PEDS EXAM 4

T/F: A grade II murmur is loud but does not have a thrill associated with it.

FALSE A grade II murmur is soft and easily heard. a grade III murmur is loud but does not have a thrill.

T/F: Developmental dysplasia of the hip is more common in males.

FALSE Developmental dysplasia of the hip is more common in females.

T/F: Congenital cardiac anomaly refers to an enlargement of the heart caused by hypertrophy or thickening of the walls of the heart.

FALSE Hypertrophic cardiomyopathy refers to an enlargement of the heart caused by hypertrophy or thickening of the walls of the heart.

T/F: The primary signs of cerebral palsy include loss of developmental milestones, respiratory muscle weakness, and presence of pectus excavatum.

FALSE Primary signs of cerebral palsy include motor impairments such as spasticity, muscle weakness, and ataxia, which is lack of coordination of muscle movements during voluntary movements such as walking or picking up objects.

T/F: The normal HR is lower in infancy than in adulthood

FALSE The normal heart rate in infancy is at its highest. The heart rate decreases as the child matures, reaching the normal adult level in adolescence.

Tetralogy of Fallot is a congenital heart defect that refers to a combination of _______ heart defects occurring together.

FOUR ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy.

________________ is an acute, systemic vasculitis occurring mostly in infants and young children.

Kawasaki disease

Which anticonvulsant is first-line treatment for seizures?

Keppra

Problems w/ manual dexterity and coordination

dyspraxia

most common form of childhood cancer

leukemia

An 8-year-old child is seen for moodiness and irritability. The child has begun to develop breast and pubic hair and the parents are concerned that these changes are occurring at too early an age. Which would the nurse suspect? A. precocious puberty B. pseudopuberty C. adrenal hyperplasia D. neurofibromatosis

A. precocious puberty

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)? A. splash pattern B. nonuniform pattern C. stocking-glove pattern on hands or feet D. spattering pattern

C. stocking-glove pattern on hands or feet

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? A. vagus nerve stimulation B. ketogenic diet C. frequent temperature assessment D. use of anticonvulsant medications

D. use of anticonvulsant medications

A nurse is preparing a plan of care for an infant who has undergone surgery to repair a myelomeningocele. The nurse would include placing the infant in which positions postoperatively? Select all that apply. A. prone B. right side lying C. left side lying D. semi-Fowler E. supine

A, B, C These positions allow the incision to heal.

The nurse is caring for a 14-year-old boy in Buck traction for a slipped capital femoral epiphysis (SCFE). What information would the nurse include when completing a neurovascular assessment of the affected leg? Select all that apply. A. Color B. Sensation C. Pulse D. Capillary refill E. Vital signs

A, B, C, D

A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? Select all that apply. A. oxygen gauge and tubing B. suction at bedside C. tongue blade D. padding for side rails E. smelling salts

A, B, D

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply. A. "If I am sexually active I need to let my doctor know." B. "As long as I use two forms of birth control I don't need to have monthly pregnancy testing." C. "I am young so I won't need to have the liver tests the pamphlet suggests." D. "This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." E. "It's important I get my CBC blood test when my doctor orders it."

A, D, E

A parent calls the clinic nurse to say the child has shin splints after playing soccer. What instructions should the nurse provide this parent? A. "Applying ice to the area will reduce the pain and swelling." B. "Apply ice to the injury for 60 minutes on and 60 minutes off." C. "Elevate the legs, and use bed rest for 24 hours." D. "Taking warm baths will help relax muscles and reduce pain."

A. "Applying ice to the area will reduce pain and swelling

The nurse is speaking with the mother of a child diagnosed with contact dermatitis from poison ivy. Which statement by the mother indicates a need for further education? A. "As long as he takes a shower as soon as he gets inside, he shouldn't get this again." B. "I will need to make sure the dog gets a bath if he goes in the woods." C. "When he plays in the woods again, I will make sure he wears long pants and long sleeves." D. "I can buy a medicine to put on him before he goes out to prevent him from getting this again."

A. "As long as he takes a shower as soon as he gets inside, he shouldn't get this again."

The nurse is caring for a child recently fitted with braces on both legs due to cerebral palsy (CP). What would the nurse emphasize in the discharge teaching? A. "Check the skin that is covered by the braces for redness and breakdown." B. "It is very important to comply with the use of this brace." C. "Please try and follow the therapist's on and off schedule." D. "If the brace is painful, feel free to take it off."

A. "Check the skin that is covered by the braces for redness and breakdown."

The nurse is caring for a newborn with facial nerve palsy from birth trauma. The mother is very upset and concerned about the child's prognosis. Which response by the nurse would be most appropriate? A. "In most cases treatment is not necessary, only observation." B, "Have you seen any signs of improvement?" C. "Was this from pressure resulting from forceps?" D. "This is the most common facial nerve palsy."

A. "In most cases treatment is not necessary, only observation."

The parents of a 2-year-old toddler newly diagnosed with tricuspid atresia ask the nurse, "I do not understand why our toddler's fingertips are spread out and rounder than normal fingertips?" Which response by the nurse is best? A. "The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes." B. "Increased cardiac workload from your toddler's heart defect affects various parts of the body, including the fingers." C. "The number of red blood cells has significantly increased from the heart defect, resulting in the cells pooling in the fingertips." D. "This is a common complication of tricuspid atresia. Unfortunately, there is nothing we can do to treat it."

A. "The low blood oxygen levels from the heart defect causes the lack of oxygen to the fingers, causing these changes."

A newborn has a generalized rash on the skin, which the nurse identifies as erythema toxicum neonatorum. Which information would the nurse include when explaining the condition to the newborn's parent? A. "What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this." B. "This is a normal newborn rash; do not be so worried." C. "What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition. You will need to apply a topical cream twice a day until it disappears." D. "What you see on your newborn's skin is erythema toxicum neonatorum. It is an extensive skin condition that is rare in newborns. You will need to treat the infant as soon as possible to prevent its spread."

A. "What you see on your newborn's skin is erythema toxicum neonatorum. It is a common newborn skin condition that typically resolves on its own in about 1 week. There is nothing special you will need to do for this."

A parent expresses a concern about white scales that have begun to flake off the 1-week-old infant's scalp. The parent asks, "What can I do to prevent this?" Which response by the nurse would be most appropriate? A. "Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes." B. "Your child most likely has dandruff. You can treat it with daily with anti-seborrheic shampoo, like Head and Shoulders." C. "How often do you bathe your infant? The infant should have a thorough shampooing every day to prevent things like this." D. "Your child most likely has infantile seborrheic dermatitis, or cradle cap. There is no intervention needed and it should resolve in 1 week."

A. "Your child most likely has infantile seborrheic dermatitis, or cradle cap. You can care for it by cleansing the hair and scalp daily with baby shampoo. You can also apply baby oil to the area for 10 to 15 minutes and then rinse away the flakes."

The nurse is providing child and family education prior to discharge following a cardiac catheterization. The nurse is teaching about signs and symptoms of complications. Which statement by the mother indicates a need for further teaching? A. "the feeling of the heart skipping a beat is common." B. "we need to avoid tub baths for the next 3 days." C. "strenuous activity should be limited for the next 3 days." D. "we need to watch for changes in skin color or difficulty breathing."

A. "the feeling of the heart skipping a beat is common."

The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? A. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. B. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing. C. Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge. D. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription.

A. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication.

A nurse is caring for a child with second- and third-degree (partial- and full-thickness) burns over 15% of the body. The child reports severe itching in and around the burn sites. Which action would be most appropriate for the nurse to perform? A. Administer diphenhydramine. B. Turn the child every 2 hours. C. Soak the child in a colloidal bath. D. Provide diversional activities.

A. Administer diphenhydramine

The nurse is administering medications to the child with congestive heart failure (CHF). Large doses of what medication are used initially in the treatment of CHF to attain a therapeutic level? A. Digoxin B. Albuterol sulfate C. Ferrous sulfate D. Spironolactone

A. Digoxin

The nurse is caring for a child with a second-degree (partial-thickness) burn. What assessment findings would the nurse expect to observe? A. Edema with wet, blistering skin B. Reddened and leathery skin C. Edema with dry or waxy-looking skin D. Peeling skin with eschar

A. Edema with wet, blistering skin

The nurse is caring for a 6-year-old child with a congenital heart defect. To best relieve a hypercyanotic spell, what action would be the priority? A. Place the child in a knee-to-chest position. B. Use a calm, comforting approach. C. Provide supplemental oxygen. D. Administer morphine as prescribed.

A. Place the child in a knee-to-chest position

Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis? A. Signs of increased intracranial pressure (ICP) B. Degree and extent of nuchal rigidity C. Occurrence of urine and fecal contamination D. Onset and character of fever

A. Signs of increased intracranial pressure (ICP)

The nurse is preparing a child suspected of having a thyroid disorder for a thyroid scan. What information regarding the child should the nurse alert the doctor or nuclear medicine department about? A. The child is allergic to shellfish. B. The child is taking a vitamin supplement. C. The child has had an MRI of their leg within the past 6 weeks. D. The child wears a medical alert bracelet for diabetes.

A. The child is allergic to shellfish

A group of students is reviewing information about bone healing in children. The students demonstrate understanding of this information when they state: A. a child's bones heal more quickly than those of an adult. B. a fracture closer to the growth plate heals much slower than one in the metaphysis. C. the process of breaking down and forming new bone is decreased in children compared with adults. D. callus production is slower (but greater in amount) in children than in adults.

A. a child's bones heal more quickly than those of an adult

A group of students is reviewing information about the skeletal development in children. The students demonstrate understanding of the information when they identify that ossification is complete by what age? A. adolescence B. school age C. preschool age D. toddlerhood

A. adolescence

The nurse is caring for a child with urticaria. What is the priority action? A. assessing the child's airway and breathing and noting any wheezing or stridor B. obtaining a detailed history of new foods, medications, stress, or changes in environment C. inspecting the skin and noting evidence of raised, edematous hives anywhere on the body D. Noting whether hives are pruritic, blanch when pressed, or are migrating

A. assessing the child's airway and breathing and noting any wheezing or stridor

The nurse is assessing the heart rate of a 6-month-old infant and determines it to be 82 beats/min. What action should the nurse take first? A. Conduct a cardiovascular assessment B. Report the finding to the HCP C. Obtain a health history form the parent D. Reassess the HR in 5 min

A. conduct a cardiovascular assessment

A child is diagnosed with hyperthyroidism. What finding would the nurse expect to assess? A. Heat intolerance B. Constipation C. Weight gain D. Facial edema

A. heat intolerance

A young child has just been admitted to the emergency department with a burn that encompasses the epidermis and the underlying dermis. From which type of burn does this child suffer? A. Second-degree or partial-thickness burn B. First-degree or superficial burn C. Fourth-degree or fat-layer burn D. Third-degree or full-thickness burn

A. second degree or partial-thickness burn

An adolescent wears a body brace for scoliosis. Which client education should the nurse provide? A. to continue with age-appropriate activities B. to stand absolutely still when not wearing the brace C. to wear the brace a maximum of 20 hours each day D. that secondary sex changes will stop until the brace is removed

A. to continue with age-appropriate activities

The nurse is caring for a child with heart failure related to a congenital heart defect. One of the nursing diagnoses identified includes "Excess fluid volume." During a family care planning conference. the parents ask why this diagnosis applies to their child. What is the best response by the nurse? A. "We have standardized care plans for children with congenital heart defects and this nursing diagnosis is on the care plan." B. "Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs." C. "The heart is a pump and it isn't pumping effectively." D. "It is a difficult process to understand. Rest assured that we are doing everything in your child's best interest."

B. "Cardiac problems cause the heart to not pump effectively, which causes swelling in the body and fluid in the lungs."

The nurse is teaching new parents about cephalohematoma. Which statement by the parents suggests the need for further teaching? A. "We should expect to see swelling on one side of our infant's scalp in a couple days." B. "We should expect to see some discoloration on our child's scalp." C. "A delivery assisted with forceps contributed to the cephalohematoma." D. "Most cases of cephalohematoma resolve and only require observation."

B. "We should expect to see some discoloration on our child's scalp."

The nurse is speaking with the parents of a child recently diagnosed with hypothyroidism. Which statement by a parent indicates an understanding of symptoms of this disorder? A. "Heat intolerance is a caused by low thyroid levels." B. "When they get my son's thyroid levels normal, he won't be so tired." C. "Most people with hypothyroidism have smooth, velvety skin." D. "My son's nervousness may be a symptom of his hypothyroidism."

B. "When they get my son's thyroid levels normal, he won't be so tired."

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis? A. Have the child's 2-year-old brother stay in the room. B. Avoid making noise when in the child's room. C. Rock the child frequently. D. Keep the lights on brightly so that he can see his mother.

B. Avoid making noise when in the child's room

A 6-year-old girl is diagnosed with aortic stenosis. The mother asks the nurse what the likely treatment for this condition will involve. What should the nurse tell the mother? A. Insertion of Dacron-coated stainless-steel coils by interventional cardiac catheterization B. Insertion of a catheter with an uninflated balloon tip into the affected area followed by inflation of the balloon to open the narrowing C. Surgical closure by ductal ligation D. No treatment is necessary, as the defect will resolve spontaneously

B. Insertion of a catheter with an uninflated balloon tip into the affects area followed by inflation of the balloon to open the narrowing

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges? A. Positive Chadwick sign B. Positive Kernig sign C. Negative Kernig sign D. Negative Brudzinski sign

B. Positive Kernig sign

An infant with tetralogy of Fallot becomes cyanotic. Which nursing intervention would be the first priority? A. Start and IV for fluids B. Put the infant in a knee-to-chest position C. Prepare the infant for surgery D. Raise the head of the bed

B. Put the infant in a knee-to-chest position

In caring for a child in traction, which intervention is the highest priority for the nurse? A. The nurse should record accurate intake and output. B. The nurse should monitor for decreased circulation every 4 hours. C. The nurse should provide age-appropriate activities for the child. D. The nurse should clean the pin sites at least once every 8 hours.

B. The nurse should monitor for decreased circulation every 4 hours.

In working with infants diagnosed with atopic dermatitis, the nurse anticipates that when these children are older they will likely have a tendency to have which disorder? A. hemophilia B. asthma C. rheumatoid arthritis D. otitis media

B. asthma

A child has been diagnosed with a basilar skull fracture. The nurse identifies ecchymosis behind the child's ear. This would be documented as: A. raccoon eyes. B. Battle sign. C. rhinorrhea. D. otorrhea.

B. battle sign

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever? A. "This disorder is caused by genetic factors." B. "Children who have this diagnosis may have had strep throat." C. "Being up-to-date on immunizations is the best way to prevent this disorder." D. "The onset and progression of this disorder is rapid."

B. children who have this diagnosis may have had strep throat

The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal? A. bilirubin B. creatine kinase C. serum potassium D. sodium

B. creatine kinase Serum creatine kinase levels are elevated early in the disorder, when significant muscle wasting is actively occurring.

The nurse is teaching a child with type 1 diabetes mellitus to administer insulin. The child is receiving a combination of short-acting and long-acting insulin. The nurse knows that the child has appropriately learned the technique when the child: A. administers the insulin into a doll at a 30-degree angle. B. draws up the short-acting insulin into the syringe first. C. wipes off the needle with an alcohol swab. D. administers the insulin intramuscularly into rotating sites.

B. draws up the short-acting insulin into the syringe first

The nurse is collecting data on a 5-year-old child admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment is consistent with this diagnosis? A. cyanosis of the fingernails B. failure to gain weight C. scissoring of the legs with toes pointed down D. jerking movements of arms and legs

B. failure to gain weight

Which site is most frequently used to perform a bone marrow aspiration? A. Humerus B. Iliac crest C. Rib cage D. Femur

B. iliac crest

Any individual taking phenobarbital for a seizure disorder should be taught: A. to brush his or her teeth four times a day. B. never to discontinue the drug abruptly. C. never to go swimming. D. to avoid foods containing caffeine.

B. never to discontinue the drug abruptly

A nurse is reviewing the medical record of a child who has sustained a fracture. Documentation reveals a bowing deformity. The nurse interprets this fracture as: A. incomplete fracture B. significant bending without breaking C. bone that breaks in two pieces D. bone buckling due to compression

B. significant bending without breaking

Which diagnostic measure is most accurate in detecting neural tube defects? A. flat plate of the lower abdomen after the 23rd week of gestation B. significant level of alpha-fetoprotein present in amniotic fluid C. amniocentesis for lecithin-sphingomyelin (L/S) ratio D. presence of high maternal levels of albumin after 12th week of gestation

B. significant level of alpha-fetoprotein in amniotic fluid

The nurse is discussing treatment for a child diagnosed with scoliosis. Which statement indicates the parents understand the nurse's education? A. "Because our child has scoliosis, treatment will include halo traction." B. "The treatment for our child's scoliosis is anticipated to last between 3 to 4 months." C. "Because our child is being treated by using braces, the braces will have to be worn almost all the time." D. "The most successful treatment for scoliosis is surgery before reaching adult age."

C. "Because our child is being treated using braces, the braces will have to be worn almost all the time."

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? A. "I brush my child's teeth once every day." B. "My child's stools are darker than usual." C. "I mix ferrous sulfate with milk in a bottle." D. "My child takes ferrous sulfate after meals."

C. "I mix ferrous sulfate with milk in a bottle."

The parents of a 5-year-old child with a cardiovascular disorder tell the nurse they don't understand why their child isn't gaining weight, "We make sure our child has 3 very nutritious meals every day." How should the nurse respond? A. "Are you sure you are making nutrient-dense foods?" B. "Maybe your child doesn't really like the foods your making. This could lead to not gaining sufficient weight." C. "It's great you are providing nutritious meals, but small, frequent meals will tire your child less and promote weight gain." D. "It's hard to get your child to eat enough at this age to maintain their weight since they are expending so much energy with the heart condition."

C. "It's great you are providing nutritious meals, but small, frequent meals will tire your child less and promote weight gain."

The nurse has told the 14-year-old adolescent with diabetes that the doctor would like to have a hemoglobin A1C test performed. Which comment by the client indicates that she understands what this test is for? A. "That is the test that I take after I have fasted for at least 8 hours." B. "I monitor my own blood glucose every day at home. I don't see why the doctor would want this done." C. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months." D. "The normal level for my hemoglobin A1C is between 60 to 100 mg/dl."

C. "This will tell my doctor what my average blood glucose level has been over the last 2 to 3 months."

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? A. "We should avoid tight clothing and heat." B. "We need to develop ways to prevent him from scratching." C. "We should avoid using petroleum jelly." D. "We should keep his fingernails short and clean."

C. "We should avoid using petroleum jelly." It is important to apply moisture multiple times throughout the day. Petroleum jelly is a recommended moisturizer that is inexpensive and readily available.

A nurse is providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? A. "We need to avoid any skin product containing perfumes, dyes, or fragrances." B. "We should use a mild soap for sensitive skin." C. "We should bathe our child in hot water, twice a day." D. "We should use soap to clean only dirty areas."

C. "We should bathe our child in hot water, twice a day."

A 13-year-old adolescent is being treated for scoliosis with a brace. During the first follow-up appointment after the brace was initiated, which statement by the adolescent indicates the need for further instruction? A. "I check my brace daily to make sure there is no damage or change to it." B. "I leave my brace on for gym at school." C. "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed." D. "I wear a t-shirt under my brace."

C. "When I get home from school, I look forward to taking off my brace for a few hours before I go to bed."

A newborn was diagnosed as having hypothyroidism at birth. The parent asks the nurse how the disease could be discovered this early. Which is the nurse's best answer? A. Hypothyroidism is usually detected at birth by the newborn's physical appearance. B. A newborn has a typical rash at birth that suggests the diagnosis. C. A simple blood test to diagnose hypothyroidism is required in most states. D. The newborn is already severely impaired at birth, and this suggests the diagnosis.

C. A simple blood test to diagnose hypothyroidism is required in most states

What information is most correct regarding the nervous system of the child? A. The child has underdeveloped fine motor skills and well-developed gross motor skills. B. The child has underdeveloped gross motor skills and well-developed fine motor skills. C. As the child grows, the gross and fine motor skills increase. D. The child's nervous system is fully developed at birth.

C. As the child grows, the gross and fine motor skills increase

A child is born with clubfoot (congenital talipes equinovarus). The child later receives a cast on the affected leg to correct the problem. Which measure should the nurse mention to the mother to ensure good circulation in the affected leg? A. Perform passive foot exercises. B. Change the infant's diapers frequently. C. Check the infant's toes for coldness or blueness. D. Apply Denis Browne splints to the infant each night.

C. Check the infant's toes for coldness or blueness.

A child has been prescribed desmopressin acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? A. Desmopressin acetate works on your pancreas to stimulate insulin production. B. Desmopressin acetate is a synthetic form of insulin used to lower your blood sugar. C. Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output. D. Desmopressin acetate works to help your kidneys work more efficiently.

C. Desmopressin acetate is a synthetic antidiuretic hormone that will slow down your urine output

The nurse is caring for a 14-year-old girl with atrial fibrillation. Which medication would the nurse expect to be prescribed? A. Alprostadil B. Furosemide C. Digoxin D. Indomethacin

C. Digoxin

The nurse is preparing a plan to educate the parents of a 10-year-old boy with a learning disorder. What will be part of this plan? A. Encourage parents to give the child personal space. B. Tell parents to check on the child regularly. C. Explain the child's strengths and weaknesses. D. Have parents learn the child's facial expressions.

C. Explain the child's strengths and weaknesses

The nurse is conducting a physical examination of a 10-year-old boy with a suspected neuromuscular disorder. Which finding is a sign of Duchenne muscular dystrophy? A. appearance of smaller than normal calf muscles B. lordosis C. Gowers sign D. indications of hydrocephalus

C. Gower's sign Gowers sign is the inability of the child to rise from the floor in the standard fashion because of weakness.

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia? A. Increased WBC B. Decreased WBC C. Increased RBC D. Decreased RBC

C. Increased RBC

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? A. Sudden, momentary loss of muscle tone, with a brief loss of consciousness B. Muscle tone maintained and child frozen in position C. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention D. Brief, sudden contracture of a muscle or muscle group

C. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

A nurse is assessing a little boy who has been diagnosed with Tourette syndrome. Which finding would the nurse expect to see? A. Toe walking B. Lack of eye contact C. Speaks sudden, fast phrases out of context D. Spinning and hand-flapping

C. Speaks sudden, fast phrases out of context

An infant has presented at the clinic with impetigo. Which organism usually causes impetigo in infants? A. Escherichia coli B. Group A beta hemolytic strep C. Staphylococcus aureus D. Methicillin-resistant Staphylococcus aureus (MRSA)

C. Staphylococcus aureus

The nurse is caring for an infant who has impetigo and is hospitalized. Which nursing action is priority? A. The nurse soaks the skin with warm water. B. The nurse applies topical antibiotics to the lesions. C. The nurse follows contact precautions. D. The nurse applies elbow restraints to the infant.

C. The nurse follows contact precautions

A mother is asking for more information about her infant's patent ductus arteriosus (PDA). What would be included in the education? A. Your child may need multiple surgeries to correct this defect. B. An IV for fluids will be started immediately. C. This is caused by an opening that usually closes by 1 week of age. D. This type of defect is caused by having a genetic predisposition for it.

C. This is caused by an opening that usually closes by 1 week of age

The nurse in a pediatric cardiovascular clinic is talking with the father of a 5-year-old child who underwent cardiac surgery for a heart defect at the age of 3. The father reports that the child has been having increased shortness of breath, tires easily after playing, and has been gaining weight. The nurse is aware that the child is most likely demonstrating symptoms of which acquired cardiovascular disorder? A. cardiomyopathy B. Kawasaki disease C. heart failure D. infective endocarditis

C. heart failure

The nurse is developing the plan of care for a 3-year-old child diagnosed with atopic dermatitis. Which client outcomes are common focuses for a child with this diagnosis? Select all that apply. A. pain management B. reduction in anxiety C. maintenance of skin integrity D. prevention of infection E. promotion of skin hydration

C. maintenance of skin integrity D. prevention of infection E. promotion of skin hydration

Which finding(s) is a major criterion used to help the health care provider diagnose acute rheumatic fever in a child? Select all that apply. A. elevated erythrocyte sedimentation rate B. temperature of 101.2°F (38.4°C) C. painless nodules located on the wrists D. pericarditis with the presence of a new heart murmur E. heart block with a prolonged PR interval

C. painless nodules located on wrists D. pericarditis with the presence of a new heart murmur

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see? A. Decreased HR and impalpable pulse B. Irritability and dry mucous membranes C. Peeling hands and feet; fever D. Low BP and decreased HR

C. peeling hands and feet; fever

Which nursing diagnosis is most relevant in the first 12 hours of life for a neonate born with a myelomeningocele? A. impaired physical mobility B. delayed growth and development C. risk for infection D. constipation

C. risk for infection

A nurse is performing a newborn assessment and notices a small dimple on the sacral area. The infant has a normal neurological assessment and moves all extremities well. What does the nurse suspect that the dimple indicates? A. a normal spinal closure B. spina bifida with meningocele C. spina bifida occulta D. spina bifida with myelomeningocele

C. spina bifida occulta

The nurse is caring for an infant with Down syndrome who has been diagnosed with atrioventricular canal defect. The parents asks the nurse, "Why do you not put oxygen on our baby more often when his lips and fingernails are blue?" What is the best response by the nurse? A. "I can only place oxygen on your child if the doctor orders oxygen." B. "Oxygen isn't always the best treatment for your child's condition. Surgery is necessary." C. "This is something we should talk with the physician about. Maybe it would help your baby." D. "While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help."

D. "While it seems that oxygen would help, it actually worsens this condition. Treating the cause of the disease will help."

The nurse is teaching a group of peers regarding different types of fractures seen in children. Which statement best describes a complete fracture? A. A fracture in which the bone bends without breaking B. A fracture in which the bone buckles rather than breaks C. An incomplete fracture of the bone D. A fracture in which the bone breaks into two pieces

D. A fracture in which the bone breaks in two pieces

A school nurse is caring for a child with a severe sore throat and fever. What is the nurse's best recommendation to the parent? A. Have the child go to the emergency room B. Give acetaminophen for fever and pain, and have the child rest C. Have the child drink fluids that contain electrolytes D. Have the child be seen by the primary care provider

D. Have the child be seen by the primary care provider

A 14-year-old adolescent is suspected of having scoliosis. When doing scoliosis screening, what observation would be important for the nurse to note? A. The posterior spine when bending sideways B. The angle of the iliac crest when bending forward C. The angle of the lower chest when sitting down D. The posterior spine when bending forward

D. The posterior spine when bending forward

The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest? A. Avoid chocolate and greasy foods. B. Wash the face with abrasive soaps three times a day. C. Pop the pimples to make them go away. D. Wash the face twice a day with a mild soap then pat dry.

D. Wash the face twice a day with a mild soap then pat dry.

The nurse is conducting a physical examination of a newborn with suspected osteogenesis imperfecta. Which finding is common? A. dimpled skin, hair in lumbar region B. The sole of the foot faces backwards. C. The foot is drawn up and inward. D. blue sclera

D. blue sclera

When caring for a child who has just had a cardiac catheterization, what is a sign of hypotension? A. decreased HR and dizziness B. syncope and tachypnea C. diaphoresis and tachycardia D. cool, clammy skin and increased HR

D. cool, clammy skin and increased HR

A 7-year-old child is diagnosed with a learning disability involving reading, writing, and spelling. The nurse identifies this as: A. dysgraphia. B. dyscalculia. C. dyspraxia. D. dyslexia.

D. dyslexia

The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection? A. atopic dermatitis B. folliculitis C. scabies D. impetigo

D. impetigo

Preterm infants have more fragile capillaries in the periventricular area than term infants. This put these infants at risk for which problem? A. congenital hydrocephalus B. moderate closed-head injury C. early closure of the fontanels (fontanelles) D. intracranial hemorrhaging

D. intracranial hemorrhaging

A nurse is assessing the skin of a 12-year-old with suspected right ventricular heart failure. Where should the nurse expect to note edema in this child? A. face B. presacral region C. hands D. lower extremities

D. lower extremities

Based on knowledge of the progression of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first? A. swallowing B. breathing C. sitting D. standing

D. standing

Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n): A. antihistamine. B. diuretic. C. anticonvulsant. D. steroid.

D. steroid

The nurse is working with a 6-year-old child recently diagnosed with Legg-Calvé-Perthes disease. The child's parents tells the nurse they understand exercise is important for their child but are not sure which activities are appropriate. Which activity will the nurse recommend for this client? A. Jumping jacks B. Soccer C. Brisk walking D. Swimming

D. swimming Swimming and tricycle or bicycle riding are excellent exercises because they provide smooth joint action and will help to reduce joint destruction. In contrast, activities that place excessive strain on joints, such as running, jumping, prolonged walking, and kicking, should be avoided.

When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding? A. the spleen size increases due to frequent infection B. the liver size increases due to cardiac medications C. the spleen size increases due to the destruction of RBCs D. the liver size increase in right-sided HF

D. the liver size increases with right-sided HF

T/F: Depending on age, the structure and function of the infant's and child's cardiovascular system differ from those of adults.

TRUE

T/F: Grade I murmur is soft and hard to hear

TRUE

T/F: Keloid formation occurs more often in dark-skinned children.

TRUE

T/F: Most children with atrial septal defects are asymptomatic

TRUE

T/F: Sensitivity to latex is common among children with myelomeningocele.

TRUE Allergies to latex and rubber are common.

T/F: The apocrine sweat glands are nonfunction in infants.

TRUE Apocrine sweat glands mature during puberty

T/F: Breastfeeding a child before and after cardiac surgery may boost the infant's immune system.

TRUE Breastfeeding a child before and after cardiac surgery may help fight postoperative infection. If breastfeeding is not possible, mothers can pump milk and the breast milk may be given via bottle, dropper, or gavage feeding.

T/F: An S3 heart sound may be heard in children

TRUE The S3 heart sound may be heard in children, diminishing when moving from supine to upright.

_____________ are the shortening and hardening of muscles, tendons, or tissues leading to fixated and stiff joints.

contractures

The __________ normally closes shortly after birth but may remain open in some children with congenital heart disease

ductus arteriosus

Which lab findings are indicative of meningitis?

low glucose, high protein

Cerebral palsy is a disorder caused by abnormal development of, or damage to, the _______ areas of the brain.

motor

In children _______ is the best indicator of changes in fluid status.

weight