uworld exam 3

A peds nurse is taking history of a child hospitalized with Reye syndrome. Which of the following is a common occurrence seen in patients with Reye's Syndrome?

Cerebral Edema also fatty liver

While educating a new 7 y.o diabetic patient and the parents, the pediatric nurse includes which of the following times during the day when the child's blood sugar level needs to be monitored?

Check blood glucose levels ac and hs

A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal anti-inflammatory drug (NSAID). What nursing consideration should be included?

Check for abdominal pain and bloody stools.

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?

Choking with feedings

A child seen in renal clinic is diagnosed with Vesicoureteral Reflux (VUR). Primary reflux usually occur as a result of which of the following?

Congenital anomaly

A school age child with acute diarrhea and mild dehydration is given oral rehydration solution (ORS). The child's mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which of the following?

Continue to give ORS frequently in small amounts

The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

Corn on the cob with butter

95. The nurse is teaching infant care to parents with an infant who has been diagnosed with osteogenesis imperfecta (OI). What should the nurse include in the teaching session?

"Lift the infant by the buttocks, not the ankles, when changing diapers."

The nurse is assessing a 4 y.o boy in the pediatric clinic. Which behaviors by the client would concern the nurse for possible Duchenne muscular dystrophy? Select all.

-Frequent trips and falls at home-Places hands on thighs to push up to stand -Walks on tiptoes and has disproportionately large calves

Of the following which are possible signs of Cerebral Palsy (CP) ? Select All.

-Poor head control after age 3 months -Persistent primitive reflexes -Feeding difficulties

A 5 y.o male diagnosed with moderate dehydration should be given Oral Rehydration Solution by the nurse or parent with which of the following rehydration therapy?

100ml/kg/4 hrs

What child has a cyanotic congenital heart defect?

2 month old with tetralogy of Fallot

A 5 y.o male diagnosed with mild dehydration should be given Oral Rehydration Solution (ORS) by the nurse or parent with which of the following rehydration therapy?

50 ml/kg/ 4 hrs

A 13 y.o male has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this adolescent's fracture is how long?

8-12 weeks

A 2 y.o child is receiving digoxin(Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?

90 beats/min

A child diagnosed with Coarctation of Aorta is scheduled for a f/u visit. While assessing the pediatric nurse would expect to find which of the following symptoms?

Absent or diminished femoral pulses

A 4 y.o male seen in the peds specialty renal clinic has symptoms of end stage renal disease and visual disturbances. Which of the following is likely his diagnosis?

Alport Syndrome

What structural defects constitute tetralogy of Fallot?

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

A 10 y.o patient is undergoing hemodialysis with an internal AV fistula in place. What do you do to prevent anxiety and pain associated with the shunt?

Apply EMLA cream over fistula

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Assessing bowel function.

The parent of a child with growth hormone (GH) deficiency is learning to administer GH therapy. When is the best time for the parent to administer the GH to the child?

At bedtime using subQ needle

78. A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician?

Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride. (0.9% normal saline should be given).

Which of the following is standard therapy used in the care of children with Osteogenesis Imperfecta?

Bisphosphonate Therapy and physical therapy

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

Bowel cleansing.

What drug is an anglotensin-converting enzyme(ACE) inhibitor?

Captopril(Capoten)

Transposition of the Great Vessel(TGV) is incompatible with life.Prostaglandin E is given to children with this medical emergency to keep which of the following shunts open in an infant with TGV?

Ductus Arterlosus

When does idiopathic scoliosis become most noticeable?

During the preadolescent growth spurt.

Children with steroid induced Cushing syndrome should receive their medication at which of the following times to lessen the Cushingoid features? Give the drug:

Early in the morning upon awakening

A child is recovering from Kawasaki's Disease(KD). The child should be monitored for which?

Electrocardiograph(ECG) changes

A newborn seen in peds renal clinic receives a diagnosis of Alport Syndrome. Which of the following should be included in the counseling given to the parents?

Encourage parents to seek genetic counseling

Select from list below a reason for 'Innocent' heart murmurs in infants:

Fever

What is the most common cause for the overproduction of growth hormones in acromegaly?

Pituitary adenoma

A 3 month old with a hypercyanotic spell. What should be the nurse's first action?

Place the child in knee chest position

.A 2 y.o child diagnosed with tetralogy of Fallot becomes upset, crying, and thrashing around when a blood specimen is obtained. The childs color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first

Place the child in knee to chest position

52.What sign/symptom is a major clinical manifestation of rheumatic fever(RF)?

Polyarthritis

. The pediatric version of the Glasgow Coma Scale is used on a 3 y.o male after falling from a tree in his back yard. A score of 3 on his chart is associated with?

Poor outcome or Comatose state

A school age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?

Popcorn

A nurse is reviewing the laboratory values of a child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition?

Positive antistreptolysin titer

Which of the following would be involved in the nursing care of a child with an atrial septal defect?

Preparing the child and family for cardiac catheterization

The physician suggests that surgery be performed for patent ductus arteriosus(PDA) to prevent which complication?

Pulmonary vascular congestion

An infant was assessed in peds clinic with the following symptoms: visible peristalsis, failure to thrive, an infant who is 'always hungry', dehydration. What is the likely diagnosis?

Pyloric Stenosis

A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 2 to 5 hrs after administration?

Regular insulin

A child with hypopituitarism is being started on growth hormone (GH) therapy. Nursing considerations should be based on which knowledge?

Replacement therapy requires daily subcutaneous injections

Tetralogy of fallout consists of pulmonic stenosis, overriding aorta, ventricular septal defect, and which of the following?

Right ventricular hypertrophy

46. Of the following diagnosis, which would the nurse identify as a priority for the infant with tracheoesophageal fistula (TEF)?

Risk of injury related to increased potential for aspiration

A 12 y.o child is seen in specialty clinic has ill fitting clothes, a rib hump and hip asymmetry, recently noticed by parents. Which of the following is the likely diagnosis of this child?

Scoliosis

A child with heart failure is in Lanoxin(digoxin). The laboratory value a nurse must closely monitor is which?

Serum Potassium

A 10-yar-old in peds clinic with fever, anorexia, crampy abdominal pain preceding watery or bloody diarrhea. What is the pathogen that causes the diarrhea?

Shigella.

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Skin and stoma care.

37. The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?

The laboratory reports a negative guaiac

A 2 y.o child has simple constipation and is brought to the clinic for evaluation. The therapeutic plan initially includes

Dietary modification

A 2 y.o child is on prednisone for minimal change nephrotic syndrome (MCNS). Which of the following indicates the effectiveness of prednisone therapy?

Diuresis occurs as urinary protein excretion diminishes

What is a common clinical manifestation of juvenile hypothyroidism?

Dry skin

A 4 y.o child seen in the ER has symptoms of Kawasaki Disease(KD). Of the symptoms listed below which can potentially develop and pose a high risk for children with KD?

Coronary artery aneurysm

A nurse is caring for an infant with myelomeningocele scheduled for a surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Cover with a sterile, moist, nonadherent dressing

An 18 month old male is scheduled for surgery to reposition his undescended testes. What is this child's diagnosis?

Cryptorchidism

A 2 y.o is hospitalized with suspected intussusception. Which finding is associated with intussusception?

Currant jelly stools

A 4 yr old female seen in peds clinical has urinary symptoms. What is the medical terminology for inflammation of the bladder?

Cystitis.

Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or girl. The nurse answers the parents based on what knowledge?

Gender assignments involves collaboration between the parents and a multidisciplinary team./Gender assignment involves a complex decision-making process

A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal anti-inflammatory drug (NSAID). What nursing consideration should be included?

Give NSAIDS between meals.

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

Hematuria and proteinuria

A 10 y.o female seen in specialty peds clinic has a diagnosis of Spina Bifida. On examination the peds nurse observes dark tufts of hair at the lumbar sacral region. Which of the following is the child's diagnosis?

Spina Bifida Oculta

The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?

Stool pH 7.0

.What drug is an angiotensin-converting enzyme(ACE) inhibitor?

Enalapril(Vasotec)

A child who has a cardia catheterization is being discharged. What should the nurse include in the discharge instructions to the parents?

Give sponge baths for 3 days to prevent infection

What clinical finding may be present in an older child with Coarctation of the Aorta?

High blood pressure in the upper extremities

The student nurse is aware that the Ketogenic diet is used as a therapy for seizure control in children. Which of the following best describes the Ketogenic diet?

High fat, low carb, and adequate protein diet

Which of the following medication is commonly used to treat Kawasaki's Disease(KD)?

IVIG

A toddler with symptoms of sudden inconsolable screaming or crying, drawing up of the knees to the chest, vomiting, and a tender distended abdomen will probably be diagnosed with which of the following diseases?

Intussusception

A nurse evaluates discharge teaching as successful when the parents of a school aged child with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt?

Irritability and increasing difficulty swallowing

What statement is true concerning osteogenesis imperfecta (OI)?

It is an inherited disorder.

What statement is an advantage of a peritoneal dialysis compared with hemodialysis?

It is easy to learn and can be done at home

Which of the following musculoskeletal disorders is associated with morning stiffness that improves with activity?

Juvenile Idiopathic arthritis

The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included?

Keep environmental stimuli to a minimum.

40. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?

Ketone bodies from fat metabolism

After a tonic clonic seizure, what symptoms should the nurse expect the child to experience?

Lethargy and confusion

An 11 y.o child was just admitted to the hospital for observation after a head injury. What clinical manifestation is most essential for the nurse to assess to detect early signs of a neurological condition?

Level of consciousness

A 12 y.o child is admitted to the PICU in acute renal failure (ARF). The nurse prepares to administer which of the following medication to rapidly provoke a flow of urine?

Mannitol (Osmitrol) or furosemide (Lasix) or both

A 3 y.o is admitted to the peds unit with minimal change nephrotic syndrome. What clinical manifestations are usually seen with this diagnosis?

Massive proteinuria, hypoalbuminemia, and edema

The nurse is caring for an 18 month old with rotavirus. Which of the following clinical manifestations would the nurse expect to observe?

Mild fever and vomiting followed by onset of watery stools

Select the surgical procedures usually done in children to correct heart defects from the following list(SELECT ALL)

Modified Blalock-Taussig Shunt Bidirectional Glenn Shunt

A 15 y.o male referred to a cardiologist is diagnosed with Infective Endocarditis. Which of the following symptoms are usually seen with this condition?(SELECT ALL)

Murmur, Osler nodes, Janeway spots

The nurse is doing a neurologic assessment on a 2 month old infant after a car accident. Moro, tonic, neck, and withdrawal reflexes are present. The nurse should recognize that these reflexes suggest which of the following?

Neurologic health

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestations would indicate pyloric stenosis? Select All.

Non-bilious vomiting and weight loss -Projectile vomiting -Olive-shaped mass above umbilicus

The following symptoms describes which of the conditions listed below: Multiple fractures at birth, growth failure, autosomal recessive inheritance?

Osteogenesis Imperfecta

What bone disorder of childhood is caused by an autosomal recessive defect in the synthesis of collagen?

Osteogenesis imperfecta

The pediatric nurse is preparing to admit a 5 y.o with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe?

Overflow incontinence with constant dribbling of urine

Which of the following P's will the pediatric nurse assess on a 10 y.o male after a recent fracture of the femur to determine the extent of his injury? Select all

Pallor, pain, paresthesia

A nurse evaluates discharge teaching as successful when the parents of an infant with a ventriculoperitoneal shunt insertion identify which sign as signaling a blocked shunt?

Tense fontanel and increased head circumference

After a pyloromyotomy, a week old infant is prescribed feedings of 1 to 2 oz of Pedialyte q 3 hrs then advance to breastmilk ad tolerated postoperatively. The nurse should advance the feeding if which occurs?

The infant is taking the Pedialyte without vomiting or distention

A 14 y.o is admitted to the emergency room with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture?

This type of fracture requires different management to prevent bone growth complications

What is an important consideration for the identification and treatment of cryptorchidism in a child by age 2 years?

Treatment is necessary to maintain the ability to be fertile when older

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?

Urine output will increase

A 12 y.o is being treated with Buck's Traction. What are important nursing interventions for this client?

Verify that the skin traction maintains the extremity in an extended position

45. Which of the following parameters would the nurse monitor to evaluate the initial effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)?

Vomiting

What major complication is associated with a child with chronic renal failure?

Water and sodium retention.

A newborn seen in endocrinology specialty clinic is diagnosed with hypothyroidism. Which of the following are common symptoms of hypothyroidism as seen in newborns? Select all

Weight gain, dry skin, hair loss

A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that the antibiotic therapy will begin:

When the medication is received from the pharmacy

Duchenne Muscular Dystrophy (DMD) has which of the following inheritance patterns?

X linked recessive trait

Which of the following pharmacology therapy is used to treat infants and children with Gastroesophageal Reflux Disease (GERD)?

Zantac (Ranitidine)