exam 1 questions

You're assessing a 4 year old with epiglottitis who just arrived to the pediatric clinic. The child is drooling and has a respiratory rate of 45 breaths per minute. In addition, the child is becoming increasingly apprehensive. Which findings below exhibited by the patient represents an acute upper airway obstruction that requires IMMEDIATE treatment? Select all that apply: A. Stridor B. Cyanosis C. Chest retractions D. Nasal flaring

A,B,C

Select the systems below that are affected by cystic fibrosis: A. Reproductive B. Lymphatic C. Respiratory D. Gastrointestinal E. Neuro F. Integumentary

A,C,D,F respiratory system (this causes thick mucus to build up in the lungs and it can affect both the upper and lower respiratory system like the sinuses), gastrointestinal (pancreas, intestines, and liver are all affected due to thick mucus), and integumentary (skin's sweat glands will make extremely salty sweat)

Which statement by a mother regarding her 15 month old requires further evaluation? A. "I add honey to his oatmeal in the morning." B. "He loves drinking juice from a bottle at night...it helps him sleep." C."I only buy whole milk, not skim or low fat." D."I avoid giving him seeds, popcorn, and raisins."

B

Select all the signs and symptoms that can present with epiglottitis? A. Slow onset B. Difficulty swallowing C. Drooling D. High Fever E. Barking cough F. Stridor G. Exudate on Tonsils H. Crackles

B,C,D,F

when is ASD apparent -what are some red flags

age 3 -No babbling by 1 y/o -No two word phrases by 2 y/o

what is the Denver II test

developmental screening for FAS/ downs

Lungs rely on what for inspiration?

diaphragm

A nurse is providing teaching about social development to the parents of a preschooler. Which of the following play activities should the nurse recommend for the child? -Playing pat-a-cake -Using a push-pull toy -Creating a scrapbook -Playing dress-up

dress up

what area should be assessed first in a quiet infant? -heart -lungs -abdomen -musculoskeletal

heart lungs

what electrolyte deficiency is a CF pt at risk for

hyponatremia

main finding of ASD (autism)

impaired social interaction

when is BPD most prominent

in babies < 28 weeks premature -weight <1000 -1500 grams

A nurse is assessing an infant who has pneumonia. Which of the following findings is the priority for the nurse to report to MD? -nasal flaring -wbc of 11,300 -diarrhea -abdominal distention

nasal flaring

whats the difference btw sonorous wheezes & sibilant wheezes

sibilant: heard in asthma -high pitched sonorous:coarse, low pitched, sounds like a "snore" -Ronchi -Air passing through secretions in the larger bronchi/trachea ***heard in COPD, pneumonia, chronic bronchitis, or cystic fibrosis.

A 5 year-old patient is admitted with a broken left arm. His arm is immobilized. What nursing intervention is age apporiate for this child regarding his hospitalization? A. Discourage school friends from visiting the patient due to embarrassing the child because of his immobilized arm. B. Explain procedures in simplistic terms without diagrams. C. All the child to help with bathing, feeding, and changing bandages. D.Assess the 5 year old for questions about his appearance and the effects of how his injury will affect the future.

C

Which of the following is NOT a cause of metabolic acidosis? A. Aspirin toxicity B. Ileostomy C. Hyperaldosteronism D. Carbonic anhydrase inhibitors

C -hyperaldosteronism is part of metabolic alkalosis

A patient completed a sweat test yesterday. The results are back and are 45 mmol/L. As the nurse you know this means: A. The patient tested positive for cystic fibrosis. B. The patient tested negative for cystic fibrosis. C. The patient needs further testing because results are not conclusive.

C 60+ = positive

The parents of a 3 year old bring their child to the ER. The parents report the child suddenly developed a fever overnight and has had issues swallowing, which has led to excessive drooling. In addition, the parents explain that the child complains of sore throat, and it is hard to understand the child's speech because her voice is muffled. Based on this information, your next nursing actions will be? Select all that apply: A. Assess the child's temperature orally B. Obtain a throat culture C. Count the patient's respirations D. Assess the child's throat for tonsillar exudate E. Keep the child NPO

C,E nurse should NOT stick anything in the patient's mouth that could can a spasm (example: taking oral temperature, throat culture, using a tongue depressor etc.) and further block the airway.

A 5 year old with acute epiglottitis is intubated for airway management. As the nurse you know that all of the following can be prescribed as treatment for this condition EXCEPT? A. Intravenous fluids B. Antipyretics C. Corticosteroids D. Cough suppressants

D

what pain scale should be used post op for dx of pyloric stenosis?

FLACC -3-4 weeks is most common age

A patient is in high anion gap metabolic acidosis due to diabetic ketoacidosis. Which of the following signs and symptoms would you expect to see in this patient? A. Kussmaul's respirations B. Glucose 110 C. Hypoventilation D. Neuro-excitability

A

Diabetic ketoacidosis, aspirin toxicity, and renal failure are examples of the causes of ___________________. A. metabolic acidosis B.respiratory acidosis

A

You are observing a 5 month old for developmental skills. Which of the following skills would concern you if the infant was not demonstrating? A. Follows objects with eyes B. Crawling C. Sitting with support D. Grasps objects

A

A nurse is assessing a 3-yo toddler at a well-child visit. Which of the following manifestations should the nurse report to the MD? -Blood pressure 90/50 mm Hg -Respiratory rate 45/min -Weight 14.5 kg (32 lb) -Heart rate 110/min

A respiratory rate of 45/min is above the expected reference range for a 3-year-old

A patient is in metabolic alkalosis due to diuretic therapy. How do you expect the potassium level and bicarbonate level to be affected?* A. Increased potassium level and increased bicarb level B. Decreased potassium level and decreased bicarb level C. Increased potassium level and decreased bicarb level D. Decreased potassium level and increase bicarb level

D **will see hypokalemia

A nurse is teaching the parent of a newborn about ways to prevent SIDS. Instructions to be included? -"Place the infant in a prone position to sleep." -"Allow the infant to sleep on a large pillow." -"Use a soft mattress in the infant's crib." -"Give the infant a pacifier at bedtime."

pacifier

what organ does CF most effect

pancreas -over time, may stop producing sufficient insulin -> glucose tolerance -cf related diabetes

What is the only antidepressant approved for kids?

prozac

where is the most accurate place to take an infants BP? -lower leg -thigh -right arm -left arm

right arm

why is there abdominal pain in pt's w pneumonia

secretions go into stomach

a nurse is providing discharge teaching to the parent of a school-age child who has moderate persistent asthma. Which of the following instructions should the nurse include? -"You should give your child his salmeterol inhaler every 4 hours when he is having an acute episode of wheezing." -"You should monitor your child's weight weekly while he is receiving inhaled corticosteroid therapy." -"Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy." -"When using the peak expiratory flow meter, record your child's average of three readings."

"Pulmonary function tests will be performed every 12 to 24 months to evaluate how your child is responding to therapy."

A nurse is providing dietary teaching to the parent of a school-age child who has cystic fibrosis. Appropriate statement to make? -"You should offer your child high-protein meals and snacks throughout the day." -"Your child should decrease dietary fats to less than 10% of her caloric intake." -"Your child will need to take a 1 gram sodium chloride tablet daily throughout her lifetime." -"You should calculate your child's carbohydrate needs based on her daily activities."

"You should offer your child high-protein meals and snacks throughout the day."

A nurse in an ED is assessing a 3-month-old infant who has rotavirus and is experiencing acute vomiting and diarrhea. Manifestations that indicate moderate to severe dehydration? -Heart rate 124/min -Increased tear production -Sunken anterior fontanel -Capillary refill 2 seconds

-sunken fontanel

How long do Sx of distress have to last to be considered PTSD?

1 month

how long should a baby sleep on their back for

1 year

at what age can you put child in semi fowlers position

1 yr

A nurse is assessing the pain lvl of a 3-yr-old toddler. Appropriate pain assessment scale to use? -FACES pain rating scale -Numeric pain rating scale -CRIES pain assessment scale -Noncommunicating children's pain checklist

**FACES: 3 yrs + -numeric: 5+ -Cries: infants -noncommunicating: cognitive impairment

A nurse is performing hearing screenings for children at a community health fair. Which of the following children should the nurse refer to a provider for a more extensive hearing evaluation? -A toddler who is 18 months old and has unintelligible speech -An infant who is 3 months old and has an exaggerated startle response -A preschooler who is 4 years old and prefers playing with others rather than alone -An infant who is 8 months old and is not yet making babbling sounds

*An infant who is 8 months old and is not yet making babbling sounds -The nurse should refer an infant who is not making babbling sounds by the age of 7 months to a provider for more extensive evaluation of hearing

where do you hear fine crackles

*Heard at the end of inspiration in the lower airway Air is passing through secretions in bronchioles and alveoli; LOWER Airway Sounds like rubbing hair together

what meds do you give for LBT/ croup

-epi -dexamethasone (steroid)

what happens if NG suction is too high

-hypokalemia -metabolic alkalosis

what breath sound do you hearing with epiglottis

-inspiratory stridor

what breath sounds do you hear in croup (LBT)

-inspiratory stridor -hoarse barky cough

what would indicate a child is in mild respiratory distress

-intercostal retractions -nasal flaring

what is the gold standard dx of GERD

-pH probe

what needs to be replaced in CF

-pancreatic enzymes

what are causes of ADHD

-smoking/ alcohol prenatal -high mercury levels

A nurse is reviewing the lab report of an infant who is receiving tx for severe dehydration. The nurse should identify that which of the following lab values indicates effectiveness of the current tx? -K+ 2.9 -sodium 140 -BUN 25

-sodium 140

what are some issues associated w down syndrome

-strabismus (cross eye) -hearing loss -cardiac defects -thyroid disease -leukemia

ASD screening age

18-24 months

when do infants develop a cough

5 months

When is the earliest a child should be able to sit unsupported? -4 months -2 months -6 months -8 months

6 months

how long do children diaphragmatic breathe

6 years

what age is croup most common

< 6 years -7-36 months

A 14 month old boy is hospitalized with dehydration. He is unconsolable, screaming, and rejecting your physical contact. What best describes the infants response to you? A. Separation anxiety-PROTEST PHRASE B. Fear of injury and pain C. Separation anxiety-DESPAIR D. Loss of Control

A

what would indicate a child is in moderate respiratory distress

Intercostal, substernal, subcostal retractions

A nurse in the ED is caring for a school-age child who has epiglottis. Which of the following actions should the nurse take? -Obtain a throat culture from the child. -Monitor the child's oxygen saturation. -Put a warm mist humidifier in the child's room. -Place the child in the supine position.

Monitor the child's oxygen saturation. -The nurse should monitor the child's oxygen saturation level because the child is experiencing acute respiratory distress and it is necessary to determine if the child is responding to treatment.

Why is it important to obtain an apical heart rate in children?

Peripheral pulses are easily obliterated

FAS (Fetal Alcohol Syndrome) Characteristics

Poor coordination Failure to thrive Skeletal and joint abnormality Hearing loss

what disease might cause over hydration?

SIADH

Severe distress retractions are where

Supraclavicular, suprasternal

Assessing a school-age child immediately postop following a perforated appendix repair. Expected findings?

absence of peristalsis

True or False: A child who is 11 months old and weighs 39.5 kg can ride in a forward facing upright position safety seat. True False

false

Cystic fibrosis (CF) is a genetic disorder that causes the endocrine glands to work incorrectly. True False

false -exocrine

how long do babies breathe through their mouth for

first 4 months

What area of the body is best assessed with the child sitting up? -abdomen -fontanel -skin tugor -mucous membrane

fontanel

A nurse is planning developmental activities for a newly admitted 10-year-old child who has neutropenia. Which of the following actions should the nurse plan to take?

give book - provide a school-age child with a book about adventure as a developmental activity because children are expanding their knowledge and imagination during this age. Through reading, school-age children can feel powerful and skillful as they imagine themselves in the stories they read.

what is the first intervention for bronchiolitis

nasal suction

why do babies grunt

to prevent alveoli from collapsing

A mother brings her 8 month old child in for a well visit. Which statement by the mother would raise concern for the infants safety and the mother would need to be re-educated? A. "I love using the hot steam vaporizer when he has a cold." B. "We have a gate at the stairs." C. "Yesterday I threw away all of our house plants." D. "He is still riding in a rear-facing car seat."

A

what chromosome gives down syndrome

trisomy 21 -3 chromosomes instead of 2

where is stridor heard

upper airway -croup, epiglottitis

What is the first thing you should do before touching your pediatric patient? -wash hands -speak to child -ask parents permission -introduce yourself to parent

wash hands

what breath sounds do you hear with bronchiolitis

wheezes & crackles -Air can get in, but cannot escape d/t mucous and edema (hear wheezes and crackles)

A nurse in an ED is performing a physical assessment on a 2-wk-old male infant. Manifestation that is the priority to report to the provider? -Excoriated scrotal area -Multiple capillary hemangiomas -Depressed posterior fontanel -Substernal retractions

substernal retractions -This finding indicates the infant is experiencing acute respiratory distress and increased respiratory effort, which could quickly progress to respiratory failure.