PEDs week 4 NCLEX questions
Which of the following will be abnormal in a child with the diagnosis of hemophilia? A. Platelet count. B. Hemoglobin level. C. White blood cell count. D. Partial thromboplastin time (PTT).
D
A child with hemophilia A fell and injured a knee while playing outside. The knee is swollen and painful. Which of the following measures should be taken to stop the bleeding? Select all that apply. A. The extremity should be immobilized. B. The extremity should be elevated. C. Warm moist compresses should be applied to decrease pain. D. Passive range-of-motion exercises should be administered to the extremity. E. Factor VIII should be administered.
A, B, E
Which of the following can lead to a possible diagnosis of human immunodeficiency virus (HIV) in a child? Select all that apply. A. Repeated respiratory infections B. Intermittent diarrhea C. Excessive weight gain D. Irregular heartbeat E. Poor weight gain
A, B, E
The nurse is discharging a child who has just received chemotherapy for neuroblastoma. Which of the following statements made by the child's parent indicates a need for additional teaching? A. "I will inspect the skin often for any lesions." B. "I will do mouth care daily and monitor for any mouth sores." C. "I will wash my hands before caring for my child." D. "I will take a rectal temperature daily and report a temperature greater than 101°F (38.3°C) immediately to the health care provider."
D
Which descriptive terms should be used to escribe a school-age child with myxedematous skin/eyes/hair changes? A. The skin is oily and scaly B. The skin has pale, pale thickened patches C. The skin is moist D. The eyes are puffy, the hair is sparse, and the skin is dry
D
Which intervention should be implemented after a bone marrow aspiration? A. Ask the child to remain in a supine position. B. Place the child in an upright position for 4 hours. C. Keep the child nothing by month for 6 hours. D. Administer analgesics as needed for pain.
D
Which of the following laboratory tests will be ordered to determine the presence of the human immunodeficiency virus antigen in an infant whose mother is HIV? A. CD4 cell count. B. Western blot. C. IgG levels. D. p24 antigen assay.
D
Which of the following measures should the nurse teach the parent of a child with hemophilia to do first if the child sustains an injury to a joint causing bleeding? A. Give the child a dose of acetaminophen (Tylenol). B. Immobilize the joint and elevate the extremity. C. Apply heat to the area. D. Encourage the child to swallow frequently.
D
The nurse is instructing the parent of a child with HIV about immunizations. Which of the following should the nurse tell the parent: Select all that apply. A. Hepatitis B vaccine will not be given to this child B. Members of the family should be cautioned not to receive the varicella vaccine. C. The child will need to have a Western blot test dose prior to all immunizations D. Pneumococcal and influenza vaccines are recommended. E. Meningitis immunization.
D, E
Which of the following is a reason to perform a lumbar puncture on a child with a diagnosis of leukemia? Select all that apply. A. Rule out meningitis. B. Assess the central nervous system for infiltration C. Give intrathecal chemotherapy D. Determine increased intracranial pressure E. Stage the leukemia
B, C
Where is the primary site of origin of the tumor in children who have neuroblastoma? A. Bone. B. Kidney. C. Abdomen. D. Liver
C
Parents bring their teen to the clinic with a tender, enlarged right breast. The nurse explains that which hormone(s) secreted by the anterior pituitary influence(s) this process? A. Thyrotropin B. Gonadotropin C. Oxytocin D. Somatotropin
B
The nurse expects which of the following clinical manifestations in a child das with SCID? A. Prolonged Meaning B. Failure to thrive. C. Fatigue malaise D. Susceptibility to infection
D
A 10-year-old with severe factor VIII deficiency falls, injuries an elbow, and is brought to the ED. The nurse should prepare which of the following? A. An IM injection of factor VIII. B. An IV infusion of factor VIII. C. AN injection of desmopressin. D. An IV infusion of platelets.
B
The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems is (are) associated with sickle cell disease? Select all that apply. A. Polycythemia B. Hemarthrosis C. Aplastic crisis D. Thrombocytopenia E. Vaso-occlusive crisis
C, E
What key information should be explained to the family of a 3-year-old who has short stature and laboratory test results? A. Because of the diurnal rhythm of the body, growth hormone levels are elevated following the onset of sleep. B. Exercise can stimulate growth hormone secretion. C. The initial screening tests need to be repeated for accuracy. D. Growth hormone levels in children ae so low that stimulation testing must be done.
D
Which is the reason a student takes metformin (Glucophage) three times a day? A. Type 1 diabetes mellitus. B. Diabetes insipidus. C. Inflammatory bowel disease. D. Type 2 diabetes mellitus.
D
Which of the following is the most common opportunistic infection in children infected with human immunodeficiency virus (HIV)? A. CMV. B. Encephalitis. C. Meningitis. D. Pneumocystis pneumonia.
D
A child diagnosed with leukemia is receiving allopurinol (Zyloprim) as part of the treatment plan. The parents ask why their child is receiving this medication. What information about the medication should the nurse provide? A. Helps reduce the uric acid level caused by cell destruction. B. Helps make the chemotherapy more effective. C. Helps reduce the nausea and vomiting associated with chemotherapy D. Helps decrease pain in the bone marrow.
A
A teen who was hospitalized for chronic kidney disease (CKD) develops symptoms of polyuria, polydipsia, and bone pain. Which body mineral might be causing these symptoms? A. Elevated calcium B. Low phosphorus C. Low magnesium D. High aluminum hydroxide
A
A 12-year-old with hyperthyroidism is being treated with standard antithyroid therapy. A parent calls the office stating that the child has a sore throat and fever. Which is the nurse's best response? A. "Bring your child to the office or emergency department immediately." B. "Slight fever and sore throat are normal side effects of the medication." C. "Give your child the appropriate dose of ibuprofen and call back if symptoms worsen." D. "Give your child at least 8 oz of clear fluids and call back if symptoms worsen."
A
The most appropriate nursing diagnosis for a child with type 1 diabetes mellitus is which of the following? A. Risk for infection related to reduced body defenses. B. Impaired urinary elimination (enuresis). C. Risk for injury related to medical treatment. D. Anticipatory grieving.
A
The nurse is caring for a child with a diagnosis of ALL who is receiving chemotherapy. The nurse notes that the child's platelet count is 20,000/mm. Based on this laboratory finding, what information should the nurse provide to the child and parents? A. A soft toothbrush should be used for mouth care. B. Isolation precautions should be started immediately C. The child's vital signs, including blood pressure, should be monitored every 4 hours. D. All visitors should be discouraged from coming to see the family.
A
Which of the following is correct regarding prognostic factors for determining survival for a child newly diagnosed with ALL? A. The initial white blood cell count on diagnosis. B. The race of the child. C. The amount of time needed to initiate treatment. D. Children aged 12 to 15 years.
A
Which test provides a definitive diagnosis of aplastic anemia? A. Complete blood count with differential. B. Bone marrow aspiration. C. Serum lgG levels. D. Basic metabolic panel.
B
A baby has hypertension as a result of partial 21-hydroxylase deficiency. The parents ask the nurse to clarify why the baby is being sent home on cortisone. Which is the nurse's best response about cortisone? It: A. Increases the utilization of fatty acids for energy. B. Depresses the secretion of ACTH. C. Stimulates the adrenal glands. D. Increases the response to inflammation.
B
A teen comes into the clinic with complaints of having been under a lot of stress recently. The teen is being treated for Addison disease and is taking cortisol and aldosterone orally. Today, the teen shows symptoms of muscle weakness, fatigue, salt craving, and dehydration. What should the nurse discuss with the teen regarding the medications? A. The dosages may need to be decreased in times of stress. B. The dosages may need to be increased in times of stress. C. The aldosterone should be stopped, and the cortisol should be increased. D. The cortisol may need to be given IV to raise its level.
B
Somatotropin comes in a vial of 5 mg and is mixed with a diluent of 5 m L. There is 5 m L of solution in each vial. What amount of the solution should the nurse draw up to give a 1 mg dose? A. 0.5 mL B. 0.675 mL C. 1 mL D. 2 mL
B
What should the parent of a child with diabetes insipidus (DI) be taught about administering desmopressin acetate nasal spray? Select all that apply. A. The use of the flexible nasal tube. B. Nasal congestion causes this route to be ineffective. C. The medication should be administered every 48 hours. D. The medication should be administered every 8 to 12 hours. E. Overmedication results in signs of SIADH. F. Nasal sprays do not always work as well as injections.
A, B, D, E
The adrenal cortex secretes sex hormones. Identify which hormones would result in feminization of a young male child. Select all that apply. A. Estrogen B. Testosterone C. Progesterone D. Cortisol E. Androgens
A, C
A nurse is caring for a 15-year-old who has just been diagnosed with non-Hodgkin lymphoma. Which of the following should the nurse include in teaching the parents about this lymphoma? Select all that apply. A. The malignancy originates in the lymphoid system. B. The presence of Reed-Sternberg cells in the biopsy is considered diagnostic. C. Mediastinal involvement is typical. D. The disease is diffuse rather than nodular. E. Treatment includes chemotherapy and radiation.
A, C, D, E
The nurse is assigned to care for a newborn with goiter. The nurse's primary concern is which of the following? A. Reassuring the parents that the condition is only temporary and will be treated with medications. B. Maintaining a patent airway and preparing for emergency ventilation. C. Preparing the infant for surgery and initiating preoperative teaching with the parents. D. Obtaining a detailed history, particularly of medications taken during the mother's pregnancy.
B
The nurse is taking care of a 10-year-old diagnosed with Graves disease. Which could the nurse expect this child to have recently had? A. Weight gain, excessive thirst, and excessive hunger. B. Weight loss, difficulty sleeping, and heat sensitivity. C. Weight gain, lethargy, and goiter. D. Weight loss, poor skin turgor, and constipation.
B
The parent brings the growth record along with the 21-month-old child to a new clinic for a well-child visit. The record shows a birth weight of 8lb; the 6-month-weight was 16 lb; the 12-month weight was 18 lb; and the 15-month weight was 19 lb. With the record showing that the toddler's weight-for-age has been decreasing, the nurse should do what initially? A. Omit plotting the previous weight-for-age on the new growth chart. B. Point out the growth chart to the new health-care provider (HCP). C. Consider the toddler a child with failure to thrive. D. Weigh the child and plot on a new growth chart.
B
The parent of a 2-year-old who is HIV+ questions the nurse about placing the child in day care. Which of the following is the best response? A. The child should not go to day care until older, because there is a high risk for transmission of the disease. B. The child can go to day care without restrictions and should be allowed to participate in all activities. C. The child can go to day care but should avoid physical activity D. The child may go to day care, but the parent must inform all the parents at the day care that the child is HIV+.
B
The school nurse notices that a 14-year-old who used to be an excellent student and very active in sports is losing weight and acting very nervous. The teen was recently checked by the primary care provider (PCP), who noted the teen had a very low level of TSH. The nurse recognizes that the teen has which condition? A. Hashimoto thyroid disease B. Graves disease C. Hypothyroidism D. Juvenile autoimmune thyroiditis
B
What are the clinical manifestations of non-Hodgkin lymphoma? A. Basically the same as those in Hodgkin disease. B. Depends on the anatomical site and extent of involvement. C. Nausea, vomiting, abdominal pain. D. Behavior changes, jaundice, dry mouth.
B
Which of the following is the best method to prevent the spread of infection to an immunosuppressed child? A. Administer antibiotics prophylactically to the child. B. Have people wash their hands prior to contact with the child. C. Assign the same nurses to care for the child each day. D. Limit visitors to family members only.
B
The nurse receives a call from a parent of a child with leukemia in remission. The parent says the child has been exposed to chickenpox and has never had it. Which of the following responses is most appropriate for the nurse? Select all that apply. A. "You need to monitor the child's temperature frequently and call back if the temperature is greater than 101 F (38.1 C)." B. "The child has had two varicella immunizations as an infant tut is no longer immune after chemotherapy." C. "You need to bring the child to the clinic for a varicella immunoglobulin vaccine. " D. "Your child will need to be isolated for the next 2 weeks." E. "Your child may develop chicken pox lesions about 14 to 21 days after exposure."
B, C
A nurse is caring for an infant who is very fussy and has a diagnosis of diabetes insipidus (DI). Which parameters should the nurse monitor while the infant is on fluid restrictions? Select all that apply. A. Oral intake B. Urine output C. Appearance of the mucous membranes D. Change in pulse and temperature E. Lethargy and pain
B, E
Which of the following should the nurse expect to administer to a child with ITP and a platelet count of 5000/mm? Select all that apply. A. Platelets B. Intravenous immunoglobulin C. Packed red blood cells (PRBCs) D. White blood cells E. Prednisolone
B, E
A 13-year-old is being seen for an annual physical examination. The child ha 10 lb despite reports of excellent appetite. Appearance is normal, except for slight protruding eyeballs, and the parents report the child has had difficulty sleeping lately. The nurse should do which of the following? A. Prepare the family for a neurology consult. B. Explain the need for an ophthalmology consult. C. Discuss the plan for thyroid function tests. D. Explain the plan for an 8-hour fasting blood glucose test.
C
A 5-year-old is admitted to the hospital with complaints of leg pain and fever. On physical examination, the child is pale and has bruising over various areas of the body. The health-care provider suspects that the child has ALL. The nurse informs the parent that the diagnosis will be confirmed by which of the following: A. Lumbar puncture. B. White blood cell count. C. Bone marrow aspirate. D. Bone scan.
C
The nurse caring for a 14-year-old girl with diabetes insipidus (DI) understands which of the following about this disorder? A. DI is treated on a short-term basis with hormone replacement therapy. B. DI may cause anorexia if proper meal planning is not addressed. C. DI is treated with vasopressin on a lifelong basis. D. DI requires strict fluid limitation until resolves.
C
Which is an important nursing intervention for a child with a diagnosis of hyperthyroidism? A. Encourage an increase in physical activity. B. Do preoperative teaching for thyroidectomy. C. Promote opportunities for periods of rest. D. Do dietary planning to increase caloric intake.
C
A child is working on a school project on glands and asks the clinic nurse explain the function of the thymus gland. Which answer would the nurse provide? A. It produces hormones that help with digestion B. It is a gland that disappears by the time a baby is born. C. A major function is to stimulate the pituitary to act as the master gland. D. The gland helps with immunity in fetal life and early childhood.
D
A child with leukemia is receiving chemotherapy and is complaining of nausea. The nurse has been giving the scheduled antiemetic. Which of the following should the nurse do when the child is nauseated? A. Encourage low-protein foods. B. Encourage low-caloric foods. C. Offer the child's favorite foods. D. Offer cool, clear liquids.
D
A nurse is doing discharge education with a parent who has a child with beta-thalassemia (Cooley anemia). The nurse informs the parent that the child is at risk for which of the following conditions? A. Hypertrophy of the thyroid. B. Polycythemia vera. C. Thrombocytopenia. D. Chronic hypoxia and iron overload.
D
Prednisone is given to children who are being treated for leukemia. Why is this medication given as part of the treatment plan? A. Enhances protein metabolism. B. Enhances sodium excretion. C. Increases absorption of the chemotherapy. D. Destroys abnormal lymphocytes.
D
The nurse is caring for a child who complains of constant hunger, constant thirst, frequent urination, and recent weight loss without dieting. Which can the nurses expect to be included in care for this child? A. Limiting daily fluid intake. B. Weight management consulting. C. Strict intake and output monitoring. D. Frequent blood glucose testing.
D