PEDs Exam #2

What age group are the most vulnerable for child maltreatment? a) Infants & toddlers b) Preschoolers c) School-age children d) Adolescents

Answer: a - Infants & Toddlers The youngest children are the most vulnerable because they can not defend themselves and lack the cognitive ability to reason with the abuser.

Which of the following drugs is an angiotensin-converting enzyme (ACE) inhibitor? a) Furosemide (Lasix) b) Captopril (Capoten) c) Chlorothiazide (Diuril) d) Spironolactone (Aldactone)

Answer: b Captopril (Capoten) Captopril is an ACE inhibitor. Furosemide is a loop diuretic. Chlorothiazide works on the distal tubules. Spironolactone blocks the action of aldosterone and is a potassium-sparing diuretic.

The nurse should recognize that congestive heart failure (CHF) is which of the following? a) Disease related to cardiac defects b) Consequence of an underlying cardiac defect c) Inherited disorder associated with a variety of underlying defects d) Result of diminished electrical conduction in an abnormal myocardium

Answer: b Consequence of an underlying cardiac defect CHF is the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures to meet the body's metabolic demands. CHF is not a disease but rather a result of the inability of the heart to pump efficiently. CHF is not inherited. CHF occurs most frequently secondary to congenital heart defects in which structural abnormalities result in increased volume load or increased pressures on the ventricles.

Abdominal circumferences are monitored on a child with progressive abdominal distention secondary to a bowel obstruction. The appropriate procedure for assessment includes: a) Measuring abdomen after feedings b) Marking the point of measurement with a pen c) Measuring circumference at the symphysis pubis d) Using a new tape measure with each measurement to assure accuracy

Answer: b Marking the point of measurement with a pen Pen marks on either side of the tape measure allow the nurse to measure the same spot on the child's abdomen at each assessment. The child most likely will be kept NPO (nothing by mouth) if a bowel obstruction is present. If the child is being fed, the assessment should be done before feedings. The symphysis pubis is too low. Usually the largest part of the abdomen is at the umbilicus.

Which of the following is a high-fiber food that the nurse could recommend for a child with chronic constipation? a) White rice b) Popcorn c) Fruit juice d) Ripe bananas

Answer: b Popcorn Popcorn is a high-fiber food. Refined rice is not a significant source of fiber. Unrefined brown rice is a fiber source. Fruit juices are not a significant source of fiber. Raw fruits, especially those with skins and seeds, other than ripe bananas, have high fiber.

Which of the following parental characteristics is not a predisposing factor for physical abuse of children? a) Being a single parent b) Low self esteem c) Religious background d) Age

Answer: c - Religious background Child abuse occurs across all socioeconomic, religious, cultural, racial, and ethnic groups. Being a young parent, including teen parents, a single parent, or having low self-esteem are predisposing factors for physical abuse of children.

After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds? a) 15 b) 30 c) 60 d) 120

Answer: c 60 seconds The heart rate is counted for a full minute to determine whether arrhythmias or bradycardia is present. Fifteen to thirty seconds are too short for accurate assessment. Sixty seconds is sufficient to assess heart rate and rhythm.

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. Which of the following is appropriate to relieve the abdominal discomfort during the evaluation? a) Place in Trendelenburg position b) Apply moist heat to the abdomen c) Allow to child to assume position of comfort d) Administer a saline enema to cleanse the bowel

Answer: c Allow child to assume position of comfort The child should be allowed to take a position of comfort, usually with the legs flexed. The Trendelenburg position will not help with the discomfort. If appendicitis is a possibility, administering laxative or enemas or applying heat to the area is dangerous. Such measures stimulate bowel motility

Risk factors for child neglect are: a) lack of knowledge of child's needs b) lack of resources c) caregiver substance abuse d) All of the above

Answer: d - All of the above Poor parenting skills (lack of knowledge), poverty (lack of resources), and substance abuse are risk factors for child abuse. Remember: Parenting is a learned skill and is often learned through role modeling. Those will poor role models may have difficulty parenting their own children.

The infant with congestive heart failure (CHF) has a need for: a) Decreased fat b) Increased fluids c) Decreased protein d) Increased calories

Answer: d Increased calories Infants with CHF have a greater metabolic rate because of poor cardiac function and increased heart and respiratory rates. Their caloric needs are greater than those of average infants, yet their ability to take in calories is diminished by their fatigue. The diet should include increased protein and increased fat to facilitate the child's intake of sufficient calories. Fluids must be carefully monitored because of the CHF.The infant with congestive heart failure (CHF) has a need for:

An adolescent with irritable bowel syndrome comes to see the school nurse. The nurse should know that: a) A low fiber diet may be helpful b) Milk products are a contributing factor c) Pantoprazole (a proton pump inhibitor) is effective in treatment d) Stress management may be helpful

Answer: d Stress management may be helpful Irritable bowel syndrome is believed to involve motor, autonomic, and psychologic factors. Stress management, environmental modification, and psychosocial intervention may reduce stress and gastrointestinal symptoms. A high-fiber diet with psyllium supplement is often beneficial. Milk products can exacerbate bowel problems caused by lactose intolerance. Antispasmodic drugs, antidiarrheal drugs, and simethicone are beneficial for some individuals. Proton pump inhibitors have no effect.

Most common intestinal parasites in the United States

Giardiasis Pinworms

One of the most common intestinal parasitic pathogens in the United States acquired from a contaminated water source such as a lake or swimming pool is: a) Tinea capitis b) Giardia intestinalis c) Pediculosis capitis d) Enterobiasis

b) Giardia intestinalis

which disease would cause the pt to have a "slapped cheek" appearance? a) Diptheria b) influenza c) chickenpox d) Erythema infectiosum

d) Erythema infectiosum

Enterobiasis (Pinworms) is associated with which principle symptom? a) nasal flaring b) eye itching c) diarrhea d) intense perianal itching

d) intense perianal itching

How is giardiasis transmitted?

direct contact with contaminated water or food

extravasation

escape of fluid from a blood vessel into surrounding tissue vesicant = cellular damage

infiltration IV

is not vesicant fluid goes into subQ tissue, no damage, just puffy/uncomfortable

Erythema infectiosum also known as

Fifth disease

A disease that has Koplic spots on mucosa that appear on day 3 or 4 of illness... a) Measles b) influenza c) chickenpox d) Erythema infectiosum

Measles (rubella)

Which childhood vaccine provides some protection against bacterial meningitis, epiglottitis, and bacterial pneumonia? a) Hib vaccine b) Hepatitis B vaccine c) Varicella vaccine d) Influenza vaccine

a) Hib vaccine

A pt presents with a Bulls neck... which disease would you suspect? a) Diptheria b) influenza c) chickenpox d) RSV

a) diphtheria

what is the medication of choice for scarlet fever?

penicillin (antibiotic)

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which of the following complications? a) Hypoxemia b) Right-to-left shunt of the blood c) Decreased workload on the righ side of the heart d) Pulmonary vascular congestion

Answer: d Pulmonary vascular congestion In PDA, blood flows from the higher pressure aorta into the lower pressure pulmonary vein, resulting in increased pulmonary blood flow. This creates pulmonary vascular congestion. Hypoxemia usually results from defects with mixed blood flow and decreased pulmonary blood flow. The shunt is from left to right in a PDA. The closure would stop this. There is increased workload on the left side of the heart with a PDA.

Conjunctivitis affects newborns and is often due to________?

Chlamydia trachomatis or Neisseria gonorrhoeae

what is the tx for giardiasis?

Flagyl and Tindamax + prevention of reoccurance

What causes scarlet fever?

Group A beta-hemolytic streptococci

How is Enterobiasis (Pinworms) transmitted?

Inhalation or ingestion of eggs from contaminated hands

what age group is most distressed by venipunctures?

Toddlers

Clinical manifestation of scarlet fever that are prominent?

STRAWBERRY TOUNGE OR SANDPAPER LIKE RASH