Peds exam 2

True or false: Sudden abdominal pain gone with appendicitis means the patient is getting better

False; the appendix has ruptured

A child has been diagnosed with tetralogy of fallot what does that mean? A. decreased pulmonary blood flow B. inability to stand C. Obstructive blood flow D. Stenosis of the legs

A

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? A. "An abdominal ultrasound will confirm the pocket in the intestine" B. Genotyping will be done to identify this condition C. "A biopsy will be done on a small amount of the tissue from the colon" D. An upper GI series should identify the area involved"

A

A nurse is caring for a child with bacterial endocarditis. The child is scheduled to receive moderate term antibiotic therapy and requires a peripherally inserted catheter (PICC). Which of the following statements should the nurse include when teaching the child's parents? A. " The PICC line will last for several weeks with proper care" B. " the public health nurse will rotate the insertion site every 3 days" C. "You will need to ensure the arm board is in place at all times" D. " Your child will go to the operating room to have the line placed"

A

A nurse is caring for an infant who is experiencing dehydration. Which of the following assessments is the nurse's priority? A. Measure the client's weight daily B. Check for tears C. Palpate the fontanel D. Assess the skin turgor

A

A nurse is discussing the causes of chronic diarrhea with a client. Which of the following conditions is caused by malabsorption? A. Celiac disease B. Ulcerative colitis C. Hirschsprung disease D. Chrohn's disease

A

A nurse is providing teaching to the parent of an infant who has heart failure and a new prescription for digoxin. Which of the following pieces of information should the nurse include? A. With hold the medication if the infants heart rate is less than 110/min B. mix the medication in 4 oz of infant formula C. expect the infant to vomit frequently D. Double the dose if one is missed

A

Right sided heart failure causes? A. reduced function B. increased pressure C. lung congestion D. improve cardiac function

A

The nurse is caring for an infant newly diagnosed with Hirschsprung disease. What does the nurse understand about this infant's condition? A. There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention. B. There is excessive peristalsis throughout the intestine, resulting in abdominal distention. C There is a small-bowel obstruction leading to ribbon-like stools.

A

The nurse is teaching the parents of a child with rheumatic fever. Which of the following statements by a parent indicates an understanding of the teaching? A. " my child may take aspirin for his joint pain" B. "my child will need a blood transfusion prior to discharge" C. " I will need to wear a gown when i'm in my child's room" D. "I will apply lotion to my child's peeling hands"

A

Therapeutic management with Hirschsprung disease A. Temporary ostomy and "pull through" procedure B. Permanent ostomy C. Surgery D. Steroids

A

Clinical manifestations of ASD(Atrial septal defect)SATA A. may be asymptotic B. systolic murmur C. polycytemia

A,B

What are the types of endocarditis? SATA A. bacterial endocarditis (BE) B. ineffective endocarditis (IE) C. chronic endocarditis (CE) D. subacute bacterial carditis(SBE)

A,B,D

Foods to avoid when patient has GER SATA A. Alcohol B. Spicy foods C. Tuna D. Caffeine E. Citrus such as tomatoes F. Fried food

A,B,D,E&F

Interventions for infants with constipation SATA A. Dilute prune juice B. Dilute white grape juice C. Dilute cranberry juice D. Dilute apple juice E. Dilute grape juice F. Belly rubbing G. Miralax with formula

A,B,D,E,F

What is an important management of a major burn SATA A. stop the burning process B. nutritional support C. no hospitalization is required D. send a parent to jail

A,B; the child needs to increase their protein intake

Clinical manifestations of chronic hypoxia SATA A. clubbing B. pulmonary stenosis C. polycythemia D. overriding aorta

A,C

What food choices can a child with celiac disease have SATA A. Rice B. Wheat C. Corn D. Barley E. Millet F. Rye

A,C&E

Types of shock common in kids A. hypovolemic B. initial C. delayed D. surprise

A; blood loss (hemorrhage from trauma- MVA)

A nurse is planning care for a 4 year old child who has nephrotic syndrome. Which of the following actions should the nurse take? A. Provided through skin care B. Test for blood type and cross match C. Allow ample hydrating fluid D. Maintain a low card diet

A; especially important due to edema and infection

A nurse is teaching the parent of a school age child who has celiac disease. Which of the following foods selected by the parent indicates an understanding of the teaching? A. Corn tortilla with black beans B. Pizza C. Canned soup D. Hot dogs

A; prepared soups often contain gluten

What are the common types of burns SATA A. thermal B. chemical C. electrical D. radioactive

All of them

Which of the following assessment findings would the nurse most expect to find in the child who has been diagnosed with having hypertrophic pyloric stenosis? A) Currant jelly stools and a palpable, hard mass in the right upper quadrant B) Projectile vomiting C) Weight loss and bloody diarrhea D) Severe, crampy abdominal pain and lethargy

B

what to look for in infants and young children possibly dehydrated SATA A. constant wet diaper B. dry diapers for 3+ hours C. sunken fontanels in infant D. Bradycardia E. bradypnea F. increased heartrate G. rapid breathing

B,C,F,G

What would cause a cardiac cauterization to be canceled SATA a.Allergies b. fever c. Diaper rash d. family history of heart disease

B,C. They access the femoral artery. If the child has a diaper rash do not want to introduce infection from the cath because of the rash.

A patient with glomerulonephritis should be on what kind of diet SATA A. high in sodium B. low sodium C. low to moderate protein D. high potassium foods E. low potassium

B,CE; foods with substantial amounts of potassium are generally restricted during the period of oliguria

Clinical manifestations of hypoxemia are SATA A. vomiting B. polycythemia C. Atrial septal defect D. clubbing E. hypercyanotic spell (TET spell)

B,D,E

Clinical manifestations of older children with coarctation of the aorta SATA A. irritability B. headaches C. pulmonary edema D. epistaxis (nose bleed) E. vertigo

B,D,E

A child who was brought to the ED due to dehydration what shows the child is feeling better SATA A. says feels full B. behavior is back to normal C. has loss a lot of weight D. back up to normal weight E. normal metabolic panel F. specific gravity normal and urine output improves G. begin producing tears

B,D,E,F,G

Clinical manifestations of coarctation of the aorta SATA A. strong femoral pulses and warm lower extremities B. weak femoral pulses and cool lower extremities C. hypertension D. hypotension in the lower extremities

B,D; coarctation of the aorta results in increased pressure of the head and upper extremities and decreased pressure of the body and lower extremities

first stool of the newborn is called A: encopresis B. Hirschsprung C. Meconium D. Intussusception

C

A nurse in the ED is admitting a child who has full thickness burns over 45% of his body. Which of the following actions Should the nurse take first? A. administer IV morphine B. administer topical antimicrobials C. administer IV fluid replacement D. Administer tetanus prophylaxis

C

A nurse in the ED is assessing an infant who recently started taking digoxin to treat a supra ventricular arrhythmia. Which of the following findings should the nurse identify as an indication of digoxin toxicity? A. irritability B. Diaphoresis C. vomiting D. Tachycardia

C

A nurse is caring for a child who has glomerulonephritis. Which of the following actions should the nurse take? A. monitor the child's blood pressure twice a day B. maintain the child on bedrest for 3 days C. weigh the child once a day D. Increase the child's intake of sodium

C

A nurse is caring for a child with AGN. Which of the following actions should the nurse take? A. Monitor the child's blood pressure twice a day B. Maintain the child on bedrest for 3 days C. Weigh the child once each day D. Increase the child's daily intake of sodium

C

A nurse is caring for a toddler. Which of the following laboratory findings should the nurse report to the provider? A. BUN 8 B. Uric acid 3.0 C. creat 0.9 D. Urine specific gravity 1.010

C

A nurse is planning pre-op teaching for a school age child who is scheduled for cardiac surgery. Which of the following actions should the nurse plan to take when teaching the child? A. limit teaching sessions to 10 minutes B. Use simple, concrete terms when giving explanations C. Use photographs to help explain the procedure D. Conduct the teaching session 2 days before the procedure

C

A nurse is reviewing the lab values for a 6 month old who has renal failure. which of the following findings should the nurse expect? A. BUN 5 B. Creat 0.2 C. Sodium 125 D. Potassium 4.2

C

A pediatric nurse is assessing a 2-month-old child who has been vomiting for the past 48 hours with accompanying fever of 100.7. The nurse recognizes that which of the following does not represent dehydration in an infant? A. 3-5 wet diapers a day for the past 2 days B. Lack of tears when crying C. Puffiness of the skin D. Pale oral mucosa

C

Clinical manifestation in VSD(ventricular septal defect) A. systolic murmur B. may be asymptotic C. Heart failure is common D. none

C

What is a care management with feeding? A. Don't change B. feed for an hour C. gavage feeds- limit nipple feeds to no longer than 30 minutes D. do not feed

C

What is a posprocedural care after a cardiac cath? A. Do nothing B. Let the child ambulate as much as possible C. if bleeding is noticed notify the dr immediately D. Monitor height and weight

C

What should you teach parents about prevention of rheumatic heart disease? A. no way to prevent B. keep them away from all children C. treat streptococcal tonsillitis/ pharyngitis D. A daily dose of Orange juice

C

A nurse is caring for a school age child who as glomerulonephritis. The child has decreased urinary output and a blood pressure of 160/78 and is receiving hydralazine. Which of the following lunch choices should the nurse recommend? A. 1 hot dog, 22 potato chips, and 4 oz of orange juice B. 1 sandwich with lettuce, tomato and 4 slices of bacon; a small apple and 8 oz of milk C. 3 oz grilled chicken, 1 cup of pear slices and 4 oz of apple juice D. 1 cup of cottage cheese, a small banana and 8 oz of soda

C; child is on a sodium and potassium restriction

How much urine should a child excrete A. 30 ml/kg/hr B. 500 ml/kg/hr C. 1-2 ml/kg/hr D.1,000 ml/kg/hr

C; if less could indicate renal failure

A nurse in the ED is caring for a 4 year old who has burns to the neck and face following a house fire. Which of the following actions should the nurse take first? A. Cover the childs wounds with clear, dry cloth B. establish IV access C. Provide reassurance to the child's parents D. determine the childs breathing pattern

D

A nurse is caring for a school-age child who has acute streptococcal glomerulonephritis. Which of the following manifestations should the nurse expect? A. Hypotension B. Elevated serum lipid levels C. Decreased serum potassium D. Hematuria

D

A nurse is caring for an 8 year old who has AGN(. Which of the findings should the nurse expect? A. Hypotension B. Stomatitis C. Bloody diarrhea D. Periorbital Edema

D

A nurse is providing discharge teaching to the parents of a child that has nephrotic syndrome. which of the following instructions should the nurse include in the teaching? A. Restrict the child's potassium intake B. Administer tylenol to the child twice daily C. Weigh the child once a week D. Keep the child away from people with infections

D

A nurse is reviewing the morning labs of an infant who is receiving digoxin and furosemide for the treatment of heart failure. Which of the following findings should the nurse report to the provider? A. sodium of 140 B. calcium 10.2 C. Chloride 100 D. potassium 3.2

D

During auscultation of a child with a cardiac disorder what may you hear? a. S1&S2 b. S4 c.S3 d. a murmur

D

Left sided heart failure causes A. reduced function B. improve cardiac function C. Nothing D. increased pressure & lung congestion

D

Remnant of fetal life and blood stools are associated with what disorder A. Appendicitis B. Celiac disease C. GER D. Meckel Diverticulum

D

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? a) Abdominal pain and irritability b) Sausage-shaped mass in the upper mid abdomen c) Perianal fissures and skin tags d) Hard, moveable "olive-like mass" in the upper right quadrant

D

treatment for acute glomerulonephritis is steroids true or false

False; steroid is used for nephrotic syndrome

A nurse is caring for a child who has tetralogy of fallot. Which of the following lab values should the nurse expect to find? A. platelet count of 20,000 B. WBC 4,000 C. Thyroid stimulating hormone 7.0 D. RBC 6.8

D; a child that has ToF experiences cyanosis; therefore the body responds by producing RBC production (polycythemia)

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? a) Preparing family for home care b) Promoting comfort c) Maintaining skin integrity d) Improving hydration

D; a symptom is dehydration

Give dioxin every 12 hours true or false?

True

Can nephrotic syndrome be a reoccurent problem?

Yes

A patient with nephrotic syndrome has an elevated BP true or false

false; normal to low; acute glomerulonephritis has an elevated BP

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? A.Hirschsprung disease B. Ulcerative colitis (UC) C.Short bowel syndrome (SBS) D. Gastroenteritis

A

A nurse is assessing a 6 month old infant who had a cardiac cath with right femoral entry to diagnose a possible congenital heart defect. Which of the following findings should the nurse report to the provider? A. cool toes on the right foot B. Weak pedal pulses on both feet C. Positive babinski reflex on both feet D. erythema on the right foot

A

What form of urine sample is preferred? A. clean catch B. from a diaper C. from a old foley bag D. no one way is preferred

A

You are taking care of an infant who has come back from having cleft lip and palate repair. The nurse would include all of the following in the plan of care EXCEPT: A) Use of pacifier to prevent vigorous crying B) Holding, cuddling and rocking of infant C) Arm restraints or mummy restraint D) Placing infant in the supine position

A

What does cluster care mean SATA A. letting them rest B. No not want them crying a lot C. keep them active D. Continue to make sure they are not sleeping E. Crying is recommended to make sure child is doing fine

A, B

A nurse is assessing a school age child who has celiac disease. Which of the following findings should the nurse expect? A. Elevated sweat chloride B. steatorrhea C. Clubbing of the fingers D. Jaundice

B

A nurse is caring for a child who has a ruptured appendix. Which of the following positions should the nurse encourage the child to maintain? A. Supine B. Semi-Fowler's C. Sims D. Orthopneic

B

What is a form of obstructive defects? A. ASD b. coarctation of the aorta C. VSD D. PDA

B

A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? A. Urinalysis obtained by bagged specimen. B. Urinalysis obtained by sterile catheterization. C. Analysis of serum electrolytes. D. Analysis of cerebrospinal fluid.

C

A mother and 7 month old infant present to the pediatric clinic. The infant appears developmentally appropriate and healthy, but the mother tells you that she is exacerbated. She says yesterday her infant had been incessantly crying with vomiting and jelly-like stool. But now, the infant appears fine. Which of the following GI disorders does the nurse suspect? A) Hypertrophic pyloric stenosis B) Celiac's disease C) Intussusception D) Encopresis

C

Atrial septal defect is left to right shunting true or false

True

Insensible water loses, urine and stools needs to be replaced true of false

True

True or false: When a patient has appendicitis it is okay to give an enema

False

Water intoxication results in decrease in serum sodium leads to CNS symptoms true or false

True

the pathophysiology of IE (ineffective carditis) is microorganisms grow and form vegetation on the endocardium. True or false?

True

Digoxin guidelines for age groups heart rates SATA A. below 90 in infants hold digoxin B. if HR is 100 in infants hold digoxin C. below 70 in toddler or preschooler hold digoxin D. below 60 from age 8 and above hold digoxin

A,C,D

A nurse is assessing a school age child who is 30 minutes postoperative following a cardiac cath using the left femoral artery. Which of the following findings should the nurse identify as the priority to report to the provider? A. The child rises to verbal stimuli B. the pulse strength on the child's left popliteal artery site is decreased C. the child's respiratory rate is 20/min D. The child rates his pain at the cath site at a 7 on a scale of 10

B

A nurse is caring for a 4 year old child who has a superficial partial thickness burn over 50% of his body. To meet the nutritional needs of the child, which of the following actions should the nurse plan to take? A. administer pancrelipase to the child prior to each meal B. Supplement the childs feeding with enteral feeding C. provide the child with a low protein meal D. perform dressing changes 10 minutes prior to the childs meal time

B

A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take? A. maintain the child on strict bedrest B. Check the child's blood pressure every 4 hours C. administer albumin to the child every 8 hours D. Provide the child with a low-carbohydrate diet

B

A nurse is caring for an 18 month child who has a cyanotic cardiac defect. The child cries when the parents leave the room, worsening her cyanosis and dyspnea. Into which of the following positions should the nurse place the child to improve these manifestations? A. orthopenic B. knee's to chest C. Sim's D. Semi fowlers

B

A nurse is reviewing the laboratory results of a child who has experienced diarrhea for the past 24 hours. Which of the following values for urine specific gravity should the nurse expect? a. 1.010 B. 1.035 C. 1.020 D. 1.005

B

Hirschsprung disease, hypothyroidism, meconium plug and meconium ileus(cystic fibrosis) can cause what? A. Diarrhea B. Constipation C. Vomiting D. Appendicitis

B

A child comes into the ED with vasculitis with no exudate, red lips, strawberry tongue, palms of hand red and peeling and mom states they have been sick for over a month. What do you think this child is suffering from? A. Allergic reaction B. Kawasaki disease C. otitis media D. asthma

B; the child is sick for a long time usually 6-8 weeks

A nurse is reviewing the laboratory test results of a child with acute nephrotic syndrome who has been receiving prednisone by mouth for the past week. Which of the following findings should the nurse report to the provider? A. Potassium 4 B. Sodium 142 C. WBC 3,000 D. Platelet 298,000

C; steroids suppress immune systems

An infant has been diagnosed for tetralogy of fallot and you as the nurse notice the baby is becoming cyanotic. What should you do first? A. apply oxygen B. call a code C. page RRT D. put the babies knees to chest

D; during a tet spell children under three should be put in a knee to chest position. if over 3 the child would squat

A patient with a UTi is not required to be on antibiotics true or false

False; antibiotics are needed

If the child is eating well hold digoxin true or false

False; hold if the child is frequently vomiting or poor feeding

The most common cause of a UTI is endocarditis true or false

False; its E.coli

A nurse is providing teaching to a guardian of a child who has Kawasaki disease. Which of the following statements by the guardian indicates and understanding of the teaching? SATA A. "My child will likely be irritable for the next few weeks" B. "I will notify my child's doctor if the skin on her hands begin to peel" C. "I will make sure my child does not receive any live vaccines for 18 months" D. "I will keep a record of my childs temperature until she has no fever for several days E. "My child will have joint stiffness primarily at the end of the day"

A,C,D

What are some Pediatric indicators of cardiac dysfunction SATA a. poor feeding b. bradycardia/bradypnea c. tachypnea/ tachycardia d. failure to thrive/ poor weight gain/ activity intolerance

A,C,D

what are pulmonary blood flow defects? SATA A. too much blood on the right side of the heart B. right to left shunting C. atrial septal defect D. ventricular septal defect E. patent ductus arterioles

A,C,D,E

Most common characteristics of glomerular injury in children SATA A. proteinuria B. hypoalbuminemia C. hyperlipidemia D. generalized edema E. massive urinary protein loss

All of the above

A nurse is assessing a 6 month old following a cardiac cath. Which of the following findings should the nurse report to the provider? A. Temperature of 37.5 (99.5) B. apical pulse of 140 C. BP of 86/40 D. Respiratory rate 32/min

B

The mother calls the hospital because her child is rehydrating at home. The child begins to throw up what should the nurse tell the mother? A. bring the child in immediately B. continue to rehydrate with small sips C. stop rehydrating D. give the baby juice instead

B

The child was discharged a day ago with having kawasaki disease. Upon follow up with her doctor it's time to receive her chicken pox vaccine. What should the nurse explain the child will not be receiving the chicken pox vaccine? A. mother has the dates mixed up B. chicken pox vaccine is no longer given C. deferring of live immunizations for 11 months after iGg administration D. the nurse is wrong the child may receive the vaccine

C; during Kawasaki disease the child is given aspirin for a fever.

Acute Glomerulonephritis (AGN) is from a previous strep infection true or false

Ture; grop A beta hemolytic strep