PEDS exam 3

The nurse is caring for a sick child who is scheduled for a bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis?

The bone scan would be two or more deviations below normal

Which of the following patients should the nurse assess first?

12-month old with irritability, vomiting, bulging fontanels.

Screening for scoliosis is most important for which of the following children?

12-year old female

The parents of an adolescent male with Ewing sarcoma ask the nurse what the most significant factor is contributing to their son's prognosis. Which factor should the nurse include when answering their concerns?

Degree of metastasis

The nurse is planning care for a 6-year old non-verbal patient with autism. Which of the following techniques would be most useful?

Maintaining the patient's routine.

The cardinal signs of childhood cancer are important to facilitate early recognition and prompt treatment. The cardinal signs of childhood cancer would include (SATA):

Weight loss fatigue unexplained fevers leg aches occurring at night

The nurse is providing discharge teaching to the parents of a 6 month old infant with spina bifida who had a VP shunt placed 78 days ago due to hydrocephalus. When providing discharge education on signs and symptoms of shunt malfunction which of the following should the nurse include?

*Increased head circumference *High pitched shrill cry *Pulsating posterior fontanel Poor feeding

A nurse is reviewing the medical records of several children who have undergone lead screening. The nurse would identify the child with which level as requiring a repeat test ad an environmental investigation?

25, 50: anything over 20

When assessing a patient's strength you notice the patient is able to pick her arm up, off the bed but is not able to resist you applying pressure. You would grade this child's strength as:

3

A young child admitted to the pediatric unit has fever, irritability, and vomiting. The physician suspects viral meningitis. The nurse would suspect the CSF to show?

increased lymphocyte count

A child is admitted in a vaso-occlusive sickle cell crisis. The child's care should include which of the following as the top priorities?

increased oxygen, pain management

A newborn was diagnosed as having hypothyroidism at birth. Her mother asks you how the disease could be discovered this early. Your best answer would be a) her child is already severely impaired at birth, and this suggests the diagnosis. b) hypothyroidism is usually detected at birth by the child's physical appearance. c) children have a typical rash at birth that suggests the diagnosis. d) a simple blood test to diagnose hypothyroidism is required in most states.

A simple blood test to diagnose hypothyroidism is required in most states

A patient is exhibiting a sudden interruption in activity for less than 10 seconds followed by normal activity, which most likely exhibited what type of seizure?

Absence

The nurse organizes care for an infant with tachypnea for severe iron deficiency anemia to allow for uninterrupted periods of rest. This plan would:

Appropriate because this action promotes decreased oxygen demand

You are called to the room of an adolescent who is experiencing a generalized tonic clonic seizure. The seizure started one minute prior to your arrival. What would be a priority nursing intervention?

Assist the patient to her side

The nurse is planning the postoperative care for a newborn with a myelomeningocele repair. Which of the following would be the nurse's priority nursing intervention?

Cover the sac with dry sterile dressing to maintain its integrity

An infant has just returned from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long leg casts. The toes on both feet are edematous but there is color, sensitivity, and movement to them. What should the nurse do first?

Elevate the infants legs on pillows

An 8-day-old infant has been diagnosed with congenital hypothyroidism. She has been placed on levothyroxine (Synthroid). Which of the following instructions should be given to her parents?

Fussiness, sleep disturbances, and hunger indicate the dose may be too high

Which of the following assessment findings is considered normal in a toddler?

Genu varum

The nurse is admitting a patient to the ER who presented with an open break of both the ulnar and radial bones with type 2 Salter Harris classification. The nurse understands that this child:

Has a compound fracture unlikely to impact the growth of the extremity

A parent brings a child to the pediatric clinic, stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptoms does the nurse anticipate finding with this child?

Inattention, impulsive, and hyperactivity

You are discharging a newborn that has metatarsus adductus. Which statement, if made by the mother, indicates she understands the discharge teaching?

My child will require physical therapy or stretching exercises once we are discharged.

To help an adolescent deal with diabetes, the nurse needs to consider which characteristic of adolescence?

Need to be perfect and similar to peers

What is a common clinical manifestation of Hodgkin's disease?

Nontender enlargement of lymph nodes

A nurse is assessing a child after an open reduction of a fractured femur. Which signs indicate that compartment syndrome could be occurring? SATA

Pain not relieved by medication Prolonged cap refill time Paresthesia of the leg

The mother of an infant tells the nurse that sometimes there are whitish "glow" in the pupil of the child's eye. The nurse would suspect the following?

Retinoblastoma

A child arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary glad disorder would be most associated with these symptoms.

SIADH

Which type of spinal neural tube defect does the nurse recognize as common and usually benign?

Spina bifida occulta

The healthcare provider advised the parent of a child with Sickle Cell Disease to get the pneumococcal and meningococcal vaccine at the child's follow up visit. The parent asks the nurse, "why does her child need to have those vaccines?" The nurse would respond

These immunizations will prevent infections for which your child is more susceptible

A nurse is conducting a physical examination of an 11-year old boy with Leg Calve-Perthes disease. Which assessment finding would be expected?

Trendelenburg gate

The nurse is assessing a 6-year old child. The nurse instructs the child "let me see all of your pretty white teeth." Which cranial nerve is the nurse assessing?

VII facial nerve

Which of the following would be expected in a 2-month old infant with hypotonia?

When places in horizontal suspension the infant's head droops over the examiner's supporting hand with legs and arms hanging loosely

A mother is quite concerned about her 6 year old daughter after noticing some breast bud development followed by the appearance of small amount of pubic hair. The mother asks the nurse if this is a cause for concern. What would be the best response by the nurse?

Yes, your daughter may have precocious puberty. Let's talk with your child's primary care provider because she may need a referral to an endocrinologist.

You are caring for an 18-month old in the ER who came in after one, 5-minute-long generalized seizure accompanied by fever and gastroenteritis. When giving the mom discharge instructions you should include which of the following statements?

Your child had a simple febrile seizure and requires no further workup at this time

A nurse has provided care to several children during their well-child visits. The nurse has assessed each child's neurological/musculoskeletal status. Which assessment finding indicates a problem requiring intervention?

a 4 year old who walks on his tiptoes consistently

Which of the following clinical manifestations in a preschooler would be suggestive of a disease affecting the myelin sheath around nerves?

absent DTR

What are characteristics of diabetes ketoacidosis?

acidosis dehydration lethargy

Based on knowledge of the progression of muscular dystrophy which activity would a nurse anticipate the patient to have the most difficulty with at presentation?

climbing stairs

A school nurse is consulted by a fifth-grade teacher about a student who has become increasingly inattentive ad hyperactive in the classroom. The nurse notes that the child's weight has changed from the 50th percentile to the 30th percentile. The nurse is concerned about possible graves disease. Which additional symptoms would the nurse anticipate?

exophthalmos and blurred vision

A 9-month old former preemie who is not sitting independently has been diagnosed with spastic di-paretic cerebra palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?

hyperreflexia and hypertonia in the lower extremities

The hallmark feature associated with all autism spectrum disorders is:

impaired social interaction

A 12-year old has been selected to be a cheerleader for her middle school. This child has recently been diagnosed with type 1 diabetes. The the teaching this child's mother about care for her child it is most important for the mother to understand with increased physical activity the child will most likely need:

increased glucose/carb intake prior to activity

A 6-month old infant has a hemoglobin of 9.2 at his well-child checkup. His mom asks why her child has low hemoglobin. She says he takes breast milk well so she has not started any baby foods yet. The nurse explains the low hemoglobin.

is due to normal physiological anemia because of a shortened lifespan of fetal hemoglobin

The thyroid-stimulating hormone (TSH) increases secretion in response to which hormone?

low levels of thyroid hormone

A positive Gower's sign is suggestive of:

lower extremity weakness

When discussing the subject of bleeding prevention when parents of a child diagnosed with hemophilia the nurse must consider which of the following?

relationship between developmental characteristics and preventative measures

Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis?

signs of ICP

The nurse is caring for a 2-year old boy with cerebral palsy. The medical record indicates hypertonicity and permanent contractures affecting both extremities on one side. Based on these findings, the nurse identifies this type of CP as?

spastic

The nurse is doing an assessment on a 5-month old infant. Which assessment finding would the nurse consider abnormal?

the posterior fontanel is open

The nurse is triaging an adolescent brought in after a leg injury playing football where the patient was tackled in the lower extremity region while throwing the ball, applying a force perpendicular to the long axis of the bone. Which type of fracture does the nurse anticipate?

transverse