Peds Exam 2

A nurse is caring for a child who has a suspected diagnosis of cystic fibrosis. Which of the following diagnostic tests will confirm the diagnosis?

Sweat chloride test

A nurse is teaching the guardian of a school-age child who has a new prescription for dextroamphetamine/amphetamine to treat ADHD. Which of the following information should the nurse include in the teaching? (Select all that apply.)

"An adverse effect of this medication is central nervous system stimulation." "You should limit your child's intake of caffeine-containing products." "You should give the morning dose after breakfast."

Which strategies should the school nurse recommend implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)? (Select all that apply)

Accompany verbal instructions by written format. Allow more time for testing. Reduce homework and classroom assignments.

Parent guidelines for relieving colic in an infant include: (select all that apply)

Changing infant's position frequently. Avoiding second hand smoke

A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care for the child and includes which intervention in the plan?

Check the physician's prescriptions for the amount of weight to be applied

A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?

Measles (rubeola)

A home health nurse is developing a plan of care for a child who has hemiplegic cerebral palsy. Which of the following goals is the priority for the nurse to include in the plan of care?

Modify the environment.

A child has a right femur fracture caused by a motor vehicle accident and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedal pulse is absent on the right foot. What action should the nurse take?

Notify the physician

A 12 year-old comes into the clinical with left thigh pain and a lump over the distal femur. The nurse is aware that these symptoms can be linked to which of the following medical problems.

Osteosarcoma

The mother of a hospitalized 2 year-old child with viral laryngotracheobronchitis (croup) asks a nurse why the physician did not prescribe antibiotics. The appropriate response is:

"Antibiotics are not indicated unless a bacterial infection is present."

A child who was rescued from a burning building is admitted to the burn unit with a diagnosis of smoke inhalation. For what complication should the nurse monitor?

Tracheobronchial edema

A nurse is caring for a school-age patient who possibly has Reye Syndrome. What are the risk factors for developing Reye Syndrome? (Select all that apply)

Use of aspirin A recent infection with Influenza A A recent infection of chicken pox

A nurse in the pediatric intensive care unit is assessing a 6-month-old infant with bronchiolitis. What physiological responses to this lower respiratory infections does the nurse expect? (Select all that apply)

Wheezing Sternal retractions Prolonged expiratory phase

A nurse is caring for a newborn whose mother voices concerns about sudden infant death syndrome (SIDS). The nurse should include which of the following statements in a discussion with the mother?

"Placing your child on her back when sleeping will decrease the risk of SIDS."

The nurse is caring for an adolescent who had an external fixator placed after suffering a fracture of the wrist during a bicycle accident. Which statement by the adolescent should be expected about separation anxiety?

"I hope my friends don't forget about visiting me."

A mother brings her 2 week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the mother indicates a need for further teaching regarding this disorder?

"I need to bring my infant back to the clinic in 1 month for a new cast."

A nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further teaching?

"I should apply lotion under the brace to prevent skin break down."

A nurse is providing teaching to the parents of a child who has streptococcal pharyngitis about ways to prevent disease transmission. Which of the following responses by the parents indicates an understanding of the teaching?

"We'll discard his toothbrush and buy another."

A nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed ½ cup of juice, 3 oz gelatin, 1 oz of an ice pop, and 20 mL ginger ale. How many mL should the nurse record as the child's fluid intake?

260 mL

A nurse is taking care of a 10-year-old child that weighs 30 kg. The doctor has ordered azithromycin PO 300 mg x 1 dose. Azithromycin comes in an oral suspension 100mg/5 mL in a 15 mL bottle. According to the drug handbook for children 2-15 years of age, 10 mg/kg/day but not to exceed 500 mg/day. How many milliliters should be given?

3 mL

A child has been admitted to the emergency department with an acetaminophen (Tylenol) poisoning. An antidote is being prescribed by the health care provider. Which antidote should the nurse prepare to administer?

Acetylcysteine (Mucomyst)

A nurse in an emergency department is caring for a child who is experiencing an acute asthma attack. Which of the following medications should the nurse expect to administer first?

Albuterol

A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development?

Allow the infant to stand in the crib.

The child has been complaining of joint pain in the knees and jaw for the last 6 weeks, both joints are swollen and warm to touch, but not red. The physician is ordering blood to rule out Junior Idiopathic Arthritis. Which of the following lab tests would the nurse expect the physician to order? (Select all that apply)

Antinuclear antibodies CBC with differential

Kimberly, age 3 years-old, is being admitted for about 1 week of hospitalization. Her parents tell the nurse that they are going to buy her "a lot of new toys, because she will be in the hospital." The nurse's reply should be based on an understanding of which concept?

At this age, children often need the comfort and reassurance of familiar toys from home.

The mother brings her child with cerebral palsy in to the clinic and is afraid the child is having seizures as the child has the slow worm like movements in her arms and she drools when this occurs. The nurse explains to the mother that this is not a seizure but what type of activity?

Athetoid

A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest:

Bacterial conjunctivitis

The home care nurse is performing an assessment on a client who had been diagnosed with an allergy to latex. In determining the client's risk factors associated with the allergy, the nurse questions the client about an allergy to which of the following foods? (Select all that apply)

Bananas Kiwi

A nurse is caring for a school-age child who has a concussion. Which of the following manifestations are late indications of increased intracranial pressure (ICP)? (Select all that apply)

Bradycardia Decreased Motor response

A young boy is found squirting lighter fluid into his mouth. His father calls the emergency department. The nurse taking the call should know that the primary danger is which result?

Bronchitis and chemical pneumonia

The nurse is counseling the parents of a 12-year-old child with Duchenne muscular dystrophy about problems that may develop during adolescence. What body system does the nurse expect might be affected?

Cardiopulmonary

When a person has a second degree burn that blisters, what are the key teaching points? (Select all that apply)

Clean gently with soap and water. Cover with a clean/sterile non-adhesive dressing. Administer pain medications as needed.

A 10 year-old child with asthma is treated for acute exacerbation in the emergency department. A nurse caring for the child monitors for which of the following, knowing that it indicates a worsening of the condition?

Decreased wheezing

A nurse is caring for a child who is dying. Which of the following are findings of impending death? (Select all that apply)

Difficulty swallowing Cheyne-Stokes respirations

An adolescent teen has bulimia. Which assessment finding should the nurse expect to assess?

Erosion of tooth enamel

A nurse is planning to teach the parents of a child recently diagnosed with cystic fibrosis (CF) about why the child has respiratory problems. What should the nurse consider about the underlying pathophysiology?

Excessively thick mucus obstructs airways

A nurse is monitoring a child for manifestations of hemorrhage following a tonsillectomy. Which of the following findings is a manifestation of this postoperative complication?

Frequent swallowing

A mother calls the school nurse saying that her daughter has developed a school phobia. She has been out of school 3 days. The nurse's recommendations should include which intervention?

Immediately return child to school.

An adolescent comes to the clinic with and uneven gait and shoulders not even in height. The physician diagnosis the teen with scoliosis. The nurse know what it the major concern for this person?

Impaired Body Image

A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions should the nurse include in the plan of care?

Implement seizure precautions.

Which is probably the most important criterion on which to base the decision to report suspected child abuse?

Incompatibility between the history and injury observed

A child is admitted with partial-thickness burns on 21% of the total body surface area (TBSA) progresses from the emergent phase to the acute phase of burn care. What is the most important nursing intervention at this time?

Instituting a pain management plan

Amy, age 6 years-old, needs to be hospitalized again because of a chronic illness. The clinic nurse overhears her school-age siblings tell her, "we are sick of Mom always sitting with you in the hospital and playing with you. It isn't fair that you get everything and we have to stay with the neighbors." Which is the nurse's best assessment of this situation?

Jealousy and resentment are common reactions to the illness or hospitalization of a sibling.

A nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions would be included on the list? (Select all that apply)

Keep small toys and sharp objects away from the cast. Contact the physician is the child complains of numbness or tingling in the extremity. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling.

Which assessment findings should the nurse note in a school-age child with Duchenne Muscular Dystrophy (DMD)? (Select all that apply.)

Lordosis Gower sign Waddling gait

A nurse suspects that a 7 month-old infant who is brought to the well-baby clinic for the first time may have a hearing deficit. What behavior leads the nurse to come to this conclusion?

Mother says the infant stopped making verbal sounds about a month ago

What is most important for a nurse to teach the parents of a child with Duchenne muscular dystrophy to do for their child?

Perform ROM exercises

A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?

Place the child in an upright position.

An 11 year-old child has a recurrence of Ewing sarcoma and is verbalizing wanting to stop all treatments. The nurse is aware that the best ethical practice would be which of the following plan?

Plan a meeting with the parents, child, and the medical team to provide an opportunity to discuss the child's concerns.

A nurse is teaching a parent of a preschool child about factors that affect the child's perception of death. Which of the following factors should the nurse include in the teaching?

Preschool children perceive death as temporary.

A 16-year-old boy comes into the office of the school nurse complaining of left hip pain that began when playing basketball in gym class. The boy is in the 85th percentile for height and weight. He complains of increased pain with weight bearing. The nurse observes out-toeing of the left leg with ambulation. Which nursing action is a priority?

Refer the boy to the emergency department.

A previously "potty-trained" 30-month-old child has reverted to wearing diapers while hospitalized. The nurse should reassure the parents that this is normal because of which reason?

Regression is seen during hospitalization.

A patient recently came into the Emergency Department with a diagnosis of Guillain-Barre Syndrome (GBS). What is the priority system to initially monitor for this patient?

Respiratory

A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect:

Shaken-baby syndrome.

The 17 year-old Asian patient comes to the clinic with a butterfly rash on the face, photosensitivity, and recently had strep throat. What diagnosis would you expect the doctor to make?

Systemic Lupus Erythematosus (SLE)

The school nurse is discussing testicular self-examination with adolescent boys. Why is this important?

Testicular tumors during adolescence are generally malignant.

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute" and "I'm not ready." The nurse should recognize this as which description?

This is normal behavior for a school-age child.

The school nurse has provided an instructional session on impetigo to parents of children attending the school. Which statement made by a parent indicates a need for further instruction?

"Lesions most often are located on the arms and chest."

A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make?

"Normal bone growth can be affected."