Pediatric midterm

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

D. Meningitis

The nurse is caring for a client who underwent surgery for a brain tumor. On assessment, the nurse suspects meningitis in the client. Which finding would help confirm the nurse's suspicion? A. Positive kernig's sign B. Negative Brudzinski sign C. Absence of nuchal rigidity D. Glasgow coma score:12

A. Positive kernig's sign

A nurse is caring for a child with meningococcal meningitis. What clinical finding does the nurse expect to encounter during a physical assessment? A. Purpuric skin rash B. Low-grade fever C. Tremors of the extremities D. Severe glossitis

A. Purpuric skin rash

A school-aged child who has cystic fibrosis complains to the nurse about having to undergo chest physiotherapy and wonders why it is necessary. You are the nurse. How do you explain the primary purpose of chest physiotherapy in terms the child can understand? A. It mobilizes secretions. B. It prevents a barrel chest. C. It dilates the bronchioles. D. It provides humidification.

It mobilizes secretions

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

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

A nurse who is caring for a 2-day-old neonate suspects that the infant has cystic fibrosis. What early sign of this disorder did the nurse identify? A. Unstable body temperatures B. Airway irritability C. Meconium stool at birth D. Meconium ileus

D. Meconium ileus

Match the adventitious lung sounds to the correct characteristics. Wheezing Crackles Stridor Rhonchi A. Continous, snoring, low-pitched sounds heard throughout inspiration. May clear with coughing. B. A high-pitched whistling sound, usually heard on expiration, and common to asthma. This is caused by narrowed airways or inflammation. C. A bubbling or crackling sound originating from the base of the lungs. Usually brief, this may be described as sounding wet or dry. Excess fluid in the airways causes these sounds. D. High-pitched, wheezing sound caused by disrupted airflow. Airflow is usually disrupted by a blockage in larynx or trachea.

A. rhonchi B. Wheezing C. Crackles D. Stridor

How much oxygen is present in room air? _____ percent

21%

What does epiglottitis look like in X-ray?

A pencil shape

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

A. Bradycardia

The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record? A. 13 B. 15 C. 8 D. 11

B. 15

The hypertonicity of the muscles in an infant with cerebral palsy causes scissoring of the legs. The nurse teaches the mother that the preferred way to carry the infant is in a sitting position in what way? A. Strapped in an infant seat B. Astride one of her hips C. Wrapped tightly in a blanket D. Under the arm in a football hold

B. Astride one of her hips

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? A. The child has a low-grade fever and complains of a sore throat. B. The child is leaning forward, with the chin thrust out C. The child is leaning backward, supporting himself or herself with the hands and arms. D. The child exhibits nasal flaring and bradycardia.

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

During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF? A. It is a condition transmitted as an autosomal recessive trait. B. This disease causes dilation of the passageways of many organs C. It is a chronic multisystem disorder affecting the exocrine glands D. CF causes mucus that is formed to be abnormally thick.

B. This disease causes dilation of the passageways of many organs

A nurse in the pediatric clinic should be most observant for signs of cerebral palsy in a 6-month-old infant in which instance? A. Has a 40-year-old mother B. Was born during the 32nd week of gestation C. Was born with the Moro reflex D. Was delivered by cesarean birth

B. Was born during the 32nd week of gestation

A child is admitted to the hospital with pneumonia. In addition to ensuring a patent airway, all of the following interventions are appropriate except: A. Pain and fever control B. Hydration C. Exercise D. Rest promotion

C. Exercise

The nurse creates a plan of care for a child with Reye's syndrome. Which priority intervention should the nurse include in the plan of care? A. Teach the parents signs and symptoms of a bacterial infection. B. Reassure the parents hyperglycemia is a common symptom. C. Monitor for signs of increased intracranial pressure. D. Immediately check the presence of protein in the urine.

C. Monitor for signs of increased intracranial pressure.

The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF? A. A disease that causes dilation of the passageways of many organs B. Transmitted as an autosomal dominant trait C. A disease that causes the formation of multiple cysts in the lungs D. A chronic multisystem disorder affecting the exocrine glands

D. A chronic multisystem disorder affecting the exocrine glands

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? A. Place a toy in the tent to make the child feel more comfortable. B. Call the health care provider and obtain a prescription for a mild sedative. C. Tell the mother that the child must stay in the tent D. Let the mother hold the child and direct the cool mist over the child's face

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

A 6-month-old infant is brought to the emergency department in severe respiratory distress. A diagnosis of respiratory syncytial virus (RSV) infection is made, and the infant is admitted to the pediatric unit. What should be included in the nursing plan of care? A. Administer prescribed antibiotic immediately B. Allow parents and sibling to room in with the infant. C. Place in a warm, dry environment D. Maintain standard and contact precautions

D. Maintain standard and contact precautions

The parents of an 18-month-old toddler are anxious to know why their child has experienced several episodes of acute otitis media. What should the nurse explain to the parents about why infants and toddlers are prone to middle ear infections? A. Young children have short, horizontally positioned eustachian tubes. B. The child's tympanic membrane slants horizontally rather than vertically. C. A child's external canal slants downwards. D. A & B answers are correct E. All answers are correct.

E. All answers are correct.

The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Should the diet be high in calories or low?

High in calories

The nurse reviews the health record of a 2-year-old child. The health care provider has documented that the results of a tuberculin skin test have indicated an area of induration measuring 5 mm. Is this a positive or negative result? It is a __________ result.

Negative

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as positive or negative?

Positive

A child has been admitted to the pediatric unit with a severe asthma attack. What type of acid-base imbalance should the nurse expect the child to develop?

Respiratory acidosis caused by impaired respirations and increased formation of carbonic acid

The nurse enters a child's room and discovers that the child is having a seizure. Which actions should the nurse take? Select all that apply. Call a code. Run to get the crash cart. Loosen any restrictive clothing. Turn the child on her side. Check the child's respiratory status. Place an airway into the child's mouth.

Run to get the crash cart. Turn the child on her side. Loosen any restrictive clothing.

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

Stay with the child. Time the seizure Move furniture away from the child.

A client is scheduled for a pulmonary function test. The nurse explains that during the test one of the instructions the respiratory therapist will give the client is to breathe normally. What should the nurse teach is being measured when the client follows these directions?

Tidal volume

During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain the _________ vaccine can help prevent most cases of this condition?

haemophilus influenzae type b, Hib vaccine

Cerebral palsy is or is not progressively degenerative?

is not

The nurse is teaching a 9-year-old child with asthma how to use a metered-dose-inhaler (MDI). Place the instructions in the appropriate order. All options must be used. Rinse mouth with water Take a slow deep breath and hold for 10 seconds Shake MDI and attach it to spacer Exhale completely Place lips tightly around the mouth piece Deliver one puff of medication into spacer

1) First shake MDI and attach it to the spacer. 2) Exhale completely to optimize inhalation of the medication. 3) Place lips tightly around the mouth piece. 4) Deliver a single puff of medication into spacer. 5) Take a slow, deep breath and hold it for 10 seconds to allow for effective medication distribution. 6) After the dose, rinse mouth with water to remove any left-over medication from oral mucous membranes. Spit out the water to ensure no medication is swallowed.

The parents of a 4-month-old infant with a diagnosis of acute otitis media and fever ask the nurse about the use of antibiotics to treat this condition. What is the best response by the nurse? A. "Antibiotics are recommended for infants younger than 6 months with confirmed diagnosis of AOM (bulging tympanic membrane, ear pain, fever greater than 102.2 0 F B. "Motrin and Tylenol are used to relieve pain, especially in the first 24 hours of infection." C. "Typically antiviral medications are given to treat acute otitis media." D. "Current practice is to wait 72 hours to see whether the condition resolves."

A. "Antibiotics are recommended for infants younger than 6 months with a confirmed diagnosis of AOM (bulging tympanic membrane, ear pain, fever greater than 102.2 F

A school-age child with Down syndrome is brought to the ambulatory care center by the mother. The child has bruising all over the body. To work most effectively with this child, the nurse first addresses which complication associated with Down syndrome? A. Children with Down syndrome are more likely to develop acute leukemia than the average child. B. Children with Down syndrome scratch themselves a lot because of dry, cracked, and frequently fissuring skin C. Children with Down syndrome fall down easily as a result of hyperflexibility and muscle weakness D. Children with Down syndrome are at risk for physical abuse because of their low intellectual functioning

A. Children with Down syndrome are more likely to develop acute leukemia than the average child.

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

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

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? A. Move the infant to a room with another child with RSV. B. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child. C. Initiate strict enteric precautions. D. Leave the infant in the present room because RSV is not contagious.

A. Move the infant to a room with another child with RSV.

A 3-year-old boy in respiratory distress is treated in the emergency department. A diagnosis of acute spasmodic laryngitis (spasmodic croup) is made. At the time of discharge, the mother asks how to handle another attack at home. What should the nurse recommend? A. Placing him near a cool-mist humidifier B. Giving him over the counter cough syrup C. Offering him warm tea sweetened with honey D. Bringing him to the emergency department

A. Placing him near a cool-mist humidifier

The nurse is creating a plan of care for a newborn infant with spina bifida (myelomeningocele type). The nurse includes assessment measures in the plan to monitor for increased intracranial pressure. Which assessment technique should be performed that will best detect the presence of an increase in intracranial pressure? A. Check urine for specific gravity. B. Assess anterior fontanel for bulging. C. Assess blood pressure for signs of hypotension. D. Monitor for signs of dehydration

B. Assess anterior fontanel for bulging.

The nurse is caring for a newborn infant with spina bifida (myelomeningocele) who is scheduled for surgical closure of the sac. In the preoperative period, which is the priority problem? A. Inability to tolerate stimulation B. Infection C. Choking D. Delayed growth and development

B. Infection

The nurse assists a health care provider in performing a lumbar puncture on a 3-year-old child with leukemia in whom central nervous system disease is suspected. In which position will the nurse place the child during this procedure? (See page 223.) A. Lithotomy position B. Prone with knees flexed to the abdomen and head bent with chin resting on the chest C. Lateral recumbent position with the knees flexed and chin resting on the chest D. Modified Sims' position

C. Lateral recumbent position with the knees flexed and chin resting on the chest

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

C. Providing a quiet atmosphere with dimmed lighting

Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? A. Leukotriene modifiers B. Inhaled corticosteroids C. Short-acting β2 agonist D. Singulair (Montelukast)

C. Short-acting β2 agonist

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 health care provider, should the nurse question? A. Administer acetaminophen for fever. B. RN to obtain axillary temperatures. C. Administer humidified oxygen. D. RN to obtain throat culture

D. RN to obtain throat culture

The nurse develops a plan of care for a child at risk for tonic-clonic seizures. In the plan of care, the nurse identifies seizure precautions and documents that which item(s) need to be placed at the child's bedside? A. Emergency cart B. Padded tongue blade C. Tracheotomy set D. Suctioning equipment and oxygen

D. Suctioning equipment and oxygen

Croup, also known as acute laryngotracheobronchitis, is a self-limiting upper airway obstructive disease that affects younger children. Is croup caused by a viral infection or a bacterial infection?__________ infection

viral

The body's thermostat, also known as the [a] is an autonomic center that regulates temperature control, appetite, blood pressure, breathing, sleep patterns, and peripheral nerve discharges.

hypothalamus