Peds 5 possible questions

Which areas of evaluation are most accurate when assessing the level of consciousness (LOC) in a pediatric patient admitted from the emergency department? Select all that apply.One, some, or all responses may be correct. a.Reflexes b.Heart sounds c.Eye movement d.Pupil reaction

- Eye movement -Pupil reaction

Which statement is appropriate when addressing the concerns of parents about their daughter's health when their son has X-linked Duchenne muscular dystrophy (DMD)? Select all that apply. a. Your daughter is surely a carrier of the disease. b. It can be a new mutation, and the mother need not be a carrier c. Your daughter may be a carrier and could develop cardiomyopathy d. It is a genetic disease caused by mutation of the gene that encodes dystrophin e. Your son has inherited the disease from b

-" It can be a new mutation, and the mother need not be a carrier." -"Your daughter may be a carrier and could develop cardiomyopathy." -"It is a genetic disease caused by mutation of the gene that encodes dystrophin."

The nurse assesses for which cue when considering increased intracranial pressure in a child? Select all that apply. One, some, or all responses may be correct. a.Nausea b.headache c.Drowsiness dForceful vomiting e.Distended scalp veins f. Increased frontooccipital circumference

-Nausea -headache -Forceful vomiting

Which finding is appropriate when describing a child's postoperative level of consciousness (LOC) as "lethargic"? Select all that apply. One, some, or all responses may be correct. a. Sluggish speech b. Confused about place c. Eyes follow objects only by reflex d. Limited spontaneous movement e. Drowsy and falls asleep quickly

-Sluggish speech -Limited spontaneous movement -Drowsy and falls asleep quickly

Which is not a motor sign indicative of cerebral palsy? A. Stiff limbs B. Floppy tone C. Straight back D. Head control

A. Stiff limbs

Which purpose is appropriate for performing a lumbar puncture (LP)? a. Analyzing the cerebrospinal fluid b. Ruling out subdural effusions c. Detecting electrical activity d. Relieving intracranial pressure

Analyzing the cerebrospinal fluid

Which action is a priority during the postoperative period for a baby with a myelomeningocele who recently had a surgical repair? a. Assessing the surgical site for signs and symptoms of infection b.Administering opioid medications to manage the pain c.Monitoring the baby's bowel and bladder function d. Ensure the baby is in the prone position

Assessing the surgical site for signs and symptoms of infection

which type of cerebral palsy would be expected in the child who suffered birth asphyxia? a. Ataxic b. Athetoid c.Hemiplegic d.Spastic diplegic

Athetoid

For which reason does the nurse conduct a vital sign assessment when a patient begins to experience irregular breathing patterns? a.Heart rate and dyspnea could indicate medication toxicity.. b.Irregular breathing is a precursor to complete apnea. c.Hypothermia can be prevented by monitoring temperature and respirations. d.Dyspnea and hypotension could indicate increased intracranial pressure.

B

The nurse should suspect brain stem damage in a child when which of the following clinical manifestations is present? A. Opisthotonos B. Bilateral fixed pupils C. Acetone odor of breath D. Hyperventilation (deep and rapid breathing)

B. Bilateral fixed pupils

Normalization refers to: A. Return to a system and set of priorities based on family values. B. Establishing a normal pattern of living. C. Integrating children into normal classroom or childcare settings. D. Using a developmental approach.

B. Establishing a normal pattern of living.

What tool would the Emergency Room Nurse use to assess level of consciousness in a newly admitted child? A. Braden Scale B. Glasgow Coma Scale C. Connor Rating Scale D. Pupil response only

B. Glasgow Coma Scale

The nurse realizes that the first step in parental coping with a chronic illness in a child is which of the following? A. Gaining a working knowledge of the disorder B. Learning about available resources C. Experiencing shock and denial D. Establishing a support system

C. Experiencing shock and denial

An adolescent sustained a spinal cord injury in a motor vehicle crash. The nurse suspects the development of autonomic dysreflexia. The most appropriate action of the nurse is which of the following? A. Relieve pain with analgesics B. Administer IV fluids to treat dehydration C. Administer cardiogenic drugs D. Relieve bladder distention

D. Relieve bladder distention

Which nursing approach is appropriate when discussing family participation during hospitalization of a child who has cerebral palsy and is having corrective surgery? a. Assigning the parents specific times to visit their child in the hospital b.Telling the parents to room-in and take part in all aspects of the child's care c. Scheduling nursing care when the parents are out of the child's hospital room d. Discussing the parents' desire to participate in the care of the child

Discussing the parents' desire to participate in the care of the child

Which distinction is appropriate when describing pseudohypertrophic (Duchenne) muscular dystrophy (DMD)? a. Inherited as an autosomal dominant disorder. b. Onset occurs in later childhood and adolescence. c. Identifiable muscle weakness, usually beginning around the age of 3 years. d. Characterized by weakness of the proximal muscles of both the pelvic and shoulder girdles.

Identifiable muscle weakness, usually beginning around the age of 3 years

Which is a sign of increased intracranial pressure in infants? a. Irritability b. Photophobia c. Vomiting accompanied by diarrhea d. Pulsating anterior fontanel

Irritability

Which finding during an assessment of an 8-year-old child with Down syndrome would be immediately reported to the physician? a. Loss of bladder and bowel control b. Gagging on food while eating c. Pooling of mucus in the nose d. Cracked skin with notable redness

Loss of bladder and bowel control

Which nursing action is appropriate when caring for the child with a myelomeningocele in the preoperative stage? a. Applying a heat lamp to facilitate drying and toughening of the sac b. Placing the child on one side to decrease pressure on the spinal cord c. Keeping the skin clean and dry to prevent irritation from diarrheal stools d. Measuring the head circumference and examining the fontanels for signs of developing hydrocephalus

Measuring the head circumference and examining the fontanels for signs of developing hydrocephalus

Which management goal is a priority for an infant born with a myelomeningocele? a. Managing bowel control b. Preserving renal function c. Achieving optimal urinary continence d. Providing antibiotic therapy to prevent infections

Preserving renal function

Which intervention is appropriate when ensuring adequate nutrition of the preterm infant with cerebral palsy? a.Provide feedings by mouth. b.Provide enteral feedings. c.Provide parenteral feedings. d.Provide gastrostomy feedings.

Provide gastrostomy feedings.

Which major goal of therapy is appropriate for children with cerebral palsy (CP)? a.Curing the underlying defect causing the disorder b.Reversing degenerative processes that have occurred c.Preventing spread to individuals in close contact with the children d.Recognizing the disorder early and promoting optimal development

Recognizing the disorder early and promoting optimal development

An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks Girl Scout troop. The nurses response should be based on which knowledge? a. Most activities such as Girl Scouts cannot be adapted for children with CP. b. After-school activities usually result in extreme fatigue for children with CP. Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children c. with CP . Recreational activiti

Recreational activities often provide children with CP with opportunities for socialization and recreation.

Which nursing recommendation is appropriate for the 6-year-old child who was born with a myelomeningocele, has a neurogenic bladder, and whose parents have been performing clean intermittent catheterization? a. Explaining appropriate bladder control b. Teaching the child to perform self catheterization. C. Continuing to have the parents do the catheterization D. Encouraging the family to consider urinary diversion

Teaching the child to perform self catheterization.

Which nursing intervention is appropriate for the parents who stay at the bedside of a 2-year-old child who is unconscious but in stable condition after a car accident? a. Encouraging the parents to hold, talk to, and sing to the child as they usually would b. Avoid ointment on the lips or cleansing of the teeth until swallowing returns c. Suggesting that the parents go home until the child is alert enough to know that they are present d. Positioning the child with proper body alignment and the

a. Encouraging the parents to hold, talk to, and sing to the child as they usually would

Which recommendation is appropriate for the family of the child with newly diagnosed Duchenne (pseudohypertrophic) muscular dystrophy? a. Genetic counseling b. Therapeutic treatment c. Instruction on muscle immobilization. d. Help in finding a nursing facility for long-term care

a. Genetic counseling

Which statement by the nurse is appropriate when parents ask how siblings frequently react chronically ill child? Select all that apply. One, some, or all responses may be correct. a. Harboring feelings of jealousy. b.Withdrawal from other family members. c. Verbalizing fear of contracting the same condition. d. Expression sadness at perceived loss of a playmate.. e. Performing acts of anger at the change of family routine due to affected child's chronic condition.

a. Harboring feelings of jealousy. b.Withdrawal from other family members. c. Verbalizing fear of contracting the same condition. d. Expression sadness at perceived loss of a playmate.. e. Performing acts of anger at the change of family routine due to affected child's chronic condition.

An infant with hydrocephalus who has just undergone surgical placement of a ventriculoperitoneal shunt is monitored for which postoperative hazard? a. Infection b. Hemorrhage c. Poor feeding d. Seizure disorder

a. Infection

Which nuising intervention is appropriate for a school-age child with bacterial meningitis? a. Keeping environmental stimuli to a minimum during hospital Stay b. Avoiding giving pain medications that could dull the sensorium c. Having the child move the head from side to side at least every 2 hours d. Measuring the head circumference to facilitate detection of developing complications

a. Keeping environmental stimuli to a minimum during hospital Stay

Which clinical sign or symptom is associated with spinal cord compression from atlantoaxial instability in a child diagnosed with Down Syndrome? Select all that apply. One, some, or all responses may be correct. a. Loss of motor skills b. Persistent back pain c. Persistent neck pain d. Changes in sensation e. Loss of bladder control

a. Loss of motor skills c. Persistent neck pain d. Changes in sensation e. Loss of bladder control

Which nursing focus is appropriate for an infant who has recently undergone surgery to correct myelomeningocele? SA a. Monitoring vital signs, nourishment, signs of infection, and pain manage b.Caring for the op site and monitoring signs of cerebrospinal fluid leakage c. Educating the parents on hydrocephalus, and developing cognitive skills d. Practicing stretches and exercises to minimize muscle contractures and deformity e. Educating parents on positioning, feeding, skin care, and exercise

a. Monitoring vital signs, nourishment, signs of infection, and pain management b. Caring for the operative site and monitoring signs of cerebrospinal fluid leakage e. Educating parents on positioning, feeding, skin care, and exercise

The nurse is facilitating which concept when explaining to the family of a child with a chronic cardiac condition the importance of enrolling the child in school, pursuing hobbies and recreational interests, and attaining some independence? a.Normalization b. Communication c• Decision making d• Family-centered care

a. Normalization

Which nursing intervention is important in aiding parents who are experiencing stress due to the change of routine related to the care of a child with seizure disorder? Select all that apply. One, some, or all responses may be correct. a.Normalize the life of the child. b.Identify effective coping strategies. c. Identify appropriate support systems. d. Encourage the parents to meditate often. e. Ask the parents to avoid thinking of the future.

a. Normalize the life of the child. b.Identify effective coping strategies. c. Identify appropriate support systems.

Which is a birth defect or disorder that occurs as a new case in a family and is not inherited? a. Sporadic b. Polygenic c. Monosomy d. Association

a. Sporadic

Which statement is appropriate when explaining the diagnosis of dystonic (CP) to the parents of a 2-month-old infant who is showing slow, twisting movements of the trunk and abnormal posture? a. The child has CP, in which upper motor neuron muscular weakness occurs. b. The child has CP, in which altered skeletal muscle performance occurs. C. Your child shows disintegration of movements of the upper extremities. d. Your child has CP, in combination of spastic and dyskinetic CP symptoms occur

a. The child has CP, in which upper motor neuron muscular weakness occurs.

Which explanation by the nurse is appropriate for the parents of a baby with Down syndrome regarding solid feedings? a. Tongue thrusting is a physiologic response to feeding. b. A protruding tongue is an indication that the child does not like the food. c. Use a small, short, straight-handled spoon to place food in the front of the mouth. d. Use a small, short, round-handled spoon to place food in the side of the mouth.

a. Tongue thrusting is a physiologic response to feeding.

Which intervention would be included when caring for a hospitalized child with autism spectrum disorder? Select all that apply. One, some, or all responses may be correct. a. Encouraging the parent to stay with the child b. Engaging the child with frequent eye contact c. Placing the child in a private room d. Avoiding extraneous noises and visual distractions e. Using light touch to provide comfort to the child

a.Encouraging the parent to stay with the child c.Placing the child in a private room d.Avoiding extraneous noises and visual distractions

Which instructional information is appropriate for the parents of a child with cerebral palsy who needs multidisciplinary care and coordination? SA a. Proper handling and adapting to the home environment b. Med admin and the changing role of parents and siblings c. Techniques for immobilizing the child to preserve muscle tone and prevent joint contractures d. Special medicine administration to prevent the child from gagging during meals e. Devising and modifying equipment

a.Proper handling and adapting to the home environment b.Medication administration and the changing role of parents and siblings e. Devising and modifying equipment and activities as per the child's ability

Which specific sign is appropriate in the diagnosis of bacterial meningitis in neonates? Select all that apply. a. Weak cry b. Poor tone c. Nuchal rigidity d. Normal feedings e. Full, tense, bulging fontanel

a.Weak cry b.Poor tone e.Full, tense, bulging fontanel

Which is characteristic of X-linked recessive inheritance? a. There are no carriers. b. Affected individuals are principally males. c. Affected individuals are principally females. d. Affected individuals will always have affected parents.

b. Affected individuals are principally males.

Which nursing intervention is appropriate for the child diagnosed with Down syndrome? a. Decrease the fluid intake of the child. b. Clear the nose using a 'bulb-type syringe. c. Discourage the child from changing positions. d. Administer antibiotics until the symptoms of any infection disappear.

b. Clear the nose using a 'bulb-type syringe.

A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which? a. The need for a therapeutic abortion b. Increased risk for Down syndrome c. Increased risk for Turner syndrome d. The need for an immediate amniocentesis

b. Increased risk for Down syndrome

The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome? a. Hypertonia b. Low-set ears c. Micrognathia d. Long, thin fingers and toes

b. Low-set ears

Gingivitis is a common problem in children with cerebral palsy (CP). What preventive measure should be included in the plan of care? a. High-carbohydrate diet b. Meticulous dental hygiene c. Minimum use of fluoride d. Avoidance of medications that contribute to gingivitis

b. Meticulous dental hygiene

he parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching? a. Patterning b. Positions to reduce spasticity c. Stretching exercises after meals d. Topical analgesics for muscle spasms

b. Positions to reduce spasticity

What type of cerebral palsy (CP) is the most common type? a. Ataxic b. Spastic c. Dyskinetic d. Mixed type

b. Spastic

Which diagnostic testing provides the most accurate results when assessing head injuries in children? a. Magnetic resonance imaging (MRI) b.Computed tomography (CT) scan c. Lumbar puncture d. Electroencephalogram

b.Computed tomography (CT) scan

Which clinical manifestation suggests increased intracranial pressure in an infant? Select all that apply. a. Nausea b. Drowsiness c. Poor feeding d. Tense, bulging fontanel e. Irritability and restlessness

b.Drowsiness c. Poor feeding d.Tense, bulging fontanel e.Irritability and restlessness

An 8-month-old infant with suspected meningitis will be evaluated for which sign? Select all that apply. a.Ataria b.Irritability c. Incontinence d.Refusal to eat or nurse e.Increased head circumference

b.Irritability d.Refusal to eat or nurse e.Increased head circumference

Which characteristic is appropriate when identifying that a 2-year-old child has a communication impairment? a. Uses I, me, and you b.Uses gestures consistently c. Uses a vocabulary of 300 words d. Uses two-word to three-word phrases

b.Uses gestures consistently

A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that hes like a rag doll. He doesnt cuddle up to me like my other babies did. What is the nurses best interpretation of this lack of clinging or molding? a. Sign of detachment and rejection b. Indicative of maternal deprivation c. A physical characteristic of Down syndrome d. Suggestive of autism associated with Down syndrome

c. A physical characteristic of Down syndrome

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area with onset before age 3 years? a. Parallel play b. Gross motor development c. Ability to maintain eye contact d. Growth below the fifth percentile

c. Ability to maintain eye contact

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge? a. Affected children have some degree of cognitive impairment. b. Around 20% of affected children have normal intelligence. c. About 45% of affected children have normal intelligence. d. Cognitive impairment is expected if motor and sensory deficits are severe.

c. About 45% of affected children have normal intelligence.

Which nursing action is a priority for a child with cerebral palsy (CP) who has difficulty with mobility? a Encourage the child to stay in bed to prevent injury. b. Provide a wheelchair for the child to use at all times. c. Develop a physical therapy plan with the health care team. d. Use restraints to prevent excessive movement by the child.

c. Develop a physical therapy plan with the health care team.

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? a. Low-pitched cry b. Sunken fontanel c. Diplopia, blurred vision d. Increased blood pressure

c. Diplopia, blurred vision

Which nursing information is appropriate to include in the plan of care for a 6-year-old child with an autism spectrum disorder who is hospitalized for a surgical procedure?a. Urge the parents to go home and get some rest. b. Use therapeutic touch when providing care to the child. c. Encourage the parents to bring in the child's favorite toys. d. Place the child in a room with another 6-year-old child for company.

c. Encourage the parents to bring in the child's favorite toys

Which posturing finding is appropriate with severe dysfunction of the cerebral cortex or lesions to corticospinal tracts above the brainstem? a.Primitive b.Extension c. Flexion d.Unilateral extension posturing

c. Flexion

Spastic cerebral palsy (CP) is characterized by which clinical manifestations? a. Athetosis, dystonic movements b. Tremors, lack of active movement c. Hypertonicity; poor control of posture, balance, and coordinated motion d. Wide-based gait; poor performance of rapid, repetitive movements

c. Hypertonicity; poor control of posture, balance, and coordinated motion

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)? a. It has an autosomal dominant inheritance pattern. b. Onset occurs in later childhood and adolescence. c. It is characterized by presence of Gower sign, a waddling gait, and lordosis. Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 d. years.

c. It is characterized by presence of Gower sign, a waddling gait, and lordosis.

Which nursing intervention is appropriate for neurologic assessment of children below 2 years of age? a. Collect family and health history to identify any genetic disorders. b. Evaluate the size and shape of the head to identify any neurologic dysfunction. c. Observe spontaneous and elicited reflex responses to evaluate neurologic status. d. Employ sophisticated techniques to assess acquisition of developmental milestones.

c. Observe spontaneous and elicited reflex responses to evaluate neurologic status.

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do? a. Set up a tray with equipment the same size as for adults. b. Apply EMLA to the puncture site 15 minutes before the procedure. c. Prepare the child for conscious sedation being used for the procedure. d. Reassure the parents that the test is simple, painless, and risk free.

c. Prepare the child for conscious sedation being used for the procedure.

Which recommendation is appropriate for the parents of a child with Down syndrome whose genetic testing shows that the disorder was caused by chromosomal translocator a. The mother should be tested if she is over age 35 years. b. No further genetic testing of the family is indicated. c. The parents should be tested because the translocation might be inherited. d. The child should be retested to confirm the diagnosis of Down syndrome.

c. The parents should be tested because the translocation might be inherited.

Which genetic term refers to the transfer of all or part of a chromosome to a different chromosome after chromosome breakage? a. Trisomy b. Monosomy c. Translocation d. Nondisjunction

c. Translocation

Preferring to play alone, unable to maintain eye contact, and failure to interact with others would be reasons to assess a child for which condition? a. Glaucoma b. Down syndrome c. Hearing impairment d. Autism spectrum disorder (ASD)

d. Autism spectrum disorder (ASD)

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? a. Suction the child frequently. b. Turn the childs head side to side every hour. c. Provide environmental stimulation. d. Avoid activities that cause pain or crying.

d. Avoid activities that cause pain or crying.

Which statement is correct regarding growth and development in children with cognitive impairment (CI)? a. Children with CI require multi-step directions b.Negative attitudes are the best discipline for the child c. Cognitively impaired children learn abstract ideas quickly d. Early systematic programs aid cognitively impaired .children to achieve full potential

d. Early systematic programs aid cognitively impaired .children to achieve full potential

Which treatment is appropriate to ease spasticity in a child with cerebral palsy? a. Exercise b. Diuretic medication c. Anticonvulsant medication d. Implanted medication pumps

d. Implanted medication pumps

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition? a. Posturing b. Vital signs c. Focal neurologic signs d. Level of consciousness

d. Level of consciousness

What is the most common cause of cerebral palsy (CP)? a. Central nervous system (CNS) diseases b. Birth asphyxia c. Cerebral trauma d. Neonatal encephalopathy

d. Neonatal encephalopathy

What is a major goal of therapy for children with cerebral palsy (CP)? a. Cure the underlying defect causing the disorder. b. Reverse the degenerative processes that have occurred. c. Prevent the spread to individuals in close contact with the child. d. Recognize the disorder early and promote optimum development.

d. Recognize the disorder early and promote optimum development.

Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should be included in the childs care? a. Delay feeding solid foods until the tongue thrust has stopped. b. Modify the diet as necessary to minimize the diarrhea that often occurs. c. Provide calories appropriate to the childs mental age. d. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.

d. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.

he mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the childs younger brother had when he was an infant. The nurse should base a response on which information? a. Meningitis rarely occurs during infancy. b. Often a genetic predisposition to meningitis is found. c. Vaccination to prevent all types of meningitis is now available. d. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.

d. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.

Which nursing intervention is appropriate to prevent increased intracranial pressure (ICP an unconscious child? a. Frequent suctioning b. Providing environmental stimulation c. Turning the head from side to side every hour d.Avoiding activities that result in pain or crying

d.Avoiding activities that result in pain or crying

Which level of consciousness is appropriate for the young child who is arousable with stimulation after a head injury? a.Stupor b.Lethargy c. Confusion d.Obtundation

d.Obtundation

Which nursing action is appropriate when caring for a young child with a head injury whose pupils have suddenly become fixed and dilated? a. Reorientation of the patient b. Glasgow Coma Scale assessment c. Institution of seizure precautions d.Preparations for a neurologic emergency

d.Preparations for a neurologic emergency

A child who walks on the toes with flexion at the knees and hips, and has a stiff gait with slow, deliberate steps is exhibiting signs of which condition? a. Ataxia b. Cerebellar gait c. Extrapyramidal gait d. Spastic paraplegic gait

d.Spastic paraplegic gait