Pedi Exam 6 Practice

A nine-year- old has been diagnosed with a learning disorder that is characterized by problems with manual dexterity and coordination. The nurse teaches parents that this disorder is called: 1. Dysgraphia. 2. Dyscalculia. 3. Dyspraxia. 4. Dyslexia.

3. Dyspraxia.

The nurse is caring for four clients in the neonatal intensive care unit. Which infant has the greatest risk of developing retinopathy of prematurity (ROP)? 1. 28-weeks-gestation infant who has been on long-term oxygen and weighed 1,400 grams 2. 32-weeks-gestation infant of African heritage with a congenital heart defect who needed no oxygen and weighed 1,850 grams 3. 28-weeks-gestation female infant who was on short-term oxygen, weighed 1,420 grams, and was treated with phototherapy 4. 36-weeks-gestation, small-for- gestational-age infant who was in an oxyhood for 12 hours and weighed 1,800 grams

1. 28-weeks-gestation infant who has been on long-term oxygen and weighed 1,400 grams

The child has been admitted to the hospital unit newly diagnosed with retinoblastoma. What would the nurse expect to see when examining the child's eye? 1. A white reflex 2. Blue-tinged sclera 3. A red reflex 4. Yellow sclera

1. A white reflex

A child has thrombocytopenia secondary to chemotherapy treatments. Based on this finding, what should the nurse do? 1. Avoid administering intramuscular injections (IM). 2. Monitor intake and output. 3. Use palpation as a component of assessment. 4. Avoid performing oral hygiene.

1. Avoid administering intramuscular injections (IM).

The nurse is working with the mother of a child with autism. The goal of the session is to plan strategies to increase the child's socialization. The nurse is explaining behavior modification as a treatment process. The nurse will encourage the mother to: 1. Create a reward system when the child interacts with a person. 2. Punish the child when the child's social behaviors are inappropriate. 3. Use dolls to demonstrate appropriate social interactions to the child. 4. Enroll the child in a day care to encourage interaction with other children.

1. Create a reward system when the child interacts with a person.

Following diagnosis of Ewing's sarcoma, the physician orders chemotherapy for the 12-year- old child. After discussion with the physician, the parents refuse a central line so the chemotherapy will be administered by peripheral line. The nurse will prevent extravasation by: Standard Text: Select all that apply. 1. Ensuring that the intravenous line is a free flowing line. 2. Administering the medication by infusion pump. 3. Checking for blood return before and during chemotherapy administration. 4. Diluting the medication with normal saline. 5. Administering the vesicant drug last.

1. Ensuring that the intravenous line is a free flowing line. 3. Checking for blood return before and during chemotherapy administration.

The nurse is assessing a four-year- old child with a possible alteration in mental health. Which findings indicate a need for further investigation? Standard Text: Select all that apply. 1. Fails to make eye contact 2. Flinches when touched on the arm 3. History of limited prenatal care and precipitant delivery 4. Head circumference has not changed in over one year 5. Flat facial expressions

1. Fails to make eye contact 2. Flinches when touched on the arm 3. History of limited prenatal care and precipitant delivery 5. Flat facial expressions

The waiting room of the mental health clinic is full of children with various mental health issues. The nurse watches the children and notes that which child is displaying symptoms of autism? 1. Four-year- old girl who doesn't make eye contact with mother and resists the mother's touch 2. Three-year- old boy who joins one group of children then moves to another group of children without joining their activities 3. 18-month- old child who walks around the area using the furniture to provide balance 4. Six-year- old boy who chatters constantly to anyone who will listen

1. Four-year- old girl who doesn't make eye contact with mother and resists the mother's touch

Manifestations of cancer in the pediatric patient vary by type and location but typically include which of the following general manifestations? Standard Text: Select all that apply. 1. Infection 2. Weight gain 3. Polycythemia 4. Neurologic symptoms 5. Pain 6. Cachexia

1. Infection 4. Neurologic symptoms 5. Pain 6. Cachexia

A 10-month- old infant has had numerous ear infections since birth. The nurse will discuss with the parents ways that might reduce the incidence of otitis media and will include which strategies? Standard Text: Select all that apply. 1. Prohibiting tobacco smoke in the home 2. Avoiding use of a pacifier while the child is sleeping 3. Breastfeeding the infant 4. Cleaning the child's ears nightly with peroxide 5. Avoiding use of wood-burning stoves

1. Prohibiting tobacco smoke in the home 2. Avoiding use of a pacifier while the child is sleeping 5. Avoiding use of wood-burning stoves

A child is receiving chemotherapy induction for acute lymphocytic leukemia (ALL). Taking common side effects into consideration, which nursing diagnoses would be appropriate during the induction chemotherapy? Standard Text: Select all that apply. 1. Risk for injury: hemorrhagic cystitis 2. Skin integrity: impaired mucous membrane 3. Fluid and electrolyte impairment: nausea and vomiting 4. Risk for infection 5. Impaired sleep pattern 6. Diarrhea

1. Risk for injury: hemorrhagic cystitis 2. Skin integrity: impaired mucous membrane 3. Fluid and electrolyte impairment: nausea and vomiting 6. Diarrhea

A seven-year- old girl has been clinging to her mother and refusing to go to school. The child is diagnosed with separation anxiety disorder, and the treatment plan will include cognitive-behavioral therapy (CBT). The nurse would explain to the parents that CBT will include: Standard Text: Select all that apply. 1. Self-talking. 2. Relaxation. 3. Hypnosis. 4. Anti-depressant medications. 5. Recognition of feelings.

1. Self-talking. 2. Relaxation. 5. Recognition of feelings.

The nurse is monitoring the urine specific gravity and pH on a child receiving chemotherapy. The nurse will try to maintain the urine values at what levels? 1. Specific gravity 1.030 and pH 7.5 2. Specific gravity 1.005 and pH 6 3. Specific gravity 1.030 and pH 6 4. Specific gravity 1.005 and pH 7.5

4. Specific gravity 1.005 and pH 7.5

The nurse is caring for a young child with otitis media. The parent asks the nurse why children seem to get otitis media frequently but adults do not. The nurse would explain that younger children get otitis media more often because: 1. The eustachian tube is shorter, wider, and horizontal in younger children. 2. The eustachian tube is shorter, more narrow, and horizontal in younger children. 3. The eustachian tube is longer, wider, and vertical in younger children. 4. The eustachian tube is longer, more narrow, and vertical in younger children.

1. The eustachian tube is shorter, wider, and horizontal in younger children.

During rounds, the interdisciplinary team is discussing the care of a child with a newly diagnosed Wilms' tumor. The nurse describes the mother as being angry and upset that they are not caring properly for her child. What behavior probably is the cause of the mother's anger? 1. The mother is beginning the stages of grief over loss of her previously well child. 2. The mother is feeling guilty for not recognizing that the child was ill. 3. The nurses are negligent in providing safe care for the child. 4. The mother does not have adequate support from Social Services.

1. The mother is beginning the stages of grief over loss of her previously well child.

The school nurse is screening all second graders for tonsillitis and pharyngitis. Which finding is a normal finding in this age group? 1. Tonsils are large and seem to fill the throat. 2. Child is complaining of sore throat and drooling 3. White patches are observed on the tonsils. 4. Throat appears red, and child has a low-grade fever

1. Tonsils are large and seem to fill the throat.

The nurse can assist a child who has a mild hearing loss and reads lips to adapt to hospitalization by: 1. Touching the child lightly before speaking. 2. Using a picture board as the main means of communication. 3. Speaking in a loud voice while facing the child. 4. Speaking directly to the parents for communication.

1. Touching the child lightly before speaking.

A child with rhabdomyosarcoma is to undergo radiation therapy after surgical removal of the tumor. The parents should be taught to: 1. Apply lotion to the area before radiation therapy. 2. Apply sunscreen to the area when the child is exposed to sunlight. 3. Remove any markings left after each radiation treatment. 4. Vigorously scrub the area when bathing the child.

2. Apply sunscreen to the area when the child is exposed to sunlight.

The antiemetic drug ondansetron (Zofran) is being administered to a child receiving chemotherapy. It should be administered: 1. Only if the child experiences nausea. 2. Before chemotherapy administration, as a prophylactic measure. 3. After the chemotherapy has been administered. 4. Never; this antiemetic is not effective for controlling nausea and vomiting associated with chemotherapy.

2. Before chemotherapy administration, as a prophylactic measure.

After years of treatment with chemotherapy and radiation, a child with a brain tumor is shown to be refractory to treatment, and a DNR (Do Not Resuscitate) has been obtained. The mother has reached the stage of acceptance; the father is angry that the medical and nursing team has not been able to "save" his child. How would the multidisciplinary team best support this family? 1. Tell the father that he should have brought his child in earlier for treatment. 2. Continue to include the family in planning care and assure them that the child will be kept comfortable in the days to come. 3. Initiate a Social Services referral. 4. Contact the on-call chaplain for consultation with the entire family and ask him to take the father aside for additional assistance.

2. Continue to include the family in planning care and assure them that the child will be kept comfortable in the days to come.

The nurse is taking care of a child who had a tonsillectomy. During the postoperative period, the nurse should observe the child for which clinical manifestation? 1. Arrhythmias 2. Dehydration 3. Increased blood sugar 4. Increased urinary output

2. Dehydration

The 10-year- old boy is admitted to the pediatric neurologic unit with a suspected craniopharyngioma. The nurse will assess the child with which symptoms related to this brain tumor? Standard Text: Select all that apply. 1. Evening nausea 2. Excessive urination leading to dehydration 3. Nystagmus 4. Headaches 5. Orbital ecchymosis

2. Excessive urination leading to dehydration 3. Nystagmus 4. Headaches

A five-year- old child is on chemotherapy for rhabdomyosarcoma. Despite antiemetics, the child complains of nausea. The mother wants the child to eat and is pushing the child to eat the food. The nurse would talk with the mother and suggest that she not push the food on the nauseated child because: 1. The child does not need to eat as he is on intravenous fluids. 2. Forcing the child to eat may lead to a food aversion for the child. 3. Vomiting can lead to damage to the stomach. 4. Pushing the child to eat leads to a psychological conflict that may turn the child away from the parent.

2. Forcing the child to eat may lead to a food aversion for the child.

A three-year- old child has been found to have a mild to moderate hearing loss. The mother tells the nurse: "The doctor told me I should put my child in day care but didn't tell me why. Do you know why the doctor recommends day care?" The nurse's response will be based on the knowledge that day care will: 1. Help the child recognize his hearing deficit. 2. Increase the child's socialization skills. 3. Improve the child's immunity by increased exposure to organisms. 4. Teach other children that children are different.

2. Increase the child's socialization skills.

A nurse is caring for a visually impaired 10-year- old child. The nursing intervention with the highest priority for this child during the admission process would be: 1. Explaining playroom policies. 2. Orienting the child to where furniture is placed in the room. 3. Taking the child on a tour of the unit. 4. Letting the child touch equipment that will be used during the hospitalization.

2. Orienting the child to where furniture is placed in the room.

The nurse has taught a group of parents how to care for their children who have just had tympanostomy tubes inserted. The nurse will know the parents understand how to care for their child's tympanostomy tubes if they: Standard Text: Select all that apply. 1. Limit their diets to soft, bland foods. 2. Restrict the children to quiet activities after surgery. 3. Administer a decongestant for one to two weeks following surgery. 4. Encourage the children to drink generous amounts of fluids. 5. Avoid getting water in their ears during bath time.

2. Restrict the children to quiet activities after surgery. 4. Encourage the children to drink generous amounts of fluids. 5. Avoid getting water in their ears during bath time.

The nurse knows that the mother of a six-year- old needs more teaching about her son's diagnosis of ADHD when she states: 1. "I will develop a reward system for desired behaviors." 2. "I will take my child to the physician every three months for a weight and height check." 3. "I will let him do his homework while he is watching his favorite television show." 4. "I will stick to the same routine each day after school."

3. "I will let him do his homework while he is watching his favorite television show."

The parent of a child newly diagnosed with cancer verbalizes regret to the nurse for not seeking earlier medical attention for the child's symptoms. Which response would be most therapeutic? 1. "You may feel guilty, but you should not blame yourself." 2. "Most cancers can be treated easily.&" 3. "Many types of cancer are difficult to diagnose and might not show early symptoms." 4. "Early diagnosis is not significant in the diagnosis and management of cancer."

3. "Many types of cancer are difficult to diagnose and might not show early symptoms."

The nurse has completed postoperative discharge teaching to the parents of a child who has had a tonsillectomy. Which statement indicates the parents have understood the teaching? 1. "We will call the physician for any indication of ear pain." 2. "We will be sure to give our child adequate amounts of citrus juices." 3. "We will plan on administering acetaminophen (Tylenol) for pain." 4. "We will keep our child on bed rest for ten days after the surgery."

3. "We will plan on administering acetaminophen (Tylenol) for pain."

A mother brings her 22-month- old child to the well-child clinic for an evaluation. The mother states that this child does not seem to be developing like her sister's child of the same age. The nurse will perform which screening test that may provide information about the child's development? 1. MRI of the head 2. An EEG 3. A Denver II 4. Chromosomal study

3. A Denver II

A child with autism is being admitted to the hospital with dehydration. Upon admission, the nurse should: 1. Encourage the parents to avoid bringing favorite toys from home that might be lost. 2. Take the child on a tour of the pediatric unit. 3. Assign the child to his single-bed hospital room. 4. Take the child to the playroom for arts and crafts.

3. Assign the child to his single-bed hospital room.

The school nurse and teacher are working on a plan to improve the behavior and learning of a child recently diagnosed with attention deficit/hyperactivity disorder (ADHD). Which activities will the nurse suggest be included in the plan? Standard Text: Select all that apply. 1. Asking the mother to seek a prescription for methylphenidate (Ritalin) for the child 2. Placing the child's desk at the back of the room to reduce distractions 3. Developing a consistent routine for the classroom 4. Limiting the decorations in the classroom 5. Determining areas where the child performs well and using these areas to promote self-esteem

3. Developing a consistent routine for the classroom 4. Limiting the decorations in the classroom 5. Determining areas where the child performs well and using these areas to promote self-esteem

The nurse at a high school is screening students for mental health issues. The nurse would want to refer the adolescent for depression if the child shows which symptoms of depression? Standard Text: Select all that apply. 1. Agoraphobia 2. Somatic complaints 3. Focus on violence 4. Poor self-care 5. Poor school performance

3. Focus on violence 4. Poor self-care 5. Poor school performance

The nurse is assessing a child with Down syndrome. The child is at greater risk of developing which illness than children who do not have Down syndrome? 1. Rheumatic heart disease 2. Glomerulonephritis 3. Leukemia 4. Hepatitis

3. Leukemia

The ten-year- old child was diagnosed with a medulloblastoma; following surgery the child is started on chemotherapy by intrathecal injection. While preparing the family for the start of chemotherapy, the nurse will explain that intrathecal administration was chosen because: 1. It reduces side effects. 2. It does not require the child being "stuck." 3. Many chemotherapy drugs do not cross the blood-brain barrier. 4. Intrathecal administration is less expensive than intravenous administration.

3. Many chemotherapy drugs do not cross the blood-brain barrier.

The child is receiving chemotherapy for acute lymphocytic leukemia. The nurse recognizes that a potential oncological emergency for this child would be tumor lysis syndrome. For which symptoms should the nurse monitor this child? 1. Respiratory distress and cyanosis 2. Thrombocytopenia and leukocytosis 3. Oliguria and altered levels of consciousness 4. Upper-extremity edema and neck vein distension

3. Oliguria and altered levels of consciousness

A neonate has been diagnosed with a herpes simplex viral infection of the eye. Which medication will the nurse prepare to administer? 1. Oral erythromycin 2. Fluoroquinolone eyedrops or ointment 3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment 4. Intravenous penicillin

3. Parenteral acyclovir (Zovirax) and vidarabine (VIRA-A) ophthalmic ointment

While screening children, the nurse notes that one child seems to have "crossed eyes." Which screening tool might the nurse utilize to further screen this child? 1. Examine the eye with an otoscope. 2. Check for the "red reflex" in the eyes. 3. Perform the cover-uncover test. 4. Use a tonometer to evaluate the eyes.

3. Perform the cover-uncover test.

The mother of a six-year- old brings her son to the physician because his teacher thinks he might have attention deficit/hyperactivity disorder (ADHD). The nurse is interviewing the mother about the child's history. The nurse knows that which factors could be associated with ADHD? 1. Measles, mumps, and rubella vaccine 2. Advanced parental age 3. Prenatal exposure to smoke 4. Immune response

3. Prenatal exposure to smoke

Following a facial injury of a 12-year- old youth during a baseball game, a nurse speaks with the league administrators about first aid for teeth that may be lost. The nurse will instruct the administration that appropriate first aid will include: Select all that apply. 1. Not worrying about the tooth loss, as children this age still have their "baby" teeth. 2. Only handling the lost tooth by the roots and avoiding touching the crown of the tooth. 3. Rinsing the lost tooth with sterile saline. 4. Placing the tooth back into its socket and taking the child to an emergency dental facility. 5. Keeping the tooth clean and dry during transport to an emergency dental facility.

3. Rinsing the lost tooth with sterile saline. 4. Placing the tooth back into its socket and taking the child to an emergency dental facility.

A mother brings her 11-year- old son to the pediatric clinic for investigation of stomach complaints. The mother says that for the last two months, the child has complained of abdominal pain three to four mornings per week. The mother states the child usually complains on school days and always seems to be better by afternoon. The child was able to attend a weekend Boy Scout camp without difficulty but has missed several days of school due to complaints. The nurse would suspect which mental health disorder? 1. Separation anxiety 2. Depression 3. School phobia 4. Bipolar disorder

3. School phobia

A child has epistaxis while at school. The school nurse appropriately intervenes by: 1. Lying the child down and applying a warm pack. 2. Tilting the child's head back, squeezing the bridge of the nose, and applying a warm moist pack to the nose. 3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose. 4. Immediately packing the nares with a cotton ball soaked with Neo-Synephrine.

3. Tilting the child's head forward, squeezing the nares below the nasal bone, and applying ice to the nose.

An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The nurse knows the teen understands what to expect for the schedule of administration for leucovorin therapy if the teen says: 1. "I don't have any pain, so I won't need to take the leucovorin this time." 2. "I don't have any nausea, so I won't need the leucovorin." 3. "I'm glad I only need one dose of the leucovorin." 4. "It is important that I receive my leucovorin on time as it protects my body from the methotrexate."

4. "It is important that I receive my leucovorin on time as it protects my body from the methotrexate."

A child has been diagnosed with Ewing sarcoma and is being started on a chemotherapy protocol. The mother questions the nurse on why more than one drug is being used as it would seem that using fewer drugs would decrease the side effects. The best response by the nurse would include the information that: 1. The child's cancer is a severe form and needs additional drugs to remove the cancer. 2. A protocol is a proven means of treatment. 3. A protocol is used in children but not adults due to the chemotherapy's effect on growth. 4. A protocol involves a group of drugs that work in different modes and have different side effects.

4. A protocol involves a group of drugs that work in different modes and have different side effects.

A nurse is performing a developmental assessment on several children in a clinic setting. Which children exhibit a delay in meeting developmental milestones? Standard Text: Select all that apply. 1. An 18-month- old toddler who is unable to speak in sentences 2. A two-year- old who is unable to cut with scissors 3. A two-year- old who cannot recite her phone number 4. A six-year- old who is unable to sit still for a short story 5. A five-year- old who is unable to button his shirt

4. A six-year- old who is unable to sit still for a short story 5. A five-year- old who is unable to button his shirt

A child has been diagnosed with a Wilms' tumor and is being treated with chemotherapy. Prior to administering the chemotherapy, what will the nurse monitor to determine if the child has any capability of fighting infection? 1. Hemoglobin 2. Red blood cell count 3. Platelets 4. Absolute neutrophil count (ANC)

4. Absolute neutrophil count (ANC)

An infant has acute otitis media. Which of the following would be the most important for the nurse to teach the parents? 1. Keep the baby in a flat position during sleep. 2. Administer a decongestant. 3. Place the baby to sleep with a pacifier. 4. Administer acetaminophen (Tylenol) to relieve discomfort.

4. Administer acetaminophen (Tylenol) to relieve discomfort.

The nurse is explaining to the mother that her child with cancer will receive chemotherapy daily for one month and then no treatments for six weeks. Following the period of rest, chemotherapy will be administered again for another month. The mother asks why the child can't receive the medication for two months straight. The nurse would explain that the rest period: 1. Prevents the child from having side effects from the drugs. 2. Is due to the scheduling requirements of the infusion center. 3. Is necessary because receiving the medication for more than one month can cause heart failure. 4. Allows normal cells to repair themselves while the cancer cells die.

4. Allows normal cells to repair themselves while the cancer cells die.

The nurse is reviewing discharge instructions for a child who has received a cochlear implant. In addition to encouraging speech therapy for the child, the nurse will instruct the parents to monitor the child for signs of: 1. Ringing in the ears. 2. Pharyngitis. 3. Hearing loss. 4. Bacterial meningitis.

4. Bacterial meningitis.

A nurse is caring for a visually impaired 20-month- old who has not begun to walk. Which nursing diagnosis would be appropriate for this child? 1. Self-care deficit 2. Impaired physical mobility 3. Impaired home maintenance 4. Delayed growth and development

4. Delayed growth and development

A child has cancer and has been treated with chemotherapy. The most recent lab value indicates that the white blood cell count is very low. Based on this result, which would the nurse expect to administer? 1. Epoetin alfa (Epogen) 2. Ondansetron (Zofran) 3. Oprelvekin (Neumega) 4. Filgrastim (Neupogen)

4. Filgrastim (Neupogen)

A child with leukemia has a granulocyte count of 250/mm and a platelet count 150,000/mm. Nursing intervention would include which of the following? 1. Fluid restriction 2. Avoidance of mouth care 3. Strict isolation 4. Good hand washing

4. Good hand washing

A child has recently been diagnosed with leukemia. The child's sibling is expressing feelings of anger and guilt. This reaction by the sibling is: 1. Abnormal; the sibling should be referred to a psychologist. 2. Unexpected; the cancer is easily treated. 3. Unusual; the illness doesn't affect the sibling. 4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.

4. Normal; the sibling is affected, too, and anger and guilt are expected feelings.

A nurse who is planning to teach school-age children about the "common cold" should include what information? 1. Aspirin should be taken for alleviation of fever if the common cold is contracted. 2. Antibiotics will eliminate the nasopharyngitis virus. 3. Vaccinations can prevent contraction of a nasopharyngitis virus. 4. Proper hand washing can prevent the spread of the common cold.

4. Proper hand washing can prevent the spread of the common cold.

The nurse works in an oncology clinic. A preschool-age child is being seen in the clinic, and the nurse anticipates a diagnosis of cancer. The nurse prepares for which of the common reactions preschool-age children have following illnesses and hospitalizations? 1. Unawareness of the illness and its severity 2. Acceptance, especially if able to discuss the disease with children their own age 3. Understanding of what cancer is and how it is treated 4. Thoughts that they caused their illness and are being punished

4. Thoughts that they caused their illness and are being punished

The school nurse notices a sixth-grade girl with bald patches in her hair. The hair itself is clean and shiny. Prior to referring the girl to her healthcare provider for alopecia, the nurse would want to watch the child for signs of: 1. Lice. 2. Dietary imbalances. 3. Schizophrenia. 4. Trichotillomania.

4. Trichotillomania.

Following diagnosis of osteosarcoma, a 14-year- old girl has a below-the- knee amputation. The girl has had trouble accepting the reality of her amputation. Which behavior, when observed by the nurse, indicates she is beginning to accept the amputation? 1. The girl complains of pain in the missing leg. 2. When physical therapy comes, she is willing to have her temporary prosthetic applied and attempts crutch training. 3. Prior to visiting hours, she asks to be helped to a wheelchair with a blanket over her legs. 4. When the nurses change the dressing on the stump, she watches the dressing change.

4. When the nurses change the dressing on the stump, she watches the dressing change.