Peds Exam 1: Practice Questions
What happens if you push fentanyl too fast?
It causes "chest wall rigidity" if pushed too fast pt will go apneic & will not respond to compression b/c chest goes rock hard
What are the two types of pain?
*Acute: warning or a disease threat to the body, right now -Caused by injury, illness, surgery, trauma, a painful medical procedure *Chronic: pain that persists for 3+ months -Pain that persists beyond expected period of healing -Recurrent Pain: episodic/recurs ~Migraines, abdominal pain, sickle cell pain
What are the three types of pain scales?
*FLACC *Faces *Number Scale (0-10)
When should each of the following age groups be taught/told about their procedures? *Older child & teen *4-7 yrs *3-4 yrs *2 yrs and under
*Older child & teen - 1 week before *4-7 yrs - 1-2 days before *3-4 yrs- 1 day before *2 yrs and under - morning of or just before
What components or factors do we need to consider to assess pain in children?
*Onset of pain *Pain Duration/pattern *Is current tx effective? *Factors that aggravate or relieve the pain *Other sx and complications concurrently felt *Interference w/ the child's mood, function, and interactions
At what age do toddlers walk independently?
18 months- otherwise could be delayed in some way
What do retractions w/ expiratory wheeze suggest?
A lower airway obstruction
The mother of an obese 10-year-old child asks the nurse what she can do at home to help the child have a more healthy weight. Which is the best response made by the nurse? A) "Encourage the child to increase daily physical activity." B) "Eliminate all fat from the child's diet." C) "Encourage the child to skip breakfast to reduce calories." D) "Eliminate all snacks from the child's diet."
A) "Encourage the child to increase daily physical activity."
The nurse is caring for a 5-year-old boy. The boy's mother complains that they are constantly fighting about the boy's choice of clothing. Her son insists on selecting his own clothes. The mother is tired of the power struggle and is embarrassed by her son's mismatched apparel. The mother asks for guidance. How should the nurse respond? A) "Offer two or three coordinated outfits and let the child choose." B) "Lay his clothes out in the order in which they are to be put on." C) "Only give your son clothes that are easy to put on." D) "Remind him of the importance of dressing appropriately."
A) "Offer two or three coordinated outfits and let the child choose."
A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond? A) "Tell me about Boo-ga-loo." B) "I don't see anyone." C) "Are you kidding me?" D) "Where did you get that funny name?"
A) "Tell me about Boo-ga-loo."
Which of the following would be considered a normal respiratory rate in a newborn? A) 50 B) 70 C) 20
A) 50
Which of the following is a difference in diagnosing TB in children as opposed to adults? A) Children are asymptomatic even when the TB skin test is positive. B) Chest radiographs are positive in children. C) The infection progresses rapidly to disease. D) Clinical findings appear within 3 months of exposure.
A) Children are asymptomatic even when the TB skin test is positive.
Prior to conducting a blood-drawing procedure, the nurse teaches a child to imagine swimming in a cool, shady park with friends and family. Which technique did the nurse use with this client? A) Imagery B) Park therapy C) Thought-stopping D) Nerve stimulation
A) Imagery
What measure at home could help a child with an upper respiratory infection breathe more easily? A) Increasing room humidity B) Playing "rapid breathing" games C) Limiting fluid intake D) Enforcing strict bed rest
A) Increasing room humidity
Which of the following are true of pediatric airway components compared to adults? SELECT ALL THAT APPLY. A) Larger tongue B) Narrower cricoid cartilage C) Increased airway resistance
A) Larger tongue B) Narrower cricoid cartilage C) Increased airway resistance
Which of the following describes wheezes? A) Musical, high pitched, resulting from bronchoconstriction B) Low pitched, snoring noise, resulting from secretions in airway C) High pitched, whistling noise, due to a sort of obstruction D) A velcro-like nonmusical sound, d/t fluid in lungs
A) Musical, high pitched, resulting from bronchoconstriction
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents that the child is displaying: A) Object permanence. B) Mental combinations. C) Preoperational thinking. D) Concrete thinking.
A) Object permanence.
The nurse is caring for an 8 year old child with burns on both hands. When assessing this child's pain, which technique would be most appropriate for the nurse to us? A) Obtaining a self-report B) Evaluating physiologic indicators C) Observing behaviors D) Assessing the burns
A) Obtaining a self-report B/c 8 years and older have the cognitive ability to use numerical pain scale
What is the first nursing intervention to implement in a child who is desatting? A) Raise HOB B) Apply O2 C) Assess lung sounds
A) Raise HOB
The nurse is preparing to administer albuterol to a 14-year-old client for the first time. Prior to administration, which adverse reaction is priority for the nurse to educate the client? A) Tachycardia B) Hypoactivity C) Bronchial muscle relaxation D) Increased appetite
A) Tachycardia
The nurse is caring for a 17-year-old client recovering from a failed suicide attempt. Which factor should the nurse recognize as potentially causing the client to reattempt suicide? A) The client states feeling sad. B) The client has three other siblings. C) The client performs in the school band. D) The client is on the honor roll at school.
A) The client states feeling sad.
Which of the following are true regarding Colic? SELECT ALL THAT APPLY. A) There is no pharmacological treatment B) It is often worse in the morning C) It peaks at 6 months of age D) It is a self-limiting condition of increased fussiness and inconsolable crying
A) There is no pharmacological treatment D) It is a self-limiting condition of increased fussiness and inconsolable crying
TRUE OR FALSE: Toddlers react to painful procedures the same way as painless procedures. A) True B) False
A) True
What is the number one reason toddlers go to the doctors office?
Acute Otitis Media (AOM) aka ear infections
How do you inspect the ear of a preschooler?
Age 3 Pull it up and back
What do retractions w/ stridor or snoring (inspiratory) suggest?
An upper airway obstruction
When should a parent start solid foods?
At 6 months of age **Start with iron-fortified cereal, then add other pureed foods slowly to prevent allergies
The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate? A) "A daily multi-vitamin will boost the immune system." B) "Handwashing is an effective way to prevent infection." C) "Remind your child to cover the mouth when coughing." D) "Clean your bathroom and kitchen when they look dirty."
B) "Handwashing is an effective way to prevent infection."
The nurse is discussing home safety with the parents of a 10-year-old client. Which statement by the client's parents most concerns the nurse? A) "Our child is home alone for an hour each day." B) "Our child swims alone before we get home from work." C) "We do our best to keep no-cook snacks in the home." D) "Our child refuses to eat any green vegetables."
B) "Our child swims alone before we get home from work."
The nurse is assessing several children. Which child is most at risk for dysphagia? A) 7-month-old with erythematous rash B) 5-year-old with epiglottitis C) 2-month-old with toxic appearance D) 8-month-old with fever and fatigue
B) 5-year-old with epiglottitis
Which of the following is the most common (80%) reason that parents bring their toddlers to their PCP? A) Atopic Dermatitis B) Acute Otitis Media C) Acute Asthma Exacerbation D) Colic
B) Acute Otitis Media (An ear infection)
If the TB skin test is reactive, which of the following diagnostics should be done? A) CT scan B) Chest x-ray C) MRI D) Bronchoscopy
B) Chest x-ray
3-year-old client with history of an upper respiratory infection that slowly increased in severity over approximately 1 week. Today, the client exhibits a brassy cough, dyspnea, and irritability. Heart rate 110 beats/min, respiratory rate 45. Which croup syndrome is most likely? A) Epiglottits B) Laryngotracheobronchitis C) Spasmodic Larnygitis D) Tracheitis
B) Laryngotracheobronchitis
The nurse is performing a respiratory assessment on a child. The nurse includes five steps in her assessing technique: observation, inspection, palpation, and percussion. Which step was left out of her techniques? A) Feeding the child B) Listening to the lung sounds C) Playing with the child D) Touching
B) Listening to the lung sounds
Which of the following describes rhonchi? A) Musical, high pitched, resulting from bronchoconstriction B) Low pitched, snoring noise, resulting from secretions in airway C) High pitched, whistling noise, due to a sort of obstruction D) A velcro-like nonmusical sound, d/t fluid in lungs
B) Low pitched, snoring noise, resulting from secretions in airway
The nurse is caring for an infant who will have surgery. What type of pain assessment would the nurse use? A) None, because infants do not feel pain. B) Observation of facial and body actions. C) A self-pain rating scale from 1 to 10. D) None, because infants do not remember pain.
B) Observation of facial and body actions.
A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks the nurse about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. What reminders should the nurse give to the mother for when she discusses sex? A) Encourage her to talk to her peers and teachers in health class. B) Promote open lines of communication; listen instead of lecture; and share family values. C) Do not initiate any conversation; let the teen come and seek the advise of the parent. D) Discuss with the teen the experiences that you had so that she can connect on a personal level.
B) Promote open lines of communication; listen instead of lecture; and share family values.
Which of the following dictates the attainment of skills from trunk to extremities? A) Cephalocaudal B) Proximodistal C) Distal Proximal D) Caudalcephalic
B) Proximodistal
Which of the following is the first line of treatment for adolescent depression? A) Cognitive behavior therapy B) Psychotherapy C) Antidepressants D) Selective serotonin reuptake inhibitors (SSRIs)
B) Psychotherapy B/c Psychotherapy is the first choice of treatment for adolescent depression. If there is no improvement after 4 to 8 weeks, pharmacotherapy with antidepressants (typically SSRIs) is warranted.
Where is the best area to do any invasive procedure for a small child? (For example: an IV, burn care, etc.) A) Their patient room B) The treatment room C) The play deck room D) The on call room
B) The treatment room B/c want to keep their private patient room a safe zone and a place not to feel scared
The nurse is providing education to the parents of a 3-month-old infant during a well-child visit. Which position should the nurse instruct the parents to avoid to reduce the risk of sudden infant death syndrome (SIDS)? A) Sitting B) Supine C) Prone D) Side-lying
C) Prone
How long should a child be sitting in a rear facing car seat?
Before 2 years of age *2-4 yrs ride in forward facing in back seat in five-point harness
The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. Which response by the nurse would be most appropriate? A) "Look how cute she is." B) "Are you almost ready to be discharged?" C) "Always hold your baby for feedings instead of propping the bottles." D) "Is she almost done feeding?"
C) "Always hold your baby for feedings instead of propping the bottles."
A 4-year-old with bronchiolitis has been admitted to the hospital with respiratory compromise. The father asks the nurse why the physician won't prescribe an antibiotic, "My child just keeps getting worse." What is the best response by the nurse? A) "You have a very good physician who I trust completely. I'm sure everything possible is being done for your child." B) "Oftentimes it is more beneficial to treat the symptoms of bronchiolitis rather than try to kill the bacteria with an antibiotic." C) "Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses." D) "Your physician probably doesn't want to take a chance of your child building up an immunity to the antibiotic in case the condition worsens and more antibiotics are needed."
C) "Bronchiolitis is almost always caused by the respiratory syncytial virus (RSV). Unfortunately, antibiotics don't work on viruses."
During the health history, the mother of a 4-month-old child tells the nurse she is concerned that her baby is not doing what he should be at this age. What is the nurse's best response? A) "All mothers worry about their babies. I'm sure he's doing well." B) "Fill out the questionnaire and then I can let you know." C) "Tell me what concerns you." D) "'I'll be able to tell you more after I do this physical."
C) "Tell me what concerns you."
The parent of a toddler notices the child plays nicely next to another toddler but does not play with that child. The parent expresses concern about this behavior to the nurse during an examination. Which response by the nurse is appropriate? A) "I believe your toddler is exhibiting signs of autism spectrum disorder." B) "This behavior needs to be further assessed to ensure appropriate development." C) "This is called parallel play and is normal for this age group." D) "Be sure to inform the primary health care provider of your concerns."
C) "This is called parallel play and is normal for this age group."
The health care provider has prescribed beclomethasone for long term control of asthma. The nurse is most correct to advise the client that beclomethasone is a: A) Mast cell stabilizer. B) Xanthine derivative. C) Corticosteroid. D) Leukotriene inhibitor.
C) Corticosteroid.
While the phlebotomist draws blood from a toddler's right arm, the nurse is having the child blow bubbles with the left hand. Which pain management technique is the nurse using with the child? A) Imagery B) Hypnosis C) Distraction D) Thought-stopping
C) Distraction
A nurse is conducting a physical examination of an uncooperative preschooler. In order to encourage deep breathing during lung auscultation what could the nurse say? A) Do you want your mother to listen to your lungs? B) You must breathe deeply so I can hear your lungs. C) Do you think you can blow out this light bulb on my pen? D) You cannot leave until I listen to your lungs.
C) Do you think you can blow out this light bulb on my pen?
Which of the following describes stridor? A) Musical, high pitched, resulting from bronchoconstriction B) Low pitched, snoring noise, resulting from secretions in airway C) High pitched, whistling noise, due to a sort of obstruction D) A velcro-like nonmusical sound, d/t fluid in lungs
C) High pitched, whistling noise, due to a sort of obstruction
A nurse is teaching a group of parents about asthma in children. What information should the nurse include in the teaching? A) There are no specific triggers that can bring on an asthma attack. B) Children diagnosed with asthma should avoid playing sports. C) Inflammation, increased mucus, and bronchoconstriction characterize asthma. D) Seasonal allergies do not increase a child's risk of developing asthma.
C) Inflammation, increased mucus, and bronchoconstriction characterize asthma.
The nurse is caring for a 3-year-old girl who is cyanotic and breathing rapidly. Which intervention is best to relieve these symptoms? A) Saline lavage B) Suction C) Oxygen administration D) Saline gargles
C) Oxygen administration
The nurse is trying to pick a method to teach a 4-year-old with cystic fibrosis a good way to exercise her lungs. Which would be the developmentally correct strategy to help this client? A) Teach the client to hop on one foot. B) Teach the client to blow bubbles. C) Teach the client to blow bubbles. D) Teach the client to ride a bike.
C) Teach the client to blow bubbles.
The parents of a 12-year-old girl report their daughter is missing an increasing amount of school. They further share that the child says she feels ill and begs to stay home. What action by the parents will be most therapeutic? A) The parents should allow the child to stay home if necessary. B) The parents need to demand the child go to school. C) The parents need to attempt to determine why the child is avoiding school. D) The parents need to establish a contract with their child about attending school.
C) The parents need to attempt to determine why the child is avoiding school.
What type of play do preschoolers partake in?
Cooperative Play (Together, w/ same toys)
The nurse is documenting the bonding and nurturing relationship of Ruby and her infant Rose. What observation would be a positive documentation of nurturing? A) "The client holds the infant out on the lap and does not make eye contact." B) "The client holds the infant but doesn't speak much." C) "The client rarely spoke to the infant throughout care." D) "The client was noted to be kissing and hugging the infant during all care given."
D) "The client was noted to be kissing and hugging the infant during all care given."
Which of the following describes crackles? A) Musical, high pitched, resulting from bronchoconstriction B) Low pitched, snoring noise, resulting from secretions in airway C) High pitched, whistling noise, due to a sort of obstruction D) A velcro-like nonmusical sound, d/t fluid in lungs
D) A velcro-like nonmusical sound, d/t fluid in lungs
A child is at risk for infection related to a respiratory disorder. What would the nurse educate the family on to prevent infection? A) The type of medication needed B) Which friends can come and play C) The amount of exercise the child needs D) Hygiene, handwashing
D) Hygiene, handwashing
Which of the following is a form of respiratory treatment for a child with bronchopulmonary dysplasia (BPD)? A) Offering a healthy diet B) Encouraging coughing C) Encouraging the patient to walk D) Nasopharyngeal or tracheal suctioning
D) Nasopharyngeal or tracheal suctioning
When preparing the room for an infant with bronchiolitis, which equipment is most important? A) A tracheostomy set B) A metered dose inhaler C) IV antibiotics D) Oxygen tubing and facemask
D) Oxygen tubing and facemask
A pediatric client is having difficulty breathing. Which nursing intervention is appropriate for this client? A) Continue to monitor the child. B) Place the child in a supine position in the bed. C) Have family members leave the child's room to decrease stimuli. D) Provide oxygen as needed to maintain oxygen saturation above 93%.
D) Provide oxygen as needed to maintain oxygen saturation above 93%.
The nurse would assess respirations in a 9-month-old infant when the client is: A) Playing in the playroom. B) Crying. C) Laughing. D) Quiet in the parent's lap.
D) Quiet in the parent's lap.
What is a definitive test for cystic fibrosis? A) Complete blood count B) Blood gas C) Blood culture D) Sweat chloride
D) Sweat chloride
If there is a foreign body in the larynx, how will the client present? A) Edematous B) Speaks clearly C) Quietly D) With stridor
D) With stridor
What are examples of indirect lung injuries?
Sepsis, major trauma and transfusion-related acute lung injury
What type of play do toddlers partake in?
Parallel Play
What are examples of direct lung injuries?
Pneumonia, aspiration of gastric contents, inhalation injury, near-drowning events
How do you inspect the ear of a newborn?
Pull pinna back and down.
When do children first sit up and why is this important to know?
Sit up at 6 months of age (before that they lift their head up) =Need to know b/c need to know if developmentally off *Ex) Something is off when a 12 month old isn't sitting up
What type of play do infants partake in?
Solitary Play