PEDS E3

When obtaining a health history, which question is most important for the nurse to ask the parents of a child with a diagnosis of acute glomerulonephritis? a) How many children are there in your family?What are their ages? b) Is there a family history of diabetes? If so, what was the age onset? c) How many hours does your child sleep each night? Do you think he has any type of sleep disorder? d) Has your child had a sore throat within the past month? was an antibiotic prescribed?

d) Has your child had a sore throat within the past month? was an antibiotic prescribed?

A pediatric nurse has completed parental teaching for a child needing home GH therapy. What statement by the parent indicates that teaching has been effective? a) I will give the injection before I put my child to bed b) immediately after lunch, I will give my child the medication c) I can't give the medication between lunch and dinner d) my child can get the medication at the beginning of each day.

a) I will give the injection before I put my child to bed

A 13-month-old child is scheduled for surgical repair of his hydrocele, and the parents ask the nurse what is the care management after recovery from surgery. SATA a) There may be temporary swelling and discoloration b) Chemotherapy may be necessary. c) avoid straddle toys for 2-4 weeks d) Kidney transplant may be indicated in the future.

a) There may be temporary swelling and discoloration c) avoid straddle toys for 2-4 weeks

Which of the following may be included in the non-surgical treatment of Legg- Calve-Perthes disease? a) abduction casts, complete bed rest, and avoid weight bearing activities b) adduction casts, complete bed rest, and traction c) abduction casts, avoid weight bearing activities, and traction d) adduction casts, avoid weight bearing activities, and traction

a) abduction casts, complete bed rest, and avoid weight bearing activities

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. What is the best communication approach for the approach for the nurse to implement? a) answer any questions with straightforward honesty b) Avoid discussing the seriousness of the condition c) explain that although amputation is difficult, it will cure the cancer d)Assist adolescent to accept amputation as better than a long course of chemotherapy

a) answer any questions with straightforward honesty

The nurse assesses a young girl with a probable sprained wrist. In addition to calling the child's parents, what is the most appropriate, immediate action for the school nurse to take? a) apply ice b) observe for edema and discoloration c) Encourage the child to assume a position of comfort d ) administration of acetaminophen

a) apply ice

The nurse is caring for a child with wilms tumor. What is the most important nursing intervention preoperatively? a) avoid abdominal palpation b) maintain strict intake and output c) measure abdominal girth d) auscultate bowel sounds

a) avoid abdominal palpation

A school nurse is performing scoliosis screening, what action should the nurse ask the child to do? a) bend forward at the waist with the arms hanging freely b) lie flat on the floor and extend legs straight from the trunk c) sit in a chair while lifting the feet and legs to a right angle d) stand against the wall while pressing the back firmly against the wall

a) bend forward at the waist with the arms hanging freely

The nurse plans to decrease the potassium intake of a child with chronic renal failure. Which foods will the nurse omit from the child's diet choices? a) citrus fruits, sodas, and peanut butter b) seafood, meat and table salt c) whole grains, nuts, and soybeans d) dairy products, eggs and meats

a) citrus fruits, sodas, and peanut butter

What is the first line of therapy for managing a child with nephrotic syndrome? a) corticosteroids b) antibiotics c) diuretics d) potassium supplements

a) corticosteroids

Conservation treatment for elenas hip dysplasia was unsuccessful and a spica cast is applied. At the time of discharge Elena's mother asks how to clean the cast if Elena soils it. The best response is to use a ? a) damp cloth with tap water b) damp sponge and dilute chlorine bleach c) dry brush and hydrogen peroxide d) dry cloth and liquid and white shoe cleaner

a) damp cloth with tap water

The most important nursing consideration related to congenital hypothyroidism is which of the following? a) early identification of the disorder b) facilitation of parent-infant attachment c) initiate referrals for mental retardation d) helping parents deal with future prospects for the child

a) early identification of the disorder

A child with brittle, type 1 diabetes, is found almost unresponsive with a glucometer reading of 32. Which of the following drugs would be most appropriate to treat this client? SATA a) intravenous glucose b) intramuscular glucagon c) 1 cup skim of milk d) dissolved glucose tablets e) subcutaneous glucagon

a) intravenous glucose b) intramuscular glucagon e) subcutaneous glucagon

Why is it important for the nurse to closely monitor the temperature of the child with nephrotic syndrome? a) monitor for infection b) monitor for hypertension c) monitor for encephalopathy d) monitor for urinary tract infection

a) monitor for infection

A 4-year-old boy with a fractured right femur is immobilized with skeletal traction. He is crying with pain, and the skin of his right foot is pale with no palpable pulses. What should the nurse do first? a) notify the physician of the assessment findings b)administer prescribed analgesics c) release the traction and notify the physician d) chart the observations and check the extremity again in 15 minutes

a) notify the physician of the assessment findings

What are the primary clinical manifestations of acute glomerulonephritis? SATA a) oliguria b) hematuria c) proteinuria d) hypotension

a) oliguria b) hematuria c) proteinuria

An infant is admitted to the newborn nursery. What assessment data on the physical exam would the nurse find. to validate a possible congenital hip dysplasia? a) positive ortolani click b) trendelenburg sign c) affected leg shorter than the other d) homans sign

a) positive ortolani click

What is the desired patient outcome for the child with nephrotic syndrome? a) protein-free urine b) moderate edema c) ascites present d) weight gain

a) protein- free urine

Which is the most accurate of the therapeutic management of osteogenic sarcoma? a) treatment usually consists of surgery and chemotherapy b) amputation of the affected extremity is rarely necessary c) intensive irradiation is the primary treatment d) bone marrow transplantation is the best for long-term survival

a) treatment usually consists of surgery and chemotherapy

Which of the following best describes epispadias? a) urinary meatus located on the dorsal surface of penis b) urinary meatus located on ventral surface of penis c) ventral curvature of penis with stenosis of foreskin d) torsion of spermatic cord

a) urinary meatus located on the dorsal surface of penis

A school-age child has been admitted to the hospital diagnosed with nephrotic syndrome. Which clinical manifestations should the nurse expect to assess? SATA a) weight gain b) generalized edema c) proteinuria > 2+ d) fatigue e) moderately elevated blood pressure

a) weight gain b) generalized edema c) proteinuria > 2+ d) fatigue

The nurse is working with a child who has growth hormone deficiency and who will mostly likely have a diagnosis of delayed growth development related to inadequate growth secretion. Which of the following nursing diagnosis is the most likely additional diagnosis for this child? a). Disturbed body image related to short stature b). At risk for injury related to inability to protect self c).Imbalanced nutrition more than body requirements

a)Disturbed body image related to short stature

A mother brings her 12 year old to her primary care physician, she mentions that her child has been eating more lately but losing weight, she is always tried but her eyes look wide awake. Which diagnosis would you consider given the clinical manifestations? a) hyperthyroidism b) hypothyroidism c) hyperpitiutarism d) pheochromocytoma e) hypopituitarism

a)hyperthyroidism

What should the nurse identify as the priority goals in the therapeutic management of juvenile arthritis? a) prevent joint discomfort; control pain, regain proper alignment b) prevent loss of joint function: control pain, achieve cure c) prevent physical deformity; control pain, preserve joint function d)prevent skin breakdown; control pain, promote symptoms

c) prevent physical deformity; control pain, preserve joint function

A nurse is providing discharge instructions for a child with diabetes. Which prescription if written, should the question? a) multivitamins b)Antibiotics c) steroids d) oral hypoglycemics

c) steroids

The emergency center nurse is informed that a patient with a greenstick fracture is in route. Which of the above indicates what the nurse should find when assessing the fracture? ( A, B, C, D)

ANS:C

A young child has just returned from surgery with a cast. What is the priority nursing intervention? a) elevate the head of the bed b) check the circulation c) turn the client to the right side d) offer small sips of water

b) check the circulation

A 13 year old girl is brought to the clinic with the complaint of insomnia and hyperactivity. Other symptoms include gradual weight loss despite a good appetite; warm moist, skin; and unusually fine hair. These manifestation are suggestive of which of the following? a) hypothyroidism b) hyperthyroidism c) hypopituitarism d) hyperpituitarism

b) hyperthyroidism

Postoperative care of the adolescent following a spinal fusion for scoliosis includes? SATA a) oral analgesics b) logrolling every 2 hours c) nasogastric intubation d) straight catheterization every 4-6 hours

b) logrolling every 2 hours c) nasogastric intubation

Which of the following best describes acute glomerulonephritis? a) occurs from poor renal blood flow b) occurs after an antecedent streptococcal infection c) associated with renal vascular disorders d) associated with structural anomalies of the genitourinary tract

b) occurs after an antecedent streptococcal infection

The primary clinical manifestation of acute renal failure is: a) edema b) oliguria c) metabolic acidosis d) weight gain and proteinuria

b) oliguria

Narrowing or stenosis of preputial opening of the foreskin, describes which genitourinary defect? a) testicular torsion b) phimosis c) epispadias d) hypospadias

b) phimosis

What diagnostic test allows visualization of the renal parenchyma and renal pelvis without exposure to external beam radiation or radioactive isotopes? a) KUB(flat plate radiograph of abdomen and pelvis) b) renal ultrasound c) computed tomography d) voiding cystourethrography

b) renal ultrasound

Nursing interventions when taking care of a child diagnosed with Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH) should include which of the following? SATA a) encouraging fluids to prevent overload b) restricting fluids to prevent overload c) weighing the client daily d) strict intake and output to monitor fluid status

b) restricting fluids to prevent overload c) weighing the client daily d) strict intake and output to monitor fluid status

A graduate nurse is orientating on a new medical-surgical unit. What action related to insulin, if witnessed, would require the preceptor to intervene immediately? a)A graduate nurse charts the insulin medication late b) the graduate nurse mixes two long-acting insulins c) The graduate nurse draws clear insulin into the syringe first d) The graduate nurse verifies an insulin dose with licensed personnel

b) the graduate nurse mixes two long-acting insulins

What is the most important host factor influencing the occurrence of urinary tract infections? a) sterile urine b) urinary stasis c) urine pH of 6 d) WBC 1 polymorphonuclear leukocytes /field

b) urinary stasis

An LPN is orienting in on an orthopedic floor of a hospital. The assigned client is a young child with a newly applied cast. What action, if witnessed, requires immediate follow-up by the R.N.? a) engage the child in quiet activities but encourage the use of muscles b) use fingers when handling the cast to prevent trauma while the cast is drying c) keep a clear path for ambulation d) elevate casted extremity for the first 24 hours

b) use fingers when handling cast to prevent trauma while cast is drying

The sign that most strongly suggests hyperglycemia in children is a)constant crying b)enuresis c)increased activity d)decreased hunger

b)enuresis

A child is admitted with a possible diagnosis of diabetes insipidus? Which sign is highly associated with this disease?

b)polyuria

Which signs/symptoms would the nurse not expect to find in a child diagnosed with progressive lymphocytic thyroiditis (or Hashimoto disease) a)an enlarged thyroid gland b)polyuria c)hoarseness d)dysphagia

b)polyuria

What is a critical nursing assessment of an infant with goiter? a) growth b)respirations c)increased appetite d) increased interest in playing

b)respirations

A 5 -5-year-old girl has been seen by the school nurse for urinary incontinence three times in the past two days. The school nurse would suspect that this child's symptoms of urinary incontinence is likely due to: a) school phobia b) family crisis c) possible urinary tract infection d) possible urinary structural defects

c) possible urinary tract infection

A nurse has been assigned the following patients: which should the nurse assess first? a) 15-year-old amputee who has pain at a level of 6 on a scale of 1-10 b) A 16- year old cushings client with a moon face and a buffalo hump c) A 17- year old with diabetes who is irritable, hungry,headache, diaphoretic d) A 14-year-old with hyperthyroidism exhibiting exophthalmos

c) A 17- year old with diabetes who is irritable,hungry,headache,diaphoretic.

An orthopedic nurse is caring for a child with a musculoskeletal alteration. What should the nurse infer about the psychological or physiological effects of immobilization on a 4-year-old on traction? SATA a) He will have increased communication skills due to the quiet time to reflect b) He will have increased need for oxygen and decreased chest expansion c) He will have increased levels of anxiety leading to restlessness and regression d) He will have a decreased muscle tone, strength, and endurance due to bed rest

c) He will have increased levels of anxiety leading to restlessness and regression d) He will have a decreased muscle tone, strength, and endurance due to bed rest

The nurse is admitting a school-age child with acute renal failure with a reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate? a) pH b) osmolarity c) creatinine clearance d) protein level

c) creatinine clearance

A child diagnosed with bilateral cryptorchidism. The nurse knows that this disorder is usually associated with? SATA a) recurrent bladder infections b) incontinence c) decreased fertility d) risk for testicular cancer

c) decreased fertility d) risk for testicular cancer

A child receiving propylthiouracil (PTU), an antithyroid drug, for the treatment of hyperthyroidism(Graves Disease). The parents and child should be taught to recognize and report which of the following symptoms? a) coughing b)ear pain c) fever, sore throat d) upper respiratory infection

c) fever, sore throat

Which of the following is a major complication in a child with a chronic renal failure? a) hypokalemia b) metabolic acidosis c) fluid and sodium retention d) dietary restrictions

c) fluid and sodium retention

A client is admitted with a diagnosis of osteomyelitis. Based on this diagnosis what treatment should the nurse begin to prep in anticipation of an order? a) joint replacement surgery b) bracing and casting c) intravenous antibiotic therapy d) long term corticosteroid therapy

c) intravenous antibiotic therapy

Diabetes insipidus is diagnosed in a child with head trauma. What rationale should the nurse offer regarding polyuria and polydipsia associated with this disease? a) it is due to hypersecretion of hormone ACTH b) itis due to hypersecretion of the growth hormone c) it is due hyposecretion of hormone vasopressin d) it is due to hyposecretion of PTH

c) it is due hyposecretion of hormone vasopressin

The mother of an 11 year old child with insulin-dependant diabetes mellitus asked why her child cannot avoid all those shots and take pills as a n uncle does. Which of the following is the nurses best reply? a)The pill works with an adult pancreas only b)The drugs affect fat and protein metabolism not sugar c)Your child needs insulin replaced, and the oral hypoglycemics only work with an existing supply of insulin d)Perhaps when your child is older the pancreas will produce its own insulin and then your child can take oral hypoglycemics.

c)Your child needs insulin replaced, and the oral hypoglycemics only work with an existing supply of insulin

Which factor is most likely to decrease a diabetic child's need for insulin? a)infection b)emotional trauma c)increased exercise d)hospitalization

c)increased exercise

Which clinical manifestation may occur in the child who is receiving too much methimazole (Tapazole) for the treatment of hyperthyroidism(graves disease) a) enlargement of all lymph glands b)pancreatitis or cholecystitis c)lethargy and somnolence d)seizures

c)lethargy and somnolence

A seasoned nurse is caring for a child with juvenile rheumatoid arthritis. What should the nurse make the priority for a more positive outcome? a) applying ice packs to relieve acute swelling and pain b)administer acetaminophen to reduce inflammation c)supervising muscle-strengthening and joint-mobilization exercises d)encourage range of motion exercises during periods of inflammation

c)supervising muscle-strengthening and joint-mobilization exercises

During baby Elenas newborn assessment, the nurse practitioner placed her in prone position and observed that her left gluteal fold was deeper and higher than the right one. A congenital left hip dislocation was suspected. To confirm the diagnosis the nurse practitioner checks the ortolani sign. To do this, the nurse practitioner should place the infant in the supine position and? a) adduct and extend both legs and observe for shortness of the left leg b) apply pressure to the left femoral head and feel if the acetabulum slips out of place and then slips back when pressure is released c) flex both knees and hips with feet flat on the table and observe for a lower left knee click d) abduct the thighs and place anterior pressure at the hip to see if the femoral head slips forward into the acetabulum

d) abduct the thighs and place anterior pressure at the hip to see if the femoral head slips forward into the acetabulum

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid releasing sugar should be followed by which of the following? a) protein b) fruit juice c) several glasses of water d) complex carbohydrate and protein

d) complex carbohydrate and protein

Which of the following is a correct description of a contusion? a) The position of bone ends is disrupted from its socket b) subluxation of radial head c) microscopic tear to muscle d) damage to soft tissue subcutaneous structures and muscle

d) damage to soft tissue subcutaneous structures, and muscle

The nurse is caring for a child with acute renal failure. Which of the following clinical manifestation should the nurse recognize as a sign of hyperkalemia? a) dyspnea b) seizure c) oliguria d) electrocardiographic abnormalities

d) electrocardiographic abnormalities

During the acute phase of post-streptococcal glomerulonephritis, which of the following diagnostic tests results would the nurse expect to find? a) negative protein in the urine b) decreased serum creatinine c) decreased serum creatinine d) elevated ASO titers

d) elevated ASO titers

Amy age 15 has just undergone a below the knee amputation of her leg following a motor vehicle accident. Post Op she complains of pain and cramping in her left foot. What is the best action for the nurse to take? a) notify the physician immediately for the possibility of nerve damage b) withdraw the narcotics due to possible overdose c) understand this to be a reaction to anesthesia d) explain this to be a normal sensation with amputation

d) explain this to be a normal sensation with amputation

For nephrotic syndrome, prednisone is administered until which of the following occurs? a) relapse b) urinary tract infection is gone c) generalized edema subsides d) given 6-12 weeks until no protein in urine

d) given 6-12 weeks until no protein in urine

The callus that develops at the fracture site is important because it? a) allows for functional use of the injured part b) provides sufficient support for weight bearing c) serves as a source for providing an adequate blood supply d) is a means for holding bone fragments together

d) is a means for holding bone fragments together

Which symptom might be an indication that the child is receiving too much of the Antithyroid drug PTU (propylthiouracil)? a) emotional lability with sudden episodes of crying of elation b) exophthalmos or protruding eyeballs c) weight loss d) lethargy

d) lethargy

A nurse is caring for a child in a hip spica cast. Upon assessment of the limb distance to the cast, the nurse notes coolness , discoloration, a weak pulse, swelling, and a capillary refill > 4 seconds. What should the nurse do next? a) remove the cast immediately b) perform passive range of motion exercises c) apply a warm compress to the area d) notify the HCP

d) notify the HCP

Which development of the following would be the most appropriate play activity for a 3 year old child in a spica cast ,considering both safety and development? a) Marbles b) game of checkers c) stacking blocks d) playing with toy smart phone

d) playing with toy smart phone

Diagnosis of a urinary tract infection is based on the presence of which of the following ? a) 10,000 calories per ml of a single uropathic organism b) pyuria and 10,000 colonies per ml of a single uropathic organism c) pyuria and 20,000 colonies per ml of a single uropathic organism d) pyuria and 50,000 colonies per ml of a single uropathic organism

d) pyuria and 50,000 colonies per ml of a single uropathic organism

The rationale for elevating an extremity after a soft tissue injury, such as a sprained ankle, it is to : a) increases the pain threshold b) increases metabolism in the tissues c) produces a deep tissue vasodilation d) reduces edema formation

d) reduces edema formation

The nurse is caring for an immobilized preschool child . Which of the following is helpful during this period of immobilization? a) encourage wearing pajamas b) let the child have few behavorial limitations c) keep the child away from other immobilized children if possible' d) take child for a "walk "by wagon outside the room

d) take child for a "walk "by wagon outside the room

A 15-year-old female is brought to the emergency room with the following clinical findings: severe irritability and restlessness, hypertension, severe tachycardia, and hyperthermia. She has a history of hyperthyroidism and has just stopped taking her medication. These manifestations are a result of: a) hypothyroidism b) myxedema c) goiter d) thyrotoxicosis

d) thyrotoxicosis

Which of the following is a physiologic effect of immobilization on children? a) metabolic rate increases b) increased joint mobility can lead to contractures in a short time c) bone calcium increases d) venous stasis can lead to pulmonary emboli and / or thrombi

d) venous stasis can lead to pulmonary emboli and / or thrombi