Pediatrics Exam 4 NCLEX Questions Pt 1
A child with Kawasaki disease is receiving low-dose aspirin. The mother calls the clinic and states that the child has been exposed to influenza. Which recommendation should the nurse take? Select all that apply. A. Increase fluid intake. B. Stop the aspirin. C. Keep the child home from school. D. Watch for fever. E. Weigh the child daily
B, D
Which statements by the mother of a toddler should leave the nurse to suspect that the child is at risk for iron deficiency anemia? Select all that apply. A. He drinks over four glasses of milk per day. B. I cannot keep enough apple juice in the house he must drink over 10 ounces per day. C. He refuses to eat more than two different kinds of vegetables. D. He does not like meat, but will eat small amounts of it. E. He sleeps 12 hours every night and takes a two hour nap
A, B
An infant has been transferred from the ICU to the pediatric floor after undergoing surgery to correct a heart defect which Taskin the nurse delegate to license practical nurse? Select all that apply. A. Administering oral medications B. administering IV morphine C. obtaining vital signs D. morning hygiene E. circulation checks F. discharge teaching
A, C, D
After surgery to correct a tetralogy of Fallot, the child's parents expressed concern to the nurse that their four-year-old child wants to be held more frequently than usual. The nurse recommends: A. Introducing a new skill. B. Play therapy. C. Encouraging the behavior. D. Having the volunteer hold the child
B
An eight week old infant with congenital heart disease has been discharged. What is the most important information for the nurse to convey regarding feeling? A. Allow the infant one hour to complete each feeding. B. Position the infant in an upright position after each feeding. C. Give feedings per nasogastric tube to conserve energy. D. Provide a higher calorie formula or fortified breastmilk
D
Because of the risks associated with administration of anti-hemophilic factor, The nurse should teach the child's family to recognize it immediately report which problem? A. Yellowing of the skin B. constipation C. abdominal distention D. hives
D
A child has had open heart surgery to repair tetralogy of fallot with a patch. The nurse should instruct the parents to:
A
What is the most appropriate method to use when drawing blood from a child with hemophilia? A. Use finger punctures for lab draws. B. Prepare to administer platelets. C. Apply heat to the extremities before any punctures. D. Schedule all labs to be drawn at one time.
D
Which information should the nurse include when completing discharge instructions for the parent of a 12 month old child diagnosed with Kawasaki disease and being discharged home? A. After the child extra fluids every two hours for two weeks. B. Take the child's temperature daily for several days. C. Check the child's blood pressure daily until the follow up appointment. D. Call the healthcare provider if they irregularity last for two more weeks.
B
Which outcome indicates that the activity restriction necessary for seven-year-old child with rheumatic fever during the acute phase has been effective? A. Joints demonstrate absence of permanent injury. B. The resting heart rate is between 60 and 100 BPM. C. The child exhibits a decreasing chorea movements. D. The subcutaneous nodules over the joints are no longer palpable.
B
A 12-year-old with rheumatic fever has a history of long-term aspirin use. Which client statement most indicates that the client is experiencing a serious adverse reaction to aspirin? A. I hear a ringing in my ears. B. I put lotion on my itchy skin. C. My stomach hurts after I take the medicine. D. These pills make me cough
A
A 16-month-old child is diagnosed with Kawasaki disease and is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. What should the nurse do first? A. Apply lotion to the hands and feet. B. Offer foods a toddler likes. C. Place a toddler in a quiet environment. D. Encourage the parents to get some rest
C
A nurse is fine and care for a 12-year-old with rheumatic fever. The nurse should teach the parents to: A. Observe the child closely. B. Allow the child to participate in activities that will not tire him. C. Provide for adequate periods of rest between activities. D. Encourage someone in the family to be with the child 24 hours a day.
C
A seven-year-old with hemophilia A has fallen and badly bruised his knee. Which intervention should be done first one managing the clients hemarthrosis? A. Use active range of motion to prevent immobility. B. Play cold packs to promote basal constriction. C. Apply pressure in immobilizer joint. D. The healthcare provider of the injury
C
The nurse explains to the parents of a one-year-old child admitted to the hospital in sickle cell crisis that the local tissue damage this child had on admission is caused by which factor? A. Auto immune reaction complicated by hypoxia. B. Lack of oxygen in the red blood cells. C. Obstruction to circulation. D. Elevated serum bilirubin concentration.
C
Which clinical manifestation would lead the nurse to suspect an infant has hydrocephaly? Select all that apply. A. Depressed fontanelle B. headache C. vomiting D. low pitched cry E. irritability F. pupillary changes G. bulging fontanelle
C, E, F
A child diagnosed with tetralogy of Fallot becomes upset cries and thrashes around when a blood specimen is obtained. The child becomes cyanotic, and the respiratory rate increases to 44 breaths per minute. Which action should the nurse do first? A. Obtain a prescription for sedation for the child. B. Assess for an irregular heart rate and rhythm. C. Explain to the child that it will only hurt for a short time. D. Place the child in a knee to chest position
D
A nurse evaluates discharge teaching as successful when the parents of school-age child with a ventriculoperitoneal son in certain identify which sign as signaling a blocked shunt? A. Decreased urine output with stable intake B. Tense fontanelle and increased head circumference C. Elevated temperature and reddened incisional site D. Irritability and increasing difficulty with eating
D
The nurse is preparing to administer furosemide to three-year-old with a heart defect. The nurse verifies the child's identity by checking the armband and: A. Asking the child to state her name. B. checking the room number C. asking the child to tell her birthdate. D. Asking the parent the child's name
D
Before placement of a ventriculoperitoneal shunt for hydrocephalus, an infant is irritable, lethargic, and difficult to feed. To maintain the infants nutritional status which action would be most appropriate? A. Feed the infant just before doing any procedures. B. Give the infant small, frequent feedings. C. Feed the infant in a horizontal position. D. Give large, less frequent feedings.
B
The healthcare provider prescribes post assessments through the night for a 12-year-old child with rheumatic fever who has a daytime heart rate of 120 bpm. The nurse explains to the mother that this is to evaluate if the elevated heart rate is caused by: A. The morning digitalis. B. Normal activity during waking hours. C. A warmer daytime environment. D. Normal variations in day and evening hours
B
The mother tells the nurse she will be afraid to allow her child with hemophilia to participate in sports because of the danger of injury and bleeding. After explaining that physical fitness is important for children with hemophilia, which activity should the nurse suggest as ideal? A. Snow skiing B. swimming C. basketball D. gymnastics
B
The nurse is teaching the parents of a child is sickle cell disease. To instruct them on how to prevent sickle cell crisis, the nurse should include which instructions? A. Exercise in cool temperatures. B. Drink at least 2 quarts of fluids daily. C. Avoid contact sports. D. Take anti-inflammatory medications before exercising
B
A diagnosis of hemophilia A is confirmed in an infant. Which instruction should the nurse provide the parents as an infant becomes more mobile and starts to crawl? A. Administer 1/2 of a children's asking for temperature higher than 101°F. B. So thick padding into the elbows and knees of the child's clothing. C. Check the color of the children's urine every day. D. Expect irruption of the primary teeth to produce moderate to severe bleeding
A
An 18 month old with a congenital heart defect is to receive digoxin twice a day. Which instructions should the nurse give to the parents? A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm. B. Signs of toxicity include increased pulse and visual disturbances. C. Digoxin is absorbed better if taken with meals. D. If the child that is within 15 minutes of administration, the dosage should be repeated
A
As part of the preoperative teaching for the family of a child undergoing a tetralogy of Fallot repair, the nurse tells the family upon returning to the pediatric floor that the child may: A. Be placed on a reduced sodium diet. B. Have an activity restriction for several days. C. Be assigned to an isolation room. D. Have visits limited to a select few.
A
The nurse is providing postoperative care for an infant who had a ventriculoperitoneal shunt placed to correct hydrocephalus. Which clinical finding warrants immediate intervention? A. Abdominal distention B. lethargy C. facial Edema D. headache
A
Which initial physical finding indicates the development of carditis in a child with rheumatic fever? A. Heart murmur B. low blood pressure C. irregular pulse D. anterior chest wall pain
A
Which signs and symptoms would leave the nurse to suspect a child has tetralogy of Fallot? Select all that apply. A. murmur B. history of squatting C. bounding pulses D. cyanosis E. faint pulse F. tachypnea
A, B, D, F
Which action indicates but the parents of a 12 month old with iron deficiency anemia understand how to administer iron supplements? Select all that apply. A. They administer iron supplements in combination with fruit juice. B. They administer iron supplements with meals. C. They report dark stools. D. They brush the child's teeth after administering the iron supplements. They decrease dietary intake of foods fortified with iron.
A, D
Discharge teaching for a three month old infant with a cardiac defect who is to receive digoxin action should include which information? Select all that apply. A. Give the medication at regular intervals B. Mix the medication with a small volume of breastmilk or formula C. Repeat the dose one timer for child vomit immediately after administration D. Notify the healthcare provider of poor feeding or vomiting E. Make up any missed doses as soon as realized F. Notify the HCP if more than two consecutive doses are missed
A, D, F to achieve optimal therpeutic levels, digoxin should be given at regular intervals without variation. Vomiting and poor feeding are signs of toxicity. if more than 2 consecutive doses are missed
The nurse is transferring a child who has had open heart surgery from the intensive care unit to the pediatric unit. The child's blood pressure has been fluctuating but has been stable doing last two hours. The nurse from the pediatric intensive care unit should include which information in the report to the nurse and the pediatric unit? Select all that apply. A. Medications being used B. current vital signs C. potential for blood pressure to drop D. drip rate for the intravenous infusion E. time of the most recent dose of pain medication F. medications given during surgery
A,B, C, D, E
The nurse of a child hospitalized with tetra Charla GFL it tells the nurse of the child's three-year-old sibling has become quiet and shy and demonstrates more than usual amount of genital curiosity since this child hospitalization. The nurse should tell the parent: A. This behavior is very typical for a three-year-old. B. This may be how your child expresses feeling a need for attention. C. This may be an indication that your child may have been sexually abused. D. This may be a sign of depression in your child
B
A transfusion of packed Red blood cells has been prescribed for a one-year-old with sickle cell anemia. The infant has a 25 gauge IV infusing dextrose with sodium and potassium. Using the situation, background, assessment, and recommendation method of communication, the nurse contact the healthcare provider in recommends: A. Starting a second IV with a 22 gauge catheter to infuse normal saline with the blood. B. Using the existing IV, but changing the fluids to normal saline for the transfusion. C. Replacing the IV with a 22 gauge catheter to infuse the prescribed fluids. D. Starting a second IV with a 25 gauge catheter to infuse normal saline with the transfusion
B
A child with hemophilia presents with a burning sensation in the knee and reluctance to move the body part. The nurse collaborates with the care team to provide factor replacement and: A. Administer an aspirin containing compound. B. Institute rest, ice, compression and elevation. C. Begin physical therapy with active range of motion. D. Initiates contraction
B
A parent ask the nurse if a child iron deficiency anemia is related to the child's frequent infections. The nurse responds based on understanding of which principal? A. Little is known about iron deficiency anemia and its relationship to infection in children. B. Children with iron deficiency anemia are more susceptible to infection than our other children. C. Children with iron deficiency anemia are less susceptible to infection then are other children. D. Children with iron deficiency anemia are equally as susceptible to infection as our other children
B
An infant wearing 9 kg is in the pediatric intensive care unit following arterial switch surgery. In the past hour, the infant had 16 mL of urine output. Which action should the nurse take? A. Notify the healthcare provider immediately. B. Record the urine output in the medical record. C. Administer fluid bolus immediately. D. Assess for other signs of hypervolemia.
B
When assessing a child after heart surgery to correct a tetralogy of Fallot, which findings should alert the nurse to suspect a low cardiac output? A. Bounding pulses and mottled skin. B. Altered level of consciousness and 30 pulse. C. Capillary refill of two seconds and blood pressure of 96/67. D. Extremities warm to the touch and pale skin
B
Which foods should the nurse encourage a parent to offer to a child with iron deficiency anemia? A. Rice cereal, whole milk, and yellow vegetables. B. Potato, peas, and chicken. C. Macaroni, cheese, and ham. D. Pudding, green vegetables, and rice
B
Which intervention is the greatest priority for the therapeutic management of a child with congestive heart failure caused by pulmonary stenosis? A. Educating the family about the signs and symptoms of infection. B. Administering enoxaparin to improve left ventricular contractility. C. Assessing heart rate and blood pressure every two hours. D. Administering furosemide to decrease systemic venous congestion
D
The nurse is assisting with conscious sedation for a six-year-old undergoing a bone marrow biopsy. The nurse is most important responsibility during the procedure is to: A. Administer the topical anesthetic. B. Keep the parents informed. C. Monitor the client. D. Record the procedure
C
The nurse is caring for a newborn with a large ventricular septal defect. The client has undergone pulmonary artery banding. Which assessment findings indicate that the pulmonary artery band is functioning effectively? A. Capillary refill is less than 30 seconds. B. Urine output is greater than 1 mL/kg/h. C. Breath sounds are clear and equal bilaterally. D. Radial pulses are bounding
C
When teaching a preschool age child how to perform coughing and deep breathing exercises before correct of surgery for tetralogy of Fallot which teaching and learning principles should the nurse address first? A. Organizing information to be taught in a logical sequence. B. Arranging to use actual equipment for demonstrations. C. Building the teaching of the child's current level of knowledge. D. Presenting the information in order from simplest to most complex
C
Which action should the nurse take when providing postoperative nursing care to a child afternoon insertion of a ventriculoperitoneal shunt? A. Administer narcotics for pain control. B. Check the hearing for glucose and protein. C. Monitoring for increased temperature. D. Test cerebrospinal fluid leakage for protein.
C
The parents of a child with sickle cell disease ask the nurse why their child's hemoglobin was normal at birth but now their child has as hemoglobin. Which response by the nurse is appropriate? A. The placenta bars passage of the hemoglobin S from the mother to the fetus. B. The red bone marrow does not begin to produce hemoglobin S until several months after birth. C. Antibodies transmitted from you to the fetus provide the newborn with temporary immunity. D. The newborn has a high concentration of fetal hemoglobin in the blood for sometime after birth
D
Which action should the nurse perform to help alleviate a child's join pain associated with rheumatic fever? A. Maintain the joints in an extended position. B. Apply gentle traction to the child's affected joints. C. Support proper alignment with rolled pillows. D. Use a bed cradle to avoid the weight of bed linens on joints
D
