Peds Exam 3
A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur? A)Loud without a thrill B)Loud with a precordial thrill C)Soft and easily heard D)Loud, audible with a stethoscope
A
After teaching a class on the role of white blood cells in infection, the nurse determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? A)Neutrophils B)Eosinophils C)Basophils D)Lymphocytes
A
The nurse is auscultating the bowel sounds of a 4-year-old child and documents hypoactive bowel sounds. What might this finding indicate? a. Obstruction b. Gastroenteritis c. Diarrhea d. Infection
A
The nurse is caring for a 3-year-old girl with short bowel syndrome as a result of trauma to the small intestine. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. How should the nurse respond? A) "I will help you become an expert on your daughter's care." B) "You must learn how to care for your daughter at home." C) "You really need the support of your husband." D) "There is a lot to learn and you need a positive attitude."
A
The nurse is taking a health history of an 11-year-old girl with recurrent abdominal pain. Which response would lead the nurse to suspect irritable bowel syndrome? A) "I always feel better after I have a bowel movement." B) "I don't take any medicine right now." C) "The pain comes and goes." D) "The pain doesn't wake me up in the middle of the night."
A
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
A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as: A) hypospadias. B) epispadias. C) varicocele. D) hydrocele.
B
A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? A) Klebsiella B) Escherichia coli C) Staphylococcus aureus D) Pseudomonas
B
The nurse is preparing a teaching plan for the parents of a child who has been diagnosed with a congenital heart defect. What would the nurse be least likely to include? A) Daily weight assessment B) Maintenance of strict bed rest C) Prevention of infection D) Signs of complications
B
The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). What would the nurse encourage the parents to avoid? A) Liberal fluid intake B) Caffeine C) Cranberry juice D) Cotton underwear
B
The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A) Cloudy yellow B) Cola colored C) Pale to almost clear urine D) Light orange to moderately yellow colored
B
The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A) Cloudy yellow B) Cola colored C) Pale to almost clear urine D) Light orange to moderately yellow colored
B
The nurse observes a child for neurologic disorders. What is the earliest indicator of improvement or deterioration of neurologic status? a. Vital signs b. Level of consciousness c. Motor function d. Reflexes
B
The parents of a boy diagnosed with Hirschsprung disease are anxious and fearful of the upcoming surgery. The mother states, "I'm worried about having to care for our son's ostomy." Which intervention would be most helpful for the parents? A) Explaining to them about the diagnosis and surgery B) Having a wound, ostomy, and continence nurse meet with them C) Reinforcing that the ostomy will be temporary D) Teaching them about the medications used to slow stool output
B
What would the nurse include when teaching parents how to prevent otitis externa? A)Daily ear cleaning with cotton swabs B)Wearing earplugs when swimming C)Using a hair dryer on high to dry the ear canals D)Using hydrogen peroxide to dry the canal skin
B
When conducting a physical examination of a child with suspected Kawasaki disease, which finding would the nurse expect to assess? A) Hirsutism or striae B) Strawberry tongue C) Malar rash D) Café au lait spots
B
•The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which test as most helpful in determining the extent of the child's hypoxia? •A) Pulmonary function test •B) Pulse oximetry •C) Peak expiratory flow •D) Chest radiograph
B
Auscultation of a child's heart reveals a loud murmur with a precordial thrill. The nurse documents this as which grade? A) Grade II B) Grade III C) Grade IV D) Grade V
C
Bacterial pneumonia is suspected in a 4-year-old boy with fever, headache, and chest pain. Which assessment finding would most likely indicate the need for this child to be hospitalized? A) Fever B) Oxygen saturation level of 96% C) Tachypnea with retractions D) Pale skin color
C
The mother of a 4-year-old boy has contacted the healthcare provider's office. She reports her son was exposed to someone with chickenpox. She has inquired about when her son may show if he has gotten the disease. What information should be provided? A)The illness should be seen in a week if he has been exposed. B)Symptoms of the disease should show up within 24 to 48 hours of exposure. C)The incubation period for the disease is between 10 and 21 days. D)Younger children will have longer periods of incubation.
C
The nurse is assisting with lab testing to measure the type of protein produced in the liver that is present during episodes of acute inflammation. Which of the following tests is the nurse performing? a. Complete blood count b. Erythrocyte sedimentation rate c. C-reactive protein d. Blood culture and sensitivity
C
The nurse is caring for a 2-month-old infant who has been diagnosed with acute heart failure. The nurse is providing teaching about nutrition. Which statement by the mother indicates a need for further teaching? A)"The baby may need as much as 150 calories/kg/day." B)"Small, frequent feedings are best if tolerated." C)"I need to feed him every hour to make sure he eats enough." D)"Gavage feedings may be required for now."
C
A 16-year-old boy reports to the school nurse reporting headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis? A) Fixed and dilated pupils B) Frequent urination C) Sunset eyes D) Sunlight is "too bright"
D
A 16-year-old boy reports to the school nurse reporting headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis? A)Fixed and dilated pupils B)Frequent urination C)Sunset eyes D)Sunlight is "too bright"
D
The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever? A)98.2° F (36.8° C) B)99.2° F (37.3° C) C)100° F (37.8° C) D)100.8° F (38.2° C)
D
The nurse is assisting with testing on a newborn suspected of having a neural tube defect. Which of the following diagnostic tests would be used to confirm this condition? a. Lumbar puncture b. Electroencephalogram c. Fluoroscopy d. Magnetic resonance imaging
D
The nurse is caring for a 4-year-old boy who has undergone an appendectomy. The child is unwilling to use the incentive spirometer. Which approach would be most appropriate to elicit the child's cooperation? A) "Can you cough for me please?" B) "You must blow in this or you might get pneumonia." C) "If you don't try, I will have to get the healthcare provider." D) "Can you blow this cotton ball across the tray?"
D
The nurse is caring for a child with cystic fibrosis. Which of the following treatments would be used to promote mucus clearance through percussion or vibration? a. Suctioning b. Chest tube c. Bronchoscopy d. Chest physiotherapy
D
The nurse is examining a 5-year-old 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
The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which condition would the nurse explain as resolving by itself without the use of antibiotics? A) Blepharitis B) Hordeolum C) Corneal abrasion D) Chalazion
D
The nurse is percussing the chest of a child with a suspected respiratory disorder. What sound might the nurse note that would indicate pneumonia? a. Decreased fremitus b. Dull sound c. Tympany d. Hyperresonance
D
A child requires supplemental oxygen therapy at 8 liters per minute. Which delivery device would the nurse most likely expect to be used? A)Simple mask B)Venturi mask C)Nasal cannula D)Oxygen hood
A
A child with heart failure is receiving supplemental oxygen. The nurse understands that in addition to improving oxygen saturation, this intervention also has what effect? A)Cause vasodilation B)Increase pulmonary vascular resistance C)Promote diuresis D)Mobilize secretions
A
The nurse is providing care to a child with pancreatitis. When reviewing the child's laboratory test results, what would the nurse expect to find? Select all that apply. A) Leukocytosis B) Decreased C-reactive protein C) Elevated serum amylase levels D) Positive stool culture E) Decreased serum lipase levels
A, C
A 10-year-old boy is seen in the emergency department after falling down a flight of stairs and hitting his head. The child will be monitored overnight for complications. Which occurrence in the coming hours will warrant further assessment? A) The child reports a backache. B) The child is increasingly irritable with his mother and caregivers. C) The child refuses offers of snacks. D) The child reports his stomach is upset.
B
A 10-year-old boy is seen in the emergency department after falling down a flight of stairs and hitting his head. The child will be monitored overnight for complications. Which occurrence in the coming hours will warrant further assessment? A)The child reports a backache. B)The child is increasingly irritable with his mother and caregivers. C)The child refuses offers of snacks. D)The child reports his stomach is upset.
B
A nurse is examining a 7-year-old boy with hordeolum. Which would the nurse expect to find? A)Redness B)Scaling C)Pain D)Edema
C
The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding? A)Indications of increased intracranial pressure B)An increase in the blood glucose level C)A decrease in the liver enzymes D)A presence of protein in the urine
A
A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which finding? A)Children's demand for oxygen is lower than that of adults. B)Children develop hypoxemia more rapidly than adults do. C)An increase in oxygen saturation leads to a much larger decrease in pO2. D)Children's bronchi are wider in diameter than those of an adult.
B
The nurse is assessing a 5-year-old girl who is anxious, has a high fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what action would be least appropriate for the nurse to perform? A)Providing 100% oxygen B)Visualizing the throat C)Having the child sit forward D)Auscultating for lung sounds
B
A group of nursing students are reviewing information about childhood infectious diseases. The students demonstrate understanding of this information when they identify which disease as a common childhood exanthem? A)Mumps B)Rabies C)Rubella D)West Nile virus
C
A nurse is instructing a parent on how to obtain a stool culture for ova and parasites from a child with diarrhea. What would the nurse include in the teaching plan? A)"Give the child bismuth and then collect the next specimen." B)"Obtain the specimen from the toilet after the child has a bowel movement." C)"Keep the specimen from coming into contact with any urine." D)"Bring the specimen to the laboratory on the third day."
C
A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would be the priority? A)Impaired skin integrity related to trauma secondary to pruritus and scratching B)Fluid volume deficit related to increased metabolic demands and insensible losses C)Social isolation related to infectivity and inability to go to the playroom D)Deficient knowledge related to how infection is transmitted
C
The nurse hears wheezing when auscultating a 4-year-old. Which condition would the nurse most likely rule out based on the assessment findings? A) Bronchiolitis B) Asthma C) Influenza D) Cystic fibrosis
C
The nurse is caring for a 6-year-old visually impaired boy and is about to begin the physical examination. Which intervention would be most appropriate to promote effective communication with the child? A) Show him the stethoscope. B) Describe the examination room. C) Use his name before touching him. D) Allow him to explore the exam room.
C
The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition? A)Multiple corrective surgeries to slowly remove diseased parts of his brain B)Physical, occupational, and speech therapy to maximize his potential C)Support for maintaining self-esteem because of his altered lifestyle D)Hyperventilation therapy to counteract the periods of decreased oxygenation
C
The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? A) Encouraging consumption of fruit juice B) Offering Kool-Aid or popsicles as tolerated C) Encouraging milk products to boost caloric intake D) Maintaining the intravenous (IV) fluid rate as ordered
D
The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? A) Contact the healthcare provider. B) Offer a snack and administer another dose. C) Immediately administer another dose. D) Administer next dose as ordered in 12 hours.
D
The nurse is instructing the parents of a school-age child with an eye disorder how to care for her eye. Which condition would the nurse explain as resolving by itself without the use of antibiotics? A)Blepharitis B)Hordeolum C)Corneal abrasion D)Chalazion
D
The nurse is percussing the abdomen of a child and notes a dull sound indicating a full bladder. At what anatomic location would this sound be heard? a. Over the spleen b. At the right costal margin c. Over the kidneys d. Above the symphysis pubis
D
While reviewing various studies about the use of antipyretics possibly prolonging illness, the nurse notes that there are benefits to their use for the child with fever. What would the nurse identify as the best explanation related to the benefits of antipyretics in children? A)They slow the growth of bacteria. B)They increase neutrophil production. C)They encourage T-cell proliferation. D)They help decrease fluid requirements.
D
he nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. The nurse would most likely suspect sinusitis in which child? A)A 2-year-old with thin watery nasal discharge B)A 3-year-old with sneezing and coughing C)A 5-year-old with nasal congestion and sore throat D)A 7-year-old with halitosis and thick, yellow nasal discharge
D
The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for what finding? A) Indications of increased intracranial pressure B) An increase in the blood glucose level C) A decrease in the liver enzymes D) A presence of protein in the urine
A
The nurse is teaching the mother of a 5-year-old boy with a history of impaction how to administer enemas at home. Which response from the mother indicates a need for further teaching? A) "I should position him on his abdomen with knees bent." B) "He will require 250 to 500 mL of enema solution." C) "I should wash my hands and then wear gloves." D) "He should retain the solution for 5 to 10 minutes."
A
The nurse is caring for a child that just returned from a coronary arteriogram in which the catheter was placed through the left femoral artery. Which nursing actions demonstrate knowledge of the procedure? Select all that apply. A)The nurse allows the client up to the bathroom only. B)The nurse assesses the dorsalis pedis pulse in the left foot. C)The nurse assesses the puncture site frequently. D)The nurse tells the parents that the healthcare provider will discuss the results of the procedure with them. E)The nurse assesses the client's vital signs every 8 hours.
B, C, D
The nurse is developing a teaching plan for the mother of a 4-year-old girl with cold and fever. What would the nurse include in this teaching plan? A)Keeping the child covered and warm B)Calling the healthcare provider if the child's fever lasts more than 36 hours C)Ensuring fluid intake to prevent dehydration D)Observing for changes in alertness resulting from brain damage
C
The nurse is performing a diagnostic test to determine the extent of tympanic membrane movement. What is the name for this test? a. Culture of ear discharge b. Tympanic fluid culture c. Tympanometry d. Tympanostomy
C
The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for promoting healing and preventing further skin breakdown? A) Cleaning the area well with a scented diaper wipe B) Applying a barrier/healing cream or paste on skin C) Keeping the bladder moist and covered with a sterile bag D) Covering the area with sterile gauze pads after tub baths
B
The nurse is conducting a physical examination of a child with a ventricular septal defect. 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
The nurse is conducting a physical examination of a child with suspected Crohn disease. Which finding would be the most suspicious of Crohn disease? A) Normal growth patterns B) Perianal skin tags or fissures C) Poor growth patterns D) Abdominal tenderness
B
True or false: The nurse explains to parents of a child with a fever that antipyretics will help change the course of the infection
False
True or False: The nurse caring for children with visual disorders accurately states that the most common visual difficulty seen in children is refractive errors.
True
A nurse develops a plan of care for a child that includes patching the eye. This plan of care would be most appropriate for which condition? A)Astigmatism B)Hyperopia C)Myopia D)Amblyopia
D
True or False: The nurse auscultates the fistula for the presence of a bruit in a child receiving chronic hemodialysis. This is a desired normal finding.
True
A nurse is developing a plan of care for a child who is admitted to the hospital for surgery. The child is visually impaired. What would be most appropriate for the nurse to include in the child's plan of care? Select all that apply. A)Explaining instructions using simple and specific terms the child understands B)Allowing the child to explore the postoperative equipment with his hands C)Touching the child on his shoulder before letting the child know someone is there D)Using the child's body parts to refer to the area where he may have postoperative pain E)Speaking to the child in a voice that is slightly louder than the usual tone of voice
A, B, D
A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which findings? Select all that apply. A)Complaints of stiff neck B)Photophobia C)Absent headache D)Negative Brudzinski sign E)Vomiting
A, B, E
The parents of a 7-month-old child with an infection ask the nurse about how to treat their child's fever. After providing teaching, the parents voice understanding with which statements? Select all that apply. A)"Unless my child develops a fever over 102.2°F, I don't need to make an appointment with the healthcare provider." B)"Having a temperature over 38°C puts my child at risk for the infection spreading to the bloodstream." C)"I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." D)"Even though people get frightened, fevers are not a bad thing during an infection unless it gets too high." E)"Any fever is dangerous and can cause serious damage to brain cells if it goes on too long."
A, C, D
A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions? A)"Expect his headache to get worse initially and then disappear." B)"Wake him every 2 to 4 hours to check his movement and responses." C)"Call your medical provider if he vomits more than five times." D)"Any watery fluid draining from his ears is normal."
B
A child is diagnosed with a helminthic infection. Which treatments would the nurse expect to be prescribed? Select all that apply. A)Erythromycin B)Albendazole C)Pyrantel pamoate D)Acyclovir E)Metronidazole F)Permethrin
B, C
A group of nursing students are reviewing information about inflammatory bowel disease in preparation for a class discussion on the topic. The students demonstrate understanding of the material when they identify which characteristics of Crohn disease? Select all that apply. A) Distributed in a continuous fashion B) Most common between the ages of 10 and 20 years C) Elevated erythrocyte sedimentation rate D) Low serum iron levels E) Tenesmus F) Loss of haustra within bowel
B, C, D
The nurse is assessing a child with acute poststreptococcal glomerulonephritis. What would the nurse expect to assess? Select all that apply. A) Irritability B) Abdominal pain C) Hypertension D) Crackles E) Polyphagia
B, C, D
A 5-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? A)Hyperextending the child's head while placing him on his side B)Using a tongue blade to pry open the child's jaw C)Loosening the child's clothing to ensure a patent airway D)Protecting the child from harm during the seizure
D
A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. What would the nurse have most likely assessed? A)High fever B)Dysphagia C)Toxic appearance D)Inspiratory stridor
D
A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion? A)The child's risk for cognitive problems is greatly increased. B)Structural damage occurs with febrile seizure. C)The child's risk for epilepsy is now increased. D)Febrile seizures are benign in nature.
D
True or False: The nurse caring for an infant with strabismus tells the concerned parent that there is no need to correct the visual disorder until the child reaches school age.
False
True or False: The nurse is caring for a child with diarrhea related to infectious enteritis. The nurse accurately informs the parents that most cases of diarrhea are bacterial in nature and therapeutic management is usually supportive in nature.
False
The nurse is assessing a child for cardiac disorders and documents the presence of clubbing of the fingers and toes. Which of the following conditions might this indicate? a. Infection b. Cyanosis c. Edema d. Hypoxia
D
After teaching a group of students about acute rheumatic fever, the instructor determines that the teaching was successful when the students identify which assessment finding? A)Janeway lesions B)Jerky movements of the face and upper extremities C)Black lines D)Osler nodes
B
After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? A) "If this gets worse and we don't treat it, our son could become infertile." B) "This condition should gradually go away on its own." C) "The surgeon is going to operate on him immediately." D) "It's going to be difficult putting ice packs on his scrotum."
B
Assessment of a child leads the nurse to suspect viral conjunctivitis based on what finding? A)Mild pain B)Photophobia C)Itching D)Watery discharge
B
The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement? A) Being careful to prevent spread of infection B) Teaching the parents how to gently massage the duct C) Applying hot, moist compresses to the affected eye D) Referring the child to an ophthalmologist
B
The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most appropriate when obtaining a urine specimen from the child? A) "I will need a urine sample." B) "Let your mom help you tinkle in this cup." C) "Please tinkle in this cup right now." D) "Please void in this cup instead of the toilet."
B
The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, what would be most appropriate to promote healing and prevent further skin breakdown? A) Clean the area well with a scented diaper wipe. B) Apply a barrier/healing cream or paste on the skin. C) Use a barrier wafer to attach the appliance. D) Sanitize the area with an alcohol wipe after each diaper change.
B
The nurse is caring for an infant with a temporary ileostomy. As part of the plan of care, the nurse monitors for skin breakdown around the stoma. If redness occurs, what would be most appropriate to promote healing and prevent further skin breakdown? A) Clean the area well with a scented diaper wipe. B) Apply a barrier/healing cream or paste on the skin. C) Use a barrier wafer to attach the appliance. D)Sanitize the area with an alcohol wipe after each diaper change
B
After teaching the parents of a child diagnosed with celiac disease about nutrition, the nurse determines that the teaching was effective when the parents identify which foods as appropriate for their child? Select all that apply. A) Wheat germ B) Peanut butter C) Carbonated drinks D) Shellfish E) Jelly F) Flavored yogurt
B, C, D, E
The nurse is caring for a 6-month-old with a cleft lip and palate. The mother of the child demonstrates understanding of the disorder with which statements? Select all that apply. A) "My smoking during pregnancy didn't have anything to do with this disorder. Smoking primarily causes low birth weight." B) "I know my baby takes a lot longer to feed than most children this age." C) "It really worries me that my baby may have some other disorders that haven't been detected yet." D) "I wonder if my baby will develop speech problems when language development begins?" E) "Thankfully there are healthcare providers that specialize in correcting this type of disorder."
B, C, D, E
A mother brings her child to the healthcare clinic because she thinks that the child has conjunctivitis. Which assessment findings would lead the nurse to suspect bacterial conjunctivitis? Select all that apply. A)Itching of the eyes B)Inflamed conjunctiva C)Stringy discharge D)Photophobia E)Mild pain F)Tearing
B, E
A child with a pneumothorax has a chest tube attached to a water seal system. When assessing the child, the nurse notices that the chest tube has become disconnected from the drainage system. What would the nurse do first? A)Notify the healthcare provider. B)Apply an occlusive dressing. C)Clamp the chest tube. D)Perform a respiratory assessment.
C
A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally? A)Recombinant human DNase B)Bronchodilators C)Anti-inflammatory agents D)Pancreatic enzymes
D