Pediatrics
6) A four month old is hospitalized with respiratory distress and high fever associated with a diagnosis of bronchiolitis; she is considered high risk for respiratory complications due to prematurity. Which medication is likely to be the most useful to this patient?
Palivizumab
74) A nurse is preparing a 4-year-old child with cystic fibrosis (CF) for home discharge. The nurse determines the parent needs further education when the parent states:
o "No pancreatic enzyme supplements will be necessary if our child has a good appetite and ____ bowel movements"
49) How should a nurse respond when asked by the mother of a child with b-Thalassemia why the child is receiving deferoxamine?
o "To prevent organ damage"
29) The parents of a child who is dying of cancer asks the nurse whether they should tell their 7 year old daughter that her brother is dying. What is the most appropriate response by then nurse?
o "Your daughter probably doesn't understand death as we do but fears it just the same. She should be told the truth to let her prepare for her brother's possible death.
31) A nurse is caring for a preschool child who has a new diagnosis of diabetes mellitus and is upset after an insulin injection. Which of the following play activities should the nurse recognize as being able to decrease anxiety for the child?
o A needless syringe and a doll
13) to alleviate discomfort in a child falling and immunization, you would advise the parent to?
o Administer acetaminophen
55) The ability to think through hypotheses, "what if" questions, is acquired during what stage growth?
o Adolescence
60) The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is:
o Allow her to experiment with modeling clay
23) The activity that would best foster developmental task of a disabled adolescent would be ***gave credit for 2 answers:
o Allowing her to decide if she wants to be in the AM or PM o talking to another adolescent who has a similar disorder
5) a 12 week old female infants undergoes a pulse oximetry. What should this test reveal?
o Amount of oxygen in her bloodstream
59) Nurse is working in a pediatric urgent care clinic. Which of the following patients can be discharged without the need for a urinalysis to evaluate for a UTI?
o An 8 year old male who presents with a finger laceration; his other states he has surgical reimplentation of his ureters 2 years ago
36) The pediatric nurse recognizes that a possible long-term condition associated with Kawasaki disease is:
o Aneurysm formations
8) Jimmy is a 10 year old newly diagnosed Type II Diabetic on your unit. You will be administering insulin by using the carb to insulin ratio regimen. Prior to lunch Jimmy's blood sugar was 195 mg/dl. Using the information below, how much insulin coverage will be needed after lunch?
o Answer = 6 UNITS
32) You are a community health-nurse who administers DTaP injections to children on a routine basis. These injections confer:
o Artificially acquired active immunity
57) Infants with cyanotic heart disease should not be allowed to become dehydrated because dehydration makes them prone to:
o Cerebrovascular accident
39) A nurse is ready to begin the physical examination on an eight month old infant. The child is sitting contently on his mother's lap chewing on a toy. Which of the following should the nurse do first?
o Check resp rate
34) Which assessment findings might a nurse observe when assessing a neonate diagnosed with an imperforated anus? (SATA)
o Closed anal opening o Abdominal distention o Vomiting
37) When plotting a 5 month-old infant's weight on a standardized growth chart, the nurse determines that the child's weight is between 85th and 90th percentile. Based on this finding, which action should the nurse take first?
o Compare this weight with previous weights recorded in the child's report
24) An infant will develop a sense of mistrust if she is:
o Consistently ignored
71) An infant is admitted with a diagnosis w/ RSV. The type of transmission-based isolation precautions the nurse would set up is:
o Contact precaution
65) A School age child with acute diarrhea and mild dehydration has been started on oral rehydration solutions. The child's mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which of The following?
o Continue to give the child oral rehydrating solutions frequently in small amounts
63) Which of the following is an indication of the potential complication in that asthmatic child
o Decrease in wheezing
75) A Nurses caring for newborns with suspected intro esophageal fistula. Which of following findings could the nurse expected to observe? (SATA) ***2 answers
o Either ABC or ABCE a) Coughing b) cyanosis c) apnea d) fever e) frothy saliva
68) The nurse is prearing to assess the postsurgical pain level of a 6 year-old. The child has appeared unwilling or unable to accurately report his pain level. Which of the following assessment tools would be most appropriate for this child?
o FLACC Behavioral Scale
7) A child presents to the Peds emergency room thrashing anxiously in severe distress, exhibiting: drooling, tongue protruding and croaking inspiration. He immediately assumes a tripod position. Which is the first course of action the nurse should take?
o Have a tracheostomy set at the bedside.
18) the terms "growth" and "development" are often used interchangeably. To which of the following does "developmental" refer?
o He learns to throw a ball overhead
50) A child's father expresses concern about his daughter's asthma. In counseling him about the disease, which of the following statements is most appropriate?
o Her asthma can be controlled and she can participate in usual childhood activities
a six-year-old with sickle cell disease is admitted to the PEDs unit with a vaso-occlusive crisis. What are the priority nursing concerns at this time? (select all that apply)
o Hydration o pain management o Bedrest
73) The nurse is providing instruction to a parent of a child with influenza. Which statement by the parent requires further teaching:
o I will manage the fever with baby aspirin
4) A 12 month old infant has become immune suppressed during the course of chemotherapy. When preparing the parents for the infant's discharge, what information should the nurse give concerning the measles, mumps, and rubella immunization?
o Infants receiving chemotherapy should not be given these vaccines
20) The developmental task of the preschooler. According to Erikson is gaining a sense of:
o Initiative versus guilt
56) What clinical finding warrants further intervention with acute post streptococcal glomerulonephritis?
o Inspiratory crackles
27) Which of the following is the most frequent source of symptomatic lead poisoning in children?
o Lead based paints
9) An infant has a cleft lip palette and is admitted to the hospital for a surgical repair. Listen the nurses Post operative interventions in order of priority
o Maintaining patent airway, o preventing vomiting o monitoring parenteral fluid infusions o teaching parents alternative feeding methods o assessing the infants hearing status
72) An appropriate nursing intervention when caring for a child in a cast would be to:
o Make sure cast edges are smooth and free of irritating projections
61) A seven-year-old is admitted to hospital with acute glomerulonephritis. Which of the following combinations of signs is commonly associated with the glomerulonephritis?
o Mild proteinuria o hematuria o decreased urinary output o lethargy
14) The mother of the three month old is concerned because her daughter does not sit by herself. Which of the following statements best reflects average infants sitting ability?
o Most babies did not sit steadily until eight months, she's normal
67) A major source for reducing that incidence of lead poisoning is
o Parent education
54) Which of the following statements about performing a pediatric physical assessment is correct?
o Physical examinations proceed systematically from head to toe unless developmental considerations dictate otherwise
51) The nurse would teach the parents of an infant newly diagnosed with tetralogy of Fallot to do which of the following initially if the infant suddenly became cyanotic and dyspneic:
o Place the infant in a knee-chest position
46) the nurse is caring for an infant with myelomeningocelel on the pediatric invasive care unit. While the infant is awaiting surgical correction of the defect, what is the most appropriate nursing intervention?
o Placing the infant in prone position
62) Signs and symptoms of urinary tract infections in a child aged 1 to 2 years old typically includes
o Poor feeding and vomiting
64) a five month old infant develops severe diarrhea and is given IV fluids. What is the rationale for the nurse to closely monitor the IV flowrate?
o Preventing cardiac overload
58) A major goal in caring for the dying child and the family includes:
o Providing comfort and keeping the child pain free
When teaching a newly diagnosed adolescent with type 1 diabetes about dietary management, what should the nurse include?
o Ready sources of glucose should be available
42) A one month old infant is admitted to the PED unit with a tentative diagnosis of Hirschsprung's disease. What procedure does the nurse anticipate will be used to confirm the diagnosis.
o Rectal biopsy
16) Corrective surgery for hypertrophic pyloric stenosis is performed on a 3-week old infant who had been formula fed. Which postoperative feeding order is appropriate?
o Regular feeding within 24 hours after surgery
28) Exercise for the child with diabetes mellitus type 1 may:
o Require an increased intake of food
26) A 9 year old is hospitalized for a long term illness. Best project to give her to help her achieve her developmental task would be: *** (many got this wrong and put scrapbook)
o Sewing a purse that will take one afternoon
53) A nurse is caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS). What is most important for the nurse to assess?
o Signs of dehydration
33) An early sign of hydrocephalus in an infant is: ***2 answers given
o Sunset eyes o Shrill high pitched cry
41) The parent of a pediatric client calls the ER. The parent reports the child has had a barking cough for the last three days and it always gets worse at night. The parent asked the nurse what to do. Which of the following is the best response?
o Take your child outside in the night air for 15 minutes
45) At 3 years of age, a child has a cardiac catheterization. After the procedure, which of the following interventions should be most important?
o Taking pedal pulses for the first 4 hours
47) When caring for child sickle cell anemia the MOST important nursing consideration is which of following?
o Teaching parents and child how to minimize crisis
10) the prevention of poisoning is the ultimate objective. The nurse knows that one effective counseling method to achieve this goal is that the initial discussions with parents and it should include:
o The acknowledgment that constantly safeguarding children is it difficult
70) A 10 year old with hemophelia A has slipped on the ice and bumped his knee. The knee is swollen and painful. Which of the following measures should be implemented (SATA):
o The extremity should be immobilized o The extremity should be elevated o Factor VIII should be administered
52) The parents of an infant who just had a ventriculoperitoneal (VP) shunt inserted for hydrocephalus are concerned about the prognosis. What information should the nurse give the parents?
o The shunt may need to be revised as the child grows older.
30) Which would the school nurse expect in a student who has an insultin to carbohydrate ratio of 1:10?
o The student administers 1 Unit of regular insulin fore very 10 grams of carbohydrates consumed
15) Which of the following statements by the nurse is most accurate in teaching about the typical play behavior of a toddler?
o They prefer parallel play
22) A Parenting education program has invited you to present information on poisoning that is common to children. You begin your presentation by telling parents that an important factor associated with ingestion of poison is: **2 answers taken
o This socioeconomic level of The family o evidence of stress in the family system
a Parent states " my 18 month old is difficult to please, has temper tantrums, and annoys me by throwing food from the table." What is the nurses best response to this situation?
o Toddlers are learning to assert independence and this behavior is expected
35) A nurse is caring for a child who has otitis media. Which of the following assessment findings should the nurse expect?
o Tugging on affected side
69) A school nurse is screening for scoliosis. What assessment finding would the nurse look for? (SATA)
o Uneven shoulders and hips o A one-sided rib hump o Prominent scapula
48) The nurse is caring for a child with lead poisoning and is preparing to administer edentate disodium (EDTA) as a daily order. Prior to beginning this medication the MOST important assessment the nurse makes is:
o Urine specific gravity
40) An 11 month old refuses to take amoxicillin suspension prescribed to treat his otitis media. What does the nurse advise the mother to do?
o Use a medicine dropper and place the medicine inside in his cheek
44) a child with sickle cell anemia develops fever, cough, dyspnea. The first nursing action is:
o administer oxygen to relieve the hypoxia
25) A toddler's parents want to begin toilet training. As a rule of the best instruction the nurse could give is:
o bowel training is easier than urine training
17) Julie, age 3, presents to the ER with a new-onset seizure. She is now alert and with normal vital signs. Test results reveal WBC 7.0, K 3.8, BUN 6.0, Creatinine 0.6, lead level 85, Hgb 10.8, urinalysis 1-2 epithelial cells otherwise normal. After initial treatment and stabilization=, you would expect her main therapy to consist of:
o chelation therapy with BAL and EDTA
12) which of are true regarding human "growth and development"?
o development is orderly o development is cephalo-caudal and proximal to distal o Growth and development are interrelated o Growth can be affected by the environment
11) Which of the following is an important nursing consideration when a child is hospitalized for in chelation therapy to treat lead poisoning
o keep accurate records intake and output
43) When explaining the occurrence of febrile seizures to a parent class, the nurse should include that they are common in children and:
o may occur in minor illnesses
19) the best way for infants father to help his child complete Erikson's development task of the first stages is to:
o respond to her needs consistently
21) nurses caring for her and activate 8 month old baby, who already pulled up to stand and is beginning to walk by holding on. From this assessment data, the nurse may diagnose:
o risk for injury
66) children with hemophilia should avoid
o salicylates
38) In a child with cyanotic heart disease, the club like appearance of fingers results from ALSO WORDED AS A child with clubbing, the cloud like appearance of fingers results from
o tissue change resulting from peripheral hypoxia
