PEDS test 4

How much folic acid is recommended for women of childbearing age?

0.4 mg

For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia?

A nasogastric tube fails to pass at birth.

Which clinical manifestation would most suggest acute appendicitis?

Abdominal pain that is most intense at McBurneys point

The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing?

Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours.

The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to:

Adolescents often resenting the control and enforced dependence imposed by dialysis

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. The nurses approach should include:

Answering questions with straightforward honesty.

Therapeutic management of a child with tetanus includes the administration of

Antibiotics to control bacterial proliferation at the site of injury

Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies, which are now being successfully treated with antihistamines. The nurse should suspect that the constipation is most likely caused by:

Antihistamines.

A young girl has just injured her ankle at school. In addition to calling the childs parents, the most appropriate immediate action by the school nurse is to:

Apply ice.

Which interaction is part of the discharge plan for a school-age child with osteomyelitis who is receiving home antibiotic therapy?

Arrangements for tutoring and schoolwork

A stool specimen from a child with diarrhea shows the presence of neutrophils and red blood cells. This is most suggestive of which condition?

Bacterial gastroenteritis

Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to:

Bind phosphorus.

The nurse is explaining to a parent how to care for a child with vomiting associated with a viral illness. The nurse should include:

Brushing teeth or rinsing mouth after vomiting.

The nurse is caring for a child with acute renal failure. What clinical manifestation should he or she recognize as a sign of hyperkalemia?

Cardiac arrhythmia

The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include:

Cleansing of suture line, supine and side-lying positions, and arm restraints.

The nurse is conducting discharge teaching with parents of a preschool child with myelomeningocele, repaired at birth, who is being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the childs genitourinary function (Select all that apply)?

Continue to perform the clean intermittent catheterizations (CIC) at home Administer the oxybutynin chloride (Ditropan) as prescribed. Monitor for signs of a recurrent UTI.

What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis?

Coping with stress and avoiding triggers

What is used to treat moderate-to-severe inflammatory bowel disease?

Corticosteroids

Therapeutic management of nephrosis includes:

Corticosteroids.

The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?

Creatinine clearance

One of the clinical manifestations of chronic renal failure is uremic frost. What best describes this term?

Deposits of urea crystals on skin

When assessing the child with osteogenesis imperfecta, the nurse should expect to observe:

Discolored teeth.

An advantage to using a fiberglass cast instead of a plaster cast is that a fiberglass cast:

Dries rapidly.

When does idiopathic scoliosis become most noticeable?

During preadolescent growth spurt

The nurse is teaching the parents of a 7-year-old child who has just had a cast applied for a fractured arm with the wrist and elbow immobilized. Which instructions should be included in the teaching?

Elevate casted arm when resting and when sitting up.

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include:

Elevating the head but giving nothing by mouth.

A mother who intended to breastfeed has given birth to an infant with a cleft palate. Nursing interventions should include (Select all that apply):

Encouraging and helping mother to breastfeed. Recommending use of a breast pump to maintain lactation until infant can suck.

Bismuth subsalicylate, clarithromycin, and metronidazole are prescribed for a child with a peptic ulcer to:

Eradicate Helicobacter pylori.

The most appropriate nursing diagnosis for the child with acute glomerulonephritis is:

Excess Fluid Volume related to decreased plasma filtration.

The nurse is conducting an assessment on a school-age child with urosepsis. Which assessment finding should the nurse expect?

Fever with a positive blood culture

A current recommendation to prevent neural tube defects is the supplementation of:

Folic acid for all women of childbearing age.

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, the nurse should explain that:

Frequent, serial casting is tried first

A parasite that causes acute diarrhea is:

Giardia lamblia.

Which intervention should be included in the nurses plan of care for a 7-year-old child with encopresis who has cleared the initial impaction?

Give the child a choice of beverage to mix with a laxative.

Kristin, age 10 years, 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?

Growth can be affected by this type of fracture.

. A child is admitted with acute glomerulonephritis. The nurse would expect the urinalysis during this acute phase to show:`

Hematuria and proteinuria.

Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings?

Hep A

Which vaccine is now recommended for the immunization of all newborns?

Hepatitis B vaccine

What would cause a nurse to suspect that an infection has developed under a cast?

Hot spots felt on cast surface

Which problem is most often associated with myelomeningocele?

Hydrocephalus

Which type of dehydration results from water loss in excess of electrolyte loss?

Hypertonic dehydration

The nurse is conducting teaching for an adolescent being discharged to home after a renal transplantation. The adolescent needs further teaching if which statement is made?

I am glad I only have to take the immunosuppressant medication for two weeks

A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which intervention should the nurse perform first?

Implement a standing prescription to empty the bladder with a sterile in-and-out Foley catheter.

The nurse closely monitors the temperature of a child with nephrosis. The purpose of this is to detect an early sign of

Infection.

A school-age child is diagnosed with systemic lupus erythematosus (SLE). The nurse should plan to implement which interventions for this child (Select all that apply)?

Instructions to avoid exposure to sunlight Teaching about body changes associated with SLE

Which statement is most descriptive of Meckels diverticulum?

Intestinal bleeding may be mild or profuse

The primary method of treating osteomyelitis is:

Intravenous antibiotic therapy.

A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child will begin with:

Intravenous fluids.

Which statement is descriptive of renal transplantation in children?

It is preferred means of renal replacement therapy in children.

Which term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine?

Kyphosis

The diet of a child with chronic renal failure is usually characterized as:

Low in phosphorus.

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. Which nursing care interventions are needed for this child (Select all that apply)?

Monitoring and maintaining systemic blood pressure. Administering corticosteroids Monitoring for respiratory complications.

The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching?

My child should not eat bananas or kiwis.

The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include?

Nasogastric intubation and urinary catheter may be required.

A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is:

Necessary because it will be an adjustment

The most common problem of children born with a myelomeningocele is:

Neurogenic bladder.

Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?

Nonsteroidal antiinflammatory drugs (NSAIDs)

The primary clinical manifestations of acute renal failure are:

Oliguria and hypertension.

Which statement best characterizes hepatitis A?

Onset is usually rapid and acute

. An advantage of peritoneal dialysis is that:

Parents and older children can perform treatments.

The narrowing of preputial opening of foreskin is called:

Phimosis

The narrowing of the preputial opening of the foreskin is called:

Phimosis.

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)?

Positive Ortolani sign and Unequal gluteal folds

The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?

Progressive weakness and wasting of skeletal muscle

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is to place him:

Prone, turn head to side, and nipple feed.

Which interventions should a nurse implement when caring for a child with hepatitis(Select all that apply)?

Provide a well-balanced, low-fat diet. Teach parents not to administer any over-the-counter medications. Instruct parents on the importance of good hand washing

Caring for the newborn with a cleft lip and palate before surgical repair includes:

Providing satisfaction of sucking needs

A young boy has just been diagnosed with pseudohypertrophic (Duchennes) muscular dystrophy. The management plan should include:

Recommending genetic counseling

An objective of care for the child with nephrosis is to:

Reduce excretion of urinary protein.

A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to

Reduce gastric acid production

An important nursing consideration in the care of a child with celiac disease is to:

Refer to a nutritionist for detailed dietary instructions and education.

During the first few days after surgery for cleft lip, which intervention should the nurse do?

Remove restraints periodically to cuddle infant.

Which diagnostic test allows visualization of the renal parenchyma and renal pelvis without exposure to external beam radiation or radioactive isotopes?

Renal ultrasound

The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. What should be included?

Return to the clinic every 1 to 2 weeks.

The viral pathogen that frequently causes acute diarrhea in young children is:

Rotavirus

Discharge planning for the child with juvenile arthritis includes the need for:

Routine ophthalmologic examinations to assess for visual problems

The most common cause of acute renal failure in children is:

Severe dehydration.

The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome (Select all that apply)?

Severe pain not relieved by analgesics Tingling of extremity Inability to move extremity

Which factor predisposes a child to urinary tract infections?

Short urethra in young girls

A school-age child with chronic renal failure is admitted to the hospital with a serum potassium level of 5.2 mEq/L. Which prescribed medication should the nurse plan to administer?

Sodium polystyrene sulfonate (Kayexalate)

Which type of hernia has an impaired blood supply to the herniated organ?

Strangulated hernia

Which finding should cause the nurse to suspect a diagnosis of spastic cerebral palsy?

Sudden jerking movement caused by stimuli

When caring for a child with probable appendicitis, the nurse should be alert to recognize that a sign of perforation is:

Sudden relief from pain

Therapeutic management of most children with Hirschsprungs disease is primarily

Surgical removal of affected section of bowel.

An important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA) is to

Teach child and family the correct administration of medications.

What should the nurse include in a teaching plan for the parents of a child with vesicoureteral reflux?

The importance of taking prophylactic antibiotics

The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching?

The red blood cell count should begin to improve with these injections.

Which nursing intervention is appropriate to assess for neurovascular competency in a child who fell off the monkey bars at school and hurt his arm?

The skin color, temperature, movement, sensation, and capillary refill of the extremity

What is the most appropriate nursing response to the father of a newborn infant with myelomeningocele who asks about the cause of this condition?

There may be no definitive cause identified

. A 4-month-old infant has gastroesophageal reflux disease (GERD) but is thriving without other complications. What should the nurse suggest to minimize reflux?

Thicken formula with rice cereal.

What is most descriptive of the therapeutic management of osteosarcoma?

Treatment usually consists of surgery and chemotherapy

A child with secondary enuresis who complains of dysuria or urgency should be evaluated for what condition (Select all that apply)?

UTI and diabetes

. Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant uremic breath odor

When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as:

Uremia.

The nurse is assisting the pediatric provider with a newborn examination. The provider notes that the infant has hypospadias. The nurse understands that hypospadias refers to:

Urethral opening along ventral surface of penis.

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. The nurses best response should be that the:

Urinary output will increase

What effect does immobilization have on the cardiovascular system?

Venous stasis

A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions?

WBC >2; specific gravity 1.030

Which intervention is appropriate when examining a male infant for cryptorchidism

Warming the room

A major complication in a child with chronic renal failure is:

Water and sodium retention

What should the nurse recommend to prevent urinary tract infections in young girls?

Wearing cotton underpants

The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching?

You will need to avoid adding salt to your childs food.

A clinic nurse is conducting a staff in-service for other clinic staff regarding the signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session (Select all that apply)?

abdominal mass ear sore and throat pain ecchymosis of the conjunctiva

Acute diarrhea is often caused by:

antibiotic therapy

A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria. Which dietary menu items should be allowed for this child (Select all that apply)?

apples carrot sticks strawberries

What is characterized by a chronic inflammatory process that may involve any part of the gastrointestinal tract from mouth to anus?

chrons disease

Which description of a stool is characteristic of intussusception?

currant jelly stool

The nurse is caring for a 4-year-old child immobilized by a fractured hip. Which complications should the nurse monitor?

decreased metabolic rate

An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of:

dehydration

A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess (Select all that apply)?

facial edema fatigue frothy urine

. Nurses must be alert for increased fluid requirements when a child has:

fever

A common side effect of corticosteroid therapy is:

increased appetite

. The earliest clinical manifestation of biliary atresia is:

jaundice

The best chance of survival for a child with cirrhosis is:

liver transplant

An infant with pyloric stenosis experiences excessive vomiting that can result in:

metabolic alkalosis

A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurses response should be based on knowledge that this drug is:

not indicated

Which diagnostic finding is present when a child has primary nephrotic syndrome?

proteinuria

The diet of a child with nephrosis usually includes:

salt restriction

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations would be observed (Select all that apply)?

vomiting failure to gain weight persistent diaper rash

A nurse is conducting dietary teaching on high-fiber foods for parents of a child with constipation. Which foods should the nurse include as being high in fiber (Select all that apply)?

whole grain breads bran pancakes raw carrots

When infants are seen for fractures, which nursing intervention is a priority?

Assess for child abuse. Fractures in infants are often nonaccidental

An appropriate nursing intervention when caring for a child in traction is to:

Assess for tightness, weakness, or contractures in uninvolved joints and muscles.

The nurse uses the palms of the hands when handling a wet cast to:

Avoid indenting the cast

Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include:

Avoiding using any latex product.

Which statement is accurate concerning a childs musculoskeletal system and how it may be different from an adults?

Because soft tissues are resilient in children, dislocations and sprains are less common than in adults.

The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac?

Covered with a sterile, moist, nonadherent dressing

. A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initialtherapeutic approach to the mother should be to:

Encourage her to express her feelings

Osteosarcoma is the most common bone cancer in children. Where are most of the primary tumor sites?

Femur

Spastic cerebral palsy is characterized by:

Hypertonicity and poor control of posture, balance, and coordinated motion

The parents of a child with cerebral palsy ask the nurse if any drugs can decrease their childs spasticity. The nurses response should be based on knowing that:

Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.

The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to:

Notify the practitioner

Four-year-old David is placed in Bucks extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. What should the nurse do first?

Notify the practitioner of the changes noted.

Therapeutic management of the child with acute diarrhea and dehydration usually begins with:

Oral rehydration solution (ORS)

Which condition can result from the bone demineralization associated with immobility?

Osteoporosis

What is the major focus of the therapeutic management for a child with lactose intolerance?

Teaching dietary modifications

An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include:

Teaching the family signs of central venous catheter infection.

A 4-year-old child is newly diagnosed with Legg-Calv-Perthes disease. Nursing considerations should include which action?

Teaching the family the care and management of the corrective appliance

The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborns defect?

Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves

The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis?

Visible peristalsis and weight loss

A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement?

Were glad there is a cure for this disorder.

The nurse is admitting a school-age child with suspected Guillain-Barr syndrome (GBS). Which nursing intervention is a priority in the care for this child?

assessing respiratory efforts

Which assessment findings should the nurse note in a school-age child with Duchennes muscular dystrophy (DMD) (Select all that apply)?

lordosis, gowers sign, and a waddling gait

What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching?

oatmeal

A high-fiber food that the nurse could recommend for a child with chronic constipation is:

popcorn

Which type of traction uses skin traction on the lower leg and a padded sling under the knee?

russell

Which term is used to describe a type of fracture that does not produce a break in the skin?

simple

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What should the nurse suggest to remove this material?

soak in the bathtub

What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux?

teach the parents how to do infant cardiopulmonary resuscitation (CPR)

The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant (Select all that apply)?

temperature instability irritability lethargy