Exam 2 Practice Questions

A ("ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason.")

The parents of a 6-year-old child with idiopathic thrombocytopenic purpura (ITP) ask the nurse, "What causes this disease?" Which response by the nurse would be most appropriate? A. "ITP is primarily an autoimmune disease in that the immune system attacks and destroys the body's own platelets, for an unknown reason." B. "ITP is a serious bleeding disorder characterized by a decreased, absent, or dysfunctional coagulation." C. "ITP occurs when the body's iron stores are depleted due to rapid physical growth, inadequate iron intake, inadequate iron absorption, or loss of blood." D. "ITP is characterized by the loss of surface area on the red blood cell membrane."

B (Most infants are nasal breathers rather than mouth breathers.)

What statement is the most accurate regarding the structure and function of the newborn's respiratory syste m? a. The diameter of the child's trachea is the same as that of adults. b. Most infants are nasal breathers rather than mouth breathers. c. The respiratory tract in the child is fully developed by age 2. d. Infants and young children have smaller tongues in proportion to their mouths.

A (Cold, clammy skin and increased heart rate)

When caring for a child that has just had a cardiac catheterization, what is a sign of hypotension? a. Cold, clammy skin and increased heart rate b. Decreased heart rate and dizziness c. Syncope and tachypnea d. Diaphoresis and tachycardia

B (not to pick or irritate her nose)

When planning care for a child with idiopathic thrombocytopenic purpura, the nurse plans to teach her: A. what foods are high in folic acid. B. not to pick or irritate her nose. C. to use mainly cold water to wash. D. to apply a soothing cream to lesions.

B (A 15-year-old girl constantly sucks ice cubes)

Which assessment below would increase your suspicion that iron-deficiency anemia may be present in a child? A. A 3-month-old boy sucks his thumb B. A 15-year-old girl constantly sucks ice cubes C. An 8-year-old girl is shy and does not participate in class D. A 7-month old boy does not say whole words yet

C ("It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain.")

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond? a. "Are you sure you are making nutrient dense foods?" b. "Maybe your child doesn't really like the foods your making. This could lead to not gaining sufficient weight." c. "It's great you are providing nutritious meals, but smaller frequent meals will tire your child less and promote weight gain." d. "It's hard to get your child to eat enough at this age to maintain their weight since they are expending so much energy with the heart condition."

BDE (Tachypnea, Weak infant sucking, Bilateral crackles in lung fields)

A child is suspected of having tricuspid atresia. Which findings are consistent with this disorder? Select all that apply. a. Peripheral cyanosis in the first few hours after birth b. Tachypnea c. Bradypnea d. Weak infant sucking e. Bilateral crackles in lung fields

D (Teach the child and his parents to keep a headache diary)

. A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate? a) Have the child sleep without a pillow under his head. b) Have the parents call the doctor if the child vomits more than twice. c) Review the signs of increased intracranial pressure with parents. d) Teach the child and his parents to keep a headache diary.

B (Factor VIII)

. A toddler who is beginning to walk has fallen and hit his head on the corner of a low table. The caregiver has been unable to stop the bleeding and brings the child to the pediatric clinic. The nurse is gathering data during the admission process and notes several bruises and swollen joints. A diagnosis of hemophilia is confirmed. This child most likely has a deficiency of which blood factor? A. Factor V B. Factor VIII C. Factor X D. Factor XIII

C (His stools will appear black)

A 9-month-old boy with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help you determine that he is actually taking it daily? A. His reticulocyte count will have decreased. B. He will develop diarrhea. C. His stools will appear black. D. He will be less irritable than he was at his last visit.

D (Sunsetting)

6. The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: a) Nystagmus b) Decorticate posturing c) Doll's eye d) Sunsetting

C (Overriding of the aorta)

A client's newborn is diagnosed with tetralogy of Fallot. When explaining this condition to the client, which defect would the nurse's description include? a. Atrial septal defect b. Stenosis of the aorta c. Overriding of the aorta d. Left ventricular hypertrophy

DEABC (Orientedx3, disorientation, obtundation, stupor, coma)

A nurse demonstrates understanding of the various levels of consciousness as they progress from most alert to least alert. Place the levels of consciousness in the order that reflects this progression. a) Obtundation b) Stupor c) Coma d) Oriented to person, place, and time e) Disorientation

A ("Red meat is a good option; he loves the hamburgers from the drive-thru.")

A nurse is providing dietary interventions for a 5-year-old with an iron deficiency. Which response indicates a need for further teaching? A. "Red meat is a good option; he loves the hamburgers from the drive-thru." B. "He will enjoy tuna casserole and eggs." C. "There are many iron fortified cereals that he likes." D. "I must encourage a variety of iron-rich foods that he likes."

A (Ischemic strokes are more common than hemorrhagic strokes)

During class, a student states, "I didn't think children could have strokes. I thought this only occurred in older adults." When responding to the student, what would be most important for the instructor to integrate into the response? a) Ischemic strokes are more common than hemorrhagic strokes. b) Research has identified specific treatments for children. c) The signs and symptoms in children are different from an adult. d) Strokes in children often have an identifiable cause.

C (The family will verbalize understanding of the disease crisis)

In caring for a child with sickle cell disease, the highest priority goal is: A. The family caregivers' anxiety will be reduced. B. The child's skin integrity will be maintained. C. The family will verbalize understanding of the disease crisis. D. The child's fluid intake will improve.

ABC (Chest pain with activity, Dizziness with prolonged standing, Thrill palpated at base of heart)

The nurse is assessing a child with aortic stenosis. Which findings would the nurse most likely assess? Select all that apply. a. Chest pain with activity b. Dizziness with prolonged standing c. Thrill palpated at base of heart d. Moderately loud systolic murmur at the base of the heart e. Blood pressure in arms significantly higher than in legs

A ("I should give the enzymes before each meal or snack.")

The nurse is caring for a 10-year-old girl with cystic fibrosis who receives pancreatic enzymes. Which comment by a parent demonstrates understanding of the instructions regarding the medication? a. "I should give the enzymes before each meal or snack." b. "I should stop the enzymes if my child is taking antibiotics." c. "I should reduce the dose if she has large, malodorous stools." d. "Between meals is the best time to give the enzymes."

BCD (Observe for and report to provider any double or blurred vision, Observe and report any vomiting that occurs within six hours, Wake the child every one to two hours to check level of consciousness)

The nurse is reinforcing teaching with the caregivers of a child being discharged from the urgent care setting following a mild head injury that occurred in an in-line skating accident. What should the caregivers be instructed to do? Select all that apply. a) Administer acetaminophen for headache. b) Observe for and report to provider any double or blurred vision. c) Observe and report any vomiting that occurs within six hours. d) Wake the child every one to two hours to check level of consciousness. e) Check the pupil reaction to light every 15 minutes for two hours.

B ("Children who have this diagnosis may have had strep throat.")

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? a. "This disorder is caused by genetic factors." b. "Children who have this diagnosis may have had strep throat." c. "Being up-to-date on immunizations is the best way to prevent this disorder." d. "The onset and progression of this disorder is rapid."

C (23-month-old Ava who had heart surgery as an infant for a defect)

The nurse working at the child community clinic must administer the influenza vaccine to the high-risk kids first. Which child would she choose? a. 12-month-old Sally who is very healthy b. 21-month-old Chris who has a cold c. 23-month-old Ava who had heart surgery as an infant for a defect d. 22-month-old Jared who has a wound from touching a hot pan at home