Ped Acute Disorders NCLEX Questions

A nurse is teaching the guardians of an infant who has mild gastroesophageal reflux (GER). Which of the following instructions about feeding therapies should the nurse recommend? 1. "Apply the infant's diaper snugly prior to feedings." 2. "Administer nasogastric feedings." 3. "Thicken feedings with rice cereal." 4. "Place the infant in a lateral position for 1 hour after feedings."

3. "Thicken feedings with rice cereal."

The nurse is reviewing the primary health care provider's documentation in the record of a child admitted with a diagnosis of intussusception. The nurse expects to note that the primary health care provider has documented which manifestation? 1. Scleral jaundice 2. Projectile vomiting 3. Currant jelly-like stools 4. Pale-colored and hard stools

3. Currant jelly-like stools

A nurse is caring for a child who has a possible intussusception. The parents of the child ask the nurse how the diagnosis is determined. Which of the following responses should the nurse make? 1. "An abdominal ultrasound will confirm the pocket in the intestine." 2. "Genotyping will be done to identify this condition." 3. "A biopsy will be done on a small amount of tissue from the colon." 4. "An upper GI series should identify the area involved."

1. "An abdominal ultrasound will confirm the pocket in the intestine."

The nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching? 1. "I should place a steam vaporizer in my child's room." 2. "I will take my child out into the cool, humid night air." 3. "I could place a cool-mist humidifier in my child's room." 4. "I will have my child inhale the steam from warm running water."

1. "I should place a steam vaporizer in my child's room."

A nurse is teaching the parents of a child who has rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching? 1. "My child may take aspirin for his joint pain." 2. "My child will need a blood transfusion prior to discharge." 3. "I will need to wear a gown when I'm in my child's room." 4. "I will apply lotion to my child's peeling hands."

1. "My child may take aspirin for his joint pain."

A nurse is caring for a pre-school age child who has epiglottitis with a barking cough. Which of the following actions should the nurse take? 1. Monitor oxygen saturation. 2. Use a tongue depressor to observe the epiglottis. 3. Obtain a throat culture 4. Initiate airborne precautions.

1. Monitor oxygen saturation.

A child is suspected of suffering from intussusception. The nurse should be alert to which clinical manifestation of this condition? 1. Tender, distended abdomen 2. Presence of fecal incontinence 3. Incomplete development of the anus 4. Infrequent and difficult passage of dry stools

1. Tender, distended abdomen

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the primary health care provider did not prescribe antibiotics. Which response should the nurse make? 1. "The child may be allergic to antibiotics." 2. "The child is too young to receive antibiotics." 3. "Antibiotics are not indicated unless a bacterial infection is present." 4. "The child still has the maternal antibodies from birth and does not need antibiotics."

3. "Antibiotics are not indicated unless a bacterial infection is present."

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 nurse is caring for a 6-month-old infant who has intussusception. Which of the following actions should the nurse take? 1. Prepare to administer high-dose steroids 2. Give the child magnesium hydroxide PO 3. Prepare the child for a barium enema 4. Inform the parents that the child will need a colostomy

3. Prepare the child for a barium enema

An emergency department nurse is performing an assessment on a child with a suspected diagnosis of intussusception. Which assessment question for the parents will elicit the most specific data related to this disorder? 1. "Does the child have any food allergies?" 2. "What do the bowel movements look like?" 3. "Has the child eaten any food in the last 24 hours?" 4. "Can you describe the type of pain that the child is experiencing?"

4. "Can you describe the type of pain that the child is experiencing?"

The nurse is collecting data on an infant with a diagnosis of suspected Hirschsprung's disease. Which question to the mother will most specifically elicit information regarding this disorder? 1. "Does your infant have diarrhea?" 2. "Is your infant constantly vomiting?" 3. "Does your infant constantly spit up feedings?" 4. "Does your infant have foul-smelling, ribbon-like stools?"

4. "Does your infant have foul-smelling, ribbon-like stools?"

A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the student nurse to describe the disorder. Which statement by the student nurse indicates correct understanding of this disorder? 1. "It is an acute bowel obstruction." 2. "It is a condition that causes an acute inflammatory process in the bowel." 3. "It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel." 4. "It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

4. "It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

The nurse reviews the laboratory results for a child with a suspected diagnosis of rheumatic fever, knowing that which laboratory study would assist in confirming the diagnosis? 1. Immunoglobulin 2. Red blood cell count 3. White blood cell count 4. Anti-streptolysin O titer

4. Anti-streptolysin O titer

The nurse is preparing an infant for surgery to treat Hirschsprung's disease. Which assessment finding is priority to identify and treat? 1. Vomiting and irritability 2. Malnourishment and lethargy 3. Abdominal distension and tenderness 4. Decreased blood pressure and tachycardia

4. Decreased blood pressure and tachycardia

The clinic nurse reviews the record of an infant and notes that the primary 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

After hydrostatic reduction for intussusception, the nurse should expect to observe which client response? 1. Abdominal distension 2. Currant jelly-like stools 3. Severe, colicky-type pain with vomiting 4. Passage of barium or water-soluble contrast with stools

4. Passage of barium or water-soluble contrast with stools

An infant is seen in the primary health care provider's office for complaints of projectile vomiting after feeding. Findings indicate that the child is fussy and is gaining weight but seems never to get enough to eat. Pyloric stenosis is suspected. Which prescription would the nurse anticipate having the highest priority in the care of this child? 1. Monitor intake and output. 2. Administer predigested formula. 3. Administer omeprazole before feeding. 4. Prepare the family for surgery for the child.

4. Prepare the family for surgery for the child.

A nurse is admitting a child who has suspected epiglottitis. Which of the following actions should the nurse take first? 1. Place the child on droplet precautions. 2. Administer 0.9% sodium chloride IV solution. 3. Initiate IV antibiotics. 4. Assist with obtaining an x-ray of the child's neck.

1. Place the child on droplet precautions.

A nurse in an emergency department is assessing a 3-year-old child who has a high fever, severe dyspnea, and is drooling. Which of the following actions is the nurse's priority? 1. Prepare for nasotracheal intubation. 2. Administer an antipyretic. 3. Obtain blood culture specimens. 4. Insert an IV catheter

1. Prepare for nasotracheal intubation.

A child is admitted to the pediatric unit with a diagnosis of acute stage Kawasaki disease. Which assessment findings by the nurse are characteristic of this disorder? Select all that apply. 1. Red throat 2. Cracking lips 3. Conjunctival hyperemia 4. Desquamation of the skin 5. Enlargement of the cervical lymph nodes

1. Red throat 3. Conjunctival hyperemia 5. Enlargement of the cervical lymph nodes

The nurse is creating a plan of care for a child admitted with a diagnosis of Kawasaki disease. In developing the initial plan of care, the nurse should include monitoring the child for signs of which condition? 1. Bleeding 2. Heart failure 3. Failure to thrive 4. Decreased tolerance to stimulation

2. Heart failure

A nurse is providing teaching to the guardian of a child who has Kawasaki disease. Which of the following statements by the guardian indicates an understanding of the teaching? Select all that apply. 1. "My child will likely be irritable for the next few weeks." 2. "I will notify my child's doctor if the skin on her hands or feet begins to peel." 3. "I will ensure my child does not receive any live vaccines for at least 18 months." 4. "I will keep a record of my child's temperature until she has no fever for several days." 5. "My child will have joint stiffness primarily at the end of the day."

1. "My child will likely be irritable for the next few weeks." 3. "I will ensure my child does not receive any live vaccines for at least 18 months." 4. "I will keep a record of my child's temperature until she has no fever for several days."

The nurse is reviewing the laboratory results for an infant with suspected hypertrophic pyloric stenosis. What should the nurse expect to note as the most likely finding in this infant? 1. Metabolic acidosis 2. Metabolic alkalosis 3. Respiratory acidosis 4. Respiratory alkalosis

2. Metabolic alkalosis

The nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data 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

A nurse is caring for a 6-week-old infant following a pyloromyotomy. Which of the following forms of feeding should the nurse anticipate for the infant 6 hr after the procedure? 1. Bottle formula with added protein 2. Small, frequent bottle feedings of electrolyte solution 3. Continuous nasoduodenal tube feedings 4. Bolus feeding via gastronomy tube

2. Small, frequent bottle feedings of electrolyte solution

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? 1. The child exhibits nasal flaring and bradycardia. 2. The child is leaning forward, with the chin thrust out. 3. The child has a low-grade fever and complains of a sore throat. 4. The child is leaning backward, supporting herself or himself with the hands and arms.

2. The child is leaning forward, with the chin thrust out.

The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding? 1. Extreme fatigue 2. The presence of pain 3. An airway obstruction 4. The presence of dehydration

3. An airway obstruction

On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? 1. Cracked lips 2. Normal appearance 3. Conjunctival hyperemia 4. Desquamation of the skin

3. Conjunctival hyperemia

A nurse in an emergency department is assessing an infant who has laryngotracheobronchitis. Which of the following findings should the nurse report as an indication of impending airway obstruction? 1. Bradycardia 2. Respiratory depression 3. Nasal flaring 4. Barking cough

3. Nasal flaring

A child with rheumatic fever will be arriving to the nursing unit for admission. On admission assessment, the nurse should ask the parents which question to elicit assessment information specific to the development of rheumatic fever? 1. "Has the child complained of back pain?" 2. "Has the child complained of headaches?" 3. "Has the child had any nausea or vomiting?" 4. "Did the child have a sore throat or fever within the last 2 months?"

4. "Did the child have a sore throat or fever within the last 2 months?"

The nurse is collecting data on a child with a diagnosis of rheumatic fever. Which question should the nurse initially ask the mother of the child? 1. "Has the child been vomiting?" 2. "Has the child had any diarrhea?" 3. "Does the child complain of chest pain and numbness in the right arm?" 4. "Has the child complained of a sore throat within the past few months?"

4. "Has the child complained of a sore throat within the past few months?"

A clinic nurse is providing teaching to the parent of a 1-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? 1. "I will give lansoprazole 30 min after my baby's feedings." 2. "I will lay my baby on her side after feedings." 3. "I will give my baby a bottle just before bedtime." 4. "I will add rice cereal to my baby's feeding."

4. "I will add rice cereal to my baby's feeding."

An infant is seen in the primary health care provider's office for complaints of frequent vomiting and spitting up after feedings. Findings indicate that the infant is not gaining weight, and gastroesophageal reflux is suspected. Which would the nurse anticipate being prescribed initially in the care of this child? 1. Administer omeprazole before feeding. 2. Place infant in prone position after each feeding. 3. Instruct parents to keep a log of feedings and any reflux present. 4. Administer predigested formula and feed small, frequent feedings.

4. Administer predigested formula and feed small, frequent feedings.

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

The clinic nurse reviews the record of an infant and notes that the primary health care provider (PHCP) 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 child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action? 1. Tell the mother that the child must stay in the tent. 2. Place a toy in the tent to make the child feel more comfortable. 3. Call the primary health care provider and obtain a prescription for a mild sedative. 4. Let the mother hold the child and direct the cool mist over the child's face.

4. Let the mother hold the child and direct the cool mist over the child's face.

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying, and trying to climb out of the tent. Which is the most appropriate nursing action? 1. Tell the mother that the child must stay in the tent. 2. Place a toy in the tent to make the child feel more comfortable. 3. Call the pediatrician and obtain a prescription for a mild sedative. 4. Let the mother hold the child and direct the cool mist over the child's face.

4. Let the mother hold the child and direct the cool mist over the child's face.

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 child is diagnosed with Hirschsprung's disease. The nurse is teaching the parents about the cause of the disease. Which statement, if made by the parent, supports that teaching was successful? 1. "Special cells are not present in the rectum, which caused the disease." 2. "The protein part of wheat, barley, rye, and oats is not being digested fully." 3. "The disease occurs from increased bowel motility that leads to spasm and pain." 4. "The disease occurs because of inability to tolerate sugar found in dairy products."

1. "Special cells are not present in the rectum, which caused the disease."

The nurse is reviewing the laboratory test results for an infant suspected of having hypertrophic pyloric stenosis. The nurse should expect to note which value as the most likely laboratory finding in this infant? 1. Blood pH of 7.50 2. Blood pH of 7.35 3. Blood bicarbonate of 22 mEq/L (22 mmol/L) 4. Blood bicarbonate of 27 mEq/L (27 mmol/L)

1. Blood pH of 7.50

A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which finding indicates that the treatment has been effective? 1. Decreased stridor 2. Barking cough 3. Improved hydration 4. Decreased temperature

1. Decreased stridor

The nurse reviews the laboratory results for a child with rheumatic fever and would expect to note which findings? Select all that apply. 1. Elevated C-reactive protein 2. Elevated antistreptolysin O titer 3. Presence of Reed-Sternberg cells 4. Presence of group A beta-hemolytic strep 5. Decreased erythrocyte sedimentation rate

1. Elevated C-reactive protein 2. Elevated antistreptolysin O titer 4. Presence of group A beta-hemolytic strep

A child has been tentatively diagnosed with rheumatic fever. The nurse interprets that this diagnosis is consistent with which laboratory result obtained for this child? 1. Elevated antistreptolysin O titer 2. Decreased erythrocyte sedimentation rate 3. Negative result on antinuclear antibody assay 4. Negative result on C-reactive protein determination

1. Elevated antistreptolysin O titer

The nurse is developing a plan of care for a 5-week-old infant being admitted with hypertrophic pyloric stenosis who is scheduled for pyloromyotomy. In the preoperative period, the nurse should place the infant in which best position? 1. In an infant seat placed in the crib 2. Prone with the head of the bed elevated 3. Supine with the head at a 90-degree angle 4. Supine with the head of the bed at a 15-degree angle

1. In an infant seat placed in the crib

A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the primary health care provider, should the nurse question? 1. Obtain a throat culture. 2. Obtain axillary temperatures. 3. Administer humidified oxygen. 4. Administer acetaminophen for fever.

1. Obtain a throat culture.

A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take? 1. Place the child in an upright position 2. Obtain a throat culture 3. Transport the child to radiology for a throat x-ray 4. Visualize the epiglottis with a tongue depressor

1. Place the child in an upright position

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the pediatrician did not prescribe antibiotics. Which response should the nurse make? 1. "The child may be allergic to antibiotics." 2. "The child is too young to receive antibiotics." 3. "Antibiotics are not indicated unless a bacterial infection is present." 4. "The child still has the maternal antibodies from birth and does not need antibiotics."

3. "Antibiotics are not indicated unless a bacterial infection is present."

A mother brings her 5-week-old infant to the health care clinic and tells the nurse that the child has been vomiting after meals. The mother reports that the vomiting is becoming more frequent and forceful. The nurse suspects pyloric stenosis and asks the mother which assessment question to elicit data specific to this condition? 1. "Are the stools ribbon-like, and is the infant eating poorly?" 2. "Does the infant suddenly become pale, begin to cry, and draw the legs up to the chest?" 3. "Does the vomit contain sour, undigested food without bile, and is the infant constipated?" 4. "Does the infant cry loudly and continuously during the evening hours but nurses or takes formula well?"

3. "Does the vomit contain sour, undigested food without bile, and is the infant constipated?"

The nurse is reviewing the primary health care provider's prescriptions for a child with rheumatic fever who is suspected of having a viral infection. The nurse notes that aspirin is prescribed for the child. Which nursing action is most appropriate? 1. Administer acetaminophen for temperature elevation. 2. Administer the aspirin if the child's temperature is elevated. 3. Administer the aspirin if the child experiences any joint pain. 4. Consult with the primary health care provider to verify the prescription.

4. Consult with the primary health care provider to verify the prescription.

A 12-year-old is admitted to the hospital with a low-grade fever and joint pain. Which diagnostic test finding will assist to determine a diagnosis of rheumatic fever? 1. Absence of C-reactive protein 2. Presence of Reed-Sternberg cells 3. Decreased antistreptolysin O titer 4. Elevated erythrocyte sedimentation rate

4. Elevated erythrocyte sedimentation rate