CH 32

Which findings indicate that a child with diabetes has ketoacidosis? Select all that apply. 1 Blood pH of 7.25 2 Presence of casts in urine 3 Absence of ketones in blood 4 Presence of glucose in urine 5 Blood sugar level of 380 mg/dL

1 Blood pH of 7.25 4 Presence of glucose in urine 5 Blood sugar level of 380 mg/dL

Which factors might cause congenital heart birth defects? Select all that apply. 1 Diabetes mellitus 2 Maternal alcoholism 3 Advanced paternal age 4 Maternal drug ingestion 5 Chromosomal abnormalities

1 Diabetes mellitus 2 Maternal alcoholism 4 Maternal drug ingestion 5 Chromosomal abnormalities

Which condition causes symptoms of stomach pain, trouble concentrating, and eating dirt? 1 Benign tumor 2 Lead poisoning 3 Sickle cell disease 4 Hormone deficiency

2 Lead poisoning

Which physiologic alteration does the nurse expect in a child diagnosed with nephrotic syndrome? 1 Increased blood volume 2 Increased blood protein 3 Presence of protein in urine 4 Presence of sodium in urine

3 Presence of protein in urine

Which age group is most likely to be diagnosed with scoliosis? 1 Adults 2 Infants 3 Children 4 Adolescents

4 Adolescents

Which method is most accurate to assess urinary output in an infant? 1 Weigh diaper before and after soiling. 2 Weigh the infant every day fully clothed. 3 Calculate the total dietary intake of fluids. 4 Calculate the amount of intravenous fluid infusing only.

1 Weigh diaper before and after soiling.

Which method is the most useful way to measure fluid balance in a child with acute glomerulonephritis? 1 Weigh the child daily. 2 Perform urinalysis to check for proteinuria. 3 Calculate the intake and output every shift. 4 Perform urinalysis to monitor the specific gravity.

1 Weigh the child daily.

Which signs and symptoms would the nurse expect to find in a child with learning disabilities? Select all that apply. 1 Seizures 2 Speech problems 3 Behavior problems 4 Slowed academic progress 5 Excellent social relationships

1 Seizures 2 Speech problems 3 Behavior problems 4 Slowed academic progress

Which instructions would the nurse give to the parents of a 6-month-old infant with Down syndrome regarding feeding techniques and diet? Select all that apply. 1 "Provide the child with a fiber-rich diet." 2 "Use a small spoon with a straight handle." 3 "Stop feeding if the child spits the food out." 4 "Never feed the child if the tongue protrudes out." 5 "Provide the child with an adequate amount of fluids."

1 "Provide the child with a fiber-rich diet." 2 "Use a small spoon with a straight handle." 5 "Provide the child with an adequate amount of fluids."

The nurse is counseling the parents of a child with attention deficit hyperactivity disorder (ADHD). Which suggestions would the nurse include in the counseling session? Select all that apply. 1 "Supervise the child frequently." 2 "Do not make a strict daily routine." 3 "Check the child's adherence to medicines." 4 "Encourage the use of controversial therapies." 5 "Inform the school officials about the medication."

1 "Supervise the child frequently." 3 "Check the child's adherence to medicines." 5 "Inform the school officials about the medication."

The nurse is caring for a child who has acute laryngotracheobronchitis (LTB). Which instruction does the health care provider give to the nurse during an emergency? 1 Administer aerosolized epinephrine. 2 Offer adequate oral fluids to the child. 3 Give sedatives to the child to induce sleep. 4 Administer betamethasone (Celestone) to the child.

1 Administer aerosolized epinephrine.

Which aspects of care would the nurse include while counseling a teenaged patient following a suicide attempt? Select all that apply. 1 Encourage the teenager to express feelings openly. 2 Encourage the use of deep-breathing techniques. 3 Ask the teenager about any previous suicidal attempts. 4 Ask the teenager to leave school and stay at home. 5 Directly check the teenager's body for signs of previous attempts.

1 Encourage the teenager to express feelings openly. 2 Encourage the use of deep-breathing techniques. 3 Ask the teenager about any previous suicidal attempts.

A child with a ventricular septal defect will eventually develop signs of heart failure. Which specific assessment findings would support this diagnosis? Select all that apply. 1 Fatigue 2 Crackles 3 Bradycardia 4 Shortness of breath 5 Clear breath sounds

1 Fatigue 2 Crackles 4 Shortness of breath

Which characteristics are associated with iron deficiency anemia? Select all that apply. 1 Fatigue 2 Bradycardia 3 Weight gain 4 Spoon fingernails 5 Pale mucous membranes

1 Fatigue 4 Spoon fingernails 5 Pale mucous membranes

Which laboratory finding would the nurse correlate with a child that has fruity-smelling breath? 1 High ketones in the blood 2 High creatinine in the blood 3 High urea nitrogen in the blood 4 High clotting factors in the blood

1 High ketones in the blood

Which cause of intestinal obstruction is the most common in a 4-year-old child? 1 Intussusception 2 Inguinal hernias 3 Hirschsprung disease 4 Hypertrophic pyloric stenosis

1 Intussusception

Which medication is most likely to be prescribed for a patient who is diagnosed with human immunodeficiency virus (HIV) infection? 1 Lamivudine (Epivir) 2 Palivizumab (Synagis) 3 Naproxen (Naprosyn) 4 Sulfasalazine (Azulfidine)

1 Lamivudine (Epivir)

Which test would the nurse question being prescribed for a child suffering from meningitis who has papilledema, neurologic deficits, and a bulging fontanelle? 1 Lumbar puncture 2 Complete blood count 3 Computed tomography scan 4 Magnetic resonance imaging (MRI)

1 Lumbar puncture

Which concern would be priority for a patient with epiglottitis? 1 Maintaining a patent airway 2 Maintaining sterile technique 3 Initiating isolation precautions 4 Frequent communication with parents

1 Maintaining a patent airway

Which factors might lead to a child developing attention deficit hyperactivity disorder (ADHD)? Select all that apply. 1 Maternal cigarette smoking during pregnancy 2 Maternal alcohol consumption during pregnancy 3 Increased exposure to lead in the early childhood 4 Increased consumption of salt in the early childhood 5 Increased consumption of sugar in the early childhood

1 Maternal cigarette smoking during pregnancy 2 Maternal alcohol consumption during pregnancy 3 Increased exposure to lead in the early childhood

What is the primary goal for a young child with cerebral palsy? 1 Minimize any limitations caused by the disease. 2 Prevent the onset of any emotional disturbances. 3 Eliminate any cause of the symptoms of the disease. 4 Improve muscle coordination and control of extremities.

1 Minimize any limitations caused by the disease

Which symptoms would the nurse identify as early indicators of respiratory distress syndrome in a newborn? Select all that apply. 1 Nasal flaring 2 Apgar score of 10 3 Expiratory grunting 4 Substernal retractions 5 Temperature of 103°F (39.4°C) or higher

1 Nasal flaring 3 Expiratory grunting 4 Substernal retractions

Which signs or symptoms would the nurse expect in a child with scarlet fever? Select all that apply. 1 Pharyngitis 2 Koplik spots 3 Peeling skin on palms 4 Sandpaper-like red rash 5 White strawberry tongue

1 Pharyngitis 4 Sandpaper-like red rash 5 White strawberry tongue

The nurse is caring for a child who is undergoing anti-D antibody therapy. Which laboratory report should the nurse monitor? 1 Platelet count 2 Creatinine levels 3 Blood urea levels 4 White blood cells (WBCs)

1 Platelet count

Which special needs does the nurse implement for an autistic 8-year-old child who is a new admission to the pediatric floor? 1 Providing a private room to decrease stimulation from noises and movement 2 Using communication techniques that maintain eye contact and physical contact 3 Arranging for extra time to spend with the child to thoroughly explain procedures and treatments 4 Monitoring for loose liquid stools, typical with autistic children, and encouraging fluids at each interaction

1 Providing a private room to decrease stimulation from noises and movement

Which congenital heart defect could cause an obstruction of blood flow to the lungs? 1 Pulmonary stenosis 2 Atrial septal defect (ASD) 3 Ventricular septal defect (VSD) 4 Transposition of the great vessels

1 Pulmonary stenosis

Which signs and symptoms might a child with a congenital heart disorder exhibit? Select all that apply. 1 S3 or S4 2 Rhonchi 3 Cyanosis 4 Bradycardia 5 Cardiomegaly

1 S3 or S4 3 Cyanosis 5 Cardiomegaly

A child has been diagnosed with a large patent ductus arteriosus (PDA). Which signs and symptoms would the child exhibit? Select all that apply. 1 Hunger 2 Fatigue 3 Growth spurts 4 Heart murmur 5 Bounding pulse

2 Fatigue 4 Heart murmur 5 Bounding pulse

A nurse is caring for an infant born with a cleft lip. Which concern would be the highest priority? 1 Parental coping 2 Nutritional intake 3 Tissue or skin integrity 4 Potential for aspiration

2 Nutritional intake

Which feeding technique is best for a newborn with a cleft lip and palate? 1 Feed newborn lying on back. 2 Place newborn's head upright. 3 Use regular nipples on bottles. 4 Burp only after feeding is completed.

2 Place newborn's head upright.

Which instruction would the nurse give the parents of an infant to prevent the risk of sudden infant death syndrome (SIDS)? 1 Allow the infant to sleep on beds and sofas. 2 Place the infant on the back while sleeping. 3 Use soft pillows under the infant while sleeping. 4 Place soft towels inside the infant's crib while sleeping.

2 Place the infant on the back while sleeping.

The nurse is caring for a pediatric patient who has Wilms' tumor. The nurse would avoid abdominal palpation on the patient because this action could have which effect? 1 Increase the tumor pain. 2 Rupture the tumor capsule. 3 Increase the gastric peristalsis. 4 Lead to hematuria in the patient.

2 Rupture the tumor capsule.

Which position would the nurse recommend to a new mother to lay her infant down? 1 Prone 2 Supine 3 Side-lying 4 Head elevated

2 Supine

Under which circumstances does dehydration occur in a child? 1 When too much fluid is consumed 2 When the body loses more fluid that it absorbs 3 When microcytic cells become macrocytic cells 4 When intravenous fluids seep into the subcutaneous tissue

2 When the body loses more fluid that it absorbs

Four teenagers have been admitted to the floor for unsuccessful suicide attempts. Which patient statement is most concerning to the nurse? 1 "I will attend counseling twice a week after I am discharged." 2 "I plan to attend all of my classes at school when I return home." 3 "I am so excited that my dad is buying me a gun for my birthday next week." 4 "I will talk openly with my parents and friends if I begin to feel overwhelmed."

3 "I am so excited that my dad is buying me a gun for my birthday next week."

Which statement by the parents of an infant indicates the need for further teaching regarding diaper rashes? 1 "I should change diapers as soon as they are soiled." 2 "I should apply zinc oxide ointment on reddened skin." 3 "I should use perfumed soaps and wipes to clean the skin." 4 "I should keep the skin dry and use superabsorbent diapers."

3 "I should use perfumed soaps and wipes to clean the skin."

Which response by the nurse would be the most appropriate when parents ask about activities at school for a child newly diagnosed with juvenile idiopathic arthritis (JIA)? 1 "Provide pain medications only during school activities." 2 "Do not allow your child to participate in school activities." 3 "Talk with the school nurse to arrange for medications and rest periods." 4 "Walk your child to all his classes to make sure other kids do not pick on him."

3 "Talk with the school nurse to arrange for medications and rest periods."

Which diagnostic test is most likely to be performed on an infant who has passed currant-jelly stools? 1 Endoscopy 2 Ultrasonography 3 Barium enema (BE) 4 Barium esophagography

3 Barium enema (BE)

Which assessment findings would the nurse expect in a child with coarctation of the aorta? 1 Clear lungs bilaterally to auscultation 2 Apical heart rate of 60 beats/min and respiratory rate of 20 3 Blood pressure in upper extremities higher than in lower extremities 4 Bounding pulses in upper extremities and thready pulses in lower extremities

3 Blood pressure in upper extremities higher than in lower extremities

Which disability does the nurse suspect in a premature child with abnormal muscle tone? 1 Meningitis 2 Encephalitis 3 Cerebral palsy 4 Hydrocephalus

3 Cerebral palsy

Which endocrine disorder is the most common in children? 1 Hypothyroidism 2 Hyperthyroidism 3 Diabetes mellitus type 1 4 Diabetes mellitus type 2

3 Diabetes mellitus type 1

Which medication would be used to close the patent ductus arteriosus defect? 1 Lisinopril (Privinil) 2 Amitriptyline (Elavil) 3 Indomethacin (Indocin) 4 Metformin (Glucophage)

3 Indomethacin (Indocin)

A pediatric patient with which condition may require a chelation therapy? 1 Skin nodules 2 Subluxated hip 3 Lead poisoning 4 Periorbital edema

3 Lead poisoning

A newborn diagnosed with an atrial septal defect has a congenital abnormality. This defect is between which structures? 1 Aorta and the liver 2 Pulmonary artery and the aorta 3 Left atrium and right atrium 4 Left ventricle and right ventricle

3 Left atrium and right atrium

A child has a decreased blood supply to the femoral head, pain in the knees, and muscular atrophy in the thighs. Which condition would the nurse infer from the symptoms? 1 Talipes equinovarus 2 Suppurative arthritis 3 Legg-Calvé-Perthes disease 4 Duchenne's muscular dystrophy (DMD)

3 Legg-Calvé-Perthes disease

The nurse is caring for a cancer patient with acute lymphoid leukemia who has neutropenia. Which measure should the nurse take to ensure patient safety? 1 Serve small snacks or meals when the patient is hungry. 2 Avoid administering methotrexate (Trexall) intrathecally. 3 Monitor the patient's temperature and maintain hygiene. 4 Avoid administering prednisone (Deltasone) to the patient.

3 Monitor the patient's temperature and maintain hygiene.

Which nursing interventions would be appropriate for a school-age child with attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. 1 Instructing on the benefits of megavitamins and herbal therapies 2 Encouraging the parents to enroll the child in multiple after-school activities 3 Scheduling routine follow-up appointments for medication management and review 4 Educating the parents on discipline, rewarding, accident prevention, and safety needs 5 Explaining medications and possible side effects to the parents, the child, and educators

3 Scheduling routine follow-up appointments for medication management and review 4 Educating the parents on discipline, rewarding, accident prevention, and safety needs 5 Explaining medications and possible side effects to the parents, the child, and educators

Which treatment modalities would be appropriate for juvenile idiopathic arthritis? Select all that apply. 1 Glycosides 2 Antihypertensive drugs 3 Slow-acting antirheumatic drugs (SAARDs) 4 Nonsteroidal antiinflammatory drugs (NSAIDs) 5 Disease-modifying antirheumatic drugs (DMARDs)

3 Slow-acting antirheumatic drugs (SAARDs) 4 Nonsteroidal antiinflammatory drugs (NSAIDs) 5 Disease-modifying antirheumatic drugs (DMARDs)

Which information would the nurse provide to the parents of a child with nephritic syndrome on prednisone (Deltasone)? 1 Teach the parents about foods that have low protein content. 2 Teach the parents to insist the child eat three large meals per day. 3 Teach the parents to minimize the child's exposure to communicable diseases. 4 Teach the parents about foods that are rich in sodium to be included in the child's diet.

3 Teach the parents to minimize the child's exposure to communicable diseases.

The health care provider has prescribed iron supplements to a 5-year-old child with iron deficiency anemia. The nurse would instruct the mother to give the iron supplement when? 1 At night before bed 2 With meals or a snack 3 With citrus juice on an empty stomach 4 When the child is showing signs of fatigue

3 With citrus juice on an empty stomach

An 8-month-old child with developmental dysplasia of the hip (DDH) is admitted for the placement of a hip spica cast. Which statement by the nurse explains the purpose of the cast? 1 "It keeps the pelvis tilted in an upward position." 2 "It will internally rotate the feet to maintain correct position." 3 "It supports the pelvis and the spine and expedites spinal fusion." 4 "It will externally rotate the feet, which keeps the femur head in the acetabulum."

4 "It will externally rotate the feet, which keeps the femur head in the acetabulum."

The mother of a child with cystic fibrosis asks the nurse, "Why does my daughter need pancreatic enzymes?" Which response by the nurse would be best? 1 "They increase peristalsis." 2 "They increase your child's metabolism." 3 "They help facilitate the movement of fluid in and out of cell membranes." 4 "They are given before meals and snacks to help with digestion of fats, proteins, and carbohydrates."

4 "They are given before meals and snacks to help with digestion of fats, proteins, and carbohydrates."

Full-term, healthy infants should have adequate iron stores from their mothers until which age? 1 12 months 2 18 months 3 6 to 8 months 4 4 to 6 months

4 4 to 6 months

An amniocentesis reveals that the fetal lungs are not developed. Which intervention should the health care provider prescribe for the patient before delivery? 1 Provide ventilator support to the patient. 2 Administer digoxin (Lanoxin) to the patient. 3 Give aggressive intravenous (IV) fluids to the patient. 4 Administer betamethasone (Celestone) to the patient.

4 Administer betamethasone (Celestone) to the patient.

Which group of people is at the highest risk for depression? 1 Males aged 12 to 17 years 2 Females aged 12 to 17 years 3 Children with high level of sugar consumption 4 Children of a parent with major affective disorders

4 Children of a parent with major affective disorders

Which strategy should the nurse implement when caring for a hospitalized child who has autism? 1 Provide a common room with other children. 2 Feed the child whenever the child mouths an object. 3 Allow the family and caregivers long visits to the child. 4 Converse with the child in a brief and concrete manner.

4 Converse with the child in a brief and concrete manner.

The nurse observes that a patient has red eyes, photosensitivity, and stiff and swollen joints. Which diagnostic test does the nurse expect the health care provider to prescribe? 1 Mantoux test 2 Western blot test 3 Blood gas analysis 4 Erythrocyte sedimentation rate

4 Erythrocyte sedimentation rate

An infant who is fed with bovine's milk is fussy and has a pale tongue. Which instruction would the nurse expect from the health care provider? 1 Provide the infant with kangaroo care. 2 Feed the infant with only breast milk. 3 Avoid placing the infant on the pillow. 4 Give iron-fortified formula to the infant.

4 Give iron-fortified formula to the infant.

The parent of a 7-month-old infant tells the nurse, "My child vomits shortly after eating and is losing a lot of weight." Which condition would the nurse suspect the infant may have? 1 Gastroenteritis 2 Intussusceptions 3 Gastroesophageal reflux 4 Hypertrophic pyloric stenosis

4 Hypertrophic pyloric stenosis

Which level of impairment would the nurse infer about a child whose intelligence quotient (IQ) level is 15? 1 Mild 2 Moderate 3 Severe 4 Profound

4 Profound

Which laboratory finding indicates nephrotic syndrome? 1 Low specific gravity 2 Normal platelet count 3 Decreased hematocrit 4 Proteinuria

4 Proteinuria

Which type of cell is specific to Hodgkin lymphoma? 1 Leukemia 2 Microcytic 3 Macrocytic 4 Reed-Steinburg

4 Reed-Steinburg

A 7-year-old child has missed school because of headaches and abdominal pain. The child's pain is worse in the morning but is gone by mid-afternoon. Which problem would the nurse associate these symptoms with? 1 Child abuse 2 Malnutrition 3 Hypoglycemia 4 School avoidance

4 School avoidance

The nurse discovers a low potassium level in a child scheduled to receive a dose of digoxin (Lanoxin). Why would the nurse be concerned about the low potassium level? 1 The child has hospital acquired infection. 2 The child has developed brain deformities. 3 The child requires increased digoxin (Lanoxin) dosage. 4 The child is at increased risk of digoxin (Lanoxin) toxicity.

4 The child is at increased risk of digoxin (Lanoxin) toxicity.

Which characteristic is a hallmark sign of autism? 1 Spinning in circles 2 Rocking back and forth for hours 3 The inability to sit still for an hour 4 The inability to maintain eye contact with another person

4 The inability to maintain eye contact with another person

Which finding would the nurse notice during the examination of the genital organs of a child with hypospadias? 1 The testes in the patient have failed to descend into the scrotum. 2 The opening of the foreskin of the penis is narrowed or stenosed. 3 The urethral opening is located along the dorsal surface of the penile shaft. 4 The urethral opening is located along the ventral surface of the penile shaft.

4 The urethral opening is located along the ventral surface of the penile shaft.

Which type of newborn congenital heart disease is identified by audible systolic murmur auscultated over the third intercostal space and a palpable thrill? 1 Tetralogy of Fallot 2 Atrial septal defect 3 Patent ductus arteriosus 4 Ventricular septal defect

4 Ventricular septal defect