Questions for CA Exam 6

A nurse cares for a school-age patient admitted to the pediatric intensive care unit (PICU) with increased intracranial pressure following a bike accident. The nurse explains to the parents that which measures may be taken to relieve the pressure on their son's brain? SELECT ALL THAT APPLY. 1) A diuretic may be given to increase osmolarity and prevent the reabsorption of water. 2) A barbiturate may be administered to cause the blood vessels in the brain to constrict. 3) A corticosteroid may be administered to reduce excessive cytotoxic brain edema. 4) A narcotic may be administered to reduce the pain associated with brain injury. 5) Magnetic resonance imaging (MRI) may be ordered.

1) A diuretic may be given to increase osmolarity and prevent the reabsorption of water. 2) A barbiturate may be administered to cause the blood vessels in the brain to constrict.

A pediatrician orders a neurological exam for an adolescent patient experiencing seizures. When planning to assist with this exam, which does the nurse anticipate will be included? SELECT ALL THAT APPLY .1) Cranial nerve assessment 2) Deep tendon reflex 3) Sensory response 4) Developmental status 5) Motor response

1) Cranial nerve assessment 2) Deep tendon reflex 3) Sensory response 5) Motor response

The pediatric nurse uses the modified Glasgow Coma Scale to monitor a child's neurological status. Which are components of the assessment? SELECT ALL THAT APPLY. 1) Eye opening 2) Verbal response 3) Pain reflex 4) Motor response 5) Vital signs

1) Eye opening 2) Verbal response 4) Motor response

A school-age child who is in an adrenal crisis is admitted to the hospital. Based on this diagnosis, which does the nurse plan for when caring for this child? 1) Fluid and electrolyte replacement 2) Stabilizing blood pressure and rest 3) Monitoring intake and output 4) Providing pain relief and tepid baths

1) Fluid and electrolyte replacement

A mother brings her school-age daughter to the pediatrician. Upon hearing the daughter's symptoms, the health-care provider orders tests for type 1 diabetes. Which data collected during the nursing assessment support the diagnosis of type 1 diabetes? SELECT ALL THAT APPLY. 1) Polydipsia 2) Polyuria 3) Polyphagia 4) Enuresis 5) Hypoglycemia

1) Polydipsia 2) Polyuria 3) Polyphagia 4) Enuresis

The pediatric nurse is assessing the level of consciousness of a postsurgical pediatric patient. The nurse knows that the child's level of consciousness is controlled by which item? 1) Reticular activating system 2) Brainstem 3) Spinal cord 4) Medulla oblongata system

1) Reticular activating system

The nurse educator is teaching a group of nursing students about the anatomy and physiology of the nervous system. Which statement made by a student indicates appropriate understanding of the content? 1) "The central nervous system consists of the brain and spinal cord only." 2) "The peripheral nervous system consists of the cranial nerves, the spinal nerves, and peripheral nerves." 3) "The brain is a network of nerve cells called axons." 4) "Gray matter consists of axons that are coated with myelin, which allow nerve impulses to travel rapidly."

2) "The peripheral nervous system consists of the cranial nerves, the spinal nerves, and peripheral nerves."

The nurse is assessing an infant during a routine well-baby checkup. The infant has yellow drainage, crusting, and a small bump in the inner canthus of the right eye. Based on this data, which condition does the nurse suspect? 1) Periorbital cellulitis 2) Blocked tear duct 3) Keratitis 4) Stye

2) Blocked tear duct

An adolescent patient who is in the pediatric intensive care unit (PICU) with increased intracranial pressure related to a car accident exhibits Cushing's triad. The pediatric nurse explains to the parents that which are the elements of this condition? SELECT ALL THAT APPLY. 1) Kidney failure 2) Hypertension 3) Bradycardia 4) Irregular respiratory pattern 5) Hyperthermia

2) Hypertension 3) Bradycardia 4) Irregular respiratory pattern

The pediatric nurse reviews the effects of epinephrine on the body in response to emergent situations with the student nurse. Which descriptions from the student nurse regarding the effects of epinephrine indicate appropriate understanding? SELECT ALL THAT APPLY. 1) Increased metabolism with a decrease in blood glucose 2) Increased respiratory rate with dilated bronchioles 3) Increased skeletal muscle blood flow caused by dilated blood vessels 4) Increased blood flow to the skin and digestive tract 5) Decreased levels lead to diabetes acidosis

2) Increased respiratory rate with dilated bronchioles 3) Increased skeletal muscle blood flow caused by dilated blood vessels

The parents of an infant visit the emergency department (ED) with complaints that their son is experiencing a high fever and lack of interest in breastfeeding. Upon examination, the nurse records the following symptoms of meningitis: nuchal rigidity, a bulging fontanel, and photophobia. Which tests will the nurse explain to the parents as necessary to confirm the diagnosis of meningitis? SELECT ALL THAT APPLY. 1) Rooting reflex 2) Kernig's sign 3) Lumbar puncture 4) Computed tomography scan 5) Blood cultures

2) Kernig's sign 3) Lumbar puncture 5) Blood cultures

The nurse is providing care to a pediatric patient diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations does the nurse anticipate when conducting the physical assessment? SELECT ALL THAT APPLY. 1) Scissoring 2) Unsteady gait 3) Uncontrolled movement 4) Fine motor control problems 5) Poor coordination

2) Unsteady gait 4) Fine motor control problems 5) Poor coordination

The clinical nurse teaches the student nurse that elevated blood glucose levels (usually in excess of ___ milligrams per deciliter) and an elevated hemoglobin A1C (greater than 5.0) level are indicative of diabetes mellit

200

When discussing types of insulin with the parents of a diabetic child, the pediatric nurse tells the parents that Lantus insulin is a clear insulin that lasts for __ hours with steady levels, giving it nearly no peaking action

24

An endocrinologist orders a test(s) for a child to diagnose adrenal crisis. Which tests does the nurse anticipate based on the child's diagnosis? SELECT ALL THAT APPLY. 1) Computed tomography scan of the brain 2) White blood cell count 3) Chest radiography 4) Blood test to determine electrolyte levels 5) Aldosterone levels

3) Chest radiography 4) Blood test to determine electrolyte levels 5) Aldosterone levels

The nurse is providing education to a school-age child recently diagnosed with type 1 diabetes mellitus. Which item will the nurse include in the teaching plan regarding sick day management? 1) Holding the prescribed dose of insulin 2) Monitoring blood glucose every 8 hours 3) Monitoring for ketones after each void 4) Encouraging frequent exercise

3) Monitoring for ketones after each void

The nurse assesses a patient who presents at the clinic with the signs and symptoms of acromegaly. Which assessment data supports this diagnosis? 1) Armpit hair, pubic hair (adrenarche), body odor, acne, behavior changes (emotional lability and mood swings), and growth spurts in height 2) Delayed closure of the anterior fontanel, delayed dental eruption, and greater weight-to-height ratio with increased abdominal (truncal) fat 3) Rapid increase in skeletal growth seen each time the child is plotted on the growth chart, gradual enlargement of the hands and feet in adults 4) Excessive thirst, hypoglycemia, growth delay, excessive urine production, enuresis in the child, and dehydration

3) Rapid increase in skeletal growth seen each time the child is plotted on the growth chart, gradual enlargement of the hands and feet in adults

The nurse educator is teaching a group of students about the endocrine system. Which statement regarding this system is the most appropriate? 1) The hypothalamus is a photosensitive gland that receives light through the optic nerve. 2) The pituitary gland produces two hormones called thyroxin and triiodothyronine. 3) The pancreas produces insulin and glucagons that affect metabolism. 4) The adrenal glands produce steroidal sex hormones that regulate changes at puberty.

3) The pancreas produces insulin and glucagons that affect metabolism.

The endocrinologist orders a diagnostic test for a school-age patient and determines that the child has nephrogenic diabetes insipidus as opposed to central (neurogenic) diabetes insipidus. Based on this data, which treatment does the nurse anticipate for this child? 1) Includes the use of amoxicillin (Amoxil) to treat bacterial infection 2) Includes the use of desmopressin (DDAVP) to concentrate urine 3) Includes the use of a diuretic chlorothiazide (Diuril) to decrease urine volume 4) Includes the use of amiloride (Midamor) and indomethacin (Indocin) or aspirin

4) Includes the use of amiloride (Midamor) and indomethacin (Indocin) or aspirin

The pediatric nurse explains to parents that intracranial pressure monitoring and intubation are indicated for the child who has a Glasgow Coma Scale score of less than ________. If the child is intubated, the nurse will monitor the ventilator equipment to maintain normal ventilation with a PO2 of 120 to 140 mm Hg and a PCO2 of 30 to 35 mm Hg.

8

A 3-year-old with a history of hydrocephalus has recently undergone a ventriculo-peritoneal shunt insertion. Which postoperative intervention is the most appropriate? a. Assessing for signs of infection and for neurological function b. maintaining the head of the bed at a 90-degree angle c. encouraging the patient to lie on the operative sign d. encouraging the patient to lie supine for the first 24 hours

A. Assessing for signs of infection and for neurological function

The pediatric nurse is providing care to a pediatric patient with primary adrenal insufficiency. Which item in the patient's history is the most likely cause of this condition? a. autoimmune destruction b. genetic abnormality c. infectious process d. steroid therapy

A. autoimmune destruction

A child with diabetes insipidus is being monitored for fluid balance. Which assessment is the most accurate way to determine fluid balance? a. daily weight b. hemodynamic monitoring c. intake and output d. urine osmolality

A. daily weight

A child has a hearing loss following several ear infections. Which area of assessment is a priority for this child? a. language problems b. balance problems c. head size out of the norm d. metabolic disorders

A. language problems

A pediatric nurse is offering health prevention lecture in the community. Which topic is appropriate to include in this lecture? a. the use of DEET-containing products is contraindicated in school-aged children b. avoiding areas infested with mosquitos can be helpful in preventing encephalitis c. the incidence of Reye's syndrome has increased because of the use of acetaminophen (Tylenol) d. the varicella vaccine is not to be given to children with arthritis or Kawasaki's disease

B. avoiding areas infested with mosquitos can be helpful in preventing encephalitis

The mother of a 7-year-old girl brings her daughter to the pediatricians office for an annual examination. On assessment, the pediatric nurse notes signs or symptoms that may suggest a diagnosis of precocious puberty. Which assessment finding is inconsistent with the nurse's knowledge of this condition? a. breast development b. brittle hair c. menstruation d. some pubic hair

B. brittle hair

A child is being assessed with the Ishihara Test plates. The nurse understands that this tests what part of neurological function? a. expressive speech b. color blindness c. ocular nerve function d. coordination

B. color blindness

A nurse is reviewing laboratory findings in a child suspected of having Addison's disease. Which finding would be consistent with this condition? a. albumen 4.0 g/dL b. Cortisol 2mg/dL c. Potassium 4.4 mEq/L d. Sodium 139 mEq/L

B. cortisol 2mg/dL

An infant has been fitted with amplification devices for hearing loss. what will the nurse include in the teaching plan for the infant? a. wash the devices with cool water and pat dry weekly b. irritability can indicate the devices are turned up too loud c. the child will eventually need surgery to correct the hearing loss d.very few children need amplification devices for mild hearing loss

B. irritability can indicate the devices are turned up too loud

A child is admitted to the intensive care unit following a motor vehicle crash. The student nurse uses the Glasgow Coma Scale to evaluate the child's neurological status. When using this tool, for which assessment does the registered nurse intervene? a. verbal response b. orientation c. eye opening d. motor response

B. orientation

The pediatric nurse is admitting a child with a history of seizure activity. What will the nurse ensure is at the bedside to implement seizure precautions? a. a ventilator b. suction equipment c. intubation equipment d. soft restraints

B. suction equipment

A nurse is assessing the growth and development in a 4-year-old child. Which sentence indicates the child is probably speaking appropriately for her age? a. "I hungry" b. "No! No nap!" c. "Play ball with me" d. "I want to go to the park"

C. "Play ball with me"

A parent brings a child to the clinc and reports the child has episodes of sweating, headaches, and heart palpitations. Which medication does the nurse provide education to the parents on? a. Desmopressin (DDAVP) b. Methylprednisolone (Solu-medrol) c. Phenoxybenzamine (Dibenzyline) d. Spironolactone (aldactone)

C. Phenoxybenzamine (Dibenzyline)

A nurse is assessing a child who is in the 3rd percentile for growth. When arranging laboratory and other assessments, the nurse places priority on which endocrine gland? a. adrenal b. hypothalamus c. pituitary d. thyroid

C. Pituitary

A child's medical record states he has an altered level of consciousness. What is the priority problem for the nurse to assess for this child? a. trauma b. abusive head trauma c. infection of the brain or meninges d. brainstem abnormalities

C. infection of the brain or meninges

A child presents in the pediatric clinic where the parent reports that his facial features appear "coarser" than before and new onset of hyperhidrosis. Which diagnostic test does the nurse prepare the patient and parent for? a. 24 hour urinalysis b. anti-insulin antibody c. oral glucose tolerance test d. serum hormone assay

C. oral glucose tolerance test

The pediatric nurse understands that which endocrine gland is responsible for calcium metabolism? a. adrenal b. hypothalamus c. parathyroid d. thyroid

C. parathyroid

A school aged child with type 1 diabetes mellitus 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? a. Eat twice the amount normally eaten at lunchtime b. Take half the amount of prescribed insulin on practice days c. Take the prescribed insulin at noontime rather than in the morning d. Eat a small box of raisins or drink a cup of orange juice before soccer practice

D. Eat a small box of raisins or drink a cup of orange juice before soccer practice

A child is brought to the emergency department with a chemical burn to the eye. Which action by the nurse takes priority? a. attaching the child to the cardiac monitor b. determining the composition of the chemical c. assessing how this injury could have occurred d. flushing the eye with saline or water for 15 minutes

D. flushing the eye with saline or water for 15 minutes

The pediatric nurse monitoring electrolytes understands that at what level does hyponatremia pose the threat of causing seizures? a. less than 150 b. less than 145 c. less than 130 d. less than 125

D. less than 125

A child has been diagnosed with a pituitary tumor. what medical management does the nurse prepare the child and family for? a. chemotherapy b. radiation treatments c. steroid infusions d. surgical removal

D. surgical removal

The student nurse studying thyroid disease knows that _______ disease is the most common cause of hyperthyroidism in children.

Graves'

The pediatric nurse assesses __________ to determine brainstem involvement after a traumatic brain injury. Children with brainstem injuries have a poor prognosis.

Reflexes

The clinical nurse knows that when one hormone affects the release of another hormone it is referred to as a negative feedback system. This kind of relationship exists between the hypothalamus, the pituitary, and the __________.

Thyroid

The nurse notes documentation that a child is exhibiting an inability to flex the leg when the thigh is flexed anteriorly at the hip. Which condition does the nurse suspect? a. Meningitis b. Spinal cord injury c. Intracranial bleeding d. Decreased cerebral blood flow

a. Meningitis

The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply: a. Time the seizure b. Restrain the seizure c. Stay with the child d. Place the child in a prone position e. Move furniture away from the child f. Insert a padded tongue blade in the child's mouth

a. Time the seizure c. Stay with the child e. Move furniture away from the child

The pediatric nurse understands that the priorities of trauma care for a child with a spinal cord injury are initiated with primary attention to ______ __________, breathing and/or ventilatory support, circulation support, disability identification, and exposure of known and unknown physical limitations.

airway management

The clinic nurse examining a patient in the clinic suspects that a patient has Addison disease, a condition that is the result of an underactive adrenal gland. An underactive adrenal gland produces insufficient amounts of cortisol (a steroid hormone that helps to control the body's use of fats, proteins, and carbohydrates; suppresses inflammatory reactions in the body; and affects immune system functions) and ______________ (a steroid hormone that controls sodium and potassium in the blood).

aldosterone

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

b. It is negative

An infant with a diagnosis of hydrocephalus is scheduled for surgery. Which is the priority nursing intervention in the preoperative period? a. Test the urine for protein b. Reposition the infant frequently c. Provide a stimulating environment d. Assess blood pressure every 15 minutes

b. Reposition the infant frequently

The pediatric nurse explains to the parents of a patient that as an endocrine gland, the pancreas produces both insulin and glucagons, which in turn are carried to the body through the bloodstream. The nurse states that each hormone is produced in the islets of Langerhans but through two different types of tissue: alpha cells produce glucagon and ________ _________ produce insulin.

beta cells

The parents of a child recently diagnosed with cerebral palsy asks the nurse about the limitations of the disorder. The nurse responds by explaining that the limitations occur as a result of which pathophysiological process? a. An infectious disease of the central nervous system b. An inflammation of the brain as a result of a viral illness c. A chronic disability characterized by impaired muscle movement and posture d. A congenital condition that results in moderate to severe intellectual disabilities

c. A chronic disability characterized by impaired muscle movement and posture

A child has fluid volume deficit. The nurse performs an assessment and determines that the child is improving, and the deficit is resolving if which finding is noted a. The child has no tears b. Urine specific gravity is 1.035 c. Capillary refill is less than 2 seconds d. Urine output is less than 1 mL/kg/hour

c. Capillary refill is less than 2 seconds

A lumbar puncture is performed on a child suspected to have bacterial meningitis, and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? a. Clear CSF, decreased pressure, and elevated protein level b. Clear CSF, elevated protein, and decreased glucose level c. Cloudy CSF, elevated protein, and decreased glucose levels d. Cloudy CSF, decreased protein, and decreased glucose levels

c. Cloudy CSF, elevated protein, and decreased glucose levels

The mother of a 6-year-old who has type 1 diabetes mellitus 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? a. Hold the next dose of insulin b. Come to the clinic immediately c. Encourage the child to drink liquids d. Administer an additional dose of regular insulin

c. Encourage the child to drink liquids

The nurse should implement which interventions for a child older than 2 years with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dL? Select all that apply: a. Administer regular insulin b. Encourage the child to ambulate c. Give the child a teaspoon of honey d. Provide electrolyte replacement therapy intravenously e. Wait 30 minutes and confirm the blood glucose reading f. Prepare to administer glucagon subcutaneously if unconsciousness occurs

c. Give the child a teaspoon of honey f. Prepare to administer glucagon subcutaneously if unconsciousness occurs

The nurse is assigned to care for an 8-year-old child with a diagnosis of a basilar skull fracture. The nurse reviews the health care provider's prescription and should contact the HCP to question which prescription? a. Obtain daily weight b. Provide clear liquid intake c. Nasotracheal suction as needed d. Maintain a patent IV line

c. Nasotracheal suction as needed

The nurse is reviewing the record of a child with increased intracranial pressure and notes that the child has exhibited signs of decerebrate posturing. On assessment of the child, the nurse expects to note which characteristic of this type of posturing? a. Flaccid paralysis of all extremities b. Adduction of the arms at the shoulders c. Rigid extension and pronation of the arms and legs d. Abnormal flexion of the upper extremities and extension and adduction of the lower extremities

c. Rigid extension and pronation of the arms and legs

The pediatric nurse planning a diet for a child with type 1 diabetes knows that the goal for a dietary plan is to balance foods that include caloric intake from ______________ (50 to 60%), fats (20 to 30%), and proteins (10 to 20%).

carbs

The pediatric nurse examining a child's eyes notes the presence of a hard, small nodule on the eyelid. The nurse documents a(n) _____________, a granuloma of the meibomian gland.

chalazion

A mother arrives at the emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected. The nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP? a. Nausea b. Irritability c. Headache d. Bradycardia

d. Bradycardia

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? a. Obtains weight b. Takes the temperature c. Takes the blood pressure d. Checks the amount of urine output

d. Checks the amount of urine output

An adolescent client with type 1 diabetes mellitus is admitted to the emergency department for treatment of diabetic ketoacidosis. Which assessment findings should the nurse expect to note? a. Sweating and tremors b. Hunger and hypertension c. Cold, clammy skin and irritability d. Fruity breath odor and decreasing level of consciousness

d. Fruity breath odor and decreasing level of consciousness

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of infection, which precautionary intervention should be included in the plan of care? a. Maintain enteric precautions b. Maintain neutropenic precautions c. No precautions are required as long as antibiotics have been started d. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

d. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics

A child with type 1 diabetes mellitus is brought to the emergency department by the mother, who states that the child has been complaining of abdominal pain and has been lethargic. Diabetic ketoacidosis is diagnosed. Anticipating the plan of care, the nurse prepares to administer which type of IV infusion? a. Potassium infusion b. NPH insulin infusion c. 5% dextrose infusion d. Normal saline infusion

d. Normal saline infusion

A child is diagnosed with Reye's syndrome. The nurse creates a nursing care plan for the child and should include which intervention in the plan? a. Assessing hearing loss b. Monitoring urine output c. Changing body position every 2 hours d. Providing a quiet atmosphere with dimmed lighting

d. Providing a quiet atmosphere with dimmed lighting

The nurse has just administered ibuprofen to a child with a temperature of 102. The nurse should also take which action? a. Withhold oral fluids for 8 hours b. Sponge the child with cold water c. Plan to administer salicylate in 4 hours d. Remove excess clothing and blankets from the child

d. Remove excess clothing and blankets from the child

The nurse creates a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item needs to be place at the child's bedside? a. Emergency cart b. Tracheotomy set c. Padded tongue blade d. Suctioning equipment and oxygen

d. Suctioning equipment and oxygen

The nurse specializing in infectious diseases knows that the most common types of viral ____________ are caused by arthropod-borne (mosquito-borne) viruses and the herpes simplex type I virus.

encephalitis

The pediatric nurse discusses seizures in children with the student nurse and explains that the hospitalized child should receive continuous cardiac, respiratory, and ___________ monitoring.

oxygen