Dynamic Quizzes - Pediatric Unit

A nurse is teaching the parent of an infant who has a pavlik harness for the treatment of developmental dysplasia of the hip. The nurse should identify that which of the following statements by the parent indicates an understanding of the teaching? -I should remove the harness at night to allow my infant to stretch her legs -I will need to adjust the straps on the harness each week -I should apply baby powder to my infant's skin twice daily -I will place my infants diapers under the harness straps

never remove harness until stable which takes 6-12 weeks -do not adjust the harness -powder and lotion can cause skin breakdown with the harness

labs

potassium is 4.1-5.3 sodium is 134-150 urine specific gravity is 1.005-1.030 BUN is 5-18

a nurse is an emergency department is performing a physical assessment on a 2 week old male newborn. Which of the following findings is the priority for the nurse to report to the provider? -Excoriated scrotal area -multiple capillary hemangiomas -depressed posterior fontanel -substernal reactions

us ABC; substernal retractions affect respiratory

A nurse is planning care for a toddler who has a serum lead level of 4. Which of the following actions should the nurse plan to take? -Instruct the parents to decrease the calcium in their toddler's diet -Prepare the toddler for chelation therapy -Refer the family to child protective services -Schedule the toddler for a yearly rescreening

-The toddler should have a diet rich in caclium because calcium vitamin c and iron decreases lead absorption -Chelation therapy is required for a lead level of 45 -The nurse should schedule the toddler for a lead level rescreening in 1 year and educate the family on ways to prevent exposure.

A nurse is preparing to collect a sample from a toddler for a sickle-turbidity test. Which of the following actions should the nurse plan to take? -Obtain a sputum specimen -Perform an Allen test -Perform a finger stick -Obtain a stool specimen

-allen test are used for cap refills before an arterial puncture. -if finger test is positive, hgb electrophoresis is required to distinguish between children who have the genetic trait and children who have the disease

A school nurse is assessing an adolescent who has scoliosis. Which of the following findings should the nurse expect? -Increase in anterioir convexity of the lumbar spine -Increased curvature of the thoracic spine -Lateral flexion of the neck -A uniilateral rib hump

-an increased anterior convexity of the lumbar spine is a manifestation of lordosis -increased curavture of the thoracic spine is a manifesattion of kyphosis -lateral flexion of the neck is an indication of torticollis -a unilaterial rib hump is scoliosis

A nurse is caring for an adolescent who received a kidney transplant. Which of the following findings should the nurse identify as an indication the adolescent is rejecting the kidney -negative leukocyte esterase -serum creatinine 3.0 -negative urine protein -urine output 40

-average urine output is 33-62.5

A nurse is caring for a school age child who is recieving a blood transfusion. Which of the following manifestations should alert the nurse to a possible hemolytic transfusion reaction? -Laryngeal edema -Flank pain -Distended neck veins -Muscular weakness

-laryngeal edema is an indication of an allergic reaction the blood transfusion. -Flank pain is caused by the breakdown of RBCs and is an indication of an hemolytic reaction to the blood transfusion -Distended neck veins are an indication of circulatory overload, which is a complication of blood transfusion -Muscle weakness is an indication of an electrolyte disturbances, which is a complication of a blood transfusion

A nurse is caring for a child with vesicular rash that has been present for 6 days. The nurse should expect that the child has which of the following conditions? -Measles -Fifth Disease -Tetanus -Varicella

1. A child with measles develop Koplik spots, which spreads to upper trunk and face and can spreads to lower areas of the body. 2. Fifth Disease begins with bright red cheeks, producing a"slapped cheek" appearence that can spread to the extremities and trunk. 3. A child with tetanus develops lockjaw and muscle rigidity, DTaP immunization aids the prevention of this disease. 4. A child with varicella develops vesicular rashes.

a nurse in an emergency department is caring for a school age child who is expereincing an anaphylactic reaction. Which of the following is the priority action by the nurse? -elevate the head of the childs bed -insert a large bore IV catheter for the child -determine the allergen that caused the child's reaction -administer epinieprhine IM to the child

always administer epiniphrine IM to child if child is having anaphylactic reaction

a Nurse is interviewing the parent of an 18 month old toddler during a well child visit. The nurse should identify that which of the following findings indicates a need to assess the toddler for hearing loss? -the toddler has a vocabulary of 25 words. -The toddlers developed a mild rash following a recent varicella immunization -The toddler's moro reflex is absent -the toddler received tobramycin duirng hospitalzation 2 weeks ago

at age of 18 months, the toddler should have a vocabulary of at least 10 words. -moro reflex disappears by 5 months of age -tobramuycin is an ototoxic.

A nurse is providing teaching to the parent of an infant who has diaper dermatitis. The nurse should instruct the parent to apply which of the following to the affected area? -zinc oxide -antibiotic ointment -talcum powder -antiseptic solution

-zinc oxide for diaper dermatitis -antibiotic ointment is for overgrowth of yeast, such as candida albicas -talcum powder has been linked to respiraotry disorder in infants -antiseptic solution can cause burning and pain

A nurse is reviewing the laboratory reports of a 7 year old child who is receiving chemotherapy. Which of the following laboratory values should the nurse report to the provider? -hgb is 8.5 -WBC 9500 -Prealbumin 18 -Platelets 300,000

A child receiving chemotherapy is at risk for anemia due to the chemo effects on the blood forming cells of the bone marrow. For 7 year old child. the HGB is 10-15.5 -Prealbumin level is 15-33 for 7 year old

A nurse is providing teaching to the parent of a scchool-age child who has a new prescription for oral nystatin for the treatment of oral candidiasis. Which of the following instructions should the nruse inlcude?

Shake the medication prior to administration

A nurse is assessing a toddler who has gastroenteritis and is exhibiting manifestations of dehydration. Which of the following finidings is the nurse's priority? -Skin breakdown -Hypotension -Hyperpyrexia -Tachypnea

Skin breakdown is a symptom for gastroenteritis and dehydration but there is another priority. -They can also have hypotension but other priority -They can have this but other priority -ABC

A school nurse is assessing an adolescent who has multiple burns in various stages of healing. Which of the following behaviors should the nurse idenitfy as a possible indication. of physical abuse?

denies discomfort during assessments of injuries

A nurse is planning care for a school-age child who is in the oliguric phase of acute kidney injury (AKI) and has a sodium level of 129. Which of the following interventions should the nurse include in the plan? -Administer ibuprofen to the child for a temperature greater than 100.4 degree -Assess the child's blood pressure every 8 hrs -Weigh the child weekly at various times of the day -Initiate seizure precautions for the child

hyponatremia places the child at increased risk for neuro deficits

a nurse is assessing a 4 year old child at a well child visit. Which of the following developmental milestones should the nruse expect to observe? -identifies right from left hand -uses a utensil to spread butter -cuts an outlined shape using scissors -draws a stick figure with seven body parts

identifying from your right to level and using utensil to spread butter is expected at 6 year old -draw a stick figure with seven body parts is 5 year old child -cutoutlined shape using scissors is a 4 year old developmental milestone

A nurse is caring for a toddler who is experiencing acute diarrhea and has moderate dehydration. Which of the following nutritional items should the nurse offer to the toddler? -Apple juice -Peanut butter -chicken broth -oral rehydration solution

kids having diarrhea should not have any carbs or sodium.

A hospice nurse is caring for a preschooler who has a terminal illness. One of the preschoolers parents tells the nurses that they cannot cope anymore and are thinking about moving out of the house. Which of the following statements should the nurse make?

lets talk about some of the ways you have handled previous stressors in your life.

A nurse is providing dietary teaching to the parent of a school age child who has celiac disease. The nurse should recommend that the parent offer which of the following foods to the child? -wheat crackers -rye bread -barley soup -white rice

no gluten (wheat crackers rye bread and barley soup)

A nurse is creating a plan of care for a school-age child who has a heart disease and has developed heart failure. Which of the following interventions should the nurse include in the plan? -Provide small frequenet meals for the child -schedule time in the play room for the child -weigh the child weekly -maintain the child in supine position

the metabolic rate of a child who has heart failure is high because of poor cardiac function

A nurse is caring for a school age child who is in the Buck's traction following a leg fracture 24 hrs ago. Which of the following actions should the nurse take? -Change the child's position every 2 hours -Clean the peripheral pin sites with chlorhexidine solution every 4 days -Asess peripheral pulses once every 4 hours -Ensure that the head of the bed is elevated to the 90 degree angle

-pt should maintain supine position -only elevate the head of the bed for a child who is in cervical traction

A nurse is caring for a toddler, who has spastic (pyramidal cerebral palsy. Which of the following finidings should the nurse expect? -Negative babinkski reflex -ankle clonus -exaggerated stretch reflexes -uncontrollable movements of the face -contractures

-should be positive

A nurse is receiving change-of-shift report for four children. Which of the following children should the nurse see first? -A school-age child who has sickle cell anemia and reports decreased vision in the left eye -A school-age child who has cystric fibrosis and a frequent nonproductive cough -A preschooler who has asthma and a peak flow meter reading in the green zone -An adolescent who has meningitis and reports a sensitivity to lights and noise

A school age child who has sickle cell anemia and reports decreased vision in the left eye

A nurse is assessing a school age child who has meningitis. Which of the following findings is the priority for the nurse to report to the provider? -reports a headache as 6 on a 0-10 -Petechiae on the lower extremities -Nuchal rigidity -positive kernigs sign

Petechiae on the lower extremities can indicate the presence of meningococcemia.

A nurse is assessing the vital signs of a 10 year old child following a burn injury. The nurse should identify that which of the following findings is an indication of early septic shock? -BP is 130/90 -HR is 60/min -Temp is 102.4 -Urinary output is 100 ml/hr

Temp is 102.4

A nurse is reviewing the laboratory report of a school-age child who is experiencing fatigue. Which of the following findings should the nurse recognize as an indication of anemia? -Hematocrit 28% -Hemoglobin 13.5 g/dl -WBC 8,000 -Platelets 250,000

Hematocrit is 32-44 for school age child Hgb is 9.5-14 for school age WBC is 5-10 Platelets is 150-400

A nurse is teaching the parent of an infant about ways to prevent sudden infant death syndrome (SIDS). Which of the following instructions should the nurse include? -Place the infant in a prone position to sleep -Allow the infant to sleep on a large pillow -Use a soft mattress in the infant's crib -Give the infant a pacifier at bedtime

-Prone and side lying positions are risk factors for SIDS -placing the infant on a large pillow to sleep can increase the risk of suffocation and SIDS -the parent should use a firm mattress. soft matress is risk factor for SIDS and can lead to asphyiation -protective factors against SIDS include the use of pacifier when infant is sleeping and and breastfeeding

A nurse is caring for an infant who has respiratory syncytial virus (RSV). Which of the following actions should the nurse implement for infection control? -Have a designated stethoscope in the infant's room -Place the infant in a room equipped with negative airflow -Administer palivizumab as prescribed for the infant -Remove gloves after leaving the infants room

-a negative airflow room is only initiated for infants who need airborne precautions

a nurse is creating a plan off care for an infant who has an epidural hematoma from a head injury. Which of the following interventions should the nurse include in the pain? -Position the infant side lying with their head at a 0 degree to 5 degree -Perform a neuro assessment every 4 hours -Suction the infant's nares to remove secretions -Implement seizure precautions for the infant

Implement seizure precautions for the infant

a nurse is reviewing the lumbar puncture results of a school-age child who is suspected of having bacterial meningitis. Which of the following findings should the nurse identify as an indication of bacterial meningitis? -Decreased cerebrospinal fluid pressure -Decreased WBC count -Increased protein concentration -Increased glucose level

Increased and increased WBC is associated with bacterial meningitis Decreased glucose levels is associated with bacterial meningitis

A nurse is caring for a preschooler whose father is going home for a few hours while another relative stays with the child. Which of the following statements should the nurse make to explain to the child when their father will return? -Your daddy will be back at 7 -Your daddy will be back after he takes care of your brother -Your daddy will be back in the morning -Your daddy will be back after you eat

Preschoolers make sense of time best when they can associate with an expected daily routine