Peds review test 1

Which of the following motor development milestones would you expect an infant to attain first?

opens and closes hands

vWhich of the following organs is not directly involved in the compensatory mechanisms for shock? A.Kidney B.Pancreas C.Heart D.Liver

pancreas -The organs involved in the compensatory mechanism process for shock include: heart, brain, liver, blood vessels, kidney, and adrenal glands. The pancreas is not directly related to the compensatory process.

Which of the following is the number one way to prevent hand-foot-and-mouth disease?

Hand washing, especially following diaper changes

An infant is born with congenital clubfoot and the nurse tells the mother that serial casting should be started soon after birth. The mother asks why treatment must start so early? Which response, if made by the nurse, would best explain the need for early treatment? A. "That's how it's always done." B. "Early treatment allows the bone to be reformed before it hardens." C. "It's okay to wait if you think that would be best." D. "Early treatment allows for the extensive surgical interventions that are required later in life."

"Early treatment allows the bone to be reformed before it hardens." -Bones begin ossifying soon after birth, and are less responsive to treatment after ossification begins. At birth, bones are soft and porous and are susceptible to repositioning.

A child is admitted to the inpatient unit with Guillain-Barré syndrome. Which assessment should the nurse perform first? A. Respiratory assessment B. Neurological assessment C. Motor assessment D. Nutritional assessment

A. Respiratory assessment -The nurse should assess respiratory status first. Guillain-Barré can lead to respiratory failure and decreased oxygenation. It is important for the nurse to monitor respiratory status and intervene quickly if there are signs of decreased ventilation or oxygenation

The nurse is explaining Kohlberg's theory of moral development to the parent of a toddler. The nurse tells the parents that in the preconventional level of moral development, what factor motivates obedience?

Avoidance of punishment -Toddlers are in the preconventional level of moral development. They do not understand the concept of right and wrong. Their behavior is driven by the desire to avoid punishment and get rewards

A nurse is working with occupational therapy to plan what developmentally-appropriate toys should be given to her 10-month-old patient. Which of the following toys would be most appropriate?

Board books -Board books, toys that make noise or light up, soft dolls, teething toys, and large blocks are all appropriate toys for older infants.

A child with a history of T3 spinal cord injury presents to the emergency department with headache, facial flushing, and cardiac dysrhythmias. Which of the following conditions would the nurses suspect? A. Poikilothermia B. Spinal shock C. Spasticity D. Autonomic dysreflexia

D. Autonomic dysreflexia -Headache, facial flushing, and cardiac dysrhythmias are all symptoms of autonomic dysreflexia, a condition that can develop after spinal cord injury of T6 or above. Autonomic dysreflexia can be caused by a full bladder, constipation, pain, skin issues, tight clothing, menstrual cramps, abdominal conditions, or cuts and bruises.

vhe mother of a 3-year-old child tells the clinic nurse that her child insists on having a bottle at naptime and bedtime. Which of the following interventions should the nurse suggest to the mother?

Do not allow the child to have the bottle- A child should never be allowed to take a bottle to bed because of the increased risk of acute otitis media and dental caries. In addition, children should transition from a bottle to a cup at 15-months of age

true or false: Children with cerebral palsy are physically and intellectually disabled

False -Although children with cerebral palsy experience motor delays and physical disabilities, they often do not have intellectual disabilities. Healthcare providers should ensure children have adaptive and assistive technology to foster communications and promote mobility.

True or False: A toddler is expected to have higher blood urea nitrogen and creatinine levels when compared to an adult

False -Pediatric patients have lower blood urea nitrogen and creatinine levels when compared to an adult

vWhich of the following interventions is most important for hypovolemic shock? A. Fluid administration B. Inotrope administration C. Removal of obstruction D. Epinephrine administration

Fluid administration -The most important intervention for hypovolemic shock is administration of isotonic crystalloid fluids to restore circulating volume. If unresponsive, the healthcare provider could begin inotrope therapy. However, fluid replacement should always come first

What compensatory purpose does grunting have in pediatric patients with respiratory distress? A.Helps keep the alveoli open. B.Assists with ventilation. C.Increases the diameter of air passages. D.Opens the airway.

Helps keep the alveoli open. -Grunting helps to keep the alveoli open. Nasal flaring increases the diameter of air passages, neck hyperextension opens the airway, and retractions assist with ventilation.

Which of the following congenital heart disorders is not considered a mixed defect? A.Hypoplastic left heart syndrome B.Transposition of the great arteries C.Truncus arteriosus D.Double-outlet right ventricle

Hypoplastic left heart syndrome -is an obstructive congenital heart defect. The mixed defect disorders include transposition of the great arteries, truncus arteriosus, and double-outlet right ventricle syndrome.

Which medication is used to close a patent ductus arteriosus (PDA)?

Indomethacin -Indomethacin is used to stimulate smooth muscle contraction through inhibition of prostaglandin. This allows the defect to close. Prostaglandin would cause the defect to stay open, and would be contraindicated. Digoxin and furosemide are used for congestive heart failure management and would have no effect on the patent ductus arteriosus.

Which of the following oxygen administration methods can administer 70% to 100% oxygen? A.Nasal cannula B.Simple oxygen mask C.Venturi mask D.Non-rebreather mask

Non-rebreather mask -The nasal cannula can administer 24% to 35% oxygen, the simple oxygen mask can administer 35% to 50% oxygen, and the venturi mask can administer 24% to 50% oxygen. Only the non-rebreather mask can administer 70% to 100% oxygen.

Which of the following pain scales would be most appropriate for the nurse to implement for a 10-year-old child with a leg fracture?

Numerical Rating Scale -The Numerical Rating Scale is the most appropriate pain scale for children older than 7. FLACC is appropriate to use for infants and toddlers. The Oucher and FACES scales are used in preschool children.

vWhich of the following people are most likely to affect an adolescent's behavior?

Peers -Peers are the most influential aspect of an adolescent's life. Parents, siblings, and religious leaders are secondary contributors to adolescent's identity development.

A child with a newly diagnosed ulnar fracture has a short-arm cast applied. Which of the following symptoms would be most concerning for the nurse? A. Swelling B. Mild pain C. Itching D. Uncontrolled, severe pain

Uncontrolled, severe pain -Uncontrolled pain is the first sign of compartment syndrome. The nurse should assess the neurovascular status of the extremity and intervene immediately to prevent tissue necrosis and permanent damage.

Martha, age 9yrs, is to receive an IM injection. She is anxious but verbalizes that she would like to cooperate. How best can the nurse(s) ensure Martha's cooperation and also reduce the stress of the experience?

Use distraction techniques such as squeezing another nurse's hand or counting to 10 during injection.

mark, age of 5 yrs, just received an injection. He is upset and crying called the nurse a poopy head. what should the nurse do?

encourage mark to join the children in medical play in the play room -when they get to preschool age you want them to interact more

true or false: a FLACC score of 8 indicates mild pain

false -0 indicating no pain -10 worst possible -8 would indicate severe pain

true or false: All children with gender dysphoria later identify as gay, lesbian, or bisexual

false -Although some children with gender dysphoria later identify as gay, lesbian, or bisexual, some children only have short-term gender dysphoria that resolves by the end of adolescence

true or false: Laryngotracheobronchitis is self-limiting and transient and requires no intervention

false -Although spasmodic laryngitis is self-limiting and requires no intervention, laryngotracheobronchitis can lead to respiratory distress or failure and requires steroids, fluids, and racemic epinephrine.

true or false: Children wake up from night terrors and seek comfort from their caregivers.

false -Children do not wake during night terrors and they do not remember the episodes. In contrast, children do wake up from nightmares and seek the comfort of their caregiver. The caregiver should discuss the nightmare with the child, provide reassurance, and put them back to sleep.

true or false: Family values and home routine are two of the most important influences during the school-age period

false -School-age children experience a transition away from caregivers and the family environment, and instead focus on developing friendships and peer relationships.

True or false: The risk for coronary aneurysms ends when children enter the subacute stage of Kawasaki disease.

false -The risk for coronary aneurysms is highest when children enter the subacute stage of Kawasaki disease

True or false:Hemolytic uremic syndrome is usually proceeded by group A streptococcal infection

false- Hemolytic uremic syndrome is usually proceeded by group A streptococcal infection

Which of the following is the first line of treatment for adolescent depression?

psychotherapy -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

The nurse is assessing gross and fine motor development in a 2-year-old child. Which of the following developmental milestones would the nurse expect to observe in this child?

stack objects -2-year-old child should be able to stack objects, copy circles and lines, turn pages, run, kick a ball, and jump with two feet. The other milestones are appropriate for a 3-year-old child

Which of the following genitourinary conditions is considered to be a surgical emergency that requires immediate intervention? A.Hypospadias B.Testicular torsion C.Epispadias D.Phimosis

testicular torsion -Testicular torsion is a medical emergency that requires immediate intervention. Failure to surgically repair the defect can lead to necrosis and testicular loss. Hypospadias and epispadias requires surgical intervention, but it is not emergent. Phimosis does not typically require surgical intervention.

A 4-year-old child tells the nurse, "I got sick because I broke my sister's toy." The nurse knows that this is an example of which of the following?

transductive reasoning -The preschool child has transductive reasoning, magical thinking, and a vivid imagination. Therefore, they connect seemingly related events that are not related at all. This child is connecting the act of breaking a toy with getting sick, even though the two are not correlated

Speed, endurance, and coordination improve during the adolescent period

true -Speed, endurance, and coordination do improve during the adolescent period. There is also an increased focus on fine motor development, skill, and muscle development

true or false: Symptoms of submersion injuries can appear up to 24 hours after the submersion

true -Symptoms of submersion injuries do not always appear immediately after the submersion. Pulmonary edema, laryngospasm, and other symptoms can appear for up to 24 hours after the submersion ("secondary drowning"). Children should be closely monitored for at least 24 hours following any submersion injury.

true of false: When changing diapers, caregivers should lift children with osteogenesis imperfecta by the hips

true -The bones fracture very easily in children with osteogenesis imperfecta. Caregivers should handle children gently and avoid pulling on extremities. When changing diapers, caregivers should lift from the hips instead of the legs.