Peds Final 1 (Be sure and study all three- Peds Final 1,2,3)
Hypospadias refers to a. absence of a urethral opening. b. penis shorter than usual for age. c. urethral opening along dorsal surface of penis. d. urethral opening along ventral surface of penis.
d
A beneficial effect of administering digoxin is that it a. decreases edema. b. decreases cardiac output. c. increases heart size. d. increases venous pressure.
a
A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this child's laboratory values, the nurse is not surprised to notice which abnormality? a. Polycythemia b. Infection c. Dehydration d. Anemia
a
What is the priority nursing intervention for a child hospitalized with hemarthrosis resulting from hemophilia? a. Immobilization and elevation of the affected joint b. Administration of acetaminophen for pain relief c. Assessment of the child's response to hospitalization d. Assessment of the impact of hospitalization on the family system
a
An infant is born with bladder exstrophy. What action by the nurse is the priority? a. Obtain surgical consent for the corrective operation. b. Cover the exposed bladder with non-adherent plastic wrap. c. Insert an indwelling catheter to collect all the urine. d. Obtain consent for genetic testing on parents and infant.
b
Which defect results in increased pulmonary blood flow? a. Pulmonic stenosis b. Tricuspid atresia c. Atrial septal defect d. Transposition of the great arteries
c
Nursing care for the child in congestive heart failure includes which of the following activities? a. Counting the number of saturated diapers b. Putting the infant in the Trendelenburg position c. Removing oxygen while the infant is crying d. Organizing care to provide rest periods
d
The most common cause of acute kidney injury in children is a. pyelonephritis. b. tubular destruction. c. urinary tract obstruction. d. severe dehydration.
d
The nurse is admitting a child to the hospital for a cardiac workup. What is the first step in a cardiac assessment? a. Percussion b. Palpation c. Auscultation d. History and inspection
d
The nurse assesses the lab values of a child hospitalized with DIC. What findings are consistent for this disorder? (Select all that apply.) a. Decreased platelet count b. Increased hemoglobin c. Prolonged prothrombin time d. Elevated D-dimer e. Pancytopenia
acd
A nurse is assessing an infant for urinary tract infection (UTI). Which assessment findings should the nurse expect? (Select all that apply.) a. Change in urine odor or color b. Enuresis c. Fever or hypothermia d. Voiding urgency e. Poor weight gain
ace
The nurse is caring for a child who has beta-thalassemia. What unique facial features does the nurse assess in this child? (Select all that apply.) a. Frontal bossing b. Strabismus c. Wide-set eyes d. Maxillary prominence e. Distinct overbite
ace
The nurse is caring for a child with iron-deficiency anemia. What should the nurse expect to find when reviewing the results of the complete blood count (CBC)? (Select all that apply.) a. Low hemoglobin levels b. Elevated red blood cell (RBC) levels c. Elevated mean cell volume (MCV) levels d. Low reticulocyte count e. Decreased MCV levels
ade
33. The primary nursing intervention to prevent bacterial endocarditis is which of the following? a. Institute measures to prevent dental procedures. b. Counsel parents of high-risk children about prophylactic antibiotics. c. Observe children for complications, such as embolism and heart failure. d. Encourage restricted mobility in susceptible children.
b
8. What is an appropriate intervention for a child with nephrotic syndrome who is edematous? a. Teach the child to minimize body movements. b. Change the child's position every 2 hours. c. Avoid the use of skin lotions. d. Bathe every other day.
b
A child had an aortic stenosis defect surgically repaired 5 months ago. Which antibiotic prophylaxis is indicated for an upcoming tonsillectomy? a. No antibiotic prophylaxis is necessary. b. Amoxicillin is taken orally 1 hour before the procedure. c. Oral penicillin is given for 7 to 10 days before the procedure. d. Parenteral antibiotics are administered for 5 to 7 days after the procedure.
b
In teaching family members about their child's von Willebrand disease, what is the priority outcome for the child that the nurse should discuss? a. Prevention of injury b. Maintaining adequate hydration c. Compliance with chronic transfusion therapy d. Prevention of respiratory infections
a
In which situation is there a risk that a newborn infant will have a congenital heart defect (CHD)? a. Trisomy 21 detected on amniocentesis b. Family history of myocardial infarction c. Father has type 1 diabetes mellitus d. Older sibling born with Turner syndrome
a
The mother of a child with hemophilia asks the nurse how long her child will need to be treated for hemophilia. What is the best response to this question? a. "Hemophilia is a lifelong blood disorder." b. "There is a 25% chance that your child will have spontaneous remission." c. "Treatment continues until after the toddler years." d. "Since your first child did not have hemophilia, treatment for this child is temporary."
a
The nurse closely monitors the temperature of a child with nephrotic syndrome. The purpose of this is to detect an early sign of which possible complication? a. Infection b. Hypertension c. Encephalopathy d. Edema
a
The primary clinical manifestations of acute kidney injury are which of the following? a. Oliguria and hypertension b. Hematuria and pallor c. Proteinuria and muscle cramps d. Bacteriuria and facial edema
a
What intervention should be included in the plan of care for an infant with the nursing diagnosis of excess fluid volume related to congestive heart failure? a. Weigh the infant every day on the same scale at the same time. b. Notify the physician when weight gain exceeds more than 20 g/day. c. Put the infant in a car seat to minimize movement. d. Administer digoxin as ordered by the physician.
a
What is the nurse's first action when planning to teach the parents of an infant with a CHD? a. Assess the parents' anxiety level and readiness to learn. b. Gather literature for the parents. c. Secure a quiet place for teaching. d. Discuss the plan with the nursing team.
a
What is true about the genetic transmission of sickle cell disease? a. Both parents must carry the sickle cell trait. b. Both parents must have sickle cell disease. c. One parent must have the sickle cell trait. d. Sickle cell disease has no known pattern of inheritance.
a
What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux? a. The importance of taking prophylactic antibiotics if prescribed b. Suggestions for how to maintain fluid restrictions c. The use of bubble baths as an incentive to increase bath time d. The need for the child to hold urine for 6 to 8 hours
a
What should the nurse include in discharge teaching as the highest priority for the child with a cardiac dysrhythmia? a. CPR instructions b. Repeating digoxin if the child vomits c. Resting if dizziness occurs d. Checking the child's pulse after digoxin administration
a
Which CHD results in increased pulmonary blood flow? a. Ventricular septal defect b. Coarctation of the aorta c. Tetralogy of Fallot d. Pulmonary stenosis
a
Which dietary modification is appropriate for a child with chronic renal failure? a. Decreased protein b. Decreased fat c. Increased potassium d. Increased phosphorus
a
Which drug is an angiotensin-converting enzyme (ACE) inhibitor? a. Captopril b. Furosemide c. Spironolactone d. Chlorothiazide
a
The mother of a child who was recently diagnosed with acute glomerulonephritis asks the nurse why the physician keeps talking about "casts" in the urine. The nurse explains that casts in the urine indicate a. glomerular injury. b. glomerular healing. c. recent streptococcal infection. d. excessive amounts of protein in the urine.
a.
A child is admitted with acute glomerulonephritis. The nurse expects the urinalysis during this acute phase to show which of the following? a. Bacteriuria and hematuria b. Hematuria and proteinuria c. Bacteriuria and increased specific gravity d. Proteinuria and decreased specific gravity
b
A condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin is known as a. aplastic anemia. b. sickle cell anemia. c. thalassemia major. d. iron-deficiency anemia.
b
A nurse is assessing lab results on four patients in the general pediatric unit. What child should the nurse go see first? a. Urine specific gravity: 1.025 b. Urine ketones: positive in large amounts c. Serum BUN 21 mg/dL d Serum creatinine 0.7 mg/dL
b
An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension. On further testing, it is discovered the child has a cardiac abnormality. The initial treatment of secondary hypertension initially involves a. weight control and diet. b. treating the underlying disease. c. administration of digoxin. d. administration of beta-adrenergic receptor blockers.
b
Parents ask the nurse, "When should our child's hypospadias be corrected?" The nurse responds that correction of hypospadias should be accomplished by the time the child is a. 1 month of age. b. 6 to 12 months of age. c. school age. d. sexually mature.
b
The narrowing of preputial opening of foreskin is called a. chordee. b. phimosis. c. epispadias. d. hypospadias.
b
The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. What action by the nurse is most appropriate? a. Educate parents on daily low-dose aspirin regime. b. Prepare to administer indomethacin. c. Administer next dose of enalapril early. d. Position infant in the knee-chest position.
b
The nurse discovers a heart murmur in an infant 1 hour after birth. What does the nurse know about when fetal shunts close in the neonate? a. When the umbilical cord is cut b. Within several days of birth c. Within a month after birth d. By the end of the first year of life
b
What are the nursing priorities for a child with sickle cell disease in vaso-occlusive crisis? a. Administration of antibiotics and nebulizer treatments b. Hydration and pain management c. Blood transfusions and an increased calorie diet d. School work and diversion
b
What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well? a. Recheck the infant's blood pressure. b. Alert the provider. c. Withhold oral feeding. d. Increase the oxygen rate.
b
What is the nurse's best response to parents with questions about how her child's blood disorder will be treated? a. "Your child may be able to receive home care." b. "What did the provider tell you?" c. "Blood diseases are transient, so there is no need to worry." d. "Your child will be tired for a while and then be back to normal."
b
Which factor predisposes the urinary tract to infection? a. Increased fluid intake b. Short urethra in young girls c. Prostatic secretions in males d. Frequent emptying of the bladder
b
Which finding indicates that a child receiving prednisone for primary nephrotic syndrome is in remission? a. Urine is negative for casts for 5 days. b. Urine has <1+ protein for 3 to 7 consecutive days. c. Urine is positive for glucose for 1 week. d. Urine is up to a trace for blood for 1 week.
b
Which statement best describes patent ductus arteriosus? a. Patent ductus arteriosus involves a defect that results in a right-to-left shunting of blood in the heart. b. Patent ductus arteriosus involves a defect in which the fetal shunt between the aorta and the pulmonary artery fails to close. c. Patent ductus arteriosus is a stenotic lesion that must be surgically corrected at birth. d. Patent ductus arteriosus causes an abnormal opening between the four chambers of the heart.
b
Which statement by a school-age girl indicates the need for further teaching about the prevention of urinary tract infections (UTIs)? a. "I always wear cotton underwear." b. "I really enjoy taking a bubble bath." c. "I go to the bathroom every 3 to 4 hours." d. "I drink four to six glasses of fluid every day."
b
Which statement is descriptive of renal transplantation in children? a. It is an acceptable means of treatment after age 10 years. b. It is preferred means of renal replacement therapy in children. c. Children can receive kidneys only from other children. d. The decision is difficult, since a normal lifestyle is not possible.
b
Which strategy is appropriate when feeding the infant with congestive heart failure? a. Continue the feeding until a sufficient amount of formula is taken. b. Limit feeding time to no more than 30 minutes. c. Always bottle feed every 4 hours. d. Feed larger volumes of concentrated formula less frequently.
b
You are the nurse caring for a 4-year-old child who has developed acute renal failure as a result of hemolytic-uremic syndrome (HUS). Which bacterial infection was most likely the cause of HUS? a. Pseudomonas aeruginosa b. Escherichia coli c. Streptococcus pneumoniae d. Staphylococcus aureus
b
A nurse is planning care for a child admitted with nephrotic syndrome. Which interventions should be included in the plan of care? (Select all that apply.) a. Administration of antihypertensive medications b. Daily weights c. Salt-restricted diet d. Frequent position changes e. Teaching parents to expect tea-colored urine
bcd
The nurse is caring for a child with aplastic anemia. What nursing diagnoses are appropriate? (Select all that apply.) a. Acute Pain related to vaso-occlusion b. Risk for Infection related to inadequate secondary defenses or immunosuppression c. Ineffective Protection related to thrombocytopenia d. Ineffective Tissue Perfusion related to anemia e. Ineffective Protection related to abnormal clotting
bcd
The nurse working in the newborn nursery notices an infant who is having circumoral cyanosis. Which CHD does the nurse suspect the child may have? (Select all that apply.) a. Patent ductus arteriosus (PDA) b. Tetralogy of Fallot c. Pulmonary atresia d. Transposition of the great arteries e. Ventricular septal defect
bcd
A child has beta-thalassemia and is receiving deferoxamine. The parent asks what the purpose of this medication is. Which response by the nurse is best? a. "To improve the anemia" b. "To decrease liver and spleen swelling" c. "To eliminate excessive iron being stored in the organs" d. "To prepare your child for a bone marrow transplant"
c
A major complication in a child with chronic renal failure is a. hypokalemia. b. metabolic alkalosis. c. water and sodium retention. d. excessive excretion of blood urea nitrogen.
c
A child has a total cholesterol level of 180 mg/dL. What dietary recommendations should the nurse make to the child and the child's parents? (Select all that apply.) a. Replace whole milk with 1% milk. b. Increase servings of red meat. c. Increase servings of fish. d. Avoid excessive intake of fruit juices. e. Limit servings of whole grain.
acd
A nurse is teaching a class on acute kidney injury. The nurse relates that acute kidney injury as a result of hemolytic-uremic syndrome (HUS) is classified as a. Intrinsic renal. b. Prerenal. c. Postrenal. d. Chronic.
a
An assessment of a 7-month-old infant with a hemoglobin level of 6.5 mg/dL is likely to reveal an infant who is a. lethargic, pale, and irritable. b. thin, energetic, and sleeps little. c. anorexic, vomiting, and has watery stools. d. flushed, fussy, and tired.
a
Before giving a dose of digoxin the nurse checked an infant's apical heart rate and it was 114 beats/minute. What should the nurse do next? a. Administer the dose as ordered. b. Hold the medication until the next dose. c. Wait and recheck the apical heart rate in 30 minutes. d. Notify the physician about the infant's heart rate.
a
A nurse is conducting a class for nursing students about fetal circulation. Which statement is accurate about fetal circulation and should be included in the teaching session? a. Oxygen is carried to the fetus by the umbilical arteries. b. Blood from the inferior vena cava is shunted directly to the right ventricle through the foramen ovale. c. Pulmonary vascular resistance is high because the lungs are filled with fluid. d. Blood flows from the ductus arteriosus to the pulmonary artery.
c
The diet of a child with chronic renal failure is usually characterized as a. high in protein. b. low in vitamin D. c. low in phosphorus. d. supplemented with vitamins A, E, and K.
c
The most appropriate nursing diagnosis for the child with acute glomerulonephritis is a. Risk for Injury related to malignant process and treatment. b. Deficient Fluid Volume related to excessive losses. c. Risk for Imbalanced Fluid Volume related to a decrease in plasma filtration. d. Excess Fluid Volume related to fluid accumulation in tissues and third spaces.
c
The nurse assessing a child with acute poststreptococcal glomerulonephritis should be alert for which finding? a. Increased urine output b. Hypotension c. Tea-colored urine d. Weight gain
c
The nurse is admitting a child who has been diagnosed with Kawasaki disease. What is the most serious complication for which the nurse should assess in Kawasaki disease? a. Cardiac valvular disease b. Cardiomyopathy c. Coronary aneurysm d. Rheumatic fever
c
What describes the pathologic changes of sickle cell anemia? a. Sickle-shaped cells carry excess oxygen. b. Sickle-shaped cells decrease blood viscosity. c. Increased red blood cell destruction occurs. d. Decreased red blood cell destruction occurs.
c
What is a priority intervention in planning care for the child with disseminated intravascular coagulation (DIC)? a. Hospitalization at the first sign of bleeding b. Teaching the child relaxation techniques for pain control c. Management in the intensive care unit d. Provision of adequate hydration to prevent complications
c
What is the best response to a parent who asks the nurse whether her 5-month-old infant can have cow's milk? a. "You need to wait until she is 8 months old and eating solids well." b. "Yes, if you think that she will eat enough meat to get the iron she needs." c. "Infants younger than 12 months need iron-rich formula to get the iron they need." d. "Try it and see how she tolerates it."
c
When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure? a. The right arm b. The left arm c. All four extremities d. Both arms while the child is crying
c
Which condition is characterized by a history of bloody diarrhea, fever, abdominal pain, and low hemoglobin and platelet counts? a. Acute viral gastroenteritis b. Acute glomerulonephritis c. Hemolytic-uremic syndrome d. Acute nephrotic syndrome
c
Which statement best describes beta-thalassemia major (Cooley anemia)? a. All formed elements of the blood are depressed. b. Inadequate numbers of red blood cells are present. c. Increased incidence occurs in families of Mediterranean extraction. d. Increased incidence occurs in persons of West African descent.
c
A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if which conditions occur? (Select all that apply.) a. Respiratory rate of 36 at rest b. Appetite slowly increasing c. Temperature above 37.7° C (100° F) d. New, frequent coughing e. Turning blue or bluer than normal
cde
A nurse is teaching home care instructions to parents of a child with sickle cell disease. Which instructions should the nurse include? (Select all that apply.) a. Limit fluid intake. b. Administer aspirin for fever. c. Administer penicillin as ordered. d. Avoid cold and extreme heat. Provide for adequate rest periods.
cde
4. Which of the following is an accurate description of anemia? a. Increased blood viscosity b. Depressed hematopoietic system c. Presence of abnormal hemoglobin d. Decreased oxygen-carrying capacity of blood
d
A child who has been in good health has a platelet count of 45,000/mm , petechiae, and excessive bruising that covers the body. The nurse is aware that these signs are clinical manifestations of which disease? a. Erythroblastopenia b. von Willebrand disease c. Hemophilia d. Immune thrombocytopenic purpura (ITP)
d
A child with secondary enuresis who complains of dysuria or urgency should be evaluated for which condition? a. Hypocalciuria b. Nephrotic syndrome c. Glomerulonephritis d. UTI
d
A common, serious complication of rheumatic fever is a. seizures. b. cardiac dysrhythmias. c. pulmonary hypertension. d. cardiac valve damage.
d
A nurse is assigned to care for an infant with an unrepaired tetralogy of Fallot. What should the nurse do first when the baby is crying and becomes severely cyanotic? a. Place the infant in a knee-chest position. b. Administer oxygen. c. Administer morphine sulfate. d. Calm the infant.
d
A nurse is evaluating parents' knowledge about caring for their child who has iron-deficiency anemia. Which action shows the parents need further education? a. Decreasing the infant's daily milk intake to 24 oz or less b. Giving oral iron supplements between meals with orange juice c. Including apricots, dark-green leafy vegetables, and egg yolk in the infant's diet d. Allowing the infant to drink the iron supplement from a small medicine cup
d
For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E1? a. To decrease inflammation b. To control pain c. To decrease respirations d. To improve oxygenation
d
The nurse caring for a child diagnosed with acute rheumatic fever should assess the child for which of the following? a. Sore throat b. Elevated blood pressure c. Desquamation of the fingers and toes d. Tender, warm, inflamed joints
d
The nurse is caring for a child with Kawasaki disease. The child weighs 33 pounds. When initiating aspirin therapy, what dose does the nurse prepare to administer? a. 75 mg orally once a day b. 81 mg orally twice a day c. 200 mg three times a day d. 375 mg orally four times a day
d
What is an expected assessment finding in a child with coarctation of the aorta? a. Orthostatic hypotension b. Systolic hypertension in the lower extremities c. Blood pressure higher on the left side of the body d. Disparity in blood pressure between the upper and lower extremities
d
What is the most common causative agent of bacterial endocarditis? a. Staphylococcus albus b. Streptococcus hemolyticus c. Staphylococcus albicans d. Streptococcus viridans
d
What is the priority in the discharge plan for a child with immune thrombocytopenic purpura (ITP)? a. Teaching the parents to report excessive fatigue to the physician b. Monitoring the child's hemoglobin level every 2 weeks c. Providing a diet that contains iron-rich foods d. Establishing a safe, age-appropriate home environment
d
What should the discharge plan for a school-age child with sickle cell disease include? a. Restricting the child's participation in outside activities b. Administering aspirin for pain or fever c. Limiting the child's interaction with peers d. Administering penicillin daily as ordered
d
Which clinical finding warrants further intervention for the child with acute post streptococcal glomerulonephritis? a. Weight loss to within 1 lb of the preillness weight b. Urine output of 1 mL/kg/hr c. A positive antistreptolysin O (ASO) titer Id. nspiratory crackles
d
Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis? a. Circulatory collapse b. Cardiomegaly, systolic murmurs Hepatomegaly, intrahepatic cholestasis d. Painful swelling of hands and feet, painful joints
d
Which diagnostic finding is present when a child has primary nephrotic syndrome? a. Hyperalbuminemia b. Positive ASO titer c. Leukocytosis d. Proteinuria
d
Which information should be included in the nurse's discharge instructions for a child who underwent a cardiac catheterization earlier in the day? a. Pressure dressing is changed daily for the first week. b. The child may soak in the tub beginning tomorrow. c. Contact sports can be resumed in 2 days. d. The child can return to school on the third day after the procedure.
d
Which intervention is appropriate when examining a male infant for cryptorchidism? a. Cooling the examiner's hands b. Taking a rectal temperature c. Eliciting the cremasteric reflex d. Warming the room
d
Which of the following is a true statement describing the differences in the pediatric genitourinary system compared with the adult genitourinary system? a. The young infant's kidneys can more effectively concentrate urine than an adult's kidneys. b. After 6 years of age, kidney function is nearly like that of an adult. c. Unlike adults, most children do not regain normal kidney function after acute renal failure. d. Young children have shorter urethras, which can predispose them to UTIs.
d
Which postoperative intervention should be questioned for a child after a cardiac catheterization? a. Continue intravenous (IV) fluids until the infant is tolerating oral fluids. b. Check the dressing for bleeding. c. Assess peripheral circulation on the affected extremity. d. Keep the affected leg flexed and elevated.
d
Which statement by a parent of a child with nephrotic syndrome indicates an understanding of a no- added-salt diet? a. "I can give my child sweet pickles." b. "My child can put ketchup on his hotdog." c. "I can let my child have potato chips." d. "I do not put any salt in foods when I am cooking."
d
Which statement made by a parent indicates understanding of restrictions for a child after cardiac surgery? a. "My child needs to go to bed early for a few weeks." b. "My son is really looking forward to riding his bike next week." c. "I'm so glad we can attend religious services as a family this coming Sunday." d. "I am going to keep my child out of day care for 6 weeks."
d
Which statement suggests that a parent understands how to correctly administer digoxin? a. "I measure the amount I am supposed to give with a teaspoon." b. "I put the medicine in the baby's bottle." c. "When she spits up right after I give the medicine, I give her another dose." d. "I give the medicine at 8 in the morning and evening every day."
d
A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what conditions? (Select all that apply.) a. Hypocalciuria b. Nephrotic syndrome c. Glomerulonephritis d. UTI e. Diabetes mellitus
de
