Peds Final Review

The parents of a child with cleft lip are concerned and ask when the lip will be repaired. The nurse bases the response on the knowledge that:

Cleft lip repair is usually performed by 4 weeks of age.

If you are walking with a child who begins to have a seizure, you will ease the child to the floor to prevent injury. Which of the following additional actions will you most need to take?

Place the child on their side Monitor respiratory status Move away objects that can cause injury

Where will the pain be identified in a patient with appendicitis?

Rebound pain in the right lower quadrant

The nurse is answering questions for the parents of a newborn who has spina bifida (meningomyelocele). The parents ask when surgery can be done. Which of the following responses by the nurse is most accurate?

Surgery is usually performed within the first 24-48 hours of life

The nurse has completed the discharge teaching on the dietary regimen of a child with celiac disease. The nurse recognizes that patient education has been successful when the mother states that the child must comply with the gluten-free diet?

Throughout life

Which of the following symptoms is characteristic of a preschool age child with a UTI (Kidneys and bladder)?

Urgency, dysuria, high fever, flank pain

A child had a UTI 3 months ago and was treated with an oral antibiotic. A follow up urinalysis revealed normal results. The child has had no other problems until this visit when the child was diagnosed with another UTI. Which is the most appropriate plan?

Urinalysis, urine culture, and voiding cystourethrogram (VCUG)

A child has been diagnosed with acute glomerulonephritis. which of the following changes would the nurse expect to see in the child's laboratory results?

Urine WBCs elevated

Which of the following findings is the most often associated with the diagnosis of acute glomerulonephritis?

strep throat 2 weeks prior to diagnosis

The nurse working with the mother of a baby who was just born with spina bifida (meningomyelocele), will place priority on helping the mother with which one of the following needs?

Providing emotional support for the mother

When assessing the older child with meningitis, the nurse looks for which manifestation as a frequent first sign of increased ICP?

Restlessness and irritability

which of the following is used to treat club foot?

Serial casting

The pediatric nurse assesses the infant and suspects severe dehydration. After receiving doctor's orders, which action would the nurse perform first?

Start the intravenous line

The pediatric nurse is admitting an infant with a history of vomiting and diarrhea. Which physical findings would indicate that the baby is dehydrated? Select all that apply

Sunken fontanelles Tachycardia and capillary refill greater than 3 seconds Poor skin turgor

You are the nurse assigned to work with a child who has just returned from the recovery room post-op for placement of a shunt as a treatment for hydrocephalus. Which of the following positions will you place the child in?

flat and lying on the un-operated side

Which of the following statements by the family of a child has a nursing diagnosis of high risk for continued seizure activity most indicates that the family has followed the teaching of the nurse

"Our Child has had a growth spurt, so we made an appointment to review the medication to prevent seizures"

During the assessment of a child with celiac disease, the nurse would most likely note which of the following physical findings?

Enlarged liver

The nurse assesses the neonate immediately after birth. A tracheoesophageal fistula should be suspected if which of the following is present?

Excessive salivation and drooling

An infant is admitted to the pediatric unit to rule out Hirschsprung's disease. The nurse expects the following clinical manifestations?

Failure to pass meconium stools in 24 to 48 hours after birth

When taking a health history from the parents of an infant with pyloric stenosis, which classic symptom would the nurse expect to hear the parents describe?

Vomiting after a feeding

The nurse has taught the parents of a 6 year old child with a ventriculoperitoneal (VP) shunt to monitor for shunt malfunction. The nurse determines the parents understand the instructions if they state to notify the physician if the child develops which manifestation?

Altered level of consciousness

Which of the following is used to monitor brain growth?

Head circumference measurements

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of the infant's postoperative care include which of the following?

Arm restraints, logan's bow, cleansing of the suture line, upright/side lying position

Which of the following statements by a mother suggest to the nurse that her child has celiac disease?

His stools are large and smelly

The priority nursing focus of care in the preoperative period for the infant with pyloric stenosis focuses on:

Improving hydration

Which of the following most accurately describes bowel elimination in children born with myelomeningocele?

Incontinence with partial control through bowel training

The nurse is assessing an infant finds the following signs and symptoms: sun setting eyes with sclera seen above the iris, a high pitched cry, bulging fontanelle, dilated scalp veins, slight alteration in consciousness, and vomiting. The nurse is aware that these signs and symptoms are most consistent with

Increased ICP

A parent asks the school nurse why she should not give her children aspirin for a fever. When the nurse replies that it has to do with the possible risk of a child getting reyes syndrome while taking aspirin, the parents asks: What is reyes syndrome? Which of the following responses by the nurse would most accurately describe Reyes syndrome?

A life threatening condition following a mild viral illness, in which there is a poorly functioning liver that is enlarged, and a cerebral edema.

The nurse places a young child scheduled for a lumbar puncture in a side lying position with the head flexed and knees drawn up to the chest. The mother asks why the child has to be positioned this way. The nurse explains that:

Access to the spinal fluid is facilitated

A lumbar puncture is being done on an infant suspected to have meningitis. If the infant has bacterial meningitis, the nurse would expect the cerebrospinal fluid to show?

Decrease glucose levels

An infant is brought to the ED with the following clinical manifestations: poor skin turgor, weight loss, lethargy, depressed anterior fontanelle, and tachycardia. These symptoms are suggestive of which of the following:

Dehydration

A Child who underwent cleft palate repair has just returned from surgery with elbow restraints in place. The parents question why their child must have the restraints. The nurse would give which of the following as the best explanation to the parents?

Elbow restraints are used postop to keep the children's hand away from the surgical site

Which of the following is a major long term problem for a child with cleft lip and palate?

Emotional problems

The Glasgow coma scale consist of an assessment of:

Eye opening, verbal and motor response

A recommendation to prevent neural tube defect is the supplementation of which of the following?

Folic acid for all women of childbearing age.

When teaching the parent of an infant with Hirchprung's disease who received a temporary colostomy about the types of foods a 1 month old infant will be able to have, which of the following would the nurse recommend?

Formula diet for an infant

A 2 year old with nephrotic syndrome is admitted to the pediatric unit. The following orders have been written by the doctor in the child's medical record. Which of the following actions is highest priority for the nurse to perform

Administer steroids, IV albumin infusions, and furosemide (lasix)

The nurse is caring for a baby immediately after surgery for a cleft lip repair places major emphasis on:

Protection of the operative area

Which action should the nurse take when providing postoperative nursing care to a child after insertion of a ventriculoperitoneal shunt (VP)

Monitoring for increased temperature for postoperative infection

An infant has been born with an esophageal atresia and tracheoesophageal fistula and is scheduled for surgery. What would the nurse expect to do in the preop period?

NPO status, administer IV fluids, antibiotics, and position the baby's head elevated 20 to 30 degrees

The ultimate goal of nursing care for a child with Hirschsprung's disease is to:

Prepare the child and family for surgical removal of the affected portion of the bowel

A child has a nasogastric tube after surgery for an acute ruptured appendicitis. The purpose of the NG tube after GI surgery is which of the following?

Prevent abdominal distention

Before surgery, the priority for nursing care of a newborn with a myelomeningocele is:

Preventing infection

The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. Which of the following is the major priority nursing care?

Administer IV antibiotics therapy as soon as it is ordered

When positioning a neonate with a repaired myelomeningocele, which of the following positions is most appropriate?

Prone or side lying until healed

"The nurse is caring for a 7-year-old child with glomerulonephritis and is preparing to discuss the plan of care with the parents. In anticipating this encounter, the nurse recognizes that which is a common reaction of parents to the diagnosis of glomerulonephritis?"

Guilt that they did not seek treatment for strep throat infection sooner

A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show which of the following?

Hematuria, proteinuria

What should be part of the nurse's teaching plan for a child with epilepsy being discharge on a regimen of phenytoin (Dilantin)?

Instructions about good dental hygiene

The parents of an infant with newly repaired cleft lip question the nurse about the purpose of the logan's bow. THe nurse's best response is:

It prevents trauma at the suture line

The ED nurse has admitted an infant with bulging fontanelles, setting sun eyes, and lethargy. Which of the following diagnostic procedures would be contraindicated in this infant?

LP

A child with a diagnosis of nephrotic syndrome enters remission and is to be discharged home. The nurse should instruct the parents about the development of which symptom that would be cause for concern?

The child's shoes and clothes become tight.

The mother of an infant with myelomeningocele asks if her baby is likely to have any other defects. The nurse responds based on the understanding that correction of the myelomeningocele is commonly associated with which complication after surgery?

hydrocephalus