Quizzes

A mother brings her 18-month old to ER with croup (laryngotracheobronchitis). She wants antibiotics as her PCP would not prescribe them. Which response is appropriate? "Antibiotics are only effective against bacterial infections" "Children under 5 cannot safely receive antibiotics" "This child may be covered by his maternal antibodies" "Maybe the child is allergic to the antibiotics that need to be given" No answer text provided.

"Antibiotics are only effective against bacterial infections"

Which of the following would cause a nurse to suspect that an infection has developed under a cast? Complaint of paresthesia Cold toes Increased respirations "Hot spots" felt on cast surface"

"Hot spots" felt on cast surface" If hot spots are felt on the cast surface, they usually indicate infection beneath the area. This should be reported so that a window can be made in the cast to observe the sight.

Which statement from a 10 year- old newly diagnosed with T1D indicates he has understood the teaching? "I am so glad I can eat anything I want" "I need a snack before playing soccer "I only have to stick my finger once a day" "I should always give my shots in the same place"

"I need a snack before playing soccer

The nurse is caring for a 9- month old child who recently underwent repair of a left-sided cleft lip. Which statement by the parents would indicate the need for more teaching on how to care for their baby? "We will ensure the Logan's bow stays in place and we will clean it after feeds" "We will ensure the elbow restraints stay in place until the provider says to remove them" "We will follow up with the provider in 2 weeks as instructed" "We can give her a pacifier if she cries"

"We can give her a pacifier if she cries"

A 6 month -old boy has iron-deficiency anemia. Which of the following parental comments may help explain the condition in this child? "I can't get him to eat fruit, he doesn't like it." "I let him chew on bread now and then, he really likes it" "I never give him water." "We can't afford formula so we give him 2% cow's milk."

"We can't afford formula so we give him 2% cow's milk."

When both parents have sickle cell trait, what is the chance their children will have sickle cell anemia? 25% 50% 75% 100%

25%

The nurse is assessing a newborn. Which of the following would lead the nurse to suspect a VSD? A click heard at the right sternal border A loud murmur heard at the left sternal border BP is higher in the arms than the legs The infant refuses to eat

A loud murmur heard at the left sternal border

A 12-year old child is admitted to PICU with DKA. What are the symptoms? Select all that apply. Acidosis Alkalosis Fruity breath High bicarbonate Hyperglycemia Ketosis Overhydration

Acidosis Fruity breath Hyperglycemia Ketosis

Which of the following is the most appropriate nursing diagnosis for a child with anemia? Activity intolerance related to generalized weakness Alteration in cardiac output related to abnormal hemoglobin Potential for injury related to depressed sensorium Potential for injury related to dehydration and abnormal hemoglobin

Activity intolerance related to generalized weakness

A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include which of the following? Correction of acidosis Adequate hydration, pain management Pain management, administration of heparin Adequate oxygenation, replacement of factor VIII

Adequate hydration, pain management

Which of the following is an important nursing consideration when chest tubes will be removed from a child? Explain that it is not painful. Explain that only a small bandage will be needed. Administer analgesics before the procedure. Expect bright red drainage for several hours after removal.

Administer analgesics before the procedure.

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to which of the following? Neurologic manifestations that occur with dialysis Physiologic manifestations of renal disease Adolescents having few coping mechanisms Adolescents often resent the control and enforced dependence imposed by dialysis

Adolescents often resent the control and enforced dependence imposed by dialysis Correct: Older children and adolescents need control. The necessity of dialysis forces the adolescent into a dependent relationship, which results in these behaviors.

A 5 -month old infant is admitted after 2 days of vomiting & diarrhea. What is the best way to assess the fluid volume status of the infant? Test the urine osmolarity & blood work Maintain strict I/O records Answer Daily weights Assess skin turgor & fontanels

Answer Daily weights

A 10 year -old is admitted with chorea, fever, carditis and erythema marginatum. The diagnosis of rheumatic fever is made when which lab result is received? Anti-streptolysin O titer (ASO) is positive IgG is positive You Answered Rbc is low Wbc is elevated

Anti-streptolysin O titer (ASO) is positive

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet." The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following? Notify the physician. Apply a new bandage with more pressure. Place the child in the Trendelenburg position. Apply direct pressure above the catheterization site.

Apply direct pressure above the catheterization site.

A 15 year- old received an open compound fracture of the right femur and is placed in skeletal traction. During assessment, the nurse notes that the left foot is warmer than the right foot. What should be the nurse's next step? Assess the pedal pulses, color, warmth, sensation and movement of toes bilaterally Adjust the traction so it doesn't pull so much on the leg Encourage the patient to activate range of motion of both legs to stimulate circulation Recognize that vascular compromise may have taken place and alert the provider

Assess the pedal pulses, color, warmth, sensation and movement of toes bilaterally

A school nurse is assessing a child for scoliosis. What would the nurse assess or ask the child to do? Assess the shoulders and hips while fully clothed Bend at the waist and look for asymmetry of the back Bend the knees and hips and look for unevenness Walk forward heel to toe

Bend at the waist and look for asymmetry of the back

A 10-year old girl sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following? Healing is usually delayed in this type of fracture. Bone growth can be affected with this type of fracture. This is an unusual fracture site in young children. This type of fracture is inconsistent with a fall.

Bone growth can be affected with this type of fracture. Detection of epiphyseal injuries is sometimes difficult, but fractures involving the epiphysis or epiphyseal plate present special problems in determining whether bone growth will be affected.

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of which of the following complications? air emboli Allergic reaction Hemolytic reaction Circulatory overload

Circulatory overload

A 12-year old admitted with hemolytic uremic syndrome has had anuria for the past 24 hours. What action should the nurse anticipate? Ask the provider for a furosemide order IV fluid bolus Catheterization Dialysis

Dialysis

A 7-year-old has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which of the following should be included in the home care instructions? Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hours. The shoulder should be kept as immobile as possible to avoid pain. No restrictions of activity are indicated. Elevate the casted arm when both upright and resting.

Elevate the casted arm when both upright and resting. The injured extremity should be kept elevated while resting and in a sling when upright. This will increase venous return.

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which of the following should be included? Apply lotion or powder to minimize skin irritation. Remove the harness several times a day to prevent contractures. Emphasize the necessity to return to the clinic every 1 to 2 weeks. Place the diaper over the harness, preferably using a superabsorbent disposable diaper that is relatively thin.

Emphasize the necessity to return to the clinic every 1 to 2 weeks. Correct: Infants have a rapid growth pattern. The child needs to be assessed by the practitioner every 1 to 2 weeks for possible adjustments.

The therapeutic management of children with b-thalassemia major consists primarily of which of the following? Oxygen therapy Adequate hydration Supplemental iron Frequent blood transfusions

Frequent blood transfusions

A 9-year old child is diagnosed with Graves disease. How can the nurse assist the child and parents in planning care? Encourage strenuous activities to stay fit Have rest periods planned throughout the day Make sure the thyroid replacement is given daily at the same time Monitor calories to decrease intake

Have rest periods planned throughout the day

An 11-year-old boy has recently been diagnosed with diabetes. The nurse's teaching plan for daily injections should be based on which of the following? The parents do not need to learn the procedure. He is old enough to give most of his own injections. Self-injections will be possible when he is closer to adolescence. He can learn about self-injections when he is able to reach all injection sites.

He is old enough to give most of his own injections. School-age children are able to give their own injections.

Which of the following conditions is characterized by a history of bloody diarrhea, fever, abdominal pain, and a low hemoglobin and platelet count? Acute viral gastroenteritis Acute glomerulonephritis Hemolytic-uremic syndrome Acute nephrotic syndrome

Hemolytic-uremic syndrome c) Hemolytic-uremic syndrome is an acute disorder characterized by anemia, thrombocytopenia, and acute renal failure. Most affected children have a history of gastrointestinal symptoms

A child receives multiple blood transfusions due to thalassemia. Which complication can multiple transfusions cause? Hematuria Hematemesis Hemopytsis Hemosiderosis

Hemosiderosis

The young boy has had his spleen surgically removed due to chronic ITP (idiopathic thrombocytopenic purpura). Which statements by his parents show that discharge teaching has been effective? Select all that apply. If he gets a fever, I'll call our doctor right away If he does get sick, then we'll need to put on his medic alert bracelet Before he goes to the dentist, we'll make sure he gets antibiotics He's going to need several extra vaccines He's going to get really good at handwashing

If he gets a fever, I'll call our doctor right away Before he goes to the dentist, we'll make sure he gets antibiotics He's going to need several extra vaccines He's going to get really good at handwashing

Which of the following may be seen as an early sign in septic shock? Normothermia Increased cardiac output Vasoconstriction Angioneurotic edema

Increased cardiac output

The nurse closely monitors the temperature of a child with nephrotic syndrome. The purpose of this is to detect an early sign of which of the following possible complications? Infection Hypertension Encephalopathy Edema

Infection Correct: Infection is a constant source of danger to edematous children and those receiving corticosteroid therapy. An increased temperature could be an indication of an infection.

What clinical finding warrants further intervention for the child with acute poststreptococcal glomerulonephritis? Weight loss to within 1pound of the pre-illness weight Urine output of 1 ml/kg/hr A normal blood pressure Inspiratory crackles

Inspiratory crackles d) Children with excess fluid volume may develop pulmonary edema. Inspiratory crackles indicate fluid in the lungs

Which of the following is the primary method of treating osteomyelitis? Joint replacement Bracing and casting Intravenous antibiotic therapy Long-term corticosteroid therapy

Intravenous antibiotic therapy Osteomyelitis is an infection of the bone, most commonly caused by Staphylococcus aureus. The treatment of choice is antibiotics.

The nurse is assessing a 7 year old girl prior to cardiac catheterization. The nurse knows to pay particular attention to assessing pedal pulses. What is the best way to facilitate their assessment post-procedure? Mark the location of peripheral pulses with indelible marker Mark the pedal pulses with indelible marker , then document Document location and quality of pedal pulses Assess location and quality of peripheral pulses

Mark the pedal pulses with indelible marker , then document

The nurse is planning care for an adolescent with acquired immune deficiency syndrome (AIDS). Which of the following is the priority nursing goal? Minimizing exposure to infection. Prevent secondary cancers. Restore immunologic defenses. Identify source of infection.

Minimizing exposure to infection.

The nurse is caring for a child during a growth hormone stimulation test. Which of the following is the priority task for the care of this child? Monitoring blood glucose levels. Providing the child with ice chips. Educating the family about side effects. Monitoring intake and output.

Monitoring blood glucose levels. Correct: Monitoring blood glucose levels during a growth hormone stimulation test is the priority along with observing for signs of hypoglycemia, diaphoresis, and somnolence.

To help the adolescent deal with diabetes, the nurse must consider which of the following characteristics of adolescence? Desire to be unique Preoccupation with the future Need to be similar to peers Need to alert peers to the seriousness of the disease

Need to be similar to peers Adolescence is a time when the individual has a need to be perfect and similar to peers. Having diabetes makes adolescents different from their peers.

A 10 year old male with Cystic Fibrosis is having difficulty maintaining weight. Teaching plan for this child and family includes information about the need for which of the following? Pancreatic enzymes Salt supplements Fat-soluble vitamins only Extra vitamins

Pancreatic enzymes

The parents of a young child with congestive heart failure tell the nurse that they are "nervous" about giving digoxin. The nurse's response should be based on which of the following? It is a very safe, frequently used drug. It is difficult to either overmedicate or undermedicate with digoxin. Parents lack the expertise necessary to administer digoxin. Parents must learn specific, important guidelines for administration of digoxin.

Parents must learn specific, important guidelines for administration of digoxin.

A 14 year old male comes to the clinic with sore throat, headache & fever for 2 days. After noting palatal rash and scarlatiniform rash on the trunk. What should be the next step? Give aspirin for pain relief Draw blood for CBC Perform a rapid strep test Prepare for a lumbar puncture

Perform a rapid strep test

Which of the following is a clinical manifestation of the systemic venous congestion that can occur with congestive heart failure? Tachypnea Tachycardia Peripheral edema Pale, cool extremities

Peripheral edema

An 8-month-old infant has a hypercyanotic spell while blood is being drawn. The nurse's first action should be which of the following? Assess for neurologic defects. Place the child in the knee-chest position Begin cardiopulmonary resuscitation. Prepare the family for imminent death.

Place the child in the knee-chest position

A 6 year- old child suspected of having Type 1 diabetes presents to the ER. What would the nurse expect to find upon assessment? Blurred vision & weight gain Hyperactivity & inability to focus Polyuria, polyphagia & polydipsia Weight loss and hypotonia

Polyuria, polyphagia & polydipsia

The nurse must monitor a child with a respiratory disorder for dehydration. What would the nurse assess for? Select all that apply. Increased urinary output Poor skin turgor Thick mucus Concentrated urine Increased tears

Poor skin turgor Thick mucus Concentrated urine

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk exists of cerebrovascular accidents (strokes). Which of the following is an important objective to decrease this risk? Minimize seizures Prevent dehydration Promote cardiac output Reduce energy expenditure

Prevent dehydration

Surgical closure of the ductus arteriosus would do which of the following? Increase the flow of unoxygenated blood to the systemic circulation Decrease the edema in legs and feet Increase the oxygenation of blood Prevent the return of oxygenated blood to the lungs

Prevent the return of oxygenated blood to the lungs

A 3-week old infant is admitted with suspected pyloric stenosis. Which symptom would likely be observed? Explosive diarrhea Increased urinary output Projectile vomiting Fever & irritability

Projectile vomiting

Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. What is the priority nursing action? Keep the child warm with blankets. Apply a hypothermia blanket. Record the temperature on nurses' notes. Report findings to the physician.

Report findings to the physician.

A child is newly diagnosed with celiac disease. Which of the following are suitable foods to be included in family teaching about diet planning? Oatmeal, regular cereals Wheat & sourdough bread Rye toast, barley & wheat bran Rice, corn, tapioca, millet

Rice, corn, tapioca, millet

What are the signs and symptoms of intussusception in the infant? Sudden crying caused by abdominal pain Malnutrition, weight loss, abdominal distention Soft sausage shaped abdominal mass with pain and currant-jelly stools Dark urine with abdominal distention and failure to thrive

Soft sausage shaped abdominal mass with pain and currant-jelly stools

The nurse is examining the hands of a child with suspected iron deficiency anemia. Which finding would be expected? Cap refill <2 seconds Pink palms and nail beds Spooning of nails Absence of bruising

Spooning of nails

Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which of the following? The child needs opportunities to play with peers. The child needs to understand that peers' activities are too strenuous. Parents can meet all the child's needs. Constant parental supervision is needed to avoid overexertion.

The child needs opportunities to play with peers.

When teaching Jewish parents of a newborn with epispadias, what should the nurse include? It's wrong to have the infant circumcised and they should not do it The circumcision can be performed before the 8th day as their culture requires Circumcision should be performed to prevent infection The infant should not have a circumcision because the foreskin is needed for the repair

The infant should not have a circumcision because the foreskin is needed for the repair

The nurse is teaching the parents of a newborn diagnosed with congenital talipes equinovarus. What would the teaching include? The infant will need continuous cardiac monitoring for life The infant will need immediate surgery to correct this extremely serious deformity The newborn will undergo splinting and then serial casting of the affected feet The infant will undergo immediate brain surgery for intracranial hemorrhage

The newborn will undergo splinting and then serial casting of the affected feet

When caring for the child with Kawasaki disease, the nurse should know which of the following? The child's fever is usually responsive to antibiotics within 48 hours. The principal area of involvement is the joints. Aspirin is contraindicated. Therapeutic management includes administration of gamma globulin and aspirin.

Therapeutic management includes administration of gamma globulin and aspirin.

An adolescent is admitted to ER in sickle cell crisis with the following orders. Which order should the nurse implement first? Administer morphine IV Administer prophylactic antibiotics Initiate IV fluids Transfuse 1 unit platelets

Transfuse 1 unit platelets

Which of the following is most descriptive of the therapeutic management of osteosarcoma? Treatment usually consists of surgery and chemotherapy. Amputation of the affected extremity is always necessary. Intensive irradiation is the primary treatment. Bone marrow

Treatment usually consists of surgery and chemotherapy. The optimal therapy for osteosarcoma is a combination of surgery and chemotherapy.

A 5 year -old with sickle cell anemia is admitted to ER with severe leg pain. What crisis is she experiencing? Aplastic anemia Hyperhemolysis Splenic sequestration Vaso-occlusive crisis

Vaso-occlusive crisis

Which of the following is a physiological effect of immobilization on children? Metabolic rate increases. Increased joint mobility can lead to contractures in a short time. Bone calcium increases, Venous stasis can lead to thrombi and/or emboli formation.

Venous stasis can lead to thrombi and/or emboli formation. ANS: D Correct: The physiological effects of immobilization, as a result of decreased muscle contraction, include

A 15-year old girl is diagnosed with scoliosis. Family teaching on the cause would include? Heredity from both parents Juvenile rheumatoid arthritis Myelomeningocele at birth Vertebral abnormalities

Vertebral abnormalities

Which of the following statements is descriptive of most cases of hemophilia? Autosomal dominant disorder causing deficiency in a factor involved in the blood-clotting reaction X-linked recessive inherited disorder causing deficiency of platelets and prolonged bleeding X-linked recessive inherited disorder in which a blood-clotting factor is deficient Y-linked recessive inherited disorder in which the red blood cells become moon-shaped

X-linked recessive inherited disorder in which a blood-clotting factor is deficient

The nurse is teaching about iron supplementation to the parents of a 10-month old. Which of the following points is critical to emphasize? You must precisely measure the amount of iron Your child may become constipated from the iron Please give him plenty of fluids and fibre Place the liquid behind the teeth, as it can cause staining

You must precisely measure the amount of iron

The mother of a child who was recently diagnosed with glomerulonephritis asks why the doctor keeps talking about casts in the urine. The nurse's response is based on the knowledge that the presence of casts indicates which of the following? a. Glomerular injury b. Glomerular healing c. Recent streptococcal infection d. Excess protein in the urine

a. Glomerular injury The presence of red blood cell casts indicates glomerular injury.

What is the most appropriate intervention for an adolescent with mild scoliosis? a. Long term monitoring. b. Surgical intervention c. Bracing d. No follow up

a. Long term monitoring. A child with mild scoliosis requires long term follow up to determine whether the curve will progress or is stable.

Therapeutic management of the child with rheumatic fever includes: administration of penicillin. avoidance of salicylates (aspirin). strict bed rest for 4 to 6 weeks. administration of corticosteroids if chorea develops.

administration of penicillin.

A 13 year old girl is brought to the clinic with the complaint of "emotional lability and restlessness". Other symptoms include: gradual weight loss despite a good appetite; warm, moist skin; heat intolerance and unusually fine hair. These manifestations are most suggestive of which of the following? a.Hypothyroidism b. Hyperthyroidism c. Hypoparathyroidism d. Hyperparathyroidism

b. Hyperthyroidism b. These symptoms suggest hyperthyroidism.

The parent of a child asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on which of the following? a. It is a less expensive method of testing. b. It is not as accurate as laboratory testing. c. Children are better able to manage the diabetes. d. The parents are better able to manage the disease.

c. Children are better able to manage the diabetes.

A child with hypopituitarism is being started on growth hormone therapy. Nursing considerations should be based on knowledge of which of the following? a.Treatment is most succesful if it is started during adolescence. b.Treatment is considered succesful if children attain full stature by adulthood. c. Replacement therapy requires daily subcutaneous injections. d. Replacement therapy will be required throughout child's life.

c. Replacement therapy requires daily subcutaneous injections. c. Daily injections will be required for several years.

A pediatric nurse formulates the expected outcome that a child and family members will understand and demonstrate knowledge of meal planning for type 1 diabetes. Which nursing intervention assists with meeting this outcome? a. Avoiding the consumption of foods with sorbitol. b. Instructing to follow a simple carbohydrate and protein diet. c. Monitoring for the signs of hypoglycemia before meals. d. Teaching about the basic food groups and prescribed diet.

d. Teaching about the basic food groups and prescribed diet. Teaching the family about nutrition and the child's prescribeddiet will best enable this family to demonstrate this outcome.

What is the priority nursing diagnosis for a hospitalized infant with RSV bronchiolitis? Fatigue related to increased work of breathing ineffective breathing pattern related to inflamed airway and increased secretions Fear related to dyspnea Risk of fluid volume deficit related to inability to swallow

ineffective breathing pattern related to inflamed airway and increased secretions

Which of the following actions indicates that the parents of a 12-month-old infant with iron deficiency anemia understand how to administer iron supplements? they administer the iron supplements with fruit juice. They administer the iron supplements at meal time. They limit the number of iron-rich foods the child eats. They administer the iron supplements with milk.

they administer the iron supplements with fruit juice.