PEDIA IV (30 Items)

A. Regular diet

A 7-year-old child with acute diarrhea has been rehydrated with (ORSs). The nurse should recommend that the child's diet be advanced to include which of the following? A. Regular diet B. Clear liquids C. High-carbohydrate diet D. BRAT diet (bananas, rice, apples, and toast or tea)

C. Upper gastrointestinal (GI) tract.

Melena, the passage of black, tarry stools, suggests bleeding from: A. Perianal or rectal area. B. Hemorrhoids or anal fissures. C. Upper gastrointestinal (GI) tract. D. Lower GI tract.

B. It can be prevented by HBV vaccine.

Which of the following is true concerning hepatitis B? A. It cannot exist in carrier state. B. It can be prevented by HBV vaccine. C. Principle mode of transmission is fecal-oral route. D. Immunity to all types of hepatitis develops after one attack.

C. Onset is usually rapid and acute.

Which of the following statements best characterizes hepatitis A? A. Incubation period is 6 weeks to 6 months. B. Principal mode of transmission is through the parenteral route. C. Onset is usually rapid and acute. D. There is a persistent carrier state.

B. Dilate the bronchioles

β-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? A. Liquefy secretions B. Dilate the bronchioles C. Reduce inflammation of the lungs D. Reduce infection

C. Necessary, because it will be an adjustment

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child is: A. Not necessary because of child's age. B. Not necessary, because colostomy is temporary. C. Necessary, because it will be an adjustment. D. Necessary, because child must deal with negative body image.

B. Thicken formula with rice cereal.

A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. Which of the following should the nurse suggest to minimize reflux? A. Place in Trendelenburg position after eating. B. Thicken formula with rice cereal. C. Give continuous nasogastric tube feedings. D. Give larger, less frequent feedings.

A. Liver transplantation.

The best chance of survival for a child with cirrhosis is: A. Liver transplantation. B. Treatment with corticosteroids. C. Treatment with immune globulin. D. Providing nutritional support.

D. Inability to speak

The mother of a toddler yells to the nurse, "Help! He is choking on his food." The nurse determines that life-saving measures are necessary based on which of the following? A. Gagging B. Coughing C. Pulse over 100 D. Inability to speak

A. Asthma

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests which of the following? A. Asthma B. Pneumonia C. Bronchiolitis D. Foreign body in trachea

B. Dehydration

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of which of the following? A. Overhydration B. Dehydration C. Sodium excess D. Potassium excess

B. Carotid

Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which of the following pulses is usually palpated because it is the most central and accessible? A. Radial B. Carotid C. Femoral D. Brachial

A. Diet should be high in carbohydrates and protein.

In providing nourishment for a child with CF, which of the following factors should the nurse keep in mind? A. Diet should be high in carbohydrates and protein. B. Diet should be high in easily digested carbohydrates and fats. C. Most fruits and vegetables are not well tolerated. D. Fats and proteins must be greatly curtailed.

A. Fever

Nurses must be alert for increased fluid requirements when a child has which of the following? A. Fever B. Mechanical ventilation C. Congestive heart failure D. Increased intracranial pressure

B. Allow to assume position of comfort.

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. Which of the following is appropriate to relieve the abdominal discomfort? A. Place in Trendelenburg position. B. Allow to assume position of comfort. C. Apply moist heat to the abdomen. D. Administer a saline enema to cleanse bowel

C. Sudden relief from pain

When caring for a child with probable appendicitis, the nurse should be alert to recognize that which of the following is a sign of perforation? A. Bradycardia B. Anorexia C. Sudden relief from pain D. Decreased abdominal distention

D. Abdominal pain that is most intense at McBurney point

Which of the following clinical manifestations would be the most suggestive of acute appendicitis? A. Rebound tenderness B. Bright red or dark red rectal bleeding C. Abdominal pain that is relieved by eating D. Abdominal pain that is most intense at McBurney point

A. Popcorn

Which of the following is a high-fiber food that the nurse could recommend for a child with chronic constipation? A. Popcorn B. Pancakes C. Muffins D. Ripe bananas

A. Nausea

Which of the following is an early sign of theophylline toxicity? A. Nausea B. Seizures C. Drowsiness D. Bradycardia

B. Hepatitis B vaccine

Which of the following is now recommended for the immunization of all newborns? A. Hepatitis A vaccine B. Hepatitis B vaccine C. Hepatitis C vaccine D. Hepatitis A, B, and C vaccines

B. Chemotherapy

Which of the following is the most important consideration in managing TB in children? A. Skin testing B. Chemotherapy C. Adequate nutrition D. Adequate hydration

C. Reduce gastric acid production.

A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with GER. The purpose of this is to: A. Prevent reflux. B. Prevent hematemesis. C. Reduce gastric acid production. D. Increase gastric acid production.

C. Swimming

A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend which of the following? A. Soccer B. Running C. Swimming D. Basketball

A. Intravenous fluids.

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: A. Intravenous fluids. B. ORS. C. Clear liquids, 1 to 2 oz. at a time. D. Administration of antidiarrheal medication

D. Surgical removal of affected section of bowel

Therapeutic management of most children with Hirschsprung disease is primarily which of the following? A. Daily enemas B. Low-fiber diet C. Permanent colostomy D. Surgical removal of affected section of bowel

C. Orally administered rehydration solution (ORS)

Therapeutic management of the child with acute diarrhea and dehydration usually begins with which of the following? A. Clear liquids B. Adsorbents, such as kaolin and pectin C. Orally administered rehydration solution (ORS) D. Antidiarrheal medications such as paregoric

A. 1 year.

The Heimlich maneuver is recommended for airway obstruction in children older than: A. 1 year. B. 4 years. C. 8 years. D. 12 years.

C. Antihistamines

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 which of the following? A. Diet B. Allergies C. Antihistamines D. Emotional factors

D. Sweat chloride test

Cystic Fibrosis is suspected in a toddler. Which of the following tests is essential in establishing this diagnosis? A. Bronchoscopy B. Serum calcium C. Urine creatinine D. Sweat chloride test

B. Normal saline

Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. The enema solution should be: A. Tap water B. Normal saline C. Oil retention D. Phosphate preparation