Peds Exam 1

20. What is the earliest age at which a satisfactory radial pulse can be taken in children?

2 years

28. The nurse is testing an infants visual acuity. By which age should the infant be able to fix on and follow a target?

3 to 4 months

18. With the National Center for Health Statistics criteria, which body mass index (BMI)for-age percentiles should indicate the patient is at risk for being overweight?

85th percentile

17. The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which?

95th percentile

25. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which?

A normal finding

6. Turner syndrome is suspected in an adolescent girl with short stature. What causes this?

Absence of one of the X chromosomes

10. Which is characteristic of X-linked recessive inheritance?

Affected individuals are principally males.

9. Parents ask the nurse about the characteristics of autosomal recessive inheritance. Which is characteristic of autosomal recessive inheritance?

Affected individuals have unaffected parents.

6. When the nurse interviews an adolescent, which is especially important?

Allow an opportunity to express feelings.

The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care?

Allow the child to choose the type of juice to drink with the administration of oral medications.

24. A newborn has been diagnosed with congenital adrenal hyperplasia. Which assessment finding should the nurse expect?

Ambiguous genitalia

26. Which explains the importance of detecting strabismus in young children?

Amblyopia, a type of blindness, may result.

13. Chromosome analysis of the fetus is usually accomplished through the testing of which?

Amniotic fluid

33. When auscultating an infants lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as?

An abnormal finding warranting investigation

17. The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which?

Appropriate because of childs age

27. Which ethnic group is at risk for Tay-Sachs disease?

Ashkenazi Jewish

14. The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active?

Ask her, Are you having sex with anyone?

11. The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined?

Ask the adolescent, Why did you come here today?

20. An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions?

Autonomy

4. Which actions by the nurse demonstrate overinvolvement with patients and their families? (Select all that apply.)

Buying clothes for the patients Showing favoritism toward a patient Spending off-duty time with patients and families

1. Which genetic term refers to a person who possesses one copy of an affected gene and one copy of an unaffected gene and is clinically unaffected?

Carrier

The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching?

Childhood obesity is the most common nutritional problem among children.

3. Which is the single most important factor to consider when communicating with children?

Childs developmental level

30. Early diagnosis of congenital hypothyroidism (CH) and phenylketonuria (PKU) is essential to prevent which?

Cognitive impairment

Evidence-based practice (EBP), a decision-making model, is best described as which?

Combining knowledge with clinical experience and intuition

Which is the leading cause of death in infants younger than 1 year in the United States?

Congenital anomalies

9. Which actions by the nurse demonstrate clinical reasoning? (Select all that apply.)

Considering alternative action Using formal and informal thinking to gather data Giving deliberate thought to a patients problem Developing an outcome focused on optimum patient care

Which best describes signs and symptoms as part of a nursing diagnosis?

Cues and clusters derived from patient assessment

1. Which can be directly attributed to a single-gene disorder? (Select all that apply.)

Cystic fibrosis Neurofibromatosis

8. The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators? (Select all that apply.)

Decrease tobacco use. Improve immunization rates. Increase access to health care.

5. Which are included in the evaluation step of the nursing process? (Select all that apply.)

Determination if the outcome has been met Ascertaining if the plan requires modification Selecting alternative interventions if the outcome has not been met

29. During an otoscopic examination on an infant, in which direction is the pinna pulled?

Down and back

Which situation denotes a nontherapeutic nursepatientfamily relationship?

During shift report, the nurse is criticizing parents for not visiting their child.

8. Parents ask the nurse about the characteristics of autosomal dominant inheritance. Which statement is characteristic of autosomal dominant inheritance?

Each child of a heterozygous affected parent has a 50% chance of being affected.

19. The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate?

Evidence from randomized clinical trials showed inconsistent results

8. An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which?

Explain in simple terms how it works.

Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The nurse should respond with which statement?

Family-centered care recognizes that the family is the constant in a childs life.

6. Which should the nurse teach to parents regarding oral health of children? (Select all that apply.)

Fluoridated water should be used. Early childhood caries is a preventable disease. Dental hygiene should begin with the first tooth eruption.

4. Because children younger than 5 years are egocentric, the nurse should do which when communicating with them?

Focus communication on the child.

12. The inheritance of which is X-linked recessive?

Hemophilia A

25. Parents of a child with hemophilia A ask the nurse, What is the deficiency with this disorder? Which correct response should the nurse make?

Hemophilia A has a deficiency in factor VIII.

20. The nurse is reviewing a clients prenatal history. Which prescribed medication does the nurse understand is not considered a teratogen and prescribed during pregnancy?

Heparin sodium (Heparin)

12. The nurse is interviewing the mother of an infant. The mother reports, I had a difficult delivery, and my baby was born prematurely. This information should be recorded under which heading?

History

13. Where in the health history does a record of immunizations belong?

History

2. The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.)

Homelessness Lower income Migrant status

28. A child has been found to have a deficiency in 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase. Which condition is this child at risk for?

Hypercholesterolemia

7. The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.)

Hypertension Dyslipidemia Altered glucose metabolism

15. A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which?

Increased risk for Down syndrome

5. The nurse is interviewing a prenatal client about specific risk factors that are indications for prenatal testing. Which specific risk factors should the nurse note? (Select all that apply.)

Inherited disorder Cytomegalovirus infection Previous stillbirth or neonatal death

7. The nurse is preparing to assess a 10-month-old infant. He is sitting on his fathers lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate?

Initiate a game of peek-a-boo.

26. A child with Prader-Willi syndrome has been hospitalized. Which assessment findings does the nurse expect with this syndrome?

Insatiable hunger

1. The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first?

Introduce him- or herself.

4. Which are signs and symptoms the nurse should assess in the newborn that can indicate an inborn error of metabolism? (Select all that apply.)

Jaundice Poor feeding Metabolic acidosis

7. Which is a sex chromosome abnormality that is caused by the presence of one or more additional X chromosomes in a male?

Klinefelter

The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death?

Late school age and adolescents

4. 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?

Low-set ears

6. The nurse is teaching nursing students about assessment clues to genetic disorders in the newborn. Which should the nurse include in the teaching session? (Select all that apply.)

Low-set ears Epicanthal folds Forehead prominence

The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury?

Male, high activity level, stressful home life

3. The nurse is reviewing the characteristics of autosomal recessive inheritance. Which are true about these characteristics? (Select all that apply.)

Males and females are equally affected. Males and females are equally affected. Males and females are equally affected.

23. The nurse understands that which occurring soon after birth can indicate cystic fibrosis?

Meconium ileus

22. A hospitalized school-age child with phenylketonuria (PKU) is choosing foods from the hospitals menu. Which food choice should the nurse discourage the child from choosing?

Milkshake

The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries?

More deaths occur in males.

32. When assessing a preschoolers chest, what should the nurse expect?

Movement of the chest wall to be symmetric bilaterally and coordinated with breathing

11. A father with an X-linked recessive disorder asks the nurse what the probability is that his sons will have the disorder. Which response should the nurse make?

None of the sons will have the disorder.

14. A couple asks the nurse about the optimal time for genetic counseling. They do not plan to have children for several years. When should the nurse recommend they begin genetic counseling?

Now, if they are members of a population at risk for certain diseases

22. Where is the best place to observe for the presence of petechiae in dark-skinned individuals?

Oral mucosa

29. Phenylketonuria is a genetic disease that results in the bodys inability to correctly metabolize which?

Phenylalanine

The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking?

Preschool

1. Which responsibilities are included in the pediatric nurses promotion of the health and well-being of children? (Select all that apply.)

Promoting disease prevention Providing support and counseling Establishing a therapeutic relationship Participating in ethical decision making

9. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful?

Provide supplies for the child to draw a picture.

15. When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which?

Providing sufficient amino acids

30. What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child?

Pure tone audiometry

The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning?

Purposeful and goal directed

3. The nurse is preparing to complete documentation on a patients chart. Which should be included in documentation of nursing care? (Select all that apply.)

Reassessments Initial assessments Nursing care provided Patients response of care provided

24. The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the childs head (opisthotonos) with pain on flexion. Which is the most appropriate action?

Refer for immediate medical evaluation.

10. Which data should be included in a health history?

Review of systems

23. During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action?

Schedule the child for further evaluation.

31. What is the appropriate placement of a tongue blade for assessment of the mouth and throat?

Side of the tongue

27. Which is the most frequently used test for measuring visual acuity?

Snellen letter chart

3. Which is a birth defect or disorder that occurs as a new case in a family and is not inherited?

Sporadic

31. A breastfed infant has just been diagnosed with galactosemia. The therapeutic management of this includes which?

Stop breastfeeding the infant.

In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years?

Suicide and homicide

The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination?

The United States is ranked last among 27 countries.

5. The nurses approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle?

The child may think the equipment is alive.

17. A couple expecting their first child has a positive family history for several congenital defects and disorders. The couple tells the nurse that they are opposed to abortion for religious reasons. Which should the nurse consider when counseling the couple?

The couple should be encouraged to have recommended diagnostic testing.

19. The nurse is teaching parents of a child with cri du chat syndrome about this disorder. The nurse understands parents understand the teaching if they make which statement?

The crying pattern is abnormal and catlike.

21. The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report?

The education and certification of the nurses on the unit

21. The nurse is teaching student nurses about newborn screening. Which statement made by the student indicates understanding of the teaching?

The initial specimen should be collected as close to discharge as possible.

18. Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their childs cleft lip. Which statement should the nurse give as a response?

The malformation occurs at approximately 5 weeks of gestation; there is no known way to prevent this.

What do mortality statistics describe?

The number of individuals who have died over a specific period

2. The nurse is reviewing the characteristics of autosomal dominant inheritance. Which are true about these characteristics? (Select all that apply.)

The phenotype appears in consecutive generations. Males and females are equally likely to be affected. Children of an affected parent have a 50% chance of being affected.

16. A couple has given birth to their first child, a boy with a recessive disorder. The genetic counselor tells them that the risk of recurrence is one in four. Which statement is a correct interpretation of this information?

The risk factor remains the same for each pregnancy.

2. Which genetic term refers to the transfer of all or part of a chromosome to a different chromosome after chromosome breakage?

Translocation

5. Which abnormality is a common sex chromosome defect?

Turner syndrome

What is the major cause of death for children older than 1 year in the United States?

Unintentional injuries

16. Which parameter correlates best with measurements of total muscle mass?

Upper arm circumference

21. The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which?

Use the large cuff.

2. Which is considered a block to effective communication?

Using clichs

18. The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed?

We know that our child will show caring behaviors.

19. Rectal temperatures are indicated in which situation?

Whenever accuracy is essential