Peds Exam 2

A child w/ HF is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect? A. Causes vasodilation B. Increases pulmonary vascular resistance C. Promotes diuresis D. Mobilize secretions

A. Causes vasodilation

The nurse is preparing a teaching plan for the family and their 6 y/o son who has just been diagnosed w/ diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan? A. Developing management and decision-making skills B. Educating the parents about Type 1 DM C. Developing a nutritionally sound, 30 day meal plan D. Promoting independence w/ self administration of insulin

A. Developing management and decision-making skills

A child is diagnosed w/ a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? Select all that apply. A. Fruit juice B. Rice milk C. Yogurt D. Non-dairy creamers E. Soy milk F. Oat milk

A. Fruit juice B. Rice milk E. Soy milk F. Oat milk

The nurse is caring for a 9 y/o pt newly diagnosed w/ DM. The pt has polyuria, polydipsia, and weight loss. Which nursing diagnosis will the nurse include in the care plan? Select all that apply. A. Imbalanced nutrition: less than body requirements B. Deficient fluid volume C. Deficient knowledge regarding disease process D. Delayed growth adn development

A. Imbalanced nutrition: less than body requirements B. Deficient fluid volume C. Deficient knowledge regarding disease process

A child is diagnosed w/ Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? Select all that apply. A. Intravenous immunoglobulin B. Ibuprofen C. Acetaminophen (Tylenol) D. Aspirin E. Alprostadil

A. Intravenous immunoglobulin C. Acetaminophen D. Aspirin

The mother a 5 y/o child w/ allergies to a variety of foods including eggs, milk, peanuts, and shellfish asks if her child will "always have these problems." What response by the nurse is most accurate? A. "Sadly, allergies to foods will persist." B. "Most children w/ allergies will outgrow them." C. "We cannot be sure at this point, but most children who are allergic to peanuts will not have this allergy in adulthood." D. "In most cases, allergies to peanuts and shellfish persist into adulthood, but the others may diminish overtime."

D. "In most cases, allergies to peanuts and shellfish persist into adulthood, but the mothers may diminish overtime."

The nurse is developing a plan of care for an infant with heart failure who is receiving digoxin. The nurse would hold the dose of digoxin and notify the physician if the infant's apical pulse rate was: A. 140 bpm B. 120 bpm C. 100 bpm D. 80 bpm

D. 80 bpm Rationale: In an infant, if the apical pulse rate is < 90 bpm, then the dose is held and the provider should be notified.

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? A. Contact the physician B. Offer a snack and administer another dose of digoxin C. Immediately administer another dose C. Administer next dose as ordered in 12 hrs

D. Administer next dose as ordered in 12 hrs

A group of students are reviewing information about the various types of insulin used to treat T1DM. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration. A. Lispro B. Regular C. NPH D. Glargine (Lantus)

D. Glargine (Lantus)

A child is brought to the ED by his parents b/c he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. What would the nurse most likely have assessed for? A. High fever B. Dysphagia C. Toxic appearance D. Inspiratory stridor

D. Inspiratory stridor

A nurse is teaching the parents of a child Dx w/ CF about medication therapy. Which would the nurse instruct the parents to administer orally (w/ meals)? A. Recombinant human DNase B. Bronchodilators C. Anti-inflammatory agnts D. Pancreatic enzymes

D. Pancreatic enzymes

The nurse is examining a 5 y/o boy. Which sign or symptom is a reliable first indication of respiratory illness in children? A. Slow, irregular breathing B. A bluish tinge to the lips C. Increasing lethargy D. Rapid, shallow breathing

D. Rapid, shallow breathing

The nurse is assessing a 13 y/o boy with T2DM. What would the nurse correlate w/ disorder?A. The parents report that their child had "a cold or flu" recently. B. Blood pressure is decreased when checking VS. C. The parents report that their son "can't drink enough water." D. Auscultation reveals Kussmaul breathing.

The parents report that their son "can't drink enough water."

The nurse is providing a class for a group of childcare providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction/teaching? A. "Most allergic reactions will happen within a few minutes of eating a problematic food." B. "If a child has previously eaten a food and not had a reaction, they are not truly allergic to it." C. "Allergic reactions can happen hours after eating something." D. "In addition to hives, some children may also have vomiting and diarrhea when having an allergic reaction to a food."

B. "If a child has previously eaten a food and not had a reaction, they are not truly allergic to it."

When conducting a physical examination of a child w/ suspected Kawasaki disease, which finding would the nurse expect to assess? A. Hirsuitism or striae B. Strawberry tongue C. Malar rash D. Cafe au lait spots

B. Strawberry tongue

A 5 y/o child w/ T1DM is brought to the clinic by his mother for a follow-up visit after having his HbA1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A. 9.0%B. 8.2%C. 7.3%D. 6.9%

B. 8.2% * 6 and younger = 7.5-8.5% * 6-12 = <8% * 13-19 = <7.5% Goal is to prevent hypoglycemia in younger patients, because it can kill you faster.

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm? A. Salmeterol B. Albuterol C. Ipratropium D. Cromolyn

B. Albuterol

A child w/ diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next? A. Administer a sliding scale dose of insulin B. Give 10-15 g of simple CHO C. Offer a complex CHO snack D. Administer glucagon IM

B. Give 10-15 g of simple CHO

The nurse is conducting a physical examination of a child w/ a ventricular septal defect (VSD). Which finding would the nurse expect to assess? A. Right ventricular heave B. Holosystolic harsh murmur along the left sternal border C. Fixed split-second heart sound D. Systolic ejection murmur

B. Holosystolic harsh murmur along the left sternal border * The others are associated w/ atrial septal defects.

A nurse is providing teaching to a caregiver about acetaminophen poisoning. Which of the following information should the nurse include in the teaching? A. Nausea begins 24 hr after ingestion B. Pallor can appear as early as 2 hr after ingestion C. Jaundice will appear in 12 hr if the child consumed a toxic amount D. Children can have 4 g/day of acetaminophen

B. Pallor can appear as early as 2 hr after ingestion. Rationale: Sweating is a manifestation that starts 2 to 4 hr after ingestion.

The nurse is preparing to perform a physical exam on a child w/ asthma. Which technique would the nurse be the LEAST likely to perform? A. Inspection B. Palpation C. Percussion D. Auscultation

B. Palpation

A nurse is preparing a presentation for a group of parents w/ children diagnosed w/ T1DM. The children are all adolescents. What issues would the nurse need to address? Select all that apply. A. Self-monitoring of BG levels B. Feelings of being different C. Deficient decision-making skills D. Body image conflicts

C. Deficient decision-making skills D. Body image conflicts E. Struggle for independence

The nurse suspects that a 4 y/o w/ T1DM is experiencing hypoglycemia based on what findings? Select all that apply. A. Blurred vision B. Dry, flushed skin C. Diaphoresis D. Slurred speech E. Fruity breath odor F. Tachycardia

C. Diaphoresis D. Slurred speech F. Tachycardia * Fruity breath odor (acetone/ketone breath) is associated w/ DKA (BG > 300)

A nurse is caring for a child who is experiencing respiratory distress. Which of the following findings are early manifestations of respiratory distress? (Select all that apply.) A. Braydpnea B. Peripheral cyanosis C. Tachycardia D. Diaphoresis E. Restlessness

C. Tachycardia D. Diaphoresis E. Restlessness

T/F: Tetralogy of FAllot is a defect that involves decreased pulmonary blood flow.

True Tetralogy of FAllot includes: VSD, pulmonary valve stenosis, overriding aorta, and RV hypertrophy