Exam 3

The registered nurse is teaching the parent of a 6-year-old about behavioral start strategies for treating fecal incontinence due to functional Constipation. Which statement by the parent indicates a need for further teaching?

"I will give my child a reward for each bowel movement while sitting on the toilet."

The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be discharged soon. Which statement by the parent indicates the need for further teaching?

"I'll organize playdates to keep my child's spirits up during relapses."

95. The nurse is teaching infant care to parents with an infant who has been diagnosed with osteogenesis imperfecta (OI). What should the nurse include in the teaching session?

"Lift the infant by the buttocks, not the ankles, when changing diapers."

Which of the following statements made by the mother of a child recently diagnosed with celiac disease indicates a need for further teaching?

"My child can have small amounts of foods containing wheat as long as she remains symptoms free."

the clinic nurse is interviewing the parents of a 6-month-old client about the infants diet. Which statement by the parents is most concerning?

"infant oatmeal sweetened with fresh honey is our baby's favorite breakfast.

23. The nurse is assessing a 4 y.o boy in the pediatric clinic. Which behaviors by the client would concern the nurse for possible Duchenne muscular dystrophy? Select all.

-Frequent trips and falls at home -Places hands on thighs to push up to stand -Walks on tiptoes and has disproportionately large calves

22. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestations would indicate pyloric stenosis? Select All.

-Non-bilious vomiting and weight loss -Projectile vomiting -Olive-shaped mass above umbilicus

A 5-year-old male is diagnosed with diarrhea and mild dehydration. Which of the following oral rehydration solution (ORS) should be given by the nurse or parent to replace the stool losses?

. 50-100 mL/each stool

What statement is true concerning osteogenesis imperfecta (OI)?

. It's a disorder with varying degrees of bone fragility

100. A 4 week old infant has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this infant's fracture is how long?

2-3 weeks.

The emergency nurse is triaging four clients. Which client should the nurse assess first?

6-month-old client who is constipated, cannot hold the head up, and has a weak cry after eating honey

64. A 13 y.o male has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this adolescent's fracture is how long?

8-12 weeks

49.A 2 y.o child is receiving digoxin(Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate

90 beats/min

58. A 5 y.o male diagnosed with mild dehydration should be given Oral Rehydration Solution (ORS) by the nurse or parent with which of the following rehydration therapy?

? 50 ml/kg/ 4 hrs

6. The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which MOST LIKELY sign of this condition documented in the record?

? Choking with feedings

95.Which of the following would be involved in the nursing care of a child with an atrial septal defect?

? Preparing the child and family for cardiac catheterization

48.What finding is the most reliable guide to the adequacy of fluid replacement for a small child with burns?

? Urinary output of 1-2 ml/kg of body weight/hr

2. Which discharge teaching instructions should the nurse provide to the parents of a 2-yearold with group A streptococcal pharyngitis? Select all that apply

A. Complete all the antibiotics even if your child is feeling better B. Cool liquids and soft diet are recommended C. Keep your child D. Replace your child's toothbrush 24 hours after starting antibiotics

22.A child diagnosed with Coarctation of Aorta is scheduled for a f/u visit. While assessing the pediatric nurse would expect to find which of the following symptoms?

Absent or diminished femoral pulses

The following are considered functions of the Urinary System, EXCEPT:

Absorption of digested molecules

What is included in the therapeutic management of the child with rheumatic fever?

Administration of penicillin

What is an advantage of continuous cycling peritoneal dialysis or continuous ambulatory peritoneal dialysis for adolescents who require dialysis?

Adolescents can carry out procedures themselves.

What best describes the cause of most cases of acute glomerulonephritis?

Antecedent streptococcal infection

51.What structural defects constitute tetralogy of Fallot?

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

The parent of a 5-year-old child calls the clinic to report the recurrence of a nosebleed for which the child was seen a week ago. Which of the following instructions should the nurse reinforce? (Select all that apply.)

Apply a cold cloth to the bridge of the nose. Apply pressure by pinching the nostrils together. Attempt to keep the child calm and quiet.

. A young girl has just injured her ankle at school. In addition to notifying the child's parents, what is the most appropriate, immediate action by the school nurse?

Apply ice

What action should the school nurse take for a child who has a hematoma (black eye) with no hemorrhage into the anterior chamber?

Apply ice for the first 24 hours

33.The nurse caring for a 6 y.o child who has undergone cardiac catheterization 3 hrs ago notes the dressing and bed saturated with blood. Which initial action should the nurse take?

Apply pressure above the insertion site

140. A child hospitalized with juvenile idiopathic arthritis (JIA) complains of pain in the knees. What intervention should help to relieve the discomfort?

Applying warm, moist compresses to the knees.

What would be included in nursing interventions for a child after a cardiac catheterization?

Assess the affected extremity for temperature and color.

The parent of a 21-day-old male infant reports that the infant is "throwing up a lot." Which assessment should the nurse make to help determine if pyloric stenosis is an issue? sata

Assess the parent's feeding technique. Check if the vomiting is projectile. Compare current weight to birth weight.

72. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Assessing bowel function.

Latex allergy is suspected in a child with spina bifida. What are appropriate nursing interventions to include in care of this patient?

Avoid using any latex product. What is a common clinical manif

134. What intervention should be beneficial in reducing the risk of Reye syndrome?

Avoidance giving aspirin to children after a suspected vital illness.

36. A 2-month-old recently diagnosed with developmental dysplasia of the hip (DDH) is beginning treatment with a Pavlik harness. What instructions should the nurse provide to the parents? Select all that apply

B. "Dress the child in a shirt and knee socks under the straps" C. "Lightly massage the skin under the straps daily" D. "Place the diaper under the straps"

A nurse is teaching the parent of a 6-year-old with a urinary tract infection (UTI) how to avoid repeat infections. Which statements by the patient indicate that the teaching has been effective? Select all that apply

B. "I will make sure my child does not hold urine" C. "I will not give my child any more bubble baths" D. "I will teach my child to wipe from the front to the back"

35. The nurse is planning care for a child being admitted for Kawasaki disease and should give priority to which nursing intervention?

B. Monitor for a gallop heart rhythm and decreased urine output

24. The nurse is assessing a 4 -week -old infant during a routine office visit. Which assessment finding is most likely to alert the nurse for the presence of right hip development dysplasia?

B. Presence of extra gluteal folds on right side

30. When monitoring an infant with left -to -right sided heart shunt, which findings would the nurse expect during the physical assessment? Select all that apply

C. Diaphoresis during feedings D. Heart murmur E. Poor weight gain

37. The nurse is performing well-child examinations in a pediatric clinic. Which finding requires further evaluation

C. Lateral curvature to the spine noted on examination of a 10-year-old girl

41. The nurse is caring for an infant with osteogenesis imperfecta admitted with a new fracture. The client also has old fractures in multiple stages of healing but no bruising, abrasions, or redness of the skin. Which nursing intervention should be included in the plan of care?

C. Obtain blood pressure manually to avoid cuff overtightening

The clinic nurse assesses an 8-yearold client who reports a sore throat and has a bright red, pruritic rash on the chest that feels like bumps and looks like sunburn. Which diagnostic tool does the nurse anticipate the health care provider will prescribe?

C. Rapid Streptococcal antigen

32. The summer camp nurse and parent of a 9 -year -old with juvenile idiopathic arthritis (JIA) are discussing appropriate physical activities for the child. Which of the following activities should be included? Select all that apply

C. Stationary bicycling D. Swimming E. Yoga

80. A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal anti-inflammatory drug (NSAID). What nursing consideration should be included?

Check for abdominal pain and bloody stools.

. A 3-month-old who weighs 8.8 lb (4 kg) has just returned to the intensive care unit after surgical repair of a congenital heart defect. Which finding by the nurse should be reported immediately to the health care provider?

Chest tube output of 50 mL in the past hour.

What type of diarrhea is commonly seen in malabsorption syndromes because the intestine cannot absorb nutrients or electrolytes?

Chronic

An infant in the NICU was born with hypospadias, which of the following should be avoided when a child has such condition?

Circumcision

A parent of a 7-month-old reports that the child has been crying and vomiting with a distended belly for the past 4 hours. The infant is now lying quietly in the parent's arms with a pulse of 200/min and respirations of 60/min. Which of the following components of SBAR (situation, background, assessment, recommendation /read-back) communication is most important for the nurse to report to the health care provider?

Client is now lethargic with abnormal vital signs

143. Which of the following treatment is the best method for a 7-month-old infant with Developmental Dysplasia of the Hip (DDH)?

Closed Reduction with Spica Casting.

A newborn female infant in the NICU has signs of ambiguous genitalia, and hyponatremia. Which of the following is the infant's likely diagnosis?

Congenital Adrenal Hyperplasia

139. Which of the following is a common symptom seen in a newborn with a diagnosis of hypothyroidism?

Constipation.

A young child has recently been fitted with a knee, ankle, and foot orthosis (brace). What would be included in care of the skin?

Contact a practitioner or orthotist if skin redness does not disappear.

Major goals for the therapeutic management of juvenile idiopathic arthritis (JIA) include?

Control pain, preserve joint function Prevent skin breakdown, relieve symptoms Reduce joint discomfort, regain proper alignment

The home health nurse is visiting an infant who recently had surgery to repair tetralogy of Fallot. Which of the following signs of heart failure should the nurse teach the parents to report to the health care provider? sata

Cool extremities. Puffiness around the eyes. Reduction in number of wet diapers. Weight gain.

75. The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?

Corn on the cob with butter

18.A 4 y.o child seen in the ER has symptoms of Kawasaki Disease(KD). Of the symptoms listed below which can potentially develop and pose a high risk for children with KD?

Coronary artery aneurysm

What is included in the therapeutic management of nephrotic syndrome?

Corticosteroids

What is an important nursing responsibility when a dysrhythmia is suspected?

Count the apical rate for 1 full minute and compare with radial rate.

What urine tests of renal function is used to estimate glomerular filtration?

Creatinine

56. A 2 y.o is hospitalized with suspected intussusception. Which finding is associated with intussusception?

Currant jelly stools

98. A 4 yr old female seen in peds clinical has urinary symptoms. What is the medical terminology for inflammation of the bladder?

Cystitis.

A client diagnosed with acute glomerulonephritis has pitting edema in both lower extremities, blood pressure of 170/80 mm Hg, and proteinuria. When developing a plan of care for this client, the nurse should include which most accurate indicator of fluid loss or gain?

Daily weight measurements.

The nurse is assessing a child with a cardiac history. The child's extremities are cool with thready pulses, and urinary output is diminished. What do the assessment findings suggest for this child?

Decreased contractility

12) When monitoring an infant with a left-to-rightsided heart shunt, which findings would the nurse expect during the physical assessment?

Diaphoresis during feedings Heart murmur Poor weight gain

39. A 2 y.o child has simple constipation and is brought to the clinic for evaluation. The therapeutic plan initially includes:

Dietary modification

Which clinical finding may be present in an older child with Coarctation of the Aorta?

Diminished pulse in the lower extremities

A 2-month-old recently diagnosed with developmental dysplasia of the hip (DDH) is beginning treatment with a Pavlik harness. Which instructions should the nurse provide to the parents? Select all that apply

Dress the child in a shirt and knee socks under the straps.", "Lightly massage the skin under the straps daily.", "Place the diaper under the straps." A home health nurse is managi

115. The nurse is assisting with application of a synthetic cast on a child with a fractured humerus. What is an advantage of a synthetic cast over a plaster of Paris cast?

Drying time is faster

16.Transposition of the Great Vessel(TGV) is incompatible with life.Prostaglandin E is given to children with this medical emergency to keep which of the following shunts open in an infant with TGV?

Ductus Arterlosus

What procedure use high-frequency sound waves obtained by a transducer to produce an image of cardiac structures?

Echocardiography

54.A child is recovering from Kawasaki's Disease(KD). The child should be monitored for which?

Electrocardiograph(ECG) changes

118. A young girl has just injured her ankle at school. After notifying the child's parents and applying ice to the area, what is the next most appropriate action by the school nurse?

Elevate the extremity to reduce edema formation

After surgical repair of a fractured femur a 10 yr old has a long leg cast on. The toes on the child's cast leg are edematous, but has sensitivity, and movement. What action should the nurse take?

Elevate the foot and leg on a pillow Evidence-based practice in clinical man

73.What drug is an angiotensin-converting enzyme(ACE) inhibitor?

Enalapril(Vasotec)

) A nurse is teaching the parents of an infant with tetralogy of Fallot. Which of the following actions should the nurse include to reduce the incidence of hypercyanotic spells? Select all that apply.

Encourage smaller, frequent feedings Offer a pacifier when the infant begins to cry Promote a quiet period upon waking in the morning Swaddle the infant during procedures

The pediatric nurse cares for a 16-yearold client who is scheduled for an appendectomy in the morning. Which of the following interventions are appropriate to support the client's psychosocial needs? (Select all that apply.)

Encourage the client to have peers visit while hospitalized. Include the client as an active participant when planning care. Support the client in discussing concerns about body image changes

116. To assist in the prevention of urinary tract infections (UTIs) in children, which of the following is one of the best recommendations the nurse should make to parents?

Ensure clear liquid intake of 2 L/day

The nurse is caring for an infant diagnosed with Hirschsprung disease who is awaiting surgery. Which assessment finding requires the nurse's immediate action?

Episode of foul-smelling diarrhea and fever.

23.A 7 y.o child tested positive for Streptoccal Pharyngitis, but she's allergic to Penicillin. Which of the following antibiotics is indicated as a treatment option?

Erythromycin

Where would nonpathologic cyanosis normally be present in the newborn shortly after birth?

Feet and hands

58.Select from list below a reason for 'Innocent' heart murmurs in infants:

Fever

8) The nurse is providing discharge instructions to the parent of a child with Kawasaki disease. The nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

Fever

81. A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal anti-inflammatory drug (NSAID). What nursing consideration should be included?

Give NSAIDS between meals.

A parent brings a 6-month-old child to the Primary Health care provider after the child abruptly started crying and grabbing intermittently at the abdomen. The client stool has a red, currant Jelly appearance. What intervention does the nurse anticipate?

Give air (pneumatic) enema

What is an appropriate intervention to encourage food and fluid intake in a hospitalized child?

Give high-quality foods and snacks whenever the child expresses hunger.

61.A child who has a cardia catheterization is being discharged. What should the nurse include in the discharge instructions to the parents?

Give sponge baths for 3 days to prevent infection

When does dialysis or transplantation becomes necessary for a child in chronic renal failure?

Glomerular filtration rate falls below 10% to 15% of normal

A nurse is reviewing the laboratory values for a 3-year-old client with nephrotic syndrome. The nurse interprets the results to most clearly reflect which physiologic process related to nephrotic syndrome?

Glomerular injury

The school nurse creates a cafeteria menu for a newly enrolled child with celiac disease. Which lunches would be appropriate for this child? Select all that apply

Grilled chicken, baked potato, and strawberry yogurt, Mexican corn tacos with ground beef and cheese, Rice noodles with chicken and broccoli

. Which of the following organisms is responsible for the development of rheumatic fever?

Group A betahemolytic Streptococcus

19.The parents of a 3 y.o admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

Help the family develop a written list of specific questions to ask the practitioner

The nurse is gathering data on a 5-weekold admitted with a suspected diagnosis of pyloric stenosis. The nurse should expect to find which laboratory value?

Hematocrit of 57% (0.57) 32

69. A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show?

Hematuria and proteinuria.

56.What clinical finding may be present in an older child with Coarctation of the Aorta?

High blood pressure in the upper extremities

123. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse expect?

Hirschsprung disease.

99. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?

Hirschsprung disease.

106. A pediatric nurse assesses a newborn with symptoms of failure to pass meconium within 48 hrs after birth. Which of the following diseases will be suspected in this newborn?

Hirschsprung.

What would cause a nurse to suspect that an infection has developed under a cast?

Hot spots" felt on the cast surface

A 3-month-old with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?

I will adjust the harness straps every 3-5 days.

A 6 -month -old infant is brought to the emergency department after experiencing vomiting and diarrhea for 4 days. Which prescription from the health care provider is priority ?

IV normal Saline bolus 20 mL/kg over 1 hour

34.Which of the following medication is commonly used to treat Kawasaki's Disease(KD)?

IVIG

A pediatric nurse plans to educate the parents of a 2- yeard old child who has simple constipation. Which of the following info should be included in the teaching?

Include more fibers and fluids

The nurse is evaluating a female child with acute post streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

Increased urine output

4) The nurse receives report on 4 pediatric clients on a telemetry unit. Which client should the nurse assess first?

Infant client with ventricular septal defect with reported grunting during feeding

39. The nurse has received report on 4 pediatric clients on a telemetry unit. Which client should the nurse assess first?

Infant client with ventricular septal deficit with reported grunting during feeding

3) An 8-month-old infant is scheduled for a femorally inserted balloon angioplasty of a congenital pulmonic stenosis in the cardiac catheterization laboratory. Which finding should the nurse report to the health care provider that could possibly delay the procedure?

Infant has severe diaper rash

19. A toddler with symptoms of sudden inconsolable screaming or crying, drawing up of the knees to the chest, vomiting, and a tender distended abdomen will probably be diagnosed with which of the following diseases?

Intussusception

Which of the following statements best describes Duchenne (pseudo-hypertrophic) muscular dystrophy (DMD)?

It had an X-linked inheritance problem It is characterized by presence of the Gower sign Child exhibits a waddling gait, and lordosis

27. A 12 y.o child is admitted to the PICU in acute renal failure (ARF). The nurse prepares to administer which of the following medication to rapidly provoke a flow of urine?

Mannitol (Osmitrol) or furosemide (Lasix) or both

137. Which of the following are clinical manifestations of minimal change nephrotic syndrome, usually seen in children with this disorder?

Massive proteinuria, hypoalbuminemia, and edema

29. A 3 y.o is admitted to the peds unit with minimal change nephrotic syndrome. What clinical manifestations are usually seen with this diagnosis?

Massive proteinuria, hypoalbuminemia, and edema

A 12-month-old with Kawasaki disease received IV immunoglobulin (IVIG ) 2 months ago. The child is in the clinic for follow-up and scheduled immunizations. Which vaccine should be delayed? Select all that apply

Measles, mumps, rubella (MMR) Varicella

A 4 yr old with Spina Bifida is prepared for a straight catherization by the peds nurse. Which of the following actions by the nurse is recommended for this child?

Medicate the child with pain meds before the procedure

. An 18-month-old child is seen in the clinic with Otitis media (OM). Oral amoxicillin is prescribed instructions to the parent should include which of the following? A. Stop giving medication and come to the clinic if fever is still present in 24 hours B. Immediat

Medication may take 24 to 48 hours to make symptoms subside

45.A 13 month old child seen in the peds clinic shows symptoms of tachycardia, tachypnea, cap refills of 3 sec, and slight weight loss since the last visit. Which level of dehydration is the child entering?

Moderate

41.Select the surgical procedures usually done in children to correct heart defects from the following list(SELECT ALL)

Modified Blalock-Taussig Shunt Bidirectional Glenn Shunt

1) The nurse is planning care for a child being admitted with Kawasaki disease and shoud give priority to which nursing intervention?

Monitor for a gallop heart rhythm and decreased urine output.

2) A nurse is assessing a 1-month-old infant with an atrial septal defect (ASD). Which assessment finding does the nurse expect?

Murmur

42.A 15 y.o male referred to a cardiologist is diagnosed with Infective Endocarditis. Which of the following symptoms are usually seen with this condition?(SELECT ALL)

Murmur, Osler nodes, Janeway spots

155. A 4 yr old male is evaluated in peds specialty clinic with symptoms of muscular weakness, lordosis, calf muscle hypertrophy, and frequent falls. Which of the following is a likely diagnosis?

Muscular dystrophy.

Why are infants particularly vulnerable to acceleration-deceleration head injuries?

Musculoskeletal support of the head is insufficient

149. A 10 yr old female seen in a specialty peds clinic has a diagnosis of Spina Bifida. On examination the peds nurse observes the spinal sac with meninges and nerves. Which of the following is the child's diagnosis?

Myelomeningocele.

The nurse is doing a pre-hospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed?

Necessary information for the child and parents

2.A child was brought to the emergency department with complaints of nausea, vomiting, fruityscented breath. The resident on duty diagnosed the child with diabetes ketoacidosis. Which of the following should the nurse expect to administer?

Normal saline IV infusion

The parent of a child receiving an iron preparation tells the nurse that the child's stools are a tarry green color. What information does the nurse included in discussion with this parent?

Normally expected change resulting from the iron preparation

A child has had a short-arm synthetic cast applied. What should the nurse teach to the child and parents about cast care?

Observe the fingers for any evidence of discoloration C. Elevate the arm when resting Do not allow the child to put anything inside the cast

72.After returning from cardiac catheterization the nurse determines that the pulse distal to the catheter site is weaker. How does the nurse respond?

Observe this as a normal finding and record the data

The nurse is caring for an infant with osteogenesis imperfecta admitted with a new fracture. The client also has old fractures in multiple stages of healing but no bruising, abrasions, or redness of the skin. What nursing intervention should be included in the plan of care?

Obtain blood pressure manually to avoid cuff over-tightening.

What is the initial therapeutic management of the child with acute diarrhea and dehydration?

Oral rehydration solution

What would be included in nursing care of an infant with heart failure?

Organize activities to allow for uninterrupted sleep

60. The following symptoms describes which of the conditions listed below: Multiple fractures at birth, growth failure, autosomal recessive inheritance?

Osteogenesis Imperfecta

97. What bone disorder of childhood is caused by an autosomal recessive defect in the synthesis of collagen

Osteogenesis imperfecta.

57. The pediatric nurse is preparing to admit a 5 y.o with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe?

Overflow incontinence with constant dribbling of urine

138. A 4-year-old is seen in the ER with a fracture of the humerus. Which of the following P's are assessed to determine the extent of the child's injury?

Pain and pulselessness.

110. The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?

Pain is common, diarrhea is moderate to severe, weight loss is severe

127. The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe?

Pain is common. Diarrhea is moderate to severe. Anal and perianal lesions are common.

66. Which of the following P's will the pediatric nurse assess on a 10 y.o male after a recent fracture of the femur to determine the extent of his injury? Select all.

Pallor, pain, paresthesia

119. The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? Select all

Palpable sausage shaped abdominal mass -Vomiting -Stool mixed with blood and mucous

The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? (Select all that apply.)

Palpable sausage-shaped abdominal mass. Screaming and drawing of the knees up to the chest. Stool mixed with blood and mucus

7) A nurse is assisting a new mother as she is breastfeeding her infant. The infant has been diagnosed with tetralogy of Fallot. During feeding, the infant becomes cyanotic and is having difficulty breathing. What should be the nurse's first action?

Place infant in knee to chest position

50.A 3 month old with a hypercyanotic spell. What should be the nurse's first action?

Place the child in knee chest position

92.A 2 y.o child diagnosed with tetralogy of Fallot becomes upset, crying, and thrashing around when a blood specimen is obtained. The childs color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?

Place the child in knee to chest position

23.Select the parts of the fetal circulation of the pediatric heart in the correct order as blood flows from the placenta to the fetus:

Placenta-umbilical vein-ductus venosus-inferior vena cava-R atrium

The nurse is caring postoperatively for an 8-year-old child with multiple fractures and other traumatic injuries from a motor vehicle crash. The child is experiencing severe pain. What is an important consideration in managing the child's pain?

Plan a preventive schedule of pain medication around the clock.

52.What sign/symptom is a major clinical manifestation of rheumatic fever(RF)?

Polyarthritis

What is the primary clinical manifestation of diabetes insipidus?

Polyuria, polydipsia

34. A school age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?

Popcorn

62.A nurse is reviewing the laboratory values of a child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition?

Positive antistreptolysin titer

A nurse is reviewing the laboratory values of a child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition?

Positive antistreptolysin titer

What results when ice is applied immediately after a soft tissue injury, such as a sprained ankle?

Produces deep tissue vasodilation.

What information would a nurse counseling parents on the home care of the child with a cardiac defect before corrective surgery include?

Promote normality within the limits of the child's condition.

What are the common clinical manifestations of nephrotic syndrome?

Proteinuria, hypoalbuminemia, and edema

The nurse provides feeding instructions to a parent of an infant diagnosed with gastro-esophageal reflux (GER). Which instruction should the nurse give the parent to assist in reducing the episodes of emesis? (Select all that apply)

Provide smaller more frequent meals Thicken the feedings by adding rice cereal to the formula Burp the infant frequently during feeding

17.The physician suggests that surgery be performed for patent ductus arteriosus(PDA) to prevent which complication? P

Pulmonary vascular congestion

2. An infant was assessed in peds clinic with the following symptoms: visible peristalsis, failure to thrive, an infant who is 'always hungry', dehydration. What is the likely diagnosis?

Pyloric Stenosis

A young child is diagnosed with vesicoureteral reflux. What is a common recurrent complication in a child with this diagnosis?

Recurrent urinary tract infections

117. The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

Reduction of edema

19.Which of the following actions by the school nurse is most important in the prevention of rheumatic fever(RF)?

Refer children with sore throats for throat cultures

A 10 yr old male with Legg-Calve Perthes Disease is seen by the pediatrician. The student nurse is aware that management of this disease includes which of the following?

Rest, staging of the disease process, traction

46. Of the following diagnosis, which would the nurse identify as a priority for the infant with tracheoesophageal fistula (TEF)

Risk of injury related to increased potential for aspiration

What is the viral pathogen that frequently causes acute diarrhea in young children?

Rotavirus

Spina bifida is one of the possible neural tube defects that can occur during early embryological development. Which of the following definitions most accurately describes meningocele?

Sac formation containing meninges and spinal fluid

32. A 12 y.o child is seen in specialty clinic has ill fitting clothes, a rib hump and hip asymmetry, recently noticed by parents. Which of the following is the likely diagnosis of this child?

Scoliosis

90.A child with heart failure is in Lanoxin(digoxin). The laboratory value a nurse must closely monitor is which?

Serum Potassium

What factors predisposes the urinary tract to infection?

Short urethra in girls

73. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?

Skin and stoma care.

5. A 10 y.o female seen in specialty peds clinic has a diagnosis of Spina Bifida. On examination the peds nurse observes dark tufts of hair at the lumbar sacral region. Which of the following is the child's diagnosis?

Spina Bifida Oculta

A 2-year-old in the emergency department is suspected of having intussusception. Which assessment finding should the nurse expect?

Stools mixed with blood and mucus. 46.

You have learned that in babies and children with developmental dysplasia (dislocation) of the hip (DDH), the hip joint has not formed normally. Which of the following is the most common form of DDH?

Subluxation

a newborn is diagnosed with Tracheoesophageal Fistula at birth. An initial nursing function is to assure that which of the following orders are implemented?

Suction as needed

The parent of a newborn is concerned about the possibility of the child developing hip dysplasia. Which intervention should the nurse encourage to help reduce the risk in this newborn?

Swaddle the infant with hips flex an abducted

The nurse is assessing an infant brought to the clinic with diarrhea. He is lethargic and has dry mucous membranes. What would the nurse recognize as an early sign of dehydration?

Tachycardia

What is an early sign of heart failure that would be recognized by the nurse?

Tachypnea

What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis?

Teach the child and family the correct administration of medications.

A 4-year-old child is newly diagnosed with Legg-Calvé-Perthes disease. Nursing considerations include what?

Teach the family the care and management of the corrective appliance.

What heart defects causes hypoxemia and cyanosis because desaturated venous blood is entering the systemic circulation?

Tetralogy of Fallot

9) A 3-month-old client has stopped breathing. Identify the area where the nurse should check the client's pulse.

The brachial artery is used to detect a pulse in an unresponsive client age <1 year.Located in between armpit and elbow.

The nurse taught the caregiver of a child with ventriculoperitoneal (VP) shunt about when to contact the health care provider (HCP). The caregiver shows understanding of the instructions by contacting the HCP about which symptom?

The child vomits after awakening from a nap and 1 hour later.

35. A 14 y.o is admitted to the emergency room with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture?

This type of fracture requires different management to prevent bone growth complications

Hypospadias refers to what?

Urethral opening along ventral surface of penis

30. A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response?

Urine output will increase

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What should be the nurse's best response?

Urine output will increase

Immobilization causes what effects on the cardiovascular system?

Venous stasis

51. A 12 y.o is being treated with Buck's Traction. What are important nursing interventions for this client?

Verify that the skin traction maintains the extremity in an extended position

45. Which of the following parameters would the nurse monitor to evaluate the initial effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)?

Vomiting

104. An 11-year-old girl with celiac disease was discharged from the hospital. An appropriate teaching was carried out by the nurse if the parents are aware of avoiding which of the following?

Wheat.

which of the following instructions would be included in the preventive teaching plan about urinary tract infections for a preschool female child?

Wiping front to back

63. Duchenne Muscular Dystrophy (DMD) has which of the following inheritance patterns?

X linked recessive trait

74. Which of the following pharmacology therapy is used to treat infants and children with Gastroesophageal Reflux Disease (GERD)

Zantac (Ranitidine)

Among toddlers and children up to age five, femur fractures usually result from a low energy fall. In most cases, the orthopedic surgeon realigns the fracture using fluoroscopy or x-ray imaging as a guide and immobilizes the leg in a type of cast called a spica cast. Approximately how many weeks does it take for a fractured femur to heal in a 3- year-old?

a. 3-8 week

Reye's syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following?

a. Varicella

A nurse is caring for a child with acute glomerulonephritis. Frequent monitoring of which of the following is a priority?

blood pressure

The clinic nurse supervises a graduate nurse who is teaching the parents of a 2-year-old with acute diarrhea about home management. The nurse would need to intervene when the graduate nurse provides which instruction?

follow the bananas, rice, Apple sauce, and toast diet for the next few days."

107. A young girl has just injured her ankle at school. In addition to notifying the child's parents, what is the most appropriate, immediate action by the school nurse?

immediate action by the school nurse? A

a 10 year old child is admitted with a hx of crohn disease. The child's plan of care should include a diet that has which of the following components?

increased calories

1. Which of the following is standard therapy used in the care of children with Osteogenesis Imperfecta?

isphosphonate Therapy and physical therapy

an 8 year old is seen in peds clinic with symptoms of morning stiffness that improves with activity. The pediatric nurse suspects the child has symptoms of which of the following?

juvenile Idiopathic Arthritis

a child with pyloric stenosis is having excessive vomiting, which of the following is a potential complication?

metabolic Alkalosis

a 4 year old is seem in the ER with a fractured of the humerus. Which of the following P's are assessed to determine the extent of the child's injury?

paralysis and pallor

5. a school-age child with celiac disease asks for guidance about snack that will not exacerbate the disease, what snack should the nurse suggest?

potato chips

The summer camp nurse and parent of a 9-yearold with juvenile idiopathic arthritis (JIA) are discussing appropriate physical activities for the child. Which of the following activities should be included? Select all that apply

stationary bicycling, swimming, yoga.

36. After a pyloromyotomy, a week old infant is prescribed feedings of 1 to 2 oz of Pedialyte q 3 hrs then advance to breastmilk ad tolerated postoperatively. The nurse should advance the feeding if which occurs?

the infant is taking the Pedialyte without vomiting or distention

A child in the emergency department had a cast placed on the right arm for a nondisplaced fracture. The client is being discharged home with pain medications. Which statement by the parent indicates that additional teaching is required?

"A tingling or burning sensation within the first 24-48 hours is not a concern."

7. A 3 -month -old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik harness. Which statement made by the parent indicates a need for further instruction?

"I will adjust the harness straps every 3 -5 days" C. "I will inspect the skin un

73. The nurse is evaluating a parent's understanding of home care management for a 2-week-old client after initial cast placement for treatment of congenital clubfoot. Which of the following statements by the parent indicate a correct understanding? (Select all that apply.)

"I will check my baby's toes several times a day to ensure that they are pink and warm." "My baby will need to have a new cast applied weekly for 5-8 weeks." "When I bathe or diaper my baby, I will be sure to keep the cast dry."

a child is admitted for minimal change nephrotic syndrome. The nurse recognizes that the child's prognosis is related to what factor?

. Response to steroid therapy

A 7-month old infant seen in peds clinic is diagnosed with Isotonic Dehydration. The pediatric nurse prepares to administer which of the following fluids that will be the most appropriate to rehydrate this infant?

0.9% NaCl

. The emergency department triage nurse is assessing 4 pediatric clients. Which client is a priority for further diagnostic workup and definitive care?

1-year-old with ventriculoperitoneal shunt who has "lethargy" and pulse of 78/min.

102. At which of the following ages is recommendation made by the American Academy of Pediatrics (AAP), for pre-adolescent and adolescent females to be screened for Scoliosis?

10-12.

3.The nurse should expect the apical heart rate of a stabilized neonate to be which of the following ranges?

120-160 beats/min

53.What child has a cyanotic congenital heart defect?

2 month old with tetralogy of Fallot

108. A 3-year-old child has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this child is how long?

4 weeks.

The nurse assesses a child with intussusception. Which assessment findings require priority intervention?

Abdominal rigidity with guarding

93.Select from the list below a reason for 'innocent' heart murmur in infants:

Anemia

The nurse is preparing an adolescent girl for surgery to treat scoliosis. What would the nurse include?

Blood administration may be an option.

A child, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. What does the nurse consider when discussing this injury with her parents?

Bone growth can be affected by this type of fracture

A child diagnosed with Coarctation of aorta is scheduled for a follow up visit. While assessing, the pediatric nurse would expect to find which of the following symptom?

Bounding pulses in the upper extremities

151. A 2-year-old has chronic constipation and is brought to the clinic for evaluation. The therapeutic plan initially includes what?

Bowel cleansing

94. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?

Bowel cleansing.

A newborn is being evaluated for possible esophageal atresia with tracheoesophageal fistula. Which finding is the nurse most likely to observe?

Choking and cyanosis during feeding

In acute glomerulonephritis, what is the nurse is aware that is an early warning sign of encephalopathy?

Dizziness

70. When does idiopathic scoliosis become most noticeable?

During the preadolescent growth spurt.

33. Which of the following musculoskeletal disorders is associated with morning stiffness that improves with activity?

Juvenile Idiopathic arthritis

40. Diabetic ketoacidosis (DKA) results from an excessive accumulation of which of the following?

Ketone bodies from fat metabolism

What is a major complication of total parenteral nutrition in children?

Liver disease

10) The nurse is caring for a newborn with patent ductus arteriosus. Which assessment finding should the nurse expect?

Loud machine-like murmur.

109. A 10 y.o male with Legg-Calve Perthes Disease is seen by a pediatrician. The student nurse is aware...

Partial weight bearing on the affected side, staging of the disease process, traction.

The nurse is caring for a 2-year-old who is receiving a saline enema for treatment of intussusception. Reporting which client finding to the health care provider (HCP) is most important?

Passed a normal brown stool.

15.Tetralogy of fallout consists of pulmonic stenosis, overriding aorta, ventricular septal defect, and which of the following?

Right ventricular hypertrophy

A newborn had a bowel resection with temporary colostomy for Hirschsprung's disease. The nurse should alert the health care provider (HCP) for which assessment finding post operatively?

Stoma is Gray-tinged at the edges but pink at the center on postoperative day 5

76. The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?

Stool pH 7.0

37. The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?

The laboratory reports a negative guaiac

128. A full-term male has hypospadias. Which statement describes hypospadias?

The urethral meatus opens on the underside of the penis

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?

Therapeutic management includes administration of gamma globulin and salicylates