Practice Peds Questions

Which should the nurse include in the teaching plan for a child who had surgery to correct bilateral clubfeet and had the casts removed. select all that apply 1. Your child will need to wear a brace on the feet 23 hours a day for at least 2 months 2. Your child should see an orthopedic surgeon regularly until the age of 18 3. Your child will not be able to participate in sports that require a lot of running 4. Your child may have recurrence of clubfoot in a year or more 5. Most children treated for clubfeet develop feet that appear and function normally 6. Most children treated for clubfeet require surgery at puberty

1, 2, 4, 5. 1. After the final casting, bracing is required for 12 months. This decreases the likelihood of a recurrence. 2. Because clubfoot can recur, it is important to have regular follow-up with the orthopedic surgeon until age 18 years. 3. After treatment, most children are able to participate in any sport. 4. Even with proper bracing, there may be a recurrence. 5. Most children treated for clubfeet develop normally appearing and functioning feet. 6. Most children do not require surgery at puberty. TEST-TAKING HINT: If the test taker is aware that clubfoot can recur, providing instruction that includes long-term follow-up care will help in selecting answers

A child is brought to the emergency department after falling from a high swing and landing on the back. The nurse notes that the client also has hemophilia. Based on the client's history and the nature of the injury, which should the nurse assess for first? 1.Blood in the urine 2.Oxygen saturation 3.Presence of headache 4.Presence of slurred speech

1

The nurse is reviewing the pathophysiology of HUS. The manifestations of thedisease are due primarily to which of the following events? 1. The swollen lining of the small blood vessels damages the red blood cells, whichare then removed by the spleen, leading to anemia. 2. There is a disturbance of the glomerular basement membrane, allowing largeproteins to pass through. 3. The red blood cell changes shape, causing it to obstruct microcirculation. 4. There is a depression in the production of all formed elements of the blood.

1

The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following is most appropriate?1.Fitting the diaper under the straps. 2.Leaving the harness off while the infant sleeps. 3.Checking for skin redness under straps every other day. 4.Putting powder on the skin under the straps every day.

1

Parents bring their child to the emergency department and tell the nurse that the child has been complaining of colicky abdominal pain located in the lower right quadrant of the abdomen. The nurse suspects that the child has which disorder?1.Peritonitis 2.Appendicitis 3.Intussusception 4.Hirschsprung's disease

2 The most common symptom of appendicitis is a colicky, periumbilical, or lower abdominal pain located in the right quadrant. Peritonitis is a complication that can follow organ perforation or intestinal obstruction. The classic signs and symptoms of intussusception are acute, colicky abdominal pain with currant jelly-like stools. Clinical manifestations of Hirschsprung's disease include constipation, abdominal distention, and ribbon-like, foul-smelling stools.

A mother brings her 5-week-old infant to the health care clinic and tells the nurse that the child has been vomiting after meals. The mother reports that the vomiting is becoming more frequent and forceful. The nurse suspects pyloric stenosis and asks the mother which assessment question to elicit data specific to this condition? 1."Are the stools ribbon-like and is the infant eating poorly?" 2."Does the infant suddenly become pale, begin to cry, and draw the legs up to the chest?" 3."Does the vomit contain sour undigested food without bile, and is the infant constipated?" 4."Does the infant cry loudly and continuously during the evening hours but nurses or takes formula well?"

3 Option 3 presents classic symptoms of pyloric stenosis. Stools that are ribbon-like and a child who is eating poorly are signs of congenital megacolon (Hirschsprung's disease). An infant who suddenly becomes pale, cries out, and draws the legs up to chest is demonstrating physical signs of intussusception. Crying during the evening hours, appearing to be in pain, eating well, and gaining weight are clinical manifestations of colic.

A 1-year-old child is diagnosed with intussusception, and the mother of the child asks the nurse to describe the disorder. Which statement is correct about intussusception? 1."It is an acute bowel obstruction." 2."It is a condition that causes an acute inflammatory process in the bowel." 3."It is a condition in which a distal segment of the bowel prolapses into a proximal segment of the bowel." 4."It is a condition in which a proximal segment of the bowel prolapses into a distal segment of the bowel."

4 Intussusception occurs when a proximal segment of the bowel prolapses into a distal segment of the bowel. It is not an acute bowel obstruction, but it is a common cause in infants and young children. It is not an inflammatory process.

2. As the nurse you know which statements below are correct about the ductus arteriosus? Select all that apply: A. "The ductus arteriosus is a structure that should be present in all babies in utero." B. "The ductus arteriosus normally closes about 3 days after birth or sooner." C. "The purpose of the ductus arteriosus is to help carry blood that is entering the left side of the heart to the rest of the body, hence bypassing the lungs." D. "The ductus arteriosus connects the aorta to the pulmonary vein."

The answers are A and B. These are correct statements about the ductus arteriosus. Option A is correct because every newborn should have this structure, but it will close shortly after birth. Option C is wrong because the purpose of this structure is to help carry blood that is entering the RIGHT side (not left) of the heart to the rest of the body, hence bypassing the lungs. Option D is wrong because this structure connects the aorta to the pulmonary ARTERY (not vein).

7. A 6 year-old is admitted with sickle cell crisis. The patient has a FACE scale rating of 10 and the following vital signs: HR 115, BP 120/82, RR 18, oxygen saturation 91%, temperature 101.4'F. Select all the appropriate nursing interventions for this patient at this time? A. Administer IV Morphine per MD order B. Administer oxygen per MD order C. Keep NPO D. Apply cold compresses E. Start intravenous fluids per MD order F. Administer iron supplement per MD order G. Keep patient on bed rest H. Remove restrictive clothing or objects from the patient

The answers are A, B, E, G, and H. When a patient is in sickle cell crisis, the abnormal RBCs are sickling and sticking together, which blocks blood flow. To help alleviate the RBCs from clumping together and sickling, oxygen and hydration are priority. This will help dilute the blood (hence decrease the sticking of RBCs) and help supply oxygen to the RBCs (remember abnormal RBCs with hemoglobin S are very sensitive to low oxygen levels and will sickle when there is low oxygen). In addition, pain needs to be addressed. Opioid medication is the best on a scheduled basis rather than PRN (as needed). Avoid keeping patient NPO unless needed (remember patient needs hydration). Avoid cold compresses (can lead to more sickling) but instead use warm compresses. The patient will need FOLIC ACID supplements to help with RBC creation rather than iron (iron can actually build up in the body and collect in the organs in patients with sickle cell disease). Patients definitely need to be on bedrest, and restrictive clothing or objects (blood pressure cuff etc.) should be removed to help blood flow.

5. A concerned mother brings her 3-month-old to the clinic. The mother states the infant seems to be small for its age. In addition, she states the infant fatigues very easily while feeding and rarely finishes a feeding. While collecting a thorough health history, what other signs and symptoms described by the mother may indicate the child has a congenital heart defect, such as a ventricular septal defect? Select all that apply: A. Diarrhea B. Frequent treatment for lung infections C. Excessive wet diapers D. Diaphoresis when nursing E. Swelling in the hands and feet

The answers are: B, D, and E The nurse should listen for signs and symptoms that could represent heart failure or pulmonary hypertension. Options B, D, and E can be found in infants or children with a VSD.

The nurse is conducting a staff in-service on congenital heart defects. Which structural defects constitutes Tetralogy of Fallot? a. Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy b. Aortic stenosis, atrial septal defect, overriding aorta, left ventricular hypertrophy c. Pulmonic stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy d. Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

d

Which of the statements accurately describes Duchenne muscular dystrophy (Select all that apply) a. the absence of dystrophin leads to muscle fiber degeneration b. DMD is inerited as an x linked recessive trait c. cognitive and intellectual impairment are rare in children with DMD d.affected children have a waddling gait and lordosis and fall frequently e. ambulation usually becomes impossible by 12 years of age and affected children are confined to a wheelchair f. affected children must be hospitalized when ambulation becomes impossible

abde

A 14 yr old with a spinal cord injury is placed on a standing table and suddenly begins to sweat profusely. inc SBP and Hr inc by 50. The most helpful intervention: a, place on his back in his wheelchair and take him back to his room b. palpate bladder for distention c. administer a routine analgesic for headache and discontinue therapy d. place the stading table in horizontal position and allow adolescent to rest for a few minutes

b

The primary risk factor for CP is a. maternal chorioamnionitis b. preterm birth c.birth asphyxia d. intraventricular hemorrhage

b

Which of the following is NOT part of the diagnostic criteri a for Kawasaki disease:a. "Strawberry tongue" b. Peeling of the hands and feetc. Chorea d. Bilateral conjunctivitis without exudate

chorea

GI questions

https://quizlet.com/343111806/peds-exam-3-practice-questions-flash-cards/

"A 4-year-old has a right nephrectomy to remove a Wilms tumor. The nurse knows that it is essential to:" A. Request a low-salt diet B. Restrict fluids C. Educate the family regarding renal transplants D. Prevent urinary tract infections"

Answer D is correct. Because the child has only one remaining kidney, it is important to prevent urinary tract infections. Answers A, B, and C are not necessary, so they are incorrect.

pediatric genitourinary (nclex questions)

https://quizlet.com/456795343/pediatric-genitourinary-nclex-questions-flash-cards/

Hematology questions

https://quizlet.com/549299572/nclex-pediatrics-hematology-flash-cards/

As noted in the previous question, a loud murmur was noted during assessment of a newborn with patent ductus arteriosus. As the nurse you know that what type of murmur is a hallmark sign of this condition? harsh, loud systolic murmur soft, blowing diastolic murmur systolic and diastolic machinery-like murmur machinery-like murmur present on only diastole

systolic and diastolic machinery-like murmur

"When caring for a client with a diagnosis of thrombocytopenia, the nurse should plan to:"a.Discourage the use of stool softenersb.Assess temperature readings every six hoursc.Avoid invasive proceduresd.Encourage the use of a hard, brittle toothbrush"

"Answer: C Rationale:Thrombocytopenia is a deficiency of platelets, and leaves the patient more prone to hemmorrhage. For this reason, avoiding invasive procedures will limit the risk of hemorrhage. Stool softeners should be encouraged, while hard brittle toothbrushes should be avoided. Temperature is not the most important vital to track in this patient"

A nurse is assessing a child who has Legg‑Calve‑Perthes disease. Which of the following findings should the nurse expect? (Select all that apply.) A. Longer affected leg B. Hip stiffness C. Intense pain D. Limited ROM E. Limp with walking

BDE

A child in whom sickle cell anemia is suspected is seen in a clinic, and laboratory studies are performed. The nurse checks the laboratory results, knowing that which value would be increased in this disease? 1.Platelet count 2.Hematocrit level 3.Hemoglobin level 4.Reticulocyte count

4

The nurse provided discharge instructions to the parents of a 2-year-old child who had an orchiopexy to correct cryptorchidism. Which statement by the parents indicate that further teaching is necessary? 1."I'll check his temperature." 2."I'll give him medication so he'll be comfortable." 3."I'll check his voiding to be sure there's no problem." 4."I'll let him decide when to return to his play activities."

4 Cryptorchidism is a condition in which one or both testes fail to descend through the inguinal canal into the scrotal sac. Surgical correction may be necessary. All vigorous activities should be restricted for 2 weeks after surgery to promote healing and prevent injury. This prevents dislodging of the suture, which is internal. Normally, 2-year-olds want to be active; allowing the child to decide when to return to his play activities may prevent healing and cause injury. The parents should be taught to monitor the temperature, provide analgesics as needed, and monitor the urine output.

A toddler is hospitalized with severe dehydration. The nurse should assess the child for which possible complication?A. HypertensionB. HypokalemiaC. A rapid, bounding pulseD. Decreased specific gravity

Answer: B. HypokalemiaRationale:A. The child needs to be monitored for hypotension.B. Hypokalemia is a concern in severe dehydration.C. A rapid, thready pulse would be seen in severe dehydration.D. The urine would be concentrated, so the specific gravity would increase.

A nurse is evaluating an infant brought to the clinic with severe diarrhea. What signs and symptoms indicate that the infant has severe dehydration? A. Tachycardia, decreased tears, 5% weight loss B. Normal pulse and blood pressure, intense thirst C. Irritability, moderate thirst, normal eyes and fontanel D. Tachycardia, capillary refill greater than 3 seconds, sunken eyes and fontanel

Answer: D. Tachycardia, capillary refill greater than 3 seconds, sunken eyes and fontanelRationale:A. In severe dehydration, there is a 15% weight loss in infants.B. Tachycardia, orthostatic hypotension and shock, and intense thirst would be expected.C. The infant would be extremely irritable, with sunken eyes and fontanel.D. Tachycardia, capillary refill greater than 3 seconds, and sunken eyes and fontanel are the symptoms of severe dehydration.

You're providing care to a 6 year old male patient who is receiving treatment for nephrotic syndrome. Which assessment finding below requires you to notify the physician immediately?* A. Frothy, dark urine B. Redden area on the patient's left leg that is swollen and warm C. Elevated lipid level on morning labs D. Urine test results that shows proteinuria

B. Redden area on the patient's left leg that is swollen and warm

A 3-year-old is admitted to the pediatric unit with a diagnosis of HUS. The child is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglobin and low hematocrit levels. The child has not had any urine output in 24 hours. The nurse expects which of the following to be added to the plan of care?1. initiation of dialysis2. close observation of the childs hemodynamic status3. diuretic therapy to force urinary output4. monitoring of urinary output

Because the child issymptomatic, dialysis is thetreatment of choice.

poststreptococcal glomerulonephritis should be alert for which finding?a. Increased urine outputb. Hypotensionc. Tea-colored urined. Weight gain

C. Acute poststreptococcal glomerulonephritis is characterized by hematuria, proteinuria, edema, and renal insufficiency. Tea-colored urine is an indication of hematuria.In acute poststreptococcal glomerulonephritis the urine output may be decreased.In acute poststreptococcal glomerulonephritis blood pressure may be increased.Acute poststreptococcal glomerulonephritis is characterized by hematuria, proteinuria, edema, and renal insufficiency. Tea-colored urine is an indication of hematuria.Edema may be noted around the eyelids and ankles in patients with acute poststreptococcal glomerulonephritis; however, weight gain is associated with nephrotic syndrome.

The nurse is caring for a child with a diagnosis of hemophilia, and hemarthrosis is suspected because the child is complaining of pain in the joints. Which measure should the nurse expect to be prescribed for the child? 1.Range-of-motion exercises to the affected joint 2.Application of a heating pad to the affected joint 3.Application of a bivalved cast for joint immobilization 4.Nonsteroidal antiinflammatory drugs for the pain

Correct Answer: 3 Rationale: In an acute period, immobilization of the joint would be prescribed. Range-of-motion exercise during the acute period can increase the bleeding and would be avoided at this time. Heat will increase blood flow to the area, so it would promote increased bleeding to the area. Nonsteroidal antiinflammatory drugs (NSAIDs) can prolong bleeding time and would not be prescribed for the child.

The nurse is caring for a child with hemophilia and is reviewing the results that were sent from the laboratory. Which result should the nurse expect in this child? 1.Shortened prothrombin time (PT) 2.Prolonged PT 3.Shortened partial thromboplastin time (PTT) 4.Prolonged PTT

Correct Answer: 4 Rationale: PTT measures the activity of thromboplastin, which is dependent on intrinsic factors. In hemophilia, the intrinsic clotting factor VIII (antihemophilic factor) is deficient, resulting in a prolonged PTT. The results in the remaining options are incorrect. The PT may not necessarily be affected in this disorder.

The pediatric nurse educator is providing a teaching session to nursing staff about hemophilia. Which statement should the nurse educator include? 1."Acetylsalicylic acid is given for pain control." 2."Hemarthrosis is the result of synovial cavity aspiration." 3."Total joint rest along with ice pack application continues for 72 hours after factor VIII is administered." 4."Affected prepubescent girls should be counseled concerning menorrhagia, which may be life-threatening."

Correct Answer: 4 Rationale: The female offspring of an affected male and a carrier female is at risk for hemorrhage once puberty is attained and menstrual cycles begin, and depending on the severity of the hemophilia, a hysterectomy or ablation may be performed. The remaining options are incorrect statements. Aspirin is not routinely given to young children and would not be given to a child with a bleeding disorder because of its effects on platelet aggregation. Hemarthrosis is the result of bleeding into the joint cavity, not of aspiration. Seventy-two hours is too long for the joint to be rested because maintenance of mobility is a primary concern once the bleeding episode has been arrested.

A nurse is caring for a child who is suspected of having Legg‑Calve‑Perthes disease. The nurse should prepare the child for which of the following diagnostic procedures? A. Bone biopsy B. Genetic testing C. MRI D. Radiographs

D. A child who has Legg‑Calve‑Perthes exhibits necrosis of the femoral head and can be diagnosed by radiographs of the hip and pelvis.

A child is diagnosed with Hirschsprung's disease. The nurse is teaching the parents about the cause of the disease. Which statement, if made by the parent, supports that teaching was successful? 1."Special cells are not present in the rectum, which caused the disease." 2."The protein part of wheat, barley, rye, and oats is not being digested fully." 3."The disease occurs from increased bowel motility that leads to spasm and pain." 4."The disease occurs because of inability to tolerate sugar found in dairy products."

Hirschsprung's disease also is known as congenital aganglionosis or megacolon. It results from the absence of ganglion cells in the rectum and, to various degrees, up into the colon. Option 2 describes celiac disease. Option 3 describes irritable bowel syndrome. Option 4 describes lactose intolerance.

A patient comes to the emergency department and is being treated for distributive shock. Which patient presentation corresponds to this diagnosis?Select all that apply. A patient suffering from profuse diarrheaInability of a patient to maintain vascular tone A patient with septic shock who has a bacterial infection A patient with an overall decrease in circulating blood volume A patient with myocardial fluid accumulation causing insufficiency in meeting the body's demands

Inability of a patient to maintain vascular toneThis patient scenario corresponds to a patient diagnosed with distributive shock, and therefore the nurse should recognize septic shock as a form for distributive shock. A patient with septic shock who has a bacterial infectionThis patient scenario corresponds to a patient diagnosed with distributive shock, and therefore the nurse should recognize septic shock as a form of distributive shock.

2. While providing care to a pediatric patient with acute glomerulonephritis, you note the urine output to be 10 mL/hr. The patient weighs 30 lbs. As the nurse, you will want to limit what type of foods from the patient's diet? A. Calcium-rich foods B. Potassium-rich foods C. Purine -rich foods D. None of the above because the patient's urinary output is normal based on the patient's weight.

The answer is B. This patient is experiencing OLIGURIA (low urinary output). The patient weighs 30 lbs. which is 13.6 kg (30/2.2= 13.6). Remember a normal urinary output for a pediatric patient should be 1 mL/kg/hr. Based on the patient's weight, their urinary output is 10 mL/hr...it should be 13.6 mL/hr. Therefore, the patient is at high risk for retaining POTASSIUM due to decreased renal function. The nurse should limit foods high in potassium.

Which can occur in untreated developmental dysplasia of the hip (DDH)? Select all that apply. 1. Duck gait. 2. Pain. 3. Osteoarthritis in adulthood. 4. Osteoporosis in adulthood. 5. Increased flexibility of the hip joint in adulthood.

1, 2, 3.1. Due to abnormal hip joint function, the client's gait is stiff and waddling.2. Due to abnormal femoral head placement, the client may experience pain and decreased flexibility in adulthood.3. Due to abnormal femoral head placement, the client may experience osteoarthritis in the hip joint in adulthood.4. There is no increased risk for osteoporosis.5. There is no increased flexibility of the hip joint in adulthood.

An infant is seen in the health care provider's office for complaints of projectile vomiting after feeding. Findings indicate that the child is fussy and is gaining weight but seems to never get enough to eat. Pyloric stenosis is suspected. Which prescription would the nurse anticipate having the highest priority in the care of this child? 1.Administer predigested formula. 2.Prepare the family for surgery for the child. 3.Administer omeprazole (Prilosec) before feeding. 4.Instruct the parents to keep a log of feedings and any reflux present.

2

A 2-year-old is admitted to the pediatric floor with a diagnosis of HUS. Which ofthe following would the nurse likely find in the child's history? 1. frequent UTIs and possible VUR. 2. The child had vomiting and diarrhea before admission 3. The child was stung by a bee and experienced localized edema to the site for 3 days. 4. The child had previously been healthy and did not show any signs of illness untilthis admission.

2. HUS is often preceded by diarrhea thatmay be caused by E. coli present inundercooked meat.

The nurse knows that which of the following need to be present to diagnose HUS? 1. Increased red blood cells with a low reticulocyte count, increased platelet count,and renal failure. 2. Decreased red blood cells with a high reticulocyte count, decreased platelet count,and renal failure. 3. Increased red blood cells with a high reticulocyte count, increased platelet count,and renal failure. 4. Decreased red blood cells with a low reticulocyte count, decreased platelet count,and renal failure.

2. The triad in HUS includes decreasedred blood cells (with a high reticulocyte count as the body attempts to produce more red blood cells), decreasedplatelet count, and renal failure.

The parent of a 3w week old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. which intervention should the nurse suggest the parent do first1. Give pain medication2. Reposition the infant in the crib3. Check the neurocirculatory status of the foot4. Use a cool blow dryer to blow into the cast to control itching

3

A 5-year-old is being discharged from the hospital following the diagnosis of HUS. The child has been free of diarrhea for 1 week, and renal function has returned. The parent asks the nurse when the child can return to school. What is the nurse's best response? 1. "Immediately, as your child is no longer contagious." 2. "It would be best to keep your child home for a few more weeks because theimmune system is weak, and there could be a relapse of HUS." 3. "Your child will be contagious for approximately another 10 days, so it is best tonot allow a return just yet." 4. "It would be best to keep your child home to monitor urinary output."

3. Children with HUS are consideredcontagious for up to 17 days after theresolution of diarrhea and should beplaced on contact isolation.

A 12-year-old girl is admitted to the hospital with suspected appendicitis. What nursing interventions should be implemented preoperatively?1.Applying a heating pad for 5-minute intervals as prescribed 2.Administering acetaminophen (Tylenol) as needed for pain, as prescribed 3.Placing the adolescent in a fetal position, side-lying with legs drawn up to chest 4.Inserting a nasogastric tube and attaching it to low intermittent suction; measuring drainage as prescribed

3A client with appendicitis is more comfortable when lying in what is traditionally known as the fetal position, with the legs drawn up toward the chest. This flexed positioning assists in decreasing the pain that comes with appendicitis by decreasing the pressure on the abdominal area. Option 1 describes an intervention that is contraindicated because heat can lead to a ruptured appendix. Option 2 is incorrect. Pain medications are not given to the client with acute appendicitis because they may mask the symptoms that accompany a ruptured appendix. Option 4 describes a nursing intervention that may be necessary postoperatively.

A 12-year-old child with newly diagnosed thalassemia is brought to the clinic exhibiting delayed sexual maturation, fatigue, anorexia, pallor, and complaints of headache. The child seems listless and small for age and has frontal bossing. What should the nurse expect to note on review of the results of the laboratory tests? 1.Macrocytosis and hyperchromia 2.Excessive red blood cell production 3.Excessive mature erythrocyte proliferation 4.Deficient production of functional hemoglobin

4

The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented? 1.Watery diarrhea 2.Ribbon-like stools 3.Profuse projectile vomiting 4.Bright red blood and mucus in the stools

4 Intussusception is a telescoping of one portion of the bowel into another. The condition results in an obstruction to the passage of intestinal contents. A child with intussusception typically has severe abdominal pain that is crampy and intermittent, causing the child to draw in the knees to the chest. Vomiting may be present, but is not projectile. Bright red blood and mucus are passed through the rectum and commonly are described as currant jelly-like stools. Watery diarrhea and ribbon-like stools are not manifestations of this disorder.

An emergency department nurse is performing an assessment on a child with a suspected diagnosis of intussusception. Which assessment question for the parents will elicit the most specific data related to this disorder? 1."Does the child have any food allergies?" 2."What do the bowel movements look like?" 3."Has the child eaten any food in the last 24 hours?" 4."Can you describe the type of pain that the child is experiencing?"

4A report of severe colicky abdominal pain in a healthy, thriving child between 3 and 17 months of age is the classic presentation of intussusception. Typical behavior includes screaming and drawing the knees up to the chest. Options 1, 2, and 3 are important aspects of a health history but are not specific to the diagnosis of intussusception.

The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which symptom most likely led the mother to seek health care for the infant?1.Diarrhea2.Projectile vomiting3.Regurgitation of feedings4.Foul-smelling ribbon-like stools

4Hirschsprung's disease is a congenital anomaly also known as congenital aganglionosis or aganglionic megacolon. It occurs as the result of an absence of ganglion cells in the rectum and other areas of the affected intestine. Chronic constipation beginning in the first month of life and resulting in pellet-like or ribbon-like stools that are foul-smelling is a clinical manifestation of this disorder. Delayed passage or absence of meconium stool in the neonatal period is also a sign. Bowel obstruction especially in the neonatal period, abdominal pain and distention, and failure to thrive are also clinical manifestations. Options 1, 2, and 3 are not associated specifically with this disorder.

7.A child is admitted to the hospital with diarrhea, vomiting, and dehydration. One week earlier, the child weighed 5.6 kg. On admission to the hospital, the child weighs 4.9 kg. What percentage weight loss has the child experienced? Please calculate to the tenths place.__________ %

5.6 kg previous weight-4.9 kg new weight0.7 difference(0.7 ÷ 5.6) × 100 = 0.125 × 100 = 12.5%

A preschoolder with vomiting and diarrhea lost 0.5 kg of weight since being weighed in the pediatrician's office prior to admission to the hospital. How much fluid would the nurse calculate that this child has lost?

500mL One milliliter of body fluid is approximately equal to 1 g of body weight, so a weight loss or gain of 1 kg represents 1 liter or 1000 mL. A half-kilogram loss would be 500 mL.

A 2-month-old breastfed infant is successfully rehydrated with oral rehydration solutions (ORS) for acute diarrhea. What instructions to the mother about breastfeeding should be included by the nurse? A. Continue breastfeeding B. Stop breastfeeding until breast milk is cultured C. Stop breastfeeding until diarrhea is absent for 24 hours D. Express breast milk and dilute with sterile water before feeding

A

Which assessment is most relevant to the care of an infant with dehydration? a. Temperature, heart rate, and blood pressure. b. Respiratory rate, oxygen saturation, and lung sounds. c. Heart rate, sensorium, and skin color. d. Diet tolerance, bowel function, and abdominal girth.

ANS: C) Heart rate, sensorium, and skin color.FeedbackA Children can compensate and maintain an adequate cardiac output when they arehypovolemic. Blood pressure is not as reliable an indicator of shock as arechanges in heart rate, sensorium, and skin color.B Respiratory assessments will not provide data about impending hypovolemicshock.C Changes in heart rate, sensorium, and skin color are early indicators ofimpending shock in the child.D Diet tolerance, bowel function, and abdominal girth are not as importantindicators of shock as heart rate, sensorium, and skin color.

intervention for the child with acute poststreptococcal 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 d. Inspiratory crackles

D. Children with excess fluid volume may have pulmonary edema. Inspiratory crackles indicate fluid in the lungs. Pulmonary edema can be a life-threatening complication.

You're providing education to the parents of a child who has a patent ductus arteriosus. The parents want to know the complications of this condition. In your education, you will include which of the following complications of PDA? Select all that apply: Heart failure Pulmonary hypertension Recurrent lung infections Clubbing of the fingernails Endocarditis

HF Pulmonary hypertension Recurrent lung infectionsEndocarditis