Peds Questions
Which statement by the mother of a child with RF shows she has good understand of the care of her child? A. I will apply heat to his swollen joints to promote circulation B. I will have him do gentle stretching exercise to prevent contractures C. I will give him the aspirin that is ordered for pain and inflammation D. I will apply cold packs to his swollen joints to reduce pain
C. I will give him the aspirin that is ordered for pain and inflammation
Which of the following can be manifestations of leukemia in a child? Select all that apply. A. Leg pain B. Fever C. Excessive weight gain D. Bruising E. Enlarged lymph nodes
A. Leg pain B. Fever D. Bruising E. Enlarged lymph nodes
The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? A. Rice B. Oatmeal C. Rye toast D. Wheat bread
A
A child born with Down syndrome should be evaluated for which associated cardiac manifestation? A. Congenital Heart Defect (CHD) B. Systemic hypertension C. Hyperlipidemia D. Cardiomyopathy
A. Congenital Heart Defect (CHD)
Which of the following measures should the nurse implement to help with the nausea and vomiting from chemotherapy? Select all that apply. A. Give an antiemetic 30 minutes prior to the start of therapy B. Continue the antiemetic as ordered until 24 hours after the chemotherapy is complete C. Remove food that has a lot of odor D. Keep the child on a NPO status E. Wait until the nausea begins to start the antiemetic
A. Give an antiemetic 30 minutes prior to the start of therapy B. Continue the antiemetic as ordered until 24 hours after the chemotherapy is complete C. Remove food that has a lot of odor
Tetralogy of Fallot (TOF) involves which defects? Select all that apply. A. Ventricular Septal Defect (VSD) B. Right ventricular hypertrophy C. Left ventricular hypertrophy D. Pulmonic stenosis (PS) E. Pulmonic atresia F. Overriding Aorta G. Patent ductus arteriosus (PDA)
A. Ventricular Septal Defect (VSD) B. Right ventricular hypertrophy D. Pulmonic stenosis (PS) F. Overriding Aorta
A school aged child involved in a bicycle crash has a spleen injury and a right tibia/fibula fracture that has been casted. Which of the following could be interpreted as signs or symptoms of compartment syndrome? Select all that apply. •A.Edema •B.Numbness •C.Fever •D.Weak pulse •E.Anular rash
Answer: A, B, D •Compartment syndrome is a serious complication that results from compression of the nerves, blood vessels and muscle inside a closed space. The following s/s may be observed: Pain, Pulselessness, pallor, Paresthesia, paralysis, pressure.
A 16 year old boy is 2 hours post-op after having a spinal fusion and instrumentation to correct scoliosis. Upon assessment, the nurse finds the client's feet are cool to the touch, capillary refill time is >5 seconds and she cannot palpate a pedal pulse. Which of the following actions should the nurse take first? •A.Reposition the patient and complete the assessment again •B.Start an IV fluid bolus to help maintain adequate perfusion •C.Call the orthopedic surgeon •D.Check the patients radial pulses and compare
Answer: C• These assessment findings warrant immediate contact with the primary care provider. Prompt recognition of any neurologic impairment is imperative because delayed paralysis may develop that requires surgical intervention.
Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? Select all that apply. A. Maintain the child in a semiprivate room. B. Reduce exposure to environmental organisms. C. Use strict aseptic technique for all procedures. D. Ensure that anyone entering the child's room wears a mask. E. Apply firm pressure to a needle stick area for at least 10 minutes.
B, C, D
A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? A. Warm, dry skin B. Decreased wheezing C. Pulse rate of 90 beats/minute D. Respirations of 18 breaths/minute
B. Decreased wheezing
What associated manifestation might the nurse occasionally find in a child diagnosed with Wilms tumor? A. Atrial Fibrillation B. Hypertension C. Endocarditis D. Hyperlipidemia
B. Hypertension
The mother of an 11 month old with iron deficiency anemia tells the nurse that her infant is currently taking iron and a multivitamin. Which statement made by the mother should be of concern to the nurse. A. I give the iron and multivitamin at the same time each morning B. I give the iron and multivitamin in the morning 6-oz bottle C. I give the iron and multivitamin 2 hours before I feed him D. I give the iron and multivitamin in oral syringes toward the back of the cheek.
B. I give the iron and multivitamin in the morning 6-oz bottle
A 10 yr old has undergone a cardiac catheterization. At the end of the procedure, the nurse should first assess: A. Pain B. Pulses C. Hemoglobin and hematocrit levels D. Catheterization report
B. Pulses
A 10 yo child is recovering from a severe sore throat. The parent states that the child complains of chest pain. The nurse observes that the child has swollen joints, nodules on the fingers and a rash on the chest. The likely cause is ____________. A. Measles B. Rheumatic Fever C. Flu D. Candida Albicans
B. Rheumatic Fever
The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? A. Supine B. Side-lying C. High Fowler's D. Trendelenburg's
B. Side-lying
The nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. Which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? A. Provide less frequent, larger feedings. B. Burp the infant less frequently during feedings. C. Thin the feedings by adding water to the formula. D. Thicken the feedings by adding rice cereal to the formula.
C.
The parent of a child with cystic fibrosis is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? A. The transplant will cure the child of CF and allow the child to lead a long and healthy life B. The transplant will not cure the child of CF but will allow the child to have a longer life C. The transplant will help to reverse the multisystem damage that has been caused by CF D. The transplant will be the child's only chance for graduating from college.
B. The transplant will not cure the child of CF but will allow the child to have a longer life
After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? A. Maintain NPO status. B. Turn the child to the side. C. Administer the prescribed antiemetic. D. Notify the health care provider (HCP).
B. Turn the child to the side.
A 4-year-old child is admitted to the hospital for abdominal pain. The mother reports that the child has been pale and excessively tired and is bruising easily. On physical examination, lymphadenopathy and hepatosplenomegaly are noted. Diagnostic studies are being performed on the child because acute lymphocytic leukemia is suspected. The nurse understands that which diagnostic study should confirm this diagnosis? A. Platelet count B. Lumbar puncture C. Bone marrow biopsy D. White blood cell count
C
A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother? A. "I have a vase in the utility room, and I will get it for you." B. "I will get the vase and wash it well before you put the flowers in it." C. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time." D. "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible."
C
The mother of a 6-year-old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? A. Hold the next dose of insulin. B. Come to the clinic immediately. C. Encourage the child to drink liquids. D. Administer an additional dose of regular insulin.
C b/c ketones can be present when dehydrated
On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease? A. Cracked lips B. Normal appearance C. Conjunctival hyperemia D. Desquamation of the skin
C. Conjunctival hyperemia
The parent of an infant with CP asks the nurse if the infant will be mentally retarded. Which is the nurse's best response? A. Children with CP have some amount of mental retardation B. Approximately 20% of children with CP have normal intelligence C. Many children with CP have normal Intelligence D. Mental retardation is expected if motor and sensory deficits are severe
C. Many children with CP have normal Intelligence
A school-age child with type 1 diabetes mellitus has soccer practice three afternoons a week. The school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? A. Eat twice the amount normally eaten at lunchtime. B. Take half the amount of prescribed insulin on practice days. C. Take the prescribed insulin at noontime rather than in the morning. D. Eat a small box of raisins or drink a cup of orange juice before soccer practice.
D
The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which symptom most likely led the mother to seek health care for the infant? A. Diarrhea B. Projectile vomiting C. Regurgitation of feedings D. Foul-smelling ribbon-like stools
D.
The nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented? A. Watery diarrhea B. Ribbon-like stools C. Profuse projectile vomiting D. Bright red blood and mucus in the stools
D. Bright red blood and mucus in the stools
The parent of a young child with CP brings the child to the clinic for a checkup. Which parent's statement indicates an understanding of the child's long-term needs? A. My child will need all my attention for the next 10 years B. Once in school, my child will catch up and be like the other children C. My child will grow up and need to learn to do things independently D. I'm the one who knows the most about my child and can do the most for my child
C. My child will grow up and need to learn to do things independently
THE NURSE IS TALKING WITH A 10-YEAR-OLD BOY WHO WEARS BILATERAL HEARING AIDS. THE LEFT HEARING AID IS MAKING AN ANNOYING WHISTLING SOUND THAT THE CHILD CANNOT HEAR. WHAT INTERVENTION IS THE MOST APPROPRIATE NURSING ACTION? A. IGNORE THE SOUND. B. SUGGEST HE REINSERT THE HEARING AID. C. ASK HIM TO REVERSE THE HEARING AIDS IN HIS EARS. D. SUGGEST HE RAISE THE VOLUME OF THE HEARING AID.
CORRECT ANSWER B: SUGGEST HE REINSERT THE HEARING AID. THE WHISTLING SOUND IS ACOUSTIC FEEDBACK. THE NURSE SHOULD HAVE THE CHILD REMOVE THE HEARING AID AND REINSERT IT, MAKING SURE NO HAIR IS CAUGHT BETWEEN THE EAR MOLD AND THE EAR CANAL. IGNORING THE SOUND OR SUGGESTING HE RAISE THE VOLUME OF THE HEARING AID WOULD BE ANNOYING TO OTHERS. THE HEARING AIDS ARE MOLDED SPECIFICALLY FOR EACH EAR.
A child who has reddened eyes with no discharge; red, swollen, and peeling palms/soles of feet; dry, cracked lips; and a "strawberry tongue" most likely has___________ A. Legionnaires' Disease B. Acute glomerulonephritis C. Kawasaki's disease D. Babesiosis
C. Kawasaki's disease
A 9 yr old girl sustained a fracture in the epiphyseal plate of her right fibula when she fell off of a tree. When discussing this injury with her parents, the nurse should consider which statement? •A.Healing is usually delayed in this type of fracture• B.This is an unusual fracture site in young children• C.Growth can be affected by this type of fracture• D.This type of fracture is inconsistent with a fall, social services should be contacted
Answer: C• Detection of epiphyseal injuries is sometimes difficult, but fractures involving the epiphysis or epiphyseal plate present special problems in determining whether bone growth will be affected. Healing of epiphyseal injuries is usually prompt. The epiphysis is the weakest point of the long bones. This is a frequent site of damage during trauma.
What progressive complications should the nurse explain to parents of a child with Duchenne Muscular Dystrophy to expect?• A.Dry skin and hair, hirsutism, protruding tongue and mental retardation• B.Anorexia, gingival hyperplasia, dry skin and hair• C. Contractures, obesity and pulmonary infections• D.Trembling, frequent loss of consciousness, and slurred speech
Answer: C• Dry skin and hair, hirsutism, protruding tongue and mental retardation are s/s most often associated with Down Syndrome. Trembling, frequent loss of consciousness and slurred speech are often most evident in a head injury. DMD major complications include contractures, disuse atrophy, infections, obesity, respiratory complications and cardiopulmonary problems.
The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complication should the nurse monitor related to the child's immobilization status? •A.Metabolic rate increases• B.Increased joint mobility leading to contractors• C.Bone calcium increasing, releasing excess calcium into the body• D.Venous stasis leading to thrombi or emboli formation
Answer: D• The physiologic effects of immobilization, as a result of decreased muscle contraction, include venous stasis. This can lead to pulmonary emboli or thrombi. The metabolic rate decreases with immobilization. Loss of joint mobility leads to contractures. Bone demineralization with osteoporosis and hypercalcemia occur with immobilization.
The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? Select all that apply.• A.Positive Ortolani click •B.Negative Babinski sign •C.Trendelenburg sign •D.Lordosis •E.Unequal gluteal folds
Answers: A and E •DDH describes a spectrum of disorders related to abnormal development of the hip that may occur at any time during fetal life, infancy or childhood. A positive ortolani and barlow test have been appreciated in these cases. Unequal gluteal folds are also observed
Which should cause a nurse to suspect that an infection has developed under a cast? Select all that apply.• A.Foul smelling odor• B.Complaint of paresthesia• C.Cold toes• D.Increased respirations• E.Hot spots felt on cast surface
Answers: A and E• If hot spots are felt on the cast surface, they usually indicate infection beneath the area. This should be reported so that a window can be made in the cast to observe the site. The five Ps of ischemia from a vascular injury are pain, pallor, pulselessness, paresthesia, and paralysis. Paresthesia is an indication of vascular injury, not infection. Cold toes may be indicative of too tight a cast and need further evaluation. Increased respirations may be indicative of a respiratory tract infection or pulmonary emboli. This should be reported, and child should be evaluated.
The day care nurse is observing a 2-year-old child and suspects that the child may have strabismus. Which observation made by the nurse indicates the presence of this condition? A. The child has difficulty hearing. B. The child consistently tilts the head to see. C. The child does not respond when spoken to. D. The child consistently turns the head to hear.
B. The child consistently tilts the head to see.
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? A. The child exhibits nasal flaring and bradycardia. B. The child is leaning forward, with the chin thrust out. C. The child has a low-grade fever and complains of a sore throat. D. The child is leaning backward, supporting himself or herself with the hands and arms.
B. The child is leaning forward, with the chin thrust out.
DISTORTION OF SOUND AND PROBLEMS IN DISCRIMINATION ARE CHARACTERISTIC OF WHAT TYPE OF HEARING LOSS? A. CONDUCTIVE B. SENSORINEURAL C. CENTRAL AUDITORY IMPERCEPTIVE D. MIXED CONDUCTIVE-SENSORINEURAL
CORRECT ANSWER: B SENSORINEURAL RATIONALE: SENSORINEURAL HEARING LOSS, ALSO KNOWN AS PERCEPTIVE OR NERVE DEAFNESS, INVOLVES DAMAGE TO THE INNER EAR STRUCTURES OR THE AUDITORY NERVE. IT RESULTS IN DISTORTION OF SOUNDS AND PROBLEMS IN DISCRIMINATION. CONDUCTIVE HEARING LOSS INVOLVES MAINLY INTERFERENCE WITH LOUDNESS OF SOUND. CENTRAL AUDITORY IMPERCEPTIVE HEARING LOSS MANIFESTS AS A COMBINATION OF BOTH SENSORINEURAL AND CONDUCTIVE LOSS. THE MIXED CONDUCTIVE-SENSORINEURAL CATEGORY INCLUDES ALL HEARING LOSSES THAT DO NOT DEMONSTRATE DEFECTS IN THE CONDUCTION OR SENSORY STRUCTURES.
THE NURSE IS PERFORMING AN ASSESSMENT ON A 10-WEEK-OLD INFANT. THE NURSE UNDERSTANDS THAT THE DEVELOPMENTAL CHARACTERISTIC OF HEARING AT THIS AGE IS WHICH? A. THE INFANT RESPONDS TO HIS OWN NAME. B. THE INFANT LOCALIZES SOUNDS BY TURNING HIS HEAD DIRECTLY TO THE SOUND. C. THE INFANT LOCATES SOUND BY TURNING HIS HEAD TO THE SIDE AND THEN LOOKING UP OR DOWN. D. THE INFANT TURNS HIS HEAD TO THE SIDE WHEN SOUND IS MADE AT THE LEVEL OF THE EAR.
CORRECT ANSWER: D THE INFANT TURNS HIS HEAD TO THE SIDE WHEN SOUND IS MADE AT THE LEVEL OF THE EAR. RATIONALE: AT 8 TO 12 WEEKS OF AGE, THE INFANT TURNS THE HEAD TO THE SIDE WHEN SOUND IS MADE AT THE LEVEL OF THE EAR. AT 16 TO 24 WEEKS, THE INFANT LOCATES SOUND BY TURNING THE HEAD TO THE SIDE AND THEN LOOKING UP OR DOWN. AT 24 TO 32 WEEKS, INFANTS RESPOND TO THEIR OWN NAME. AT 32 TO 40 WEEKS, THE INFANT LOCALIZES SOUNDS BY TURNING THE HEAD DIRECTLY TOWARD THE SOUND.
WHICH EXPLAINS THE IMPORTANCE OF DETECTING STRABISMUS IN YOUNG CHILDREN? A. COLOR VISION DEFICIT MAY RESULT B. AMBLYOPIA, A TYPE OF BLINDNESS MAY RESULT C. EPICANTHAL FOLDS MAY DEVELOP IN THE AFFECTED EYE D. CORNEAL LIGHT REFLEXES MAY FALL SYMMETRICALLY WITHIN EACH PUPIL
CORRECT B AMBLYOPIA, A TYPE OF BLINDNESS MAY RESULTBY THE AGE OF 3 TO 4 MONTHS, INFANTS ARE ABLE TO FIXATE ON ONE VISUAL FIELD WITH BOTH EYES SIMULTANEOUSLY. IN STRABISMUS, OR CROSS-EYE, ONE EYE DEVIATES FROM THE POINT OF FIXATION. IF MISALIGNMENT IS CONSTANT, THE WEAK EYE BECOMES "LAZY," AND THE BRAIN EVENTUALLY SUPPRESSES THE IMAGE PRODUCED FROM THAT EYE. IF STRABISMUS IS NOT DETECTED AND CORRECTED BY AGE 4 TO 6 YEARS, BLINDNESS FROM DISUSE, KNOWN AS AMBLYOPIA, MAY OCCUR. COLOR VISION IS NOT THE ONLY CONCERN. EPICANTHAL FOLDS ARE NOT RELATED TO AMBLYOPIA. IN CHILDREN WITH STRABISMUS, THE CORNEAL LIGHT REFLEX WILL NOT BE SYMMETRIC FOR EACH EYE.
A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half-normal saline (0.45%) with 40 mEq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? A. Obtains a weight B. Takes the temperature C. Takes the blood pressure D. Checks the amount of urine output
D
The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? A. "The immunization schedule will need to be altered." B. "The child should not receive any hepatitis vaccines." C. "The child will receive all the immunizations except for the polio series." D. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
D. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."
Which are early signs and symptoms of hydrocephalus in infants A. Confusion, headache, diplopia B. Rapid head growth, poor feeding, confusion C. Papilledema, irritability, headache D. Full fontanels, poor feeding, rapid head growth
D. Full fontanels, poor feeding, rapid head growth
The parent of an infant asks the nurse what to watch for to determine if the infant has CP. Which is the nurse's best response? A. If the infant cannot sit up without support before 8 months B. If the infant demonstrates tongue thrust before 4 months C. If the infant has poor head control after 2 months D. If the infant has clenched fist after 3 months
D. If the infant has clenched fist after 3 months
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action? A. Tell the mother that the child must stay in the tent. B. Place a toy in the tent to make the child feel more comfortable. C. Call the health care provider and obtain a prescription for a mild sedative. D. Let the mother hold the child and direct the cool mist over the child's face.
D. Let the mother hold the child and direct the cool mist over the child's face.