for a few days.

1. The infant will experience a change in the normal home routine.

The nurse is planning an in-service for new RNs who will be working on a general pediatric unit. Which statements are appropriate to include when discussing normal acid-base balance? Select all that apply. 1. The lungs are responsible for excreting excess carbonic acid from body. 2. The lungs reabsorb filtered bicarbonate. 3. The kidneys form bicarbonate if needed to restore balance. 4. The liver forms bicarbonate if needed to restore balance. 5. The liver synthesizes proteins needed to maintain osmotic pressure in the fluid compartments.

1. The lungs are responsible for excreting excess carbonic acid from body. 3. The kidneys form bicarbonate if needed to restore balance. 5. The liver synthesizes proteins needed to maintain osmotic pressure in the fluid compartments.

A parent of a newborn asks the nurse why a heel stick is being done on the baby to test for phenylketonuria (PKU). Which response by the nurse is the most appropriate? 1. This screening is required and detection can be done before symptoms develop. 2. The infant has high-risk characteristics. 3. Because the infant was born by cesarean, this test is necessary. 4. Because the infant was born by vaginal delivery, this test is recommended.

1. This screening is required and detection can be done before symptoms develop.

Monitor blood glucose every 3 hours, test urine for ketones, call if over 240, drink a glass of milk when I am feeling irritable

Type 1 DM

Give tsp of honey, prepare to admin glucagon

Type 1 DM 2 year-old

Encourage the child to drink fluids

Urine positive for ketones

An ophthalmologist recommends that a young girl with strabismus receive Botox (onabotulinumtoxinA) injections. The child's mother asks the nurse, "Why does my child need Botox injections? I thought only women who want to look younger get those." Which of the following responses by the nurse is appropriate? 1. "You are correct. The physician is recommending the injection so your daughter's eyes will no longer look different from other children's eyes." 2. "Botox is administered for many reasons. In this case, the medicine will weaken the muscles around the eye that are making your daughter's eye turn." 3. "Botox is administered for many reasons. The medicine is being recommended for your daughter in order to reduce her vision in her strong eye to make her use her weak eye." 4. "You are correct. Children with strabismus often develop wrinkles around the eye that is turned, so the doctor is prescribing the medicine to prevent those wrinkles from developing."

2. "Botox is administered for many reasons. In this case, the medicine will weaken the muscles around the eye that are making your daughter's eye turn."

A 7-month-old child who has yet to have a cleft palate repaired is saying a few words. The child's lip is intact. Which of the following words would the nurse expect the child to have the most difficulty saying? 1. "Ma ma" 2. "Da da" 3. "Ba ba" 4. "Pa pa"

2. "Da da"

An infant with Hirschsprung's disease is to be discharged 1 or 2 days after surgery to create a colostomy. After teaching the infant's parents about the overall effects of their infant's surgery, the nurse determines that the teaching has been effective when the parents state which of the following? 1. "His abdomen will be large for awhile." 2. "When he's ready, toilet training may be difficult." 3. "We need to limit his intake of dairy products." 4. "We will give him vitamin supplements until he is an adolescent."

2. "When he's ready, toilet training may be difficult."

The nurse is expecting the admission of a child with severe isotonic dehydration. Which intravenous fluid should the nurse anticipate the practitioner to order initially to replace fluids? 1. D5W 2. 0.9 percent Normal Saline (NS) 3. Albumin 4. D5 0.2 percent Normal Saline

2. 0.9 percent Normal Saline (NS)

A nurse is taking care of four different pediatric clients. Which client poses the great risk for dehydration? 1. 15-year-old working out in a weight room for an hour before football practice 2. 10-year-old playing baseball outdoors in 85 degree heat 3. 5-year-old refusing to eat because of a virus 4. A newborn under a radiant warmer for an hour after the first bath

2. 10-year-old playing baseball outdoors in 85 degree heat

In the morning, a nurse receives a report on four pediatric clients who have some form of fluid-volume excess. Which client should the nurse assess first? 1. A client with periorbital edema, normal respiratory rate 2. A client with tachypnea and pulmonary congestion 3. A client with dependent and sacral edema, regular pulse 4. A client with hepatomegaly, normal respiratory rate

2. A client with tachypnea and pulmonary congestion

A nurse is educating a young boy about the assessments required to make a diagnosis of growth hormone deficiency. Which of the following information should the nurse include in his or her teaching? 1. A biopsy of the child's testes will be conducted. 2. An x-ray of the child's wrists will be performed. 3. The child will have an MRI of his hypothalamus. 4. The child will receive IV dye for an adrenal fluoroscopy.

2. An x-ray of the child's wrists will be performed.

A child diagnosed with hypopituitarism is to begin receiving daily injections. At what time should a nurse instruct the child's parents to administer the injection each day? 1. Before breakfast. 2. At bedtime. 3. With lunch. 4. Any time the child prefers.

2. At bedtime.

Which of the following assessments should be the priority for an infant who has had surgery to correct an intussusception and is now at risk for development of a paralytic ileus postoperatively? 1. Measurement of urine specific gravity. 2. Auscultation of bowel sounds. 3. Inspection of the first stool passed. 4. Measurement of gastric output.

2. Auscultation of bowel sounds.

After teaching the parents of a child with celiac disease about diet, which of the following, if stated by the parents to be avoided, indicates effective teaching? (Select all that apply.) 1. Corn tortillas. 2. Bologna on rye sandwich. 3. White rice. 4. Chocolate candy. 5. Hot dogs.

2. Bologna on rye sandwich. 4. Chocolate candy. 5. Hot dogs.

A nurse is planning care for a child with hyperkalemia. Which clinical manifestation will the nurse plan to assessment this child for based on the diagnosis? 1. Seizures 2. Bradycardia 3. Respiratory distress 4. Hyperthermia

2. Bradycardia

A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take? 1. Keep NPO until the diarrhea subsides. 2. Initiate oral rehydration therapy. 3. Start hypertonic IV solution. 4. Offer chicken broth.

2. Initiate oral rehydration therapy.

A child with type 1 diabetes is being prepared for discharge from a hospital. What should a nurse include as part of the teaching regarding diabetes care? 1. Expect hypoglycemic episodes to always occur after meals. 2. Insulin dosage may need to be decreased during sports activities. 3. The child should not self-administer injections until the teen years. 4. Insulin should never be administered during febrile illnesses.

2. Insulin dosage may need to be decreased during sports activities.

When assessing a 4-month-old infant diagnosed with possible intussusception, the nurse should expect the mother to relate which of the following about the infant's crying and episodes of pain? 1. Constant accompanied by leg extension. 2. Intermittent with knees drawn to the chest. 3. Shrill during ingestion of solids. 4. Intermittent while being held in the mother's arms.

2. Intermittent with knees drawn to the chest.

The nurse is caring for a child on bed rest who has severe edema in a left lower leg due to blocked lymphatic drainage. Which is the priority diagnosis for this child? 1. Risk for Imbalanced Nutrition: Less Than Body Requirements 2. Risk for Impaired Skin Integrity 3. Risk for Altered Body Image 4. Risk for Activity Intolerance

2. Risk for Impaired Skin Integrity

The nurse notes that a girl, 8 years old, is exhibiting signs of precocious puberty. If left untreated, the nurse is aware that the young girl is at high risk for which of the following complications? 1. Plagiocephaly 2. Short stature 3. Infertility 4. Endometriosis

2. Short stature

When teaching the mother of an infant who has received a temporary colostomy for treatment of Hirschsprung's disease about how the stoma should normally appear, which of the following descriptions about the stoma's appearance should the nurse include in the teaching? 1. Becoming dark brown in 2 months. 2. Staying deep red in color. 3. Changing to several shades of pink. 4. Turning almost purple in color.

2. Staying deep red in color.

The nurse educator is preparing an in-service for new RNs hired on a general pediatric unit regarding normal fluid and electrolyte status for children at various ages. Which statements will the educator include about normal fluid and electrolyte status of an infant? Select all that apply. 1. The infant has 75% total body water. 2. The extracellular fluid accounts for 25% of total body water in the infant. 3. A high metabolic rate requires generous fluid intake for the infant. 4. The infants kidneys are mature and able to conserve water and electrolytes. 5. The infants high body surface area promotes fluid loss.

2. The extracellular fluid accounts for 25% of total body water in the infant. 3. A high metabolic rate requires generous fluid intake for the infant. 5. The infants high body surface area promotes fluid loss.

The nurse is educating a new mother of a child born with both a cleft lip and a cleft palate regarding formula feeding. Which of the following actions should the nurse include in her teaching session? Select all that apply. 1. Instruct the mother to add rice cereal to the formula. 2. Encourage the mother to cup feed her baby rather than to bottle feed. 3. Advise the mother to hold the baby in an upright position during feedings. 4. Advise the mother to feed the baby slowly to allow the baby time to swallow and to rest. 5. Notify the mother of the importance of giving the baby pain medicine before each feeding.

3. Advise the mother to hold the baby in an upright position during feedings. 4. Advise the mother to feed the baby slowly to allow the baby time to swallow and to rest.

When developing the plan of care for an infant with a cleft lip before corrective surgery is performed, which of the following should be a priority? 1. Maintaining skin integrity in the oral cavity. 2. Using techniques to minimize crying. 3. Altering the usual method of feeding. 4. Preventing the infant from putting fingers in the mouth.

3. Altering the usual method of feeding.

The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record? 1. Incessant crying 2. Coughing at nighttime 3. Choking with feedings 4. Severe projectile vomiting

3. Choking with feedings

What is the priority nursing diagnosis for an infant receiving treatment for hyperbilirubinemia? 1. Imbalanced body temperature. 2. Alteration in elimination. 3. Deficient fluid volume. 4. Interrupted family processes.

3. Deficient fluid volume.

The mother of a 6-year-old child who has type 1 DM calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquid. 4. Administer an additional dose of regular insulin.

3. Encourage the child to drink liquid.

An infant diagnosed with Hirschsprung's disease is scheduled to receive a temporary colostomy. When initially discussing the diagnosis and treatment with the parents, which of the following would be most appropriate? 1. Assessing the adequacy of their coping skills. 2. Reassuring them that their child will be fine. 3. Encouraging them to ask questions. 4. Giving them printed material on the procedure.

3. Encouraging them to ask questions.

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy. Which diuretic would the nurse expect to give? 1. Hydrochlorothiazide (Aquazide) 2. Spironolactone (Aldactone) 3. Furosemide (Lasix) 4. Mannitol (Osmitrol)

3. Furosemide (Lasix)

The nurse should implement which interventions for a child older than 2 years with type 1 DM who has a blood glucose level of 60 mg/dL (3.4 mmol/L)? Select all that apply. 1. Administer regular insulin 2. Encourage the child to ambulate 3. Give the child a tsp of honey 4. Provide electrolyte replacement therapy IV 5. Wait 30 seconds and confirm the blood glucose reading 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs

3. Give the child a tsp of honey 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs

A school-age client diagnosed with diabetes insipidus (DI) is admitted to the pediatric unit. Which laboratory value does the nurse anticipate for this client based on the diagnosis? 1. Hypoglycemia 2. Hyperglycemia 3. Hypernatremia 4. Hypercalcemia

3. Hypernatremia

An infant has just retuned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1. Prone position 2. On the stomach 3. Left lateral position 4. Right lateral position

3. Left lateral position

When the infant returns to the unit after imperforate anus repair, the nurse should place the infant in which of the following positions? 1. On the abdomen, with legs pulled up under the body. 2. On the back, with legs extended straight out. 3. Lying on the side with the hips elevated. 4. Lying on the back in a position of comfort.

3. Lying on the side with the hips elevated.

A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? 1. Diarrhea 2. Metabolic acidosis 3. Metabolic alkalosis 4. Hyperactive bowel sounds

3. Metabolic alkalosis

A 4-week old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of emesis. The nurse should anticipate that the infant's emesis would contain gastric contents and which of the following? 1. Bile and streaks of blood 2. Mucus and bile 3. Mucus and streaks of blood 4. Stool and bile

3. Mucus and streaks of blood

In assessing the reflexes of a 15-month-old child, which finding would indicate that the child is experiencing normal development? 1. Positive Babinski reflex. 2. Asymmetric tonic neck reflex. 3. Positive patellar reflex. 4. Presence of doll's eye reflex.

3. Positive patellar reflex.

When developing the preoperative plan of care for an infant with Hirschsprung's disease, which of the following should the nurse include? 1. Administering a tap water enema. 2. Inserting a gastrostomy tube. 3. Restricting oral intake to clear liquids. 4. Using povidone-iodine solution to prepare the perineum.

3. Restricting oral intake to clear liquids.

A child with type 1 diabetes mellitus has been diagnosed with ketoacidosis. Which of the following laboratory findings is consistent with the diagnosis? 1. Hemoglobin A1C: 5.5% 2. Fasting blood glucose: 124 mg/dL 3. Serum pH: 7.24 4. Potassium level: 3.9 mEq/L

3. Serum pH: 7.24

A baby, with a history of cystic fibrosis, is admitted to the emergency department. The baby is crying loudly and drawing his legs up toward his abdomen. A diagnosis of intussusception is made. Which of the following orders would the nurse expect to receive at this time? 1. To administer a corticosteroid medication 2. To prepare the baby for abdominal surgery 3. To prepare the baby for an air enema 4. To administer an antispasmodic medication

3. To prepare the baby for an air enema

A school nurse is monitoring the eating patterns of a child with celiac disease. The nurse counsels the child to choose an alternate lunch when the child picks which of the following foods to put on the lunch tray? 1. Corn taco with refried beans 2. Rice noodles with beef and broccoli 3. Turkey meatloaf with baked potato 4. Roast pork with applesauce

3. Turkey meatloaf with baked potato

A nurse is caring for a child who has short stature. Which of the following diagnostic test should be completed to confirm growth (GH) deficiency? Select all that apply. a. CT scan of the head b. Bone age scan c. GH stimulation test d. Serum IGF-1 e. DNA testing

a. CT scan of the head b. Bone age scan c. GH stimulation test d. Serum IGF-1

A nurse is caring for a child who suspected to have Enterobius vermicularis. Which of the following actions should the nurse take? a. Perform a tape test b. Collect stool specimen for culture c. Test the stool for occult blood d. Initiate IV fluids

a. Perform a tape test

A nurse is assessing an infant who has hypertrophic pyloric stenosis. Which of the following findings should the nurse expect? Select all a. Projectile vomiting b. Dry mucus membranes c. Currant jelly stool d. Sausage shaped abdominal mass e. Constant hunger

a. Projectile vomiting b. Dry mucus membranes e. Constant hunger

A nurse is teaching a group of parents about E. coli. Which of the following information should the nurse include in the teaching? Select all that apply. a. Severe abdominal cramping occurs b. Watery diarrhea is present for more than 5 days c. It can lead to hemolytic uremic syndrome d. It is a foodborne pathogen e. Antibiotics are given for treatment

a. Severe abdominal cramping occurs c. It can lead to hemolytic uremic syndrome d. It is a foodborne pathogen

A nurse is teaching a group of parents about salmonella. Which of the following information should the nurse include in the teaching? Select all that apply. a. Incubation period is nonspecific b. It is a bacteria infection c. Bloody diarrhea is common d. Transmission can be from pets e. Antibiotics care used for treatment

b. It is a bacteria infection c. Bloody diarrhea is common d. Transmission can be from pets

A nurse is caring for an infant who is postoperative following cleft lip and palate repair. Which of the following actions should the nurse take? a. Remove the packing in the mouth b. Place the infant in an upright position c. Offer a pacifier with sucrose d. Assess the mouth with a tongue blade

b. Place the infant in an upright position

After undergoing surgical correction of pyloric stenosis, an infant is returned to the room in stable condition. While standing by the crib, the mother says, "Perhaps if I had brought my baby to the hospital sooner, the surgery could have been avoided." Which of the following should be the nurse's best response? 1. "Surgery is the most effective treatment for pyloric stenosis." 2. "Try not to worry; your baby will be fine." 3. "Do you feel that this problem indicates that you are not a good mother?" 4. "Do you think that earlier hospitalization could have avoided surgery?"

4. "Do you think that earlier hospitalization could have avoided surgery?"

A 2-month-old infant with a cleft lip is transferred to the pediatric floor immediately following surgical repair of the defect. Which of the following interventions should the nurse perform? 1. Monitor the child for passage of tarry stools. 2. Assess placement of the gastrostomy tube. 3. Monitor the child for signs of hypokalemia. 4. Assess placement of the elbow restraints.

4. Assess placement of the elbow restraints.

After surgery to repair a tracheoesophageal fistula, an infant receives gastrostomy tube feedings. After feeding the infant by this method, the nurse cradles and rocks the infant for about 15 minutes, primarily to help accomplish which of the following? 1. Promote intestinal peristalsis. 2. Prevent regurgitation of formula. 3. Relieve pressure on the surgical site. 4. Associate eating with a pleasurable experience.

4. Associate eating with a pleasurable experience.

A school-age child with type 1 DM has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do. 1. Eat twice the amount normally eaten at lunchtime. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisin or drink a cup of orange juice before soccer practice.

4. Eat a small box of raisin or drink a cup of orange juice before soccer practice.

The nurse is evaluating an infants tolerance of feedings after a pyloromyotomy. Which finding indicates that the infant is not tolerating the feeding? 1. Need for frequent burping 2. Irritability during feeding 3. The passing of gas 4. Emesis after two feedings

4. Emesis after two feedings

The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led the mother to seek health care for the infant? 1. Diarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling ribbon-like stools

4. Foul-smelling ribbon-like stools

A school-age child with phenylketonuria is eating lunch. The child has the following foods on the lunch plate. Which of the food choices should the nurse question the child for choosing? 1. Buttered baked potato 2. Salted stringed beans 3. Stewed Bing cherries 4. Fried chicken legs

4. Fried chicken legs

An adolescent clients with type 1 DM is admitted to the emergency department for treatment of DKA. Which assessment findings should the nurse expect to note? 1. Sweating and tremors 2. Hunger and HTN 3. Cold, clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness

4. Fruity breath odor and decreasing level of consciousness

Immediately after the first oral feeding after corrective surgery for pyloric stenosis, a 4-week-old infant is fussy and restless. Which of the following actions would be most appropriate at this time? 1. Encourage the parents to hold the infant. 2. Hang a mobile over the infant's crib. 3. Give the infant more to eat. 4. Give the infant a pacifier to suck on.

4. Give the infant a pacifier to suck on.

When teaching the mother of an infant who has undergone surgical repair of a cleft lip how to care for the suture line, the nurse demonstrates how to remove formula and drainage. Which of the following solutions should the nurse use? 1. Mouthwash. 2. Povidone-iodine (Betadine) solution. 3. A mild antiseptic solution. 4. Half-strength hydrogen peroxide.

4. Half-strength hydrogen peroxide.

A nurse is teaching the parent of a child who has a growth hormone deficiency. Which of the following is not a complication related to untreated growth hormone deficiency? 1. Delayed sexual development 2. Premature aging 3. Short stature 4. Increased epiphyseal closure

4. Increased epiphyseal closure

A child with type 1 DM is brought to the ED by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. DKA is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of IV infusion? 1. Potassium infusion 2. NPH insulin infusion 3. 5% dextrose infusion 4. Normal saline infusion

4. Normal saline infusion

A 14-month-old child is in hospital post-op from repair of congenital esophageal atresia (anastomosis of the ends of the esophagus). It is important for the nurse to encourage the surgeon to order a referral for the child to which of the following health-care practitioners? 1. Speech therapist 2. Stoma nurse 3. Otolaryngologist 4. Occupational therapist

4. Occupational therapist

When teaching the parent of an infant with Hirschsprung's disease who received a temporary colostomy about the types of foods the infant will be able to eat, which of the following would the nurse recommend? 1. High-fiber diet. 2. Low-fat diet. 3. High-residue diet. 4. Regular diet.

4. Regular diet.

The nurse has just administer ibuprofen to a child with a temperature of 102 F (38.8 C). The nurse should also take which action? 1. Withhold oral fluids for 8 hours 2. Sponge the child with cold water 3. Plan to administer salicylate in 4 hours 4. Remove excess clothing and blankets from the child

4. Remove excess clothing and blankets from the child

The nurse is planning care for a pediatric client diagnosed with adrenal hyperplasia. Which nursing diagnosis is most appropriate for this client? 1. Impaired Social Interaction Related to Unnatural Facial Features 2. Nutrition: Less than Body Requirements due to Nausea and Vomiting 3. Depression Related to Inability to Take in Oral Fluids 4. Risk for Deficient Fluid Volume Related to Failure of Regulatory Mechanisms

4. Risk for Deficient Fluid Volume Related to Failure of Regulatory Mechanisms

The 6-year-old son of Mr. and Mrs. Peters is admitted to the healthcare facility with the diagnosis of idiopathic hypopituitarism. His height is measured below the third percentile and weight at the 40th percentile. Which of the following would be the first action of his attending nurse? A. Recommend orthodontic referral for underdeveloped jaw. B. Collaborate with a dietician to access his caloric needs. C. Provide for a tutor for his precocious intellectual ability. D. Place him in a room with a 2-year-old boy.

B. Collaborate with a dietician to access his caloric needs.

Will is being assessed by Nurse Lucas for possible intussusception; which of the following would be least likely to provide valuable information? A. Abdominal palpation B. Family history C. Pain pattern D. Stool inspection

B. Family history

Dustin who was diagnosed with Hirschsprung's disease has a fever and watery explosive diarrhea. Which of the following would Nurse Joyce do first? A. Administer an antidiarrheal. B. Notify the physician immediately. C. Monitor the child every 30 minutes. D. Nothing. (These findings are common in Hirschsprung's disease.)

B. Notify the physician immediately.

Nurse Lonnie is aware that the most common assessment finding in a child with ulcerative colitis is: A. Intense abdominal cramps B. Profuse diarrhea C. Anal fissures D. Abdominal distention

B. Profuse diarrhea

While Andres is being assessed at the clinic, Nurse Shiela observed that the child appears to be small, with an immature face and chubby body build. Her parents stated that their child's rate of growth of all body parts is somewhat slow, but her proportions and intelligence remain normal. As a knowledgeable nurse, you know that the child has a deficiency of which of the following? A. Antidiuretic hormone (ADH) B. Parathyroid hormone (PTH) C. Growth hormone (GH) D. Melanocyte-stimulating hormone (MSH)

C. Growth hormone (GH)

Remove excess clothing and blankets

Child with temp

Nurse Angelo admits a child with suspected type 1 DM; which should the nurse ask the parents? A. "Does the child complain of headache?" B. "How much exercise does the child get?" C. "Has the child's number and type of bowel movements changed?" D. "Has the child experienced nocturia or bedwetting?" E. "How much candy and sweets does your child take daily?"

D. "Has the child experienced nocturia or bedwetting?"

A child newly diagnosed with diabetes mellitus has been stabilized with insulin injections daily. A nurse prepares discharge teaching plan regarding the insulin. The teaching plan should reinforce which of the following concepts? A. Always keep insulin vials refrigerated B. Increase the amount of insulin before exercise C. Ketones in the urine signify a need for less insulin D. Systematically rotate injection sites

D. Systematically rotate injection sites

Steve is diagnosed with celiac disease and experiences celiac crisis secondary to upper respiratory tract infection; which of the following would Nurse Nancy expect to assess? A. Lethargy B. Weight gain C. Respiratory distress D. Watery diarrhea

D. Watery diarrhea

Dehydration, mental confusion, fruity breath, weight loss, blood glucose over 300

DKA

Fruity breath odor and decreasing LOC Give NS

DKA

4-5 injections in one area before switching

DM administration

Foul ribbon like stools

Hirschsprung's disease

Prepare the family for surgery Low fiber, high protein, high calorie diet

Hirschsprung's disease

A parent of a school-age child who has GH deficiency asks the nurse how long the child will need to take injections for growth delay. Which of the following responses should the nurse make?

Injections should be continued until there is evidence of epiphyseal closure

Bright red blood and mucous in stools

Intussusception

The nurse is showing the parent of a child with Hirschsprung's disease where the aganglionic area is located. Identify the area the nurse should point out as being aganglionic.

Lower sigmoid colon.

Projectile vomiting

Pyloric stenosis

Projectile vomiting Dry mucous membranes Constant hunger

Pyloric stenosis

The nurse in a preschool suspects that a 3-year-old child may have mild strabismus. Which of the following signs/symptoms exhibited by the child has the nurse noted? Select all that apply. 1. Eye squinting 2. Complaining of headaches 3. Eyeballs protruding from the eye socket 4. White reflex on ophthalmic examination 5. Moving from side to side when looking at pictures in a book

1. Eye squinting 2. Complaining of headaches 5. Moving from side to side when looking at pictures in a book

A pediatric client diagnosed with Turner syndrome tells the nurse, I feel different from my peers. Which response by the nurse is the most appropriate? 1. Tell me more about the feelings you are experiencing. 2. These feelings are not unusual and should pass soon. 3. You'll start to grow soon, so don't worry. 4. You seem to be upset about your disease.

1. Tell me more about the feelings you are experiencing.

When assessing an infant with suspected inguinal hernia, which of the following findings would be most significant? 1. The inguinal swelling is reddened, and the abdomen is distended. 2. The infant is irritable, and a thickened spermatic cord is palpable. 3. The inguinal swelling can be reduced, and the infant has a stool in the diaper. 4. The infant's diaper is wet with urine, and the abdomen is nontender.

1. The inguinal swelling is reddened, and the abdomen is distended.

A preschool-aged client, diagnosed with croup, has an increased pCO2, a decreased pH, and a normal HCO3 blood-gas value. Which documentation in the medical record is the most appropriate? 1. Uncompensated respiratory acidosis 2. Uncompensated respiratory alkalosis 3. Uncompensated metabolic acidosis 4. Uncompensated metabolic alkalosis

1. Uncompensated respiratory acidosis

The parents of a child, whose weight is 64 lb, are advised to make sure that the child consumes the minimum fluid needed to maintain a normal hydration status. The nurse calculates the amount for the full day. Please calculate the child's needs to the nearest whole number. _____ mL/day

1682 mL/day

A nurse suspects that a newly delivered baby has Down syndrome. The nurse noted that the baby exhibited which of the following physiological characteristics? Select all that apply. 1. Elongated face 2. Protruding tongue 3. Large, high-set ears 4. Wide, flat nasal bridge 5. Asymmetric Moro reflex

2. Protruding tongue 4. Wide, flat nasal bridge

Which of the following would indicate that an infant with a tracheoesophageal fistula (TEF) needs suctioning? 1. Brassy cough. 2. Substernal retractions. 3. Decreased activity level. 4. Increased respiratory rate.

2. Substernal retractions.

A 6-month-old has had a pyloromyotomy to correct a pyloric stenosis. Three days after surgery, the parents have placed their infant in his own infant seat. The nurse should do which of the following? 1. Reposition the infant to the left side. 2. Ask the parents to put the infant back in his crib. 3. Remind the parents that the infant cannot use a pacifier now. 4. Tell the parents they have positioned their infant correctly.

4. Tell the parents they have positioned their infant correctly.

Tara is an 11-year-old girl diagnosed with type 1 diabetes mellitus(DM). She asks her attending nurse why she can't take a pill rather than shots like her grandmother does. Which of the following would be the nurse's best reply? A. "If your blood glucose levels are controlled, you can switch to using pills." B. "The pills correct fat and protein metabolism, not carbohydrate metabolism." C. "Your body does not make insulin, so the insulin injections help to replace it." D. "The pills work on the adult pancreas, you can switch when you are 18."

C. "Your body does not make insulin, so the insulin injections help to replace it."

Mr. and Ms. Byers' child failed to pass meconium within the first 24 hours after birth; this may indicate which of the following? A. Celiac disease B. Intussusception C. Hirschsprung's disease D. Abdominal-wall defect

C. Hirschsprung's disease

Place the infant in an upright position

Cleft lip and palate repair

A child has recently been diagnosed with type 1 diabetes mellitus. Which of the following factors in his medical and family histories would the nurse expect to see? 1. Child's grandfather has been diabetic since childhood. 2. Child's body mass index is 30. 3. Child rarely engages in aerobic activities. 4. Child has recently gained 15 pounds.

1. Child's grandfather has been diabetic since childhood.

On the second postoperative day after repair of a cleft palate, which of the following should the nurse use to feed a toddler? 1. Cup. 2. Straw. 3. Rubber-tipped syringe. 4. Large-holed nipple.

1. Cup.

A nurse is preparing to care for a child with a diagnosis of intussusception prior to surgery. The nurse reviews the child's medical chart and expects to find documentation of which of the following symptoms? 1. Currant jelly-like stools 2. Watery diarrhea 3. Ribbon-like stools 4. Profuse projectile vomiting

1. Currant jelly-like stools

A child, who is frightened, is hyperventilating. Which of the following blood gas values would the nurse expect to see? Select all that apply. 1. Depressed Pco2 2. Depressed Po2 3. Elevated pH 4. Elevated HCO3 5. Base excess of 0

1. Depressed Pco2 3. Elevated pH

A child is admitted to the pediatric unit with a serum potassium level of 3.0 mEq/L. For which of the following complications should the nurse carefully monitor the child? 1. Dysrhythmias 2. Thirst 3. Seizures 4. Dry mucous membranes

1. Dysrhythmias

A young boy who has been diagnosed with growth hormone deficiency is to receive synthetic growth hormone. When providing medication teaching to the boy and his parents, which of the following information should the nurse include? 1. Educate the boy and his parents regarding the rationale for the administration of the subcutaneous injections. 2. Advise the boy to immediately report signs and symptoms of gynecomastia. 3. Advise the boy that he will reach his desired height if he takes the medication as ordered. 4. Educate the boy that to maintain his height, he will have to take the medication for the rest of his life.

1. Educate the boy and his parents regarding the rationale for the administration of the subcutaneous injections.

A 3-day-old preterm infant is diagnosed with necrotizing enterocolitis. The nurse plans care around the frequent radiographs. How frequently should the nurse anticipate that the radiology staff will bring the portable machine to the nursery? 1. Every 6 hours 2. Every 12 hours 3. Every 24 hours 4. Every 48 hours

1. Every 6 hours

The nurse is caring for a child who has just returned from surgery for repair of a cleft lip. In which order, from first to last, should the nurse do the following? 1. Maintain a clear and adequate airway. 2. Maintain sufficient fluid and caloric intake. 3. Provide emotional comfort to the child. 4. Apply elbow restraints. 5. Teach the parents proper feeding methods.

1. Maintain a clear and adequate airway. 4. Apply elbow restraints. 2. Maintain sufficient fluid and caloric intake. 3. Provide emotional comfort to the child. 5. Teach the parents proper feeding methods.

The nurse is planning care for pediatric clients who have diagnoses that impact the endocrine system. Which changes occurring during the school-age and adolescence have a direct impact on the endocrine system? Select all that apply. 1. Puberty 2. Adrenarche 3. Menarche 4. Sexual exploration 5. Risk-taking behavior

1. Puberty 2. Adrenarche 3. Menarche

Which conditions in children and/or adolescents should a nurse identify as being associated with metabolic alkalosis? Select all that apply. 1. Pyloric stenosis. 2. Diabetes. 3. Renal failure. 4. Bulimia nervosa. 5. Aspirin ingestion.

1. Pyloric stenosis.

An infant is born with an esophageal atresia and tracheoesophageal fistula. Which preoperative nursing diagnosis is the priority for this infant? 1. Risk for Aspiration Related to Regurgitation 2. Acute Pain Related to Esophageal Defect 3. Ineffective Infant Feeding Pattern Related to Uncoordinated Suck and Swallow 4. Ineffective Tissue Perfusion: Gastrointestinal, Related to Decreased Circulation

1. Risk for Aspiration Related to Regurgitation

The nurse is administering gastrostomy feedings to an infant after surgery to correct a trache- oesophageal fistula (TEF). To prevent air from entering the stomach once the syringe barrel is attached to the gastrostomy tube the nurse should: 1. Unclamp the tube after pouring the complete amount of formula to be administered into the syringe barrel. 2. Pour all of the formula to be administered into the syringe barrel after opening the clamp. 3. Maintain a continuous flow of formula down the side of the syringe barrel once the clamp is opened. 4. Allow a small amount of formula to enter the stomach before pouring more formula into the syringe barrel.

1. Unclamp the tube after pouring the complete amount of formula to be administered into the syringe barrel.

A young girl is experiencing precocious puberty. Which of the following patient-care goals would be appropriate for the nurse to include in the child's plan of care? The young girl will: Select all that apply. 1. Wear age-appropriate attire. 2. Shave axillary hair, as needed. 3. Not menstruate before age nine. 4. Have normal hormonal levels while receiving medication. 5. State an understanding of the need for daily oral medications.

1. Wear age-appropriate attire. 3. Not menstruate before age nine. 4. Have normal hormonal levels while receiving medication.

A child is admitted to the hospital with diarrhea, vomiting, and dehydration. One week earlier, the child weighed 5.6 kg. On admission to the hospital, the child weighs 4.9 kg. What percentage weight loss has the child experienced? Please calculate to the tenths place. _____%

12.5%

After completing diagnostic testing, the surgeon has scheduled a newborn with the diagnosis of an imperforate anus for surgery the next day. The infant's parents are Catholic and do not want the surgery to take place unless the infant has first been baptized. The nurse asks the parents: 1. "Are you worried your baby might die?" 2. "Do you want me to help arrange the baptism?" 3. "Do you want to speak with the social worker?" 4. "Would you prefer to wait for the surgery?"

2. "Do you want me to help arrange the baptism?"

An infant diagnosed with Hirschsprung's disease undergoes surgery with the creation of a temporary colostomy. Which of the following statements by the parent regarding the colostomy indicates the need for further teaching? 1. "The colostomy is only temporary." 2. "The colostomy will give time for the nerves to return to normal." 3. "The colostomy may include two separate abdominal openings." 4. "Right after the procedure the stoma may appear purple."

2. "The colostomy will give time for the nerves to return to normal."

The nurse advises the parents of a 11⁄2-year-old who is newly diagnosed with type 1 diabetes that the child's blood glucose level before dinner should be between 90 and 140 mg/dL. The mother states, "But that is much higher than I read on an Internet Web site." Which of the following responses by the nurse is appropriate? 1. "I am sorry, I was thinking of the level for after dinner. The correct before dinner level is 70 to 110 mg/dL." 2. "The level is higher than what you will usually see because young children's diets are not as predictable as the diets of older children and adults." 3. "The level before breakfast should be 70 to 100 mg/dL, but the before dinner level should be a higher level." 4. "You will find that your primary health-care provider will change the level at each visit. The goal starts at a high level and drops as your child responds to the insulin."

2. "The level is higher than what you will usually see because young children's diets are not as predictable as the diets of older children and adults."

After teaching the parents of a neonate diagnosed with a tracheoesophageal fistula (TEF) about this anomaly, the nurse determines that the teaching was successful when the father describes the condition as which of the following? 1. "The muscle below the stomach is too tight, causing the baby to vomit forcefully." 2. "There is a blind upper pouch and an opening from the esophagus into the airway." 3. "The lower bowel is lacking certain nerves to allow normal function." 4. "A part of the bowel is on the outside without anything covering it."

2. "There is a blind upper pouch and an opening from the esophagus into the airway."

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? 1. Allowing the client to administer all the insulin injections 2. Allowing the client to choose which finger to stick for glucose testing 3. Allowing the client to draw up the insulin dose 4. Allowing the client to test blood glucose

2. Allowing the client to choose which finger to stick for glucose testing

A nurse is performing the newborn screen for phenylketonuria. Which of the following actions is the nurse performing? 1. Sending cord blood from delivery to the hospital laboratory 2. Collecting blood from a heel stick on a two-day- old baby 3. Placing a urine collection bag on the one-day- old baby 4. Analyzing a baby's meconium stool under the microscope

2. Collecting blood from a heel stick on a two-day- old baby

An infant is hospitalized for congenital adrenal hyperplasia (CAH). Which medication should a nurse anticipate to be part of the child's treatment plan? 1. Insulin. 2. Cortisone. 3. Growth hormone. 4. Thyroid hormone.

2. Cortisone.

A baby was just born with a gastroschisis. Which of the following actions by the nurse is priority? 1. Inform the parents regarding the etiology of the defect. 2. Cover the defect with a moist, sterile dressing. 3. Administer intravenous antibiotics, as ordered. 4. Educate the parents regarding the surgical repair.

2. Cover the defect with a moist, sterile dressing.

When developing the plan of care for a neonate who was diagnosed with an anorectal malformation and who subsequently underwent surgery, which of the following would be most helpful in facilitating parent-infant bonding? 1. Explaining to the parents that they can visit at any time. 2. Encouraging the parents to hold their infant. 3. Asking the parents to help monitor the infant's intake and output. 4. Helping the parents plan for their infant's discharge.

2. Encouraging the parents to hold their infant.

Preoperatively, the nurse develops a plan to prepare a 7-month-old infant psychologically for a scheduled herniorrhaphy the next day. Which of the following should the nurse expect to implement to accomplish this goal? 1. Explaining the preoperative and postoperative procedures to the mother. 2. Having the mother stay with the infant. 3. Making sure the infant's favorite toy is available. 4. Allowing the infant to play with surgical equipment.

2. Having the mother stay with the infant.

The nurse is providing education to a group of student nurses regarding disorders of the endocrine system that may lead to short stature. Which disorder will the nurse exclude in the educational session? 1. Cushing syndrome 2. Hypoparathyroidism 3. Hypothyroidism 4. Growth hormone deficiency

2. Hypoparathyroidism

A mother brings her 3-week-old infant to a clinic for a phenylketonuria recreating blood test. The test indicates a serum phenylalanine level of 1 mg/dL (60.5 mcmol/L). The nurse reviews this result and makes which interpretation? 1. It is positive 2. It is negative 3. It is inconclusive 4. It requires prescreening at age 6 weeks

2. It is negative

A 6-month-old child, with a nursing diagnosis of excess fluid volume, is being seen by the nurse. Which of the following signs/symptoms would the nurse expect to see? 1. Sunken fontanel 2. Marked weight gain 3. Soft eyeballs 4. High urine specific gravity

2. Marked weight gain

A pediatric client is admitted to the hospital unconscious. The client has a history of type 1 diabetes, and according to the client's mother, has been to two birthday parties in the last few days and has resisted taking the prescribed insulin. At school the client had two more pieces of birthday cake and some ice cream at a class birthday party. What is the likely reason for this client's unconscious state? 1. Metabolic alkalosis 2. Metabolic ketoacidosis 3. Insulin shock 4. Insulin reaction

2. Metabolic ketoacidosis

A nurse is conducting a daily weight on a pediatric client diagnosed with diabetes insipidus and notes the child has lost two pounds in 24 hours. Which action by the nurse is the most appropriate? 1. Continue to monitor the child. 2. Notify the healthcare provider regarding the weight loss. 3. Chart the weight and report the loss to the next shift. 4. Do nothing more than chart the weight, as this would be a normal finding.

2. Notify the healthcare provider regarding the weight loss.

A couple is being discharged from the hospital with their 2-day-old Down syndrome baby. The nurse is providing discharge teaching. The nurse should include in the teaching information regarding which of the following physiological characteristics of the syndrome? 1. Small cerebral ventricles 2. Weak musculature 3. Inability to feel pain 4. Low glomerular filtration rate

2. Weak musculature

Which of the following would be the best activity for the nurse to include in the plan of care for an infant experiencing severe diarrhea? 1. Monitoring the total 8-hour formula intake. 2. Weighing the infant each day. 3. Checking the anterior fontanel every shift. 4. Monitoring abdominal skin turgor every shift.

2. Weighing the infant each day.

During physical assessment of a 4-month-old infant with Hirschsprung's disease, the nurse should most likely note which of the following? 1. Scaphoid-shaped abdomen. 2. Weight less than expected for height and age. 3. Cyanosis of the fingers and toes. 4. Hyperactive deep tendon reflexes.

2. Weight less than expected for height and age.

A baby who weighs 4.8 kg is in the hospital. The child's hydration status is within normal limits. The nurse is calculating the minimum volume of fluid the child needs per hour to maintain normal hydration status. Please calculate the baby's needs to the nearest whole number. ______mL/hr

20 mL/hr

A mother asks, "How should I bathe my baby now that he's had surgery for his inguinal hernia?" Which of the following instructions should the nurse give the mother? 1. "Clean his face and diaper area for 2 weeks." 2. "Use sterile sponges to cleanse the inguinal incision." 3. "Give him a sponge bath daily for 1 week." 4. "Give the infant full tub baths every day."

3. "Give him a sponge bath daily for 1 week."

A nurse is planning care for a child diagnosed with hyperkalemia. Which clinical manifestation will the nurse look for in this child based on the diagnosis? 1. Seizures 2. Respiratory distress 3. Bradycardia 4. Hyperthermia

3. Bradycardia

A child has fluid volume deficit. The nurse performs as assessment and determines that the child is improving and the deficit is resolving if which finding is noted? 1. The child has no tears 2. Urine specific gravity is 1.035 3. Capillary refill is less than 2 seconds 4. Urine output is less than 1 mL/kg/hr

3. Capillary refill is less than 2 seconds

The nurse is caring for a newborn with a suspected diagnosis of imperforate anus. The nurse monitors the infant, knowing that which is a clinical manifestation associated with the disorder? 1. Bile-stained fecal emesis 2. The passage of currant jelly-like stools 3. Failure to pass meconium stool in the first 24 hours after birth 4. Sausage-shaped mass palpated in the upper right abdominal quadrant

3. Failure to pass meconium stool in the first 24 hours after birth

A nurse is caring for an 18-month-old child who is admitted to the pediatric unit with a diagnosis of diarrhea and a weight loss of 4%. The nurse notes that the child's serum sodium and potassium levels are: 140 mEq/L and 4.8 mEq/L, respectively. Which of the following orders by the primary health-care provider would the nurse expect to receive? 1. Restriction of all dairy products. 2. Intravenous fluid with potassium added. 3. Feedings of oral rehydration therapy. 4. Bouillon soup for lunch and dinner.

3. Feedings of oral rehydration therapy.

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated? 1. Normal blood pressure; moist mucous membranes 2. No presence of tears; undetectable blood pressure. 3. Fontanels depressed; capillary refill greater than three seconds 4. Irritable, inconsolable; dry mucous membranes

3. Fontanels depressed; capillary refill greater than three seconds

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated? 1. Skin moist and flushed; mucous membranes dry 2. Low specific gravity of urine; skin color pale 3. Fontanels depressed; capillary refill greater than three seconds 4. High specific gravity of urine; moist mucous membranes

3. Fontanels depressed; capillary refill greater than three seconds

A baby, 12 hours old, in the neonatal intensive care unit, has been diagnosed with esophageal atresia with tracheoesophageal fistula. Which of the following assessments is the highest priority for the nurse to make? 1. Quantity of nasogastric secretions 2. Apical heart rate 3. Oxygen saturation levels 4. Weight of wet diapers

3. Oxygen saturation levels

A child is severely dehydrated from a diarrheal illness. The nurse assesses the child's laboratory results. Which of the following results would the nurse expect to find? 1. Hematocrit (Hct) 30% 2. Partial pressure of oxygen (Po2) 60 mm Hg 3. Potassium (K) 3.0 mEq/L 4. Platelet (Plt) count 100,000 cells/mm3

3. Potassium (K) 3.0 mEq/L

A nurse is admitting a baby to the newborn nursery who the nurse suspects may have congenital hypothyroidism. Which of the following findings has the nurse observed? Select all that apply. 1. Clubfeet 2. Cleft palate 3. Protruding tongue 4. Umbilical hernia 5. Imperforate anus

3. Protruding tongue 4. Umbilical hernia

The nurse is planning postoperative care for an infant after a cleft-lip repair. Which nursing intervention is most appropriate for this infant? 1. Prone positioning 2. Suctioning with a Yankauer device 3. Supine or side-lying positioning 4. Avoidance of soft elbow restraints

3. Supine or side-lying positioning

The parent of a 6-month-old calls the child's primary health-care provider and states, "My child has had 5 loose stools since she woke up this morning. What should I do?" The mother is exclusively breastfeeding her baby. Which of the following responses by the nurse is appropriate? 1. "Let's figure out what you may have eaten during the last day that could have caused the diarrhea." 2. "Continue to feed the baby breast milk and give oral rehydration therapy after each feeding." 3. "That's not that unusual for babies who are breastfed but do call again if the stools turn a green color." 4. "Bring the baby in for an appointment with the doctor so that we can weigh and check over the baby."

4. "Bring the baby in for an appointment with the doctor so that we can weigh and check over the baby."

After teaching the mother of a neonate who has successfully undergone surgery to repair a low anorectal anomaly, the mother indicates that she understands her child's prognosis when she states which of the following? 1. "My child will need to wear protective pads until puberty." 2. "My child will need extra fluids to prevent constipation." 3. "My child will probably always need a high-fiber diet." 4. "My child has a good chance of being potty trained."

4. "My child has a good chance of being potty trained."

The school nurse is responsible for caring for a number of school children with type 1 diabetes. Before which of the following activities should the nurse make sure a child consumes a snack? The child who: 1. sculpts in art class. 2. plays in the band. 3. acts in the school play. 4. plays on the soccer team.

4. plays on the soccer team.

The nurse is completing the intake and output record for a preschool-age client admitted for fluid volume deficit. The client has had the following intake and output during the shift: Intake: 4 oz of Pedialyte 1/2 of an 8-oz cup of clear orange Jell-O 2 graham crackers 200 mL of D 5 sodium chloride IV Output: 345 mL of urine 50 mL of loose stool The nurse documents the clients intake as ____ milliliters. Round the answer to the nearest whole number.

440

A neonate, 3,377 grams, has been diagnosed with congenital hypothyroidism. The neonatologist has ordered Synthroid (levothyroxine sodium) to be administered orally once each day beginning today. The recommended dosage of the medication is: infants and neonates birth to 3 months: 10 to 15 mcg/kg PO daily. Please calculate the safe maximum dosage of the medication for this neonate. If rounding is needed, please round to the nearest hundredths place. ________ mcg PO daily.

50.66 mcg PO daily

A one-month-old baby, 8 lb 4 oz, is in the hospital with a diagnosis of pyloric stenosis. The nurse is carefully assessing the child's intake and output. Please calculate the minimum urinary output the baby should excrete per hour. Please calculate to the nearest tenth. ______ mL/hr

7/5 mL/hr

A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7 percent of the normal body weight. The nurse is double-checking the IV rate the practitioner has ordered. The formula the practitioner used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 cc for every kg over 10 for 24 hours. Replacement fluid is the percentage of lost body weight 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, this child's hourly IV rate for 24 hours should be ____ mL. Round the answer to the nearest whole number.

86

Nurse Aries entered the room of a child with hypopituitarism and was asked by the couple about the condition of their child. Which of the following phrases if stated by the nurse best describes the condition? A. Linear growth retardation with skeletal proportions normal for chronologic age B. A complete normal growth pattern, but with the onset of precocious puberty C. Normal growth for first five years, followed by progressive linear growth retardation D. Growth retardation in which height and weight are equally affected

A. Linear growth retardation with skeletal proportions normal for chronologic age

Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following? A. The child should be allowed to play because doing so can foster healthy self-esteem. B. The risk for fractures is increased because a GH deficiency results in fragile bones. C. Activity could aggravate insulin sensitivity, causing hyperglycemia. D. Activity would aggravate the child's joints, already over tasked by obesity.

A. The child should be allowed to play because doing so can foster healthy self-esteem.

Katie is admitted to the intensive care unit of Nurseslabs Medical Center for diabetic ketoacidosis; which of the following is of primary importance when caring for the child? A. Giving I.V. NPH insulin in high doses B. Evaluating the child for cardiac abnormalities C. Limiting fluids to prevent aggravating cerebral edema D. Monitoring and recording the child's vital signs for hypertension

B. Evaluating the child for cardiac abnormalities

Nurse Angelo is attending for a child with Cushing's syndrome; which of the following nursing interventions would be most necessary? A. Observing the child for signs and symptoms of metabolic acidosis B. Handling the child carefully to prevent bruising C. Monitoring vital signs for hypertension and tachycardia D. Monitoring the child for signs and symptoms of hypoglycemia

B. Handling the child carefully to prevent bruising

Baby Ellie is diagnosed with gastroesophageal reflux (GER); which of the following nursing diagnoses would be inappropriate? A. Risk for aspiration B. Impaired oral mucous membrane C. Deficient fluid volume D. Imbalanced nutrition: Less than body requirements

B. Impaired oral mucous membrane

Which of the following parameters would Nurse Max monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageL REFLUX (GER)? A. Urine B. Vomiting C. Weight D. Stools

B. Vomiting

An 11-year-old girl with celiac disease was discharged from the hospital. An appropriate teaching was carried out by the nurse if the parents are aware of avoiding which of the following? A. Chicken B. Wheat C. Milk D. Rice

B. Wheat

Mrs. Byers tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother? A. Make the child seat with the family in the dining room until he finishes his meal B. Provide quiet environment for the child before meals C. Do not give snacks to the child before meals D. Put the child on a chair and feed him

C. Do not give snacks to the child before meals

Nurse Karen is providing postoperative care for Dustin who has cleft palate (CP); she should position the child in which of the following? A. In an infant seat B. In the supine position C. In the prone position D. On his side

C. In the prone position

Baby Jonathan was born with cleft lip (CL); Nurse Barbara would be alert that which of the following will most likely be compromised? A. GI function B. Locomotion C. Sucking ability D. Respiratory status

C. Sucking ability

Left lateral position

Cleft lip repair

Delayed sexual development Premature aging Short stature Delayed epiphyseal closure Retarded bone age

Complications of untreated GH deficiency

CT scan of the head Bone age scan GH stimulation test Serum IGF-1

Confirm GH deficiency

Cool extremities Short neck Excessive sleep Enlarged tongue Poor sucking, jaundice, hypotonia

Congenital hypothyroidism

Which of the following should the nurse include in the insulin administration instruction for the parents of a child being discharged on insulin? A. Insert the needle and aspirate prior to injecting B. Inject insulin into the extremity to be exercised to enhance absorption C. The muscles in the abdomen and thigh are the easiest to use for self administration D. Clean the site of injection with soap and water and avoid alcohol

D. Clean the site of injection with soap and water and avoid alcohol

Choking with feedings

Esophageal atresia

Proportional height to weight

Findings to indicate a growth hormone deficiency

Cap refill less than 2 seconds

Fluid volume deficit improving

Offer frequent feedings, thicken formula with rice cereal, position baby upright after feedings

GERD

Thicken feedings by adding rice cereal to formula

GERD

Provide low fat well balanced diet, teaching hand washing techniques, avoid administering medications unless prescribed

Hepatitis

Continued until there is evidence of epiphyseal closure

How long to give GH injections

Increased urination, dehydration, kussmaul respirations

Hyperglycemia manifestation

Check the amount of urine output

Hypotonic dehydration

Failure to pass meconium stools in the first 24 hours after birth

Imperforate anus

Abdominal pain, mucous bloody stools

Meckel's diverticulum

A nurse is assessing a child who has short stature. Which of the following findings would indicate GH deficiency?

Proportional height to weight

3. A nurse assessing a child who has rotavirus infection. Which of the following are expected findings? Select all that apply. a. Fever b. Vomiting c. Watery stools d. Bloody stools e. Confusion

a. Fever b. Vomiting c. Watery stools

A nurse is teaching a parent of an infant about gastrointestinal reflux disease. Which of the following should the nurse include in the teaching? Select all a. Offer frequent feedings b. Thicken formula with rice cereal c. Position baby upright after feedings

a. Offer frequent feedings b. Thicken formula with rice cereal c. Position baby upright after feedings

A nurse is teaching an adolescent who has diabetes mellitus about manifestations of hypoglycemia. Which of the following findings should the nurse include in the teaching? Select all that apply. a. Increased urination b. Hunger c. Signs of dehydration d. Irritability e. Sweating and pallor f. Kussmaul respiration

b. Hunger d. Irritability e. Sweating and pallor

A nurse is caring for a child who has had watery diarrhea for the past 3 days. Which of the following is an appropriate action for the nurse to take? a. Offer chicken broth b. Initiate oral rehydration therapy c. Start hypertonic IV solution d. Keep NPO until the diarrhea subsides

b. Initiate oral rehydration therapy

An infant born with an omphalocele defect is admitted to the intensive-care nursery. Which instruction from the nurse manager to the unlicensed assistive personnel is most appropriate? 1. Prepare a warmer. 2. Prepare a crib. 3. Prepare a feeding of formula. 4. Prepare the bilirubin light.

1. Prepare a warmer.

When teaching an adolescent scheduled for an appendectomy about what to expect, which of the following approaches would be most effective? 1. Offering advice and opinions as needed. 2. Using age-appropriate jargon with explanations. 3. Using diagrams when explaining procedures. 4. Providing the primary essential information.

3. Using diagrams when explaining procedures.

An 11-month-old child is seen in the primary health-care practitioner's office with a chief complaint of loose stools. The child's temperature, heart rate, and respiratory rate are: 98.9°F, 148 bpm, and 46 rpm, respectively. Which of the following factors places this child at high risk for the nursing diagnosis: Deficient Fluid Volume? The child's: (Select all that apply.) 1. Age. 2. Heart rate. 3. Temperature. 4. Chief complaint. 5. Respiratory rate.

1. Age. 2. Heart rate. 4. Chief complaint. 5. Respiratory rate.

The nurse is caring for a school-age client who had an appendectomy after a ruptured appendix. Which orders does the nurse anticipate for this client? Select all that apply. 1. Antibiotics 2. A clear liquid diet 3. NG tube 4. Vital signs every 4 hours 5. Frequent monitoring of bowel sounds

1. Antibiotics 3. NG tube 4. Vital signs every 4 hours 5. Frequent monitoring of bowel sounds

A nasogastric tube inserted during surgery to correct an infant's intussusception is no longer freely removing gastric secretions. Which of the following should the nurse do next? 1. Aspirate the tube with a syringe. 2. Irrigate the tube with distilled water. 3. Increase the level of suction. 4. Rotate the tube.

1. Aspirate the tube with a syringe.

A 7-year-old child is hospitalized for a tonsillectomy. What are priority nursing actions when caring for this child after surgery? Select all that apply. 1. Advancing diet as tolerated. 2. Encouraging coughing to clear the throat. 3. Monitoring PT and PTT. 4. Administering pain medication around the clock. 5. Suctioning mouth and throat frequently.

1. Advancing diet as tolerated. 3. Monitoring PT and PTT. 4. Administering pain medication around the clock.

A newborn admitted with pyloric stenosis is lethargic and has poor skin turgor. The primary care provider has ordered I.V. fluids of dextrose water with sodium and potassium. The baby's admission potassium level is 3.4 Meq/L. The nurse should: 1. Notify the primary care provider. 2. Administer the ordered fluids. 3. Verify that the infant has urinated. 4. Have the potassium level redrawn.

3. Verify that the infant has urinated.

After teaching the parent of an infant who has had a surgical repair for a cleft lip about the use of elbow restraints at home, the nurse determines that the teaching has been successful when the parent states which of the following? 1. "We will keep the restraints on continuously except when checking the skin under them for redness." 2. "We will keep the restraints on during the day while he is awake, but take them off when we put him to bed at night." 3. "After we get home, we won't have to use the restraints because our child does not suck on his hands or fingers." 4. "We will be sure to keep the restraints on all the time until we come to see the physician for a follow-up visit."

1. "We will keep the restraints on continuously except when checking the skin under them for redness."

When obtaining the nursing history from the mother of an infant with suspected intussusception, which of the following questions would be most helpful? 1. "What do the stools look like?" 2. "When was the last time your child urinated?" 3. "Is your child eating normally?" 4. "Has your child had any episodes of vomiting?"

1. "What do the stools look like?"

After surgery to correct pyloric stenosis, the nurse instructs the parents about the postoperative feeding schedule for their infant. The parents exhibit understanding of these instructions when they state that they can start feeding the child within which of the following time frames? 1. 6 hours. 2. 8 hours. 3. 10 hours. 4. 12 hours.

1. 6 hours.

Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate? 1. A higher-concentrated formula could lead to dehydration because of high sodium content; lets discuss other strategies. 2. An undiluted formula concentrate could be given to help the child gain weight; lets look at brands. 3. Evaporated milk could be given to the infant instead of the current formula youre using. 4. A higher-concentrated formula could be given for daytime feedings; lets work on a schedule.

1. A higher-concentrated formula could lead to dehydration because of high sodium content; lets discuss other strategies.

A nurse is working with a nursing student in the care of a young child status post-appendectomy. The student checks the current order of IV gentamicin and discovers the ordered dose is above the safe dose range based on the child's weight. What should be the nurse's first action? 1. Check the child's recent lab work. 2. Contact the physician. 3. Order a hearing test. 4. Obtain an order for BUN and creatinine.

1. Check the child's recent lab work.

An infant is admitted to the pediatric unit with a diagnosis of hypertrophic pyloric stenosis after vomiting for several days. Which of the following nursing diagnoses should be the priority? 1. Deficient fluid volume related to prolonged vomiting. 2. Ineffective airway clearance related to impaired swallowing. 3. Imbalanced nutrition: Less than body requirements related to prolonged vomiting. 4. Bowel incontinence related to abdominal pain.

1. Deficient fluid volume related to prolonged vomiting.

An infant is admitted for probable pyloric stenosis. A physician orders IV fluids and makes the infant NPO pending a surgical consult. The infant is crying vigorously and the parents express frustration that they cannot feed their baby even though the surgery is not yet definite. Which is the best action for the nurse to take now? 1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting. 2. Offer the parents a pacifier for the infant. 3. Place a call to the surgeon to find out how long it will be before the consult. 4. Feed the infant a small amount of Pedialyte since the surgical repair for this condition will most likely not occur until the following day.

1. Explain to the parents that feeding an infant with pyloric stenosis can lead to electrolyte imbalances from possible vomiting.

The nurse educator is teaching a group of nursing students about the endocrine system. Which statements are appropriate for the educator to include in the teaching session? Select all that apply. 1. Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH. 2. Growth hormone regulates linear bone growth and growth of all tissues. 3. Antidiuretic hormone regulates urine concentration by the kidneys. 4. Thyroid hormone regulates serum calcium levels and phosphorus excretion. 5. Parathyroid hormone regulates metabolism of cells and body heat production.

1. Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH. 2. Growth hormone regulates linear bone growth and growth of all tissues. 3. Antidiuretic hormone regulates urine concentration by the kidneys.

The nurse educator is teaching a group of nursing students about the endocrine system. Which statements are appropriate for the educator to include in the teaching session? (Select all that apply). 1. Growth hormone regulates linear bone growth and growth of all tissues. 2. Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH. 3. Thyroid hormone regulates serum calcium levels and phosphorus excretion. 4. Parathyroid hormone regulates metabolism of cells and body heat production 5. Antidiuretic hormone regulates urine concentration by the kidneys.

1. Growth hormone regulates linear bone growth and growth of all tissues. 2. Gonadotropin-releasing hormone stimulates the anterior pituitary to produce LH and FSH. 5. Antidiuretic hormone regulates urine concentration by the kidneys.

The parents of a boy who is diagnosed with mumps ask the nurse whether there is any special _____care that they should provide their child. Which of the following responses would be appropriate for the nurse to provide? Select all that apply. 1. Offer soft foods for the child to eat. 2. Encourage the child to drink citrus fruit juices each day. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck. 5. Administer ordered antihistamines for the full course of the disease.

1. Offer soft foods for the child to eat. 3. Monitor the child carefully for signs of testicular discomfort. 4. Place an ice collar or warm compresses around the child's neck.

The parents of a child with a tracheoesophageal fistula express feelings of guilt about their baby's anomaly. Which of the following approaches by the nurse would best support the parents? 1. Helping the parents accept their feelings as a normal reaction. 2. Explaining that the parents did nothing to cause the newborn's defect. 3. Encouraging the parents to concentrate on planning their baby's care. 4. Urging the parents to visit their newborn as often as possible.

1. Helping the parents accept their feelings as a normal reaction.

The nurse is providing education to a group of student nurses regarding disorders of the endocrine system that can cause short stature. Which disorders will the nurse include in the educational session? Select all that apply. 1. Hypothyroidism 2. Turner syndrome 3. Type 1 diabetes mellitus 4. Diabetes insipidus 5. Cushing syndrome

1. Hypothyroidism 2. Turner syndrome 5. Cushing syndrome

The nurse is providing education to a pediatric client diagnosed with diabetes. The client will be playing soccer over the summer. Which change in the client's management will the nurse explore during this education session? 1. Increased food intake 2. Decreased food intake 3. Increased need for insulin 4. Decreased risk of insulin reaction

1. Increased food intake

A child with type 1 diabetes is being prepared for discharge from a hospital. What should a nurse include as part of the teaching regarding diabetes care? 1. Insulin dosage may need to be decreased during sports activities. 2. Insulin should never be administered during febrile illnesses. 3. Expect hypoglycemic episodes to always occur after meals. 4. The child should not self-administer injections until teen years.

1. Insulin dosage may need to be decreased during sports activities.

A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment does the nurse ensure is prepared at the bedside? 1. Intubation setup 2. Appropriate bag and mask 3. Sterile gauze and saline 4. Soft arm restraints

1. Intubation setup

A child has just been diagnosed with celiac disease. Which of the following signs and symptoms would the nurse expect the parents to report in the child's history? Select all that apply. 1. Irritability 2. Failure to thrive 3. Abdominal pain 4. Excessive hunger 5. Recurring diarrhea

1. Irritability 2. Failure to thrive 3. Abdominal pain 5. Recurring diarrhea

A 4-year-old child is seen at the primary health-care provider's office with vomiting and diarrhea for the past 24 hours. The primary health-care provider orders a number of interventions. If ordered, the nurse should question the administration of which of the following medications for the child? 1. Lomotil (diphenoxylate/atropine) 2. Zofran (ondansetron) 3. Reglan (metoclopramide) 4. Dramamine (dimenhydrinate)

1. Lomotil (diphenoxylate/atropine)

An infant in a newborn nursery is identified as having phenylketonuria (PKU). What is the best initial source of nutrients for an infant with this diagnosis? 1. Maternal breast milk. 2. Pregestimil. 3. Lofenalac. 4. Isomil.

1. Maternal breast milk.

While caring for a neonate with an imperforate anus, the nurse assesses the neonate's urine output for which of the following? 1. Meconium. 2. Blood. 3. Bile. 4. Acetone.

1. Meconium.

The nurse assesses the following blood gas results on an infant in the emergency department. Which of the following conclusions is consistent with the data? Po2: 90 mmHg Pco2: 34 mmHg HCO3: 16 mEq/L Base excess: -4 pH: 7.28 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

1. Metabolic acidosis

A teenage child has been diagnosed with type 2 diabetes. The nurse determines that the child will likely be administered which of the following medications? 1. Metformin (Glucophage) 2. Aspart (Novolog) 3. Detemir (Levemir) 4. Glargine (Lantus)

1. Metformin (Glucophage)

A child experienced a lacerated spleen in a motor vehicle accident. Which is the highest-priority nursing intervention on admission to the pediatric intensive care unit (PICU) following surgery? 1. Observing for signs of hypovolemic shock 2. Maintaining IV fluids 3. Implementing strict bedrest 4. Administering blood products as ordered

1. Observing for signs of hypovolemic shock

A mother brings her 3-month-old child into the emergency department. The child is listless with dry mucous membranes, tenting of the skin on the forehead, a depressed fontanel, and a history of vomiting and diarrhea for the last 36 hours. In what order from first to last should the nurse implement the physician's orders? 1. Obtain vital signs and weight. 2. Insert an I.V. and infuse fluids. 3. Apply a urine collection bag. 4. Draw blood for laboratory tests.

1. Obtain vital signs and weight. 3. Apply a urine collection bag. 2. Insert an I.V. and infuse fluids. 4. Draw blood for laboratory tests.

The nurse is administering several medications to an infant with neurologic impairment and delay. Which medication is a proton pump inhibitor that is administered for gastroesophageal reflux? 1. Omeprazole 2. Ranitidine 3. Phenytoin 4. Glycopyrrolate

1. Omeprazole

Which interventions should the nurse include when creating a care plan for a child with hepatitis? Select all that apply. 1. Providing a low-fat, well-balanced diet. 2. Teaching the child effective hand-washing techniques. 3. Scheduling playtime in the playroom with other children. 4. Notifying the HCP if jaundice is present. 5. Instructing the parents to avoid administering medications unless prescribed. 6. Arranging for indefinite homeschooling because the child will not be able to return to school.

1. Providing a low-fat, well-balanced diet. 2. Teaching the child effective hand-washing techniques. 5. Instructing the parents to avoid administering medications unless prescribed.

A nurse is planning care for a pediatric client diagnosed with adrenal insufficiency (Addison disease). Which nursing diagnosis is the priority for this client? 1. Risk for Deficient Fluid Volume 2. Risk for Injury Secondary to Hypertension 3. Acute Pain 4. Imbalanced Nutrition: More than Body Requirements

1. Risk for Deficient Fluid Volume

The nurse is educating the parents of a 2-month-old infant regarding the immunizations that the child will receive that day. The nurse should educate the parents that which of the following immunizations will protect the child from a serious gastrointestinal infection? 1. Rotavirus vaccine (RV) 2. Diphtheria, tetanus, and acellular pertussis (DTaP) 3. Haemophilus influenzae type b (Hib) 4. Pneumococcal conjugate (PCV13)

1. Rotavirus vaccine (RV)

A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a new RN on the pediatric unit, cautions the new nurse to be especially alert for which condition in the child? 1. Seizures 2. Bradycardia 3. Respiratory distress 4. Hyperthermia

1. Seizures

A baby with trisomy 21 is admitted to the newborn nursery. The baby should be assessed for which of the following features? 1. Simian crease 2. Polydactyly 3. Harlequin sign 4. Mongolian spots

1. Simian crease

The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration? 1. Tachycardia 2. Bradycardia 3. Increased blood pressure 4. Decreased blood pressure

1. Tachycardia

The nurse educator is preparing an in-service on the basic functions of the gastrointestinal (GI) system. Which statements will the nurse educator include in the in-service? Select all that apply. 1. The GI system is responsible for the ingestion of fluids and nutrients. 2. The GI system is responsible for the excretion of fluids and nutrients. 3. The GI system is responsible for the metabolism of nutrients. 4. As infants grow, their stomach capacity increases, decreasing the frequency with which they need to be fed. 5. By the second year of life, digestive processes are still developing.

1. The GI system is responsible for the ingestion of fluids and nutrients. 3. The GI system is responsible for the metabolism of nutrients. 4. As infants grow, their stomach capacity increases, decreasing the frequency with which they need to be fed.

A 7 year-old client is admitted to the hospital with a diagnosis of Cushing disease due to pituitary tumor. On physical assessment of the patient, which of the following clinical manifestations would the nurse expect to find? 1. Weight gain, moon face, hypertension, hirsutism 2. Hyperirritability, muscle rigidity, seizures, hypocalcemia 3. Weight loss, slow linear growth, hypertension, hirsutism 4. Low levels of urine cortisol and normal glucose test

1. Weight gain, moon face, hypertension, hirsutism

A child was admitted to the general pediatrics floor for dehydration. If the child weighs 15 kg, then what is the maintenance fluid needs for this child using the guidelines below? Up to 10 kg: 100ml/kg/24hr 11-20 kg: 1000 mL+ 50 mL/kg for weight above 10kg)/24 hr >20 kg: 1500 mL + (20 mL/kg for weight above 20kg)/24 hr

1250 mL/24 hr

The nurse is providing instruction to the parents of an infant with a colostomy. Which statement by the parents indicates appropriate understanding of the teaching session? 1. We will change the colostomy bag with each wet diaper. 2. We will use adhesive enhancers when we change the bag. 3. We will watch for skin irritation around the stoma. 4. We will expect a moderate amount of bleeding after cleansing the area around the stoma.

3. We will watch for skin irritation around the stoma.

Which of the following behaviors exhibited by the parents of an infant with pyloric stenosis should the nurse correctly interpret as a positive indication of parental coping? 1. Telling the nurse that they have to get away for a while. 2. Discussing the infant's care realistically. 3. Repeatedly asking if their child is normal. 4. Exhibiting fear that they will disturb the infant

2. Discussing the infant's care realistically.

A nurse is advising the parents of a child with strabismus who is to receive Botox (onabotulinumtoxinA) regarding possible side effects from the medication. Which of the following items should the nurse include? 1. Paralysis of the optic nerve 2. Drooping of the eyelid 3. Blindness in the affected eye 4. Pupillary dysfunction

2. Drooping of the eyelid

A 10-year-old child is diagnosed with enterobiasis (pinworm). Which of the following signs/symptoms would the nurse expect to see? 1. Recurrent vomiting 2. Enuresis 3. Bloody diarrhea 4. Pain

2. Enuresis

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborns diagnosis? 1. Acute diarrhea; dehydration 2. Failure to pass meconium; abdominal distention 3. Currant jelly; gelatinous stools; pain 4. Projectile vomiting; altered electrolytes

2. Failure to pass meconium; abdominal distention

A nurse is working with a nursing student in caring for an infant who has just returned from the surgical recovery area following a cleft lip repair. Which action by the nursing student should cause the nurse to intervene? 1. Placement of elbow restraints on the infant. 2. Offering the parents a regular bottle with which to feed the infant. 3. Positioning the infant in the semi-Fowler's position. 4. Advising the parents of a plan to administer pain medication around the clock.

2. Offering the parents a regular bottle with which to feed the infant.

A baby, 12 hours old, in the neonatal intensive care unit, has been diagnosed with esophageal atresia with tracheoesophageal fistula. Which of the following assessments is highest priority for the nurse to make? 1. Quantity of nasogastric secretions 2. Oxygen saturation levels 3. Apical heart rate 4. Weight of wet diapers

2. Oxygen saturation levels

A school-age client is hypokalemic. The nurse is helping the client complete her menu. Which food selection will the nurse encourage for this client? 1. A hamburger with French fries 2. Pizza with a fruit plate 3. Chicken strips with chips 4. A fajita with rice

2. Pizza with a fruit plate

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which date would the nurse expect to obtain when asking the parent about the child's symptoms? 1. Watery diarrhea 2. Projectile vomiting 3. Increased urine output 4. Vomiting large amounts of bile

2. Projectile vomiting

The nurse is caring for a pediatric client diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH) disorder. Which interventions should the nurse implement for this child? Select all that apply. 1. Encouragement of fluids 2. Strict intake and output 3. Administration of ordered diuretics 4. Specific gravity of urine 5. Weight only on admission but not daily

2. Strict intake and output 3. Administration of ordered diuretics 4. Specific gravity of urine

The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observations made by the nurse indicates the presence of this condition? 1. The child has difficulty hearing 2. The child consistently tilts the head to see 3. The child does not respond when spoken to 4. The child consistently turns the head to hear

2. The child consistently tilts the head to see

An infant is brought to an emergency department with a chief complaint of nausea and vomiting. Which nursing assessment finding should indicate to a nurse that the infant's dehydration is severe? 1. The infant is lethargic with a urinary output of less than 1 mL/kg/hr. 2. The infant has weak pulses, poor skin turgor, and cool, mottled skin. 3. The infant has warm skin, increased pulse, and capillary refill of 2 seconds. 4. The infant is irritable, with dry mucous membranes and increased respirations.

2. The infant has weak pulses, poor skin turgor, and cool, mottled skin.

When developing the plan of care for an infant with pyloric stenosis, the nurse identifies a nursing diagnosis of Deficient fluid volume related to prolonged vomiting. Which of the following parameters should the nurse expect to use when evaluating the client outcome? 1. Abdominal distention. 2. Weight loss. 3. Vomiting. 4. Respiratory effort.

2. Weight loss.

A nurse is caring for a child who has type 1 diabetes mellitus. Which of the following are manifestations of diabetic ketoacidosis? Select all a. Dehydration b. Mental confusion c. Fruity breath d. Weight gain e. Blood glucose 58

a. Dehydration b. Mental confusion c. Fruity breath

The father of a neonate scheduled for gastrointestinal surgery asks the nurse how newborns respond to painful stimuli. Which of the following should be the nurse's best response? 1. "Newborns cry and cannot be distracted to stop crying." 2. "When faced with a pain, newborns try to roll away from it." 3. "Newborns typically move their whole body in response to pain." 4. "Pain causes the newborn to withdraw the affected part."

3. "Newborns typically move their whole body in response to pain."

A male adolescent who underwent repair of an inguinal hernia earlier today and is getting ready to go home receives instructions about resuming physical activities. Which of the following statements would indicate that he has understood the instructions? 1. "I can start riding my bike next week." 2. "I have to skip physical education classes for 2 weeks." 3. "I can start wrestling again in 3 weeks." 4. "I can return to my weight-lifting class in 2 weeks."

3. "I can start wrestling again in 3 weeks."

A primary health-care provider has ordered an IV of D5 1⁄2 NS for a child with a diagnosis of dehydration. The parent asks the nurse to explain why the child must receive the solution. Which of the following responses by the nurse is appropriate? 1. "The solution contains all of the substances that should be in your child's bloodstream." 2. "The solution will replace the most important electrolytes that your child is missing." 3. "The fluid contains some sugar and some salt. Those, in addition to the fluid, will help to make your child better." 4. "The fluid is the same as the water that you drink. Your child needs the water in order to get better."

3. "The fluid contains some sugar and some salt. Those, in addition to the fluid, will help to make your child better."

After teaching the parents of an infant diagnosed with Hirschsprung's disease, the nurse determines that the parents understand the diagnosis when the father states which of the following? 1. "There is no rectal opening for stool to pass." 2. "There is a tube between the trachea and esophagus." 3. "The nerves at the end of the large colon are missing." 4. "The muscle below the stomach is too tight."

3. "The nerves at the end of the large colon are missing."

The physician is able to reduce an infant's hernia and schedules the infant for a herniorrhaphy in 2 days. The mother asks the nurse why the surgery is not performed now. Which of the following responses indicates that the nurse understands the rationale for delaying the surgery? 1. "Delaying the surgery ensures that your infant will receive the proper preoperative preparation." 2. "We need to make sure that your infant receives nothing by mouth for at least 24 hours before the surgery." 3. "Waiting these 2 days helps to allow any edema and inflammation in the area to subside." 4. "Your infant needs to wear a truss for at least 24 hours before any surgery can be attempted."

3. "Waiting these 2 days helps to allow any edema and inflammation in the area to subside."

A pediatric client is seen in the clinic with a possible diagnosis of type 2 diabetes. The mother asks what the healthcare provider uses to make the diagnosis. The nurse explains that type 2 diabetes is suspected if the child has obesity, acanthosis nigricans, and two non-fasting blood-glucose levels above which level? 1. 120 2. 80 3. 200 4. 50

3. 200

The nurse is preparing to ambulate a school-age client who had an appendectomy. In addition to pharmacological pain management, the nurse can use which nonpharmacological pain-management strategy for this client? 1. A heating pad 2. A warm, moist pack 3. A pillow on the abdomen 4. An ice pack

3. A pillow on the abdomen

Which of the following would most likely alert the nurse to the possibility that a preschooler is experiencing moderate dehydration? 1. Deep, rapid respirations. 2. Diaphoresis. 3. Absence of tear formation. 4. Decreased urine specific gravity.

3. Absence of tear formation.

The parents report that their 1-day-old is drooling and having choking episodes with excessive amounts of mucus and color changes, especially during feedings. When contacting the physician about these symptoms the nurse should request: 1. A referral to a lactation consultant. 2. That the physician further assess the client. 3. An order for an x-ray with orogastric catheter placement. 4. A serum blood glucose level per laboratory.

3. An order for an x-ray with orogastric catheter placement.

A child with severe gastroenteritis is admitted to a semiprivate room on the pediatric unit. The charge nurse should place this client with which roommate? 1. An infant with meningitis 2. A child with fever and neutropenia 3. Another child with gastroenteritis 4. A child recovering from an appendectomy

3. Another child with gastroenteritis

A nurse is caring for a child with short bowel syndrome. The nurse knows that the following conditions could have led to short bowel syndrome, except for? 1. Gastroschisis 2. Volvulus 3. Appendicitis 4. Omphalocele

3. Appendicitis

A clinic nurse has a follow-up appointment with an adolescent with juvenile idiopathic arthritis (JIA). What topic should be the nurse's top priority? 1. Sleep patterns. 2. Participation in daily exercise. 3. Avoidance of alcohol use. 4. Information regarding JIA support groups.

3. Avoidance of alcohol use.

The parent of an infant with a cleft lip and palate asks the nurse when the infant's cleft palate will be repaired. The nurse responds by stating that the first repair of a cleft palate is usually done at which of the following times? 1. Before the eruption of teeth. 2. When the child weighs approximately 10 kg (22 lb). 3. Before the development of speech. 4. After the child learns to drink from a cup.

3. Before the development of speech.

On the oncology unit, a child with a diagnosis of brain tumor developed diabetes insipidus. The nursing management includes the following except for which intervention? 1. Measure intake and output strictly. 2. Administer oral desmopressin acetate. 3. Expect serum sodium to be decreased. 4. Expect urine specific gravity to be decreased

3. Expect serum sodium to be decreased.

Immediately on return to the nursing unit after surgical repair of a cleft palate, in which of the following positions should the nurse place the child? 1. On the back with the head in a position of comfort. 2. In low Fowler's position with the head turned to the side. 3. Lying on the abdomen with the head turned to the side. 4. In reverse Trendelenburg with the head tilted forward.

3. Lying on the abdomen with the head turned to the side.

A 4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse should anticipate that the infant's vomitus would contain gastric contents and which of the following? 1. Bile and streaks of blood. 2. Mucus and bile. 3. Mucus and streaks of blood. 4. Stool and bile.

3. Mucus and streaks of blood.

Which of the following symptoms is associated with ulcerative colitis? 1. Dumping syndrome 2. Fistulas 3. Rectal bleeding 4. Soft stools

3. Rectal bleeding

A nurse assesses a child who is 12 hours status post-tonsillectomy and adenoidectomy. The child reports feeling nauseated and shows the nurse a moderate amount of red-tinged vomitus in the emesis basin. Which action should the nurse take first? 1. Administer an antiemetic as ordered. 2. Offer the child ice chips as tolerated. 3. Report the findings to the physician. 4. Apply bilateral pressure to the child's neck.

3. Report the findings to the physician.

The nurse assesses the following blood gas results on a child in the emergency department. Which of the following diagnoses is consistent with the data? Po2: 60 mmHg Pco2: 50 mmHg HCO3: 30 mEq/L Base excess: -4 pH: 7.28 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

3. Respiratory acidosis

A 6-year-old child is being assessed by a nurse for possible signs of dehydration. Which of the following assessments should the nurse perform? 1. Patellar reflexes 2. Anterior fontanel tension 3. Skin turgor 4. Pupil reactivity to light

3. Skin turgor

An adolescent client diagnosed with Graves disease is admitted to the hospital. Which clinical manifestations would the nurse expect on assessment? 1. Weight gain, hirsutism, and muscle weakness 2. Dehydration, metabolic acidosis, and hypertension 3. Tachycardia, fatigue, and heat intolerance 4. Hyperglycemia, ketonuria, and glucosuria

3. Tachycardia, fatigue, and heat intolerance

A pediatric client is diagnosed with type 1 diabetes. The nurse teaches the client the difference between insulin shock and diabetic hyperglycemia. The nurse evaluates that the client understands the teaching when the client states which characteristics of diabetic hyperglycemia? 1. Tremors and lethargy 2. Hunger and hypertension 3. Thirst and flushed skin 4. Shakiness and pallor

3. Thirst and flushed skin

A child is admitted to the pediatric unit. While the nurse was taking the nursing history, the child regurgitated vomitus that looked like coffee grounds and smelled like feces. Which of the following communications would it be appropriate for the nurse to report to the primary health-care provider? "After assessing the vomitus, it appears that the child: 1. has an obstruction proximal to the stomach." 2. has a perforated duodenal ulcer." 3. is vomiting blood from the lower bowel." 4. is exhibiting signs of ruptured esophageal varices."

3. is vomiting blood from the lower bowel."

A nurse is teaching the parent of a child who has GH deficiency. Which of the following are complications of untreated GH deficiency? Select all a. Delayed sexual development b. Premature aging c. Short stature d. Advanced bone age e. Increased epiphyseal closure

a. Delayed sexual development b. Premature aging c. Short stature

A 2-year-old child has just been diagnosed with type 1 diabetes. The nurse is providing education to the parents regarding signs of hypoglycemia. Which of the following information should the nurse include in her teaching session? 1. Child's breath will smell like fruit. 2. Child will complain of excessive thirst. 3. Child will complain of sleepiness and will appear fatigued. 4. Child's behavior will resemble a burst of anger or a temper tantrum.

4. Child's behavior will resemble a burst of anger or a temper tantrum.

The nurse in the delivery room suspects that a newly birthed baby may have an esophageal atresia with tracheoesophageal fistula because the baby is exhibiting which of the following signs and symptoms? 1. Palpable mass in left lower quadrant 2. Blood-tinged vomitus 3. Pseudostrabismus 4. Copious quantities of oral mucus

4. Copious quantities of oral mucus

A baby is admitted with a diagnosis of intussusception. Which of the following signs/ symptoms would the nurse expect to see? 1. Projective vomiting 2. Acute constipation 3. Explosive flatus 4. Currant jelly stools

4. Currant jelly stools

Which of the following would be an important assessment finding for an 8-month-old infant admitted with severe diarrhea? 1. Absent bowel sounds. 2. Pale yellow urine. 3. Normal skin elasticity. 4. Depressed anterior fontanel.

4. Depressed anterior fontanel.

A school-age client is recovering after abdominal surgery. The nurse is planning care for the return of bowel function. Which intervention should be included in the clients plan of care? 1. Fowlers position three times per day for 30 minutes each time 2. Assist the child in choosing a low-fat diet. 3. Commode at bedside 4. Ambulate 3-4 times a day.

4. Ambulate 3-4 times a day.

The nurse is administering a dose of rapid-acting insulin at 0800 to an insulin-dependent pediatric client. Based on when the insulin peaks, when will the client be at greatest risk for a hypoglycemic episode? 1. At about noon 2. Between bedtime and breakfast the next morning 3. Between lunch and dinner 4. Around 0930

4. Around 0930

A school nurse advises the dietary staff that a special lunch tray must be created for a student who has celiac disease. What recommendation should the nurse provide to the dietary staff? 1. Make sure the student has a whole-grain bread roll each day. 2. The child may have cake if the staff is celebrating someone's birthday. 3. The child's pizza should be topped with a variety of vegetables. 4. Beans and rice are suitable side dishes for this student.

4. Beans and rice are suitable side dishes for this student.

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented? 1. Watery diarrhea 2. Ribbon-like stools 3. Profuse projectile vomiting 4. Bright red blood and mucus in the stools

4. Bright red blood and mucus in the stools

A child recovering from abdominal surgery removes the nasogastric tube accidentally. A nurse replaces the naso- gastric tube and places it to low wall suction. Two hours later, the nurse discovers that there is no drainage from the tube. What should be the nurse's first action? 1. Ask the child to change position. 2. Place an urgent call to the surgeon. 3. Flush the tube with 10 mL of sterile water. 4. Check the suction mechanism and settings.

4. Check the suction mechanism and settings.

A health care provider prescribes an IV solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output

4. Checks the amount of urine output

The nurse finishes a parent-teaching session on preventing heat-related illnesses for children who exercise. Which statement by a parent indicates understanding of preventive techniques taught? 1. Hydration should occur at the end of an exercise session. 2. Water is the drink of choice to replenish fluids. 3. Wearing dark clothing during exercise is recommended. 4. During activity, stop for fluids every 15-20 minutes.

4. During activity, stop for fluids every 15-20 minutes.

A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment supports this newborn's diagnosis? 1. Altered electrolytes; projectile vomiting 2. Currant jelly stools; pain 3. Acute diarrhea; dehydration 4. Failure to pass meconium; abdominal distention

4. Failure to pass meconium; abdominal distention

A newborn who had a surgical repair of a tracheoesophageal fistula (TEF) is started on oral feedings. Which of the following should the nurse include in the teaching plan for the mother about oral feedings? 1. They are better tolerated when larger, but less frequent feedings are offered. 2. They should be offered on a feeding schedule to help the infant accept the feedings more readily. 3. They are best accepted by the infant when offered by the same nurse or by the infant's mother. 4. They are best planned in conjunction with observations of the infant's behavior.

4. They are best planned in conjunction with observations of the infant's behavior.

The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? 1. Provide less frequent, larger feedings. 2. Burp the infant less frequently during feedings. 3. Thin the feedings by adding water to the formula. 4. Thicken the feedings by adding rice cereal to the formula.

4. Thicken the feedings by adding rice cereal to the formula.

A nurse should suspect Hirschsprung's disease in a child who has which type of stooling pattern? 1. Pale gray stools. 2. Currant-jelly stools. 3. Loose, yellow stools. 4. Thin, ribbon-like stools.

4. Thin, ribbon-like stools.

A nurse is teaching a parent of an infant about gastrointestinal reflux disease (GERD). The following interventions should be included in the teaching plan, except for? 1. Encourage to hold infant in an upright position. 2. Offer small frequent feedings. 3. Thicken formula with rice cereal. 4. Use a wide based nipple for feedings.

4. Use a wide based nipple for feedings.

A child with inflammatory bowel disease is prescribed prednisone daily. At which time is it most appropriate for the family to administer the prednisone? 1. Between meals 2. One hour before meals 3. At bedtime 4. With meals

4. With meals

A 3-year-old child is being seen for a possible diagnosis of dehydration. Two weeks ago, the child weighed 34 lb 8 oz. The child's current weight is 32 lb 4 oz. Please calculate the percentage of weight loss for this child. Please calculate to the tenths place. _____%

6.5%

In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following? A. Anterior pituitary gland hypofunction B. Posterior pituitary gland hyperfunction C. Parathyroid gland hyperfunction D. Thyroid gland hyperfunction

A. Anterior pituitary gland hypofunction

Arvic who is diagnosed with diabetes mellitus type 1 displays symptoms of hypoglycemia; which of the following actions should the nurse instruct the parents? A. Give the child honey (simple sugar). B. Give the child milk (complex sugar). C. Contact the healthcare provider before doing anything. D. Give the child nothing by mouth.

A. Give the child honey (simple sugar).

In pediatric gastroesophageal reflux disease (GERD), the immaturity of lower esophageal sphincter function is manifested by frequent transient lower esophageal relaxations, which result in retrograde flow of gastric contents into the esophagus. Which statement about the esophagus is TRUE? Select all that apply. A. It is a cartilaginous tube. B. It has upper and lower sphincters. C. It lies anterior to the trachea. D. It extends from the nasal cavity to the stomach. E. All statements describe the esophagus.

B. It has upper and lower sphincters.

Which type of diabetes mellitus (DM) most likely results fromheterogenous risk factors, making it preventable? A. Type 1 B. Type 2 C. Type 1 and 2 D. Gestational diabetes

B. Type 2

Nurse Joyce is assessing a child's cultural background, she should keep in mind that: A. Cultural background usually has little bearing on a family's health practices B. Physical characteristics mark the child as part of a particular culture C. Heritage dictates a group's shared values D. Behavioral patterns are passed from one generation to the next

D. Behavioral patterns are passed from one generation to the next

Nurse Dorothy is caring for a child with Cushing's syndrome; which of the following should she include in the plan of care? A. Increase fluids to prevent dehydration B. Encourage a diet high in carbohydrates C. Monitor weight each day and report for weight loss D. Encourage a diet high in potassium

D. Encourage a diet high in potassium

Justine is admitted to the pediatric unit due to the occurrence of diabetic ketoacidosis signaling a new diagnosis of diabetes. The diabetesteam explores the cause of the episode and take steps to prevent a recurrence. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following? A. Sodium bicarbonate from renal compensation B. Potassium from cell death C. Glucose from carbohydrate metabolism D. Ketone bodies from fat metabolism

D. Ketone bodies from fat metabolism

Which of the following applies to the defect emerging from residual peritoneal fluid confined within the lower segment of the processus vaginalis? A. Inguinal hernia B. Incarcerated hernia C. Communicating hydrocele D. Noncommunicating hydrocele

D. Noncommunicating hydrocele

Nurse Nancy is assessing a child with pyloric stenosis; she is likely to note which of the following? A. "Currant jelly" stools B. Regurgitation C. Steatorrhea D. Projectile vomiting

D. Projectile vomiting

Hunger, irritable, sweating/pallor

Hypoglycemia manifestations

Eat a small box of raisins or drink a cup of OJ before soccer

Prevent hypoglycemia during practice

It is negative

Serum PKU 1 mg/dL

A nurse is reviewing sick-day management with a parent of a child who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? Select all a. monitor blood glucose levels every 3 hours b. discontinue taking insulin until feeling better c. drink 8 oz of fruit juice every hour d. test urine for ketones e. call the provider if blood glucose is greater than 240 mg/dl

a. monitor blood glucose levels every 3 hours d. test urine for ketones e. call the provider if blood glucose is greater than 240 mg/dl

A nurse is caring for a child who has Hirschsprung's disease. Which of the following actions should the nurse take? a. Encourage a high fiber, low-protein, low-calorie diet b. Prepare the family for surgery c. Place an NG tube for decompression d. Initiate bed rest

b. Prepare the family for surgery

A nurse is teaching a child who has type 1 diabetes mellitus about self-care. Which of the following statements by the child indicates understanding of the teaching? a. I should skip breakfast when I am not hungry b. I should increase my insulin with exercise c. I should drink a glass of milk when I am feeling irritable d. I should draw up the NPH insulin into the syringe before the regular insulin

c. I should drink a glass of milk when I am feeling irritable

A nurse is teaching a school-age child who has diabetes mellitus about insulin administration. Which of the following should the nurse include in the teaching? a. You should inject the needle at a 30 degree angle b. You should combine your glargine and regular insulin in the same syringe c. You should aspirate for blood before injecting the insulin d. You should give four or five injections in one area before switching sites

d. You should give four or five injections in one area before switching sites


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