PEDS success practice questions

A child with a seizure disorder has been having episodes during which she drops her pencil and simply appears to be daydreaming. This is most likely an: 1. Absence seizure 2. Akinetic seizure 3. Non-epileptic seizure 4. Simple spasm seizure

1. Absence seizure

A child diagnosed with meningitis is having a generalized tonic-clonic seizure. Which should the nurse do first? 1. Administer blow-by oxygen and call for additional help 2. Reassure the parents that seizures are common in children with meningitis 3. Call a code an ask the parents to leave the room 4. Assess the child's temperature and blood pressure

1. Administer blow-by oxygen and call for additional help

The parent of a 4 year old brings the child to the clinic and tells the nurse the child's abdomen is distended. After a complete exam, a diagnosis of Wilms tumor is suspected. Which of the following is most important when doing a physical exam on this child? 1. Avoid palpitation of the abdomen 2. Assess the urine for the presence of blood 3. Monitor vital signs, especially blood pressure 4. Obtain an accurate height and weight

1. Avoid palpitation of the abdomen!!

The nurse is caring for a 6 month old infant diagnosed with meningitis. When the child is placed in the supine position and flexes his neck, the nurse notes he flexes his knees and hips. This is referred to as: 1. Brudzinski sign 2. Cushing triad 3. Kernig sign 4. Nuchal rigidity

1. Brudzinski sign

The nurse is teaching about congenital clubfoot in infants. The nurse evaluates the teaching as successful when the parent states that clubfoot is best treated when? 1. Immediately after diagnosis 2. At age 4 to 6 months 3. Prior to walking (9-12 months) 4. After walking is established

1. Immediately after diagnosis

Which of the following is correct regarding prognostic factors for determining survival for a child newly diagnosed with ALL (Leukemia)? 1. Initial WBC count on diagnosis 2. Child's race 3. The amount of time needed to initiate treatment 4. Children aged 12-15 yeard

1. Initial WBC count on diagnosis

A child with Addisons disease takes oral cortisol supplements. What teaching should be done at each visit? SELECT ALL THAT APPLY 1. Keep an extra months supply of the med on hand at all times 2. Wear a MedicAlert bracelet at all times 3. The child is less susceptible to infections 4. Weight gain will occur 5. Your child is more susceptible to infections

1. Keep extra meds on hands at all time 5. Your child is MORE susceptible to infection

Which physical finding would the nurse consider abnormal when performing a physical assessment on a 6 month old? 1. Posterior fontanel still open 2. Anterior fontanel still open 3. Beginning signs of tooth eruption 4. Able to track and follow objects

1. Posterior fontanel still open Should close 6-8 weeks

The nurse is teaching an adolescent about Ewing sarcoma and indicates which as a common site? 1. Shaft of long bones 2. Growth plate 3, Ball of the femur 4. Bone marrow

1. Shaft of long bones

A nurse is caring for a child with von Willebrand disease. The nurse is aware that which of the following is a clinical manifestation of von Willebrand disease? SELECT ALL 1. The child bruises easily 2. Excessive menstruation 3. The child has frequent nosebleeds 4. Elevated creatinine 6. elevated BP

1. The child bruises easily 2. Excessive menstruation 3. The child has frequent nosebleeds

Which of the following factors need to be included in a teaching plan for a child with sickle cell disease? SELECT ALL 1. The child needs to be taken to the doctors when sick 2. The parent should make sure the child sleeps in an air-conditioned room 3. Emotional stress should be avoided 4. It is important to keep the child well hydrated 5. It is important to make sure the child gets adequate nutrition

1. The child needs to be taken to the doctors when sick 3. Emotional stress should be avoided 4. It is important to keep the child well hydrated 5. It is important to make sure the child gets adequate nutrition

A child with hemophilia A fell and injured a knee while playing outside. The knew is swollen and painful. Which of the following measures should be taken to stop the bleeding? SELECT ALL 1. The extremity should be immobilized 2. The extremity should be elevated 3. Warm moist compresses should be applied to decrease pain 4. Passive range of motion exercises should be administered to the extremity 5. Factor VIII replacement should be administered

1. The extremity should be immobilized 2. The extremity should be elevated 5. Factor VIII replacement should be administered

Which child requires continued follow-up because of behaviors suspected of cerebral palsy? 1. A 1 month old who demonstrates startle reflex when a loud noise is heard 2. A 6 month old who always reaches for toys with the right hand 3. A 15 month old who has not yet began to walk 4. A 2 year old who has not yet achieved bladder control during waking hours

2. A 6 month old who always reaches for toys with the right hand

The parent of a child diagnosed with osteomyelitis asks how the child acquired the illness. Which is the nurses best response? 1. Direct inoculation of the bone from stepping barefoot on a sharp stick 2. An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone 3. The blood supply to the bone was disrupted because of the Childs diabetes 4. An infection of the upper respiratory tract

2. An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone

Which test provides a definitive diagnosis of aplastic anemia? 1. CBC 2. Bone marrow aspiration 3. Serum IgG levels 4. Basic metabolic pane

2. Bone marrow aspiration

Which position initially is most beneficial for an infant who has just returned from having a VP shunt placed? 1. Semi-Fowler in an infant seat 2. Flat in the crib 3. Trendelenburg 4. In the crib with HOB elevated 90 degrees

2. Flat

A toddler is being evaluated for syndrome of inappropriate antidiuretic hormone. The nurse should observe the child for which symptoms? SELECT ALL 1. Dehydration 2. Fluid retension 3. Hyponatremia 4. Hypoglycemia 5. Myxedema

2. Fluid retention 3. Hyponatremia

The school nurse notices that a 14 year old girl who used to be an excellent student and very active in sports is losing interest and acting very nervous. The teen was recently checked by the primary care provider, who noted the teen had a very low level of TSH. The nurse recognizes that the teen has which condition? 1. Hashimotos 2. Graves Disease 3. Hypothyroidism 4. Juvenile autoimmune thyroiditis

2. Grave's Disease Graves disease is hyperthyroidism and presents with low TSH levels, weight loss, and nervousness

The parent of a child with hemophilia is asking the nurse what caused the hemophilia. Which is the nurse's best response? 1. It is an X-linked dominant disorder 2. It is an X-linked recessive disorder 3. It is an autosomal dominant disorder 4. It is an autosomal recessive disorder

2. It is an X-linked recessive disorder

An infant is born with a sac protruding through the spine, containing CSF, a portion of the meninges, and nerve roots. This condition is: 1. Meningocele 2. Myelomeningocele 3. Spina Bifida occulta 4. Anenecephaly

2. Myelomeningocele

Which should the nurse tell the parent of an infant with spina bifida? 1. Bone growth will be more than that of babies who are not sick because your baby will be less active. 2. Physical and occupational therapy will be helpful to stimulate the senses and improve cognitive skills. 3. Nutritional needs for your infant will be calculated based on activity level 4. Fine motor skills will be delayed because of the disability

2. Physical and occupational therapy will be helpful to stimulate the senses and improve cognitive skills.

The parent of a 2 year old who is HIV+ questions the nurse about placing the child in day care? Which of the following is the best response? 1. The child should not go to the day care until older, because there is a high risk for transmission of the disease. 2. The child can go to daycare without restrictions and should be allowed to participate in all activities. 3. The child can go to day car but should avoid physical activity. 4. The child may go to the day care, but the parents must inform all the parents at the day care that the child is HIV positive.

2. The child can go to daycare without restrictions and should be allowed to participate in all activities.

The nurse is caring for a 10 year old patient post parathyroidectomy. Discharge teaching should include which of the following? 1. How to administer injectable growth hormone. 2. The importance of supplemental calcium in the diet 3. The importance of increasing iodine in the diet 4. How to administer subcut insulin

2. The importance of supplemental calcium in the diet

A newborn develops tetany and has a seizure prior to discharge from the nursery. The newborn is diagnosed with hypocalcemia secondary to hypoparathyroidism and is started on calcium and vit D. Which information would be most important for the nurse to teach the parents? 1. They should observe the baby for signs of tetany and seizures 2. They should observe for weakness, nausea, vomiting, and diarrhea 3. They should administer the calcium and vit D daily as prescribed 4. They should call the clinic if they have any questions about care of the newborn

2. They should observe for weakness, nausea, vomiting, and diarrhea Vit D toxicity is a serious consequence of therapy and should be top priority in teaching

The nurse is taking care of a 10 year old diagnosed with Graves disease. Which could the nurse expect this child to have recently had? 1. Weight gain, excessive thirst, and excessive hunger 2. Weight loss, difficulty sleeping, heat sensitivity 3. Weight gain, lethargy, goiter 4. Weight loss, poor skin turgor constipation

2. Weight loss, difficulty sleeping, heat sensitivity

The nurse is aware that cloudy CSF most likely indicates? 1. Viral meningitis 2. Bacterial meningitis 3. No infection, because CSF is normally cloudy 4. Sepsis

2. bacterial meningitis

The nurse is caring for a child with Thalassemia who is receiving the first chelation therapy. What information should the nurse provide to the parent regarding the therapy? SELECT ALL 1. Decreases the risk of bleeding 2. eliminates excess iron 3. Prevents further sickling of the red blood cells 4. Provides an iron supplement 5. Hydration is necessary for the process to be effective.

2. eliminates excess iron 5. Hydration is necessary for the process to be effective.

A 6 year old white girl comes with her mother for evaluation for her acne, breast buds, axillary hair, and body odor. What information should the nurse explain to them? 1. This is typical age for girls to go into puberty 2. Encourage the girl to dress and act appropriately for her chronological age 3. She should be on birth control because she is febrile 4. She may be short if her epiphysis close early

2. encourage the girl to dress and act appropriately for her chronological age

A spinal curve of less than ____ degrees that is non-progressive does not require treatment of scoliosis

20

Which tests could be utilized to determine cortisol levels in a child with suspected Cushing syndrome? SELECT ALL THAT APPLY 1. Fasting blood glucose 2. Thyroid panel (TSH, T3, T4) 3. 24 hour urine for 17- hydroxycorticoids 4. Radiographic studies of the bones 5. Cortisone suppression test 6. Urine culture 7. Complete blood count

3. 24 hour urine for 17- hydroxycorticoids 5. Cortisone suppression test

The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems are associated with sickle cell disease? SELECT ALL 1. polycythemia 2. hemarthrosis 3. aplastic crisis 4. thrombocytopenia 5. vaso-occlusive crisis

3. Aplastic crisis 5. vaso-occlusive crisis

Which would the nurse expect to assess on a 3 week old infant with developmental dysplasia of the hip (DDH)? SELECT ALL 1. Excessive hip abduction 2. Femoral lengthening of an affective leg 3. Asymmetry of gluteal and thigh folds 4. Pain when lying prone 5. Positive Ortolani test

3. Asymmetry of gluteal and thigh folds 5. Positive Ortolani

A 6 month old male is at his well child check up. The nurse weighs him, and his mother asks if his weight is normal for his age. The nurses best response is: 1. At 6 months, his weight should be approx three times his birth weight 2. Each child gains weight at his or her own pace 3. At 6 months, his weight should be approx two times his birth weight 4. At 6 months, a child should weight about 10 lbs more than his or her birth weight

3. At 6 months, his weight should be approx two times his birth weight

A 5 year old is admitted to the hospital with complaints of leg pain and fever. On physical examination, the child is pale and has bruising over various areas of the body. ALL (leukemia) is suspected. The nurse informs the parent that the diagnosis will be confirmed by which of the following? 1. LP 2. WBC count 3. Bone marrow aspirate 4. Bone scan

3. Bone marrow aspirate

A newborn with a repaired myelomeningocele is assessed for hydrocephalus. What would the nurse expect if the infant has hydrocephalus? 1. Low-pitched cry and depressed fontanel. 2. Low-pitched cry and bulging fontanel. 3. Bulging fontanel and downwardly rotated eyes. 4. Depressed fontanel and upwardly rotated eyes.

3. Bulging fontanel and downwardly rotated eyes.

A teen is seen in clinic for a possible diagnosis of Hodgkin disease. The nurse is aware that which of the following symptoms should make the physicians suspect Hodgkin disease? 1. Fever, fatigue, and pain in the joints. 2. Anorexia with weight loss. 3. Enlarged, painless, and movable lymph nodes in the cervical area. 4. Enlarged liver with jaundice.

3. Enlarged, painless, and movable lymph nodes in the cervical area.

A nurse is caring for a 5 year old with a sickle cell vase occlusive crisis. Which of the following orders should the nurse question? SELECT ALL 1. Position the child for comfort 2. Apply hot packs to painful areas 3. Give meperidine 25mg intravenously every 4 hours as needed for pain 4. Restrict oral fluids 5. Apply oxygen per nasal cannula to keep oxygen sat above 90%

3. Give meperidine 25mg intravenously every 4 hours as needed for pain 4. Restrict oral fluids 5. Apply oxygen per nasal cannula to keep oxygen sat above 90%

Which signs best indicate increased intracranial pressure (ICP) in an infant? SELECT ALL 1. Sunken anterior fontanel 2. Complaints of blurred vision. 3. High-pitched cry. 4. Increased appetite. 5. Sleeping more than usual.

3. High pitched cry 5. Sleeping more than usual

Which would the nurse teach an adolescent is a complication of corticosteroids used in the treatment of juvenile idiopathic arthritis? 1. Fat loss 2. Adrenal stimulation 3. Immune suppression 4. Hypoglycemia

3. Immune suppression

The parent of an infant with CP asks the nurse if the infant will be mentally retarded. Which is the nurses best response? 1. Children with CP have some amount of mental retardation 2. Approx. 20% of children with CP have normal intelligence 3. Many children with CP have normal intelligence 4. Mental retardation is expected if motor and sensory deficits are severe

3. Many children with CP have normal intelligence

Which is an important nursing intervention for a child with a diagnosis of hyperthyroidism? 1. Encourage an increase in physical activity 2. Do preoperative teaching for thyroidectomy 3. Promote opportunities for periods of rest 4. Do dietary planning to increase caloric needs

3. Promote opportunities for periods of rest

The nurse is developing a plan of care for a child diagnosed with cerebral palsy (CP). Which should be the nurse's priority goal? 1. Ensure the ingestion of sufficient calories for growth 2. Decrease intracranial pressure 3. Teach appropriate parenting strategies for a special needs child 4. Ensure the child reaches full potential

3. Teach appropriate parenting strategies for a special needs child

At a follow up visit for an 8 year old who is being evaluated for short stature, the nurse measures and plots the child's height on the growth chart. Which explanation should the nurse give the child and family? 1. We want to make sure you were measures accurately the last two years. 2. We need to calculate how tall you will be when you grow to adult height. 3. We need to see how much you have grown since your last visit. 4. We need to know your height so that a dosage of medication can be calculated for you.

3. We need to see how much you have grown

Which should the nurse stress to the parents of an infant in a Pavlik harness for treatment of developmental dysplasia of the hip (DDH)? 1. Put socks on over the foot pieces of the harness to help stabilize the harness 2. Use lotions or powder on the skin to prevent rubbing of straps 3. Remove harness during diaper changes for ease of cleaning diaper area 4. Check under the straps at least 2 to 3 times daily for red areas

4. Check under the straps at least 2 to 3 times daily for red areas

A nurse is doing discharge education with a parent who has a child with beta-thalassemia (Cooley anemia). The nurse informs the patient that the child is at risk for which of the following conditions? 1. Hypertrophy of the thyroid 2. Polycythemia vera 3. thrombocytopenia 4. Chronic hypoxia and iron overload

4. Chronic hypoxia and iron overload

A 12 year old comes to the clinic with a diagnosis of Graves Disease. What information should the nurse discuss with the child? 1. Suggest weight loss 2. Encourage attending school 3. Emphasize that the disease will go into remission 4. Encourage the child to take responsibility for taking daily medications

4. Encourage the child to take responsibility for taking medications daily

The nurse is teaching the parent of a child newly diagnosed with juvenile idiopathic arthritis. The nurse would evaluate the teaching as successful when the parent is able to say that the disorder is cause by the: 1. Breakdown of osteoclasts in the joint space 2. Loss of cartilage in the joints 3. Buildup of calcium crystals in joint spaces 4. Immune-stimulated inflammatory response in the joint

4. Immune-stimulated inflammatory response in the joint

Which should the nurse prepare the parents of an infant for following surgical repair and closure of a myelomeningocele shortly after birth? The infant will: 1. Not need any long term management and should be considered cured 2. Not be at risk for urinary tract infections or movement problems 3. Have continual drainage of cerebrospinal fluid, needing frequent dressing changes. 4. Need lifelong management of urinary, orthopedic, and neurological problems

4. Need lifelong management of urinary, orthopedic, and neurological problems

Which of the following will be abnormal in a chid with the diagnosis of hemophilia? 1. Platelet count 2. Hemoglobin level 3. White blood cell count 4. Partial thromboplastin time (PTT)

4. Partial thromboplastin time (PTT)

Which of the following is the most opportunistic infection in children infected with HIV? 1. CMV 2. Encephalitis 3. Meningitis 4. Pneumocystic pneumonia

4. Pneumocystic pneumonia

A child is being admitted with the diagnosis of meningitis. Select the procedure the nurse should do FIRST: 1. Admin of IV antibiotics 2. Admin of maintenance IV fluids 3. Placement of Foley catheter 4. Send the spinal fluid and blood samples to the lab for cultures

4. Send the spinal fluid and blood samples to the lab for cultures

The nurse is instructing a family on the side effects of oral cortisol. What aspects of administering the medications should the nurse emphasize? 1. Weight gain and dietary management 2. Bitterness of the taste of the medication 3. Excitability that results from the medication 4. Taking the medication with food to decrease gastric irritation

4. Taking the medication with food to decrease gastric irritation

Which descriptive terms should be used to describe a school aged child with myxedematous skin/eyes/hair changes? 1. The skin is oily and scaly 2. The skin has pale, thickened patches 3. The skin is moist 4. The eyes are puffy, the hair is sparse, and the skin is dry

4. The eyes are puffy, the hair is sparse, and the skin is dry

When teaching parents about osteosarcoma, the nurse knows instruction has been successful when a parent says that this type of cancer is common in which age group? 1. Infants 2. Toddlers 3. School age children 4. Adolescents

4. adolescents

asymmetry of the thigh folds suggests which condition?

DDH

Which hormones does the anterior pituitary secrete?

LH, Prolactin, ACTH

Which harness is used for DDH?

Pavlik