Peds Final
The nurse is assessing a 10-year old child diagnosed with coarctation of the aorta anticipates that this child will have:
Bounding pulses in the upper extremities and weak pulses in the lower extremities
A patient brings a 4-month old to the well-child clinic for the second in routine immunizations. The nurse should prepare:
DTaP, polio, and HIB
The nurse explains that one common feature of children who die of sudden infant death syndrome (SIDS) is that:
Death occurs during sleep
Which of the following is an accurate description of of anemia?
Decreased oxygen-carrying capacity of blood
The nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community?
Deteriorating paint in older buildings
The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which of the following is the most essential part of the nursing assessment to detect early signs of a worsening condition?
Level of consciousness
The nurse assess an indication of hearing loss when a 2-month-old baby:
Does not turnt he head toward a sound
An important nursing intervention when caring for a child who is experiencing a seizure would be which of the following?
Describe and record the seizure activity observed
What is the single most important factor to consider when communicating with children?
The child's developmental level
Ringworm, frequently found in school children, is caused by which of the following?
Fungus
Which statement expresses accurately the genetic implication of cystic fibrosis (CF)?
If it is present in a child, both parents are carriers of this defective gene.
The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to detect an early sign of which of the following possible complications?
Infection
Which of the following is the primary method of treating osteomyelitis?
Intravenous antibiotic therapy
Invagination of one segment of bowel within another is called which of the following?
Intussusception
Which of the following factors predisposes the urinary tract to infection?
Short urethra in young girls
Which statement made by a 7-year-old child with type-1 diabetes mellitus indicates a need for more teaching?
"My pancreas is sick and needs insulin until it is well"
At what age should the nurse expect the anterior fontanel to close?
12 to 18 months
The nurse who is assessing a child with patent ductus arteriousus, which is a defect that increases pulmonary congestion, would anticipate finding:
A machine-like murmur
Signs and symptoms that would indicate that leg cast has interfered with the circulation of a limb would be: (Select all that apply)
A. Pallor B. Pain C. Weak Pulse E. Paralysis
Most epileptic generalized seizures are preceded by:
An aura
On admission, a child with leukemia has widespread purport and a platelet count of 19,000/mm3. What is the priority nursing intervention?
Assessing neurological status
Which of the following vitamins increases the absorption of iron?
C
When assessing clubbed fingers in an 8-year old child with a mixed congenital cardiac defect, the nurse is aware that this sign is due to
Chronic hypoxia
Labored breathing is referred to as:
Dyspnea
Which of the following types of croup is always considered a medical emergency?
Epiglottis
Pyloric stenosis can best be described as which of the following?
Hypertrophy go the pyloric muscle
A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with:
Intravenous (IV) fluids
Which of the following best describes acute glomerulonephritis?
Occurs after a streptococcal infection
To correctly instill eardrops into the ear of the infant, the nurse should:
Pull the earlobe down and back
A 10-year old girl weighing 82 lbs is diagnosed with impetigo. Her doctor orders cephalexin (Keflex) every 6 hours with a total of 1,000 mg to be given each day. The safe dose for this drug is 25 to 50 mg/kg/day divided q6-8 hrs for 10 days; 4g/day max. This medication is supplied in 250 mg capsules. How many mg will she take with each dose? How many capsules will she take in 24 hours?
250 mg, 4 capsules
Which of the following structural defects constitute tetralogy of Fallot?
Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
Which of the following is descriptive of most cases of hemophilia?
X-linked recessive inherited disorder in which a blood-clotting factor is deficient
Which of the following is a common, serious complication of thematic fever?
Cardiac valve damage
Treatment for herpes simplex virus (type 1 or 2) includes which of the following?
Oral antiviral agent
When caring for the child with Kawaski disease, the nurse should know which of the following?
Therapeutic management includes administration of gamma globulin and aspirin
A 9-year-old child hospitalized for neutropenia is placed on protective isolation. What is the most appropriate response for the nurse to make when the child asks, "Why do you have to wear a gown and mask when you are in my room?"
"The gown and mask are to protect you because you can get an infection very easily.
The nurse is checking for capillary refill on a child in Bryant's traction. How long does it take for the toe to regain color if adequate perfusion is assessed?
3 seconds
At a 2-month well-child visit, parents ask the nurse about the red area in the infant's neck. They tell the nurse the mark appeared a few weeks after birth. What does the nurse recognize this skin lesion is?
A strawberry nevus
The well-child clinic nurse will prepare to give a healthy 2-month old inoculations for: (Select all that apply)
A. DTaP (Diptheria, Tetanus, Acellular Pertussis) B. HIB (Haemophilus, Influenzae type B) C. IPV (Inactivated Polio) E. PCV13 (Pneumococcal conjugate)
The nurse is caring for a 5-year old child who is scheduled for a tonsillectomy in 2 hours. Which of the following action should the nurse include in the child's postoperative care plan? (Select all that apply).
A. Notify the surgeon if the child swallows frequently C. Place the child on the abdomen or side until fully awake D. Allow the child to have an orange popsicle after the procedure
A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is which of the following?
Apply ice
What is an important consideration for the school age child taking DDAVPfor diabetes insipidus?
Arrange for the child to use the bathroom when needed
The nurse planning to teach a family about Tay-Sachs disease understands the pattern of inheritance for inborn errors of metabolism is usually:
Autosomal recessive
An infant's parents ask the nurse about preventing otitis media (OM). Which of the following should be recommenced?
Avoid tobacco smoke
Which of the following may be beneficial in reducing the risk of Reye syndrome?
Avoidance of aspirin for children with varicella or those suspected of having influenza
What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes?
Avoiding getting water in the ears
An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs?
Blood is circulated through the lungs again, causing pulmonary circulatory congestion.
Kristin, age 10 years sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following?
Bone growth can be affected by this type of fracture
Which finding in a newborn is suggestive of tracheoesophageal fistula?
Choking on the first feeding
A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid-releasing sugar should be followed by which of the following?
Complex carbohydrate and protein
When does idiopathic scoliosis become most noticeable?
During preadolescent growth spurt
The nurse is caring for a neonate with a suspected tracheosophageal fistula. Nursing care should include which of the following?
Elevate head but give nothing by mouth
Which of the following is the priority nursing intervention when a child is unconscious after a fall?
Establish adequate airway
What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find?
Expiratory wheezing
Which of the following is considered a cardinal sign of diabetes mellitus?
Frequent urination
What should the nurse suggest before a 17-year old girl starts a protocol of isotretinoin (Accutane)for her acne?
Get a prescription for oral contraceptives
Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the chid is complaining of hunger and thirst and is drowsy at 10:30 AM. What should the nurse do first?
Give her a cup of orange juice
A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?
Hematuria, proteinuria
Which of the following is an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets?
Idiopathic thrombocytopenia purpura
Which of the following describes the pathologic changes of sickle cell anemia?
Increased red blood cell destruction occurs
What is it important to assess in a child receiving prednisone to treat nephrotic syndrome?
Infection
The nurse clarifies to the frightened mother of a child who had a febrile seizure that these seizures usually occur when the temperature:
Is on the rise
Where are Wilms tours (nephroblastomas) located?
Kidney
Which of the following drugs would be used to treat a child who has increased ICP resulting from cerebral edema?
Mannitol
Excessive vomiting can result in which of the following in an infant with pyloric stenosis?
Metabolic alkalosis
The parents of a newborn with a strawberry hemangioma (strawberry nevus) ask the nurse what the treatment will be. The nurse's response should be based on knowledge that:
No treatment is usually necessary because it will most likely disappear on its own
Synthroid (Levithyroxine Sodium) 0.1 mg once in the morning via IV is ordered fora 6 year-old child with hypothyroidism. The child weighs 49 lbs. Safe dose range for this medication is 4-5 mcg/kg/day. PO; IV 1/2 of PO dose. Is this dose safe?
Not safe
The nurse caring for a child in traction with a broken leg should add to the plan of care an intervention to prevent constipation, such as:
Offering different fluids during the day
Therapeutic management of the child with acute diarrhea and dehydration usually begins with which the following?
Oral rehydration solution (ORS) like Pedialyte
A mother reports that her child has been scratching the anal area and complaining of itching. What does the nurse suspect based on this information?
Pinworms
An 8-month old infant has a hypercyanotic tet spell while blood is being drawn.The nurse's first action should be which of the following?
Place the child in a knee-chest position
Which of the following is a major clinical manifestation of rheumatic fever?
Polyarthritis
The nurse is caring for a child with a suspected diabetes insidious. Which of the following clinical manifestations would the nurse expect to observe?
Polyuria and polydipsia
A child with extensive burns requires debridement. The nurse should anticipate that a priority goal related to this procedure is which of the following?
Reduce pain
Which of the following is an important nursing consideration in the care of a child with celiac disease?
Refer to a nutritionist for detailed dietary instructions and education.
A 5-month old diagnosed with reflux is prescribed Ranitidine Syrup (Zantac) 15 mg P.O bid. Safe dose range is 5 to 10 mg/kg/day in 2 divided doses. The infant currently weighs 11.6 lbs. Is this dose safe? How many mL will be administered?
Safe, 1mL
A 9-year old boy who currently weighs 60 lbs is ordered Digox (digoxin tablets) 0.25 mg PO daily. The safe dose range for his age group reads: 5 to 10 mcg/kg/day. Is this dose safe? How many tablets should be administered?
Safe, 2 tablets
Which of the following is the initial clinical manifestation of generalized seizures?
Seeing flashing lights
The parent of a 6 month old infant with nasopharyngitis should be instructed to notify the health professional if the infant:
Shows signs of an earache
Which of the following is a condition in which the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?
Sickle cell anemia
Therapeutic management of most children with Hirschsprung disease is primarily which of the following?
Surgical removal of affected section of bowel
When asked about correcting the hypospadias of a newborn, what does the nurse explain about this condition?
Surgical repair of the hypospadias is done before 18 months of age
Cystic Fibrosis (CF) is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis?
Sweat chloride test
Which of the following statements is the most descriptive of bronchial asthma?
There is heightened airway reactivity
Why are cool-mist vaporizers rather than steam vaporizers recommended in home treatment of respiratory tract infections?
They are safer
Which of the following is the most descriptive of the pathophysiology go leukemia?
Unrestricted production of immature white blood cells (WBCs) occurs
Hypospadias refers to which of the following?
Urethral opening along ventral surface of penis
Which of the following is a physiologic effect of immobilization on children?
Venous stasis can lead to thrombi or emboli formation
On the second day of hospitalization for a 3-month old brought in for treatment for gastroenteritis, the nurse makes all the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?
Weight loss of 4 ounces
Which of the following is an important nursing consideration when caring for a child with impetigo contagiosa?
Carefully wash hands and maintain cleanliness when caring for an infected child prevent spread of infection
Atopic dermatitis (eczema) in the infant is which of the following?
Associated with allergy with a hereditary tendency
The most common test for diagnosing pinworms in the child is which of the following?
Tape placed in the perianal area at night and check it as soon as the child awakens.
Which of the following clinical manifestations would be the most suggestive of acute appendicitis?
Abdominal pain that is most intense at McBurney point
A child is admitted with extensive burns. The nurse notes that there a burns on the child's lips and singed nasal hairs. The nurse should suspect that the child has:
An inhalation injury
The nurse clarifies that the deficiency of factor IX results in
Christmas disease
What description of a child's stool characteristics leads the nurse to suspect intussusception?
Currant jelly
The home health nurse cautions the mother of a 4-year old child with chickenpox (varicella) that she should not administer aspirin for temperature elevations because aspirin can cause children with chickenpox to:
Develop Reye syndrome
Acute diarrhea is often caused by which of the following?
Antibiotic therapy
Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when:
Acne has not responded to other treatments
Which of the following is characteristic of the immune-mediated type 1 diabetes mellitus?
Age at onset is usually younger than 20 years
