Pediatric Exam 4

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching? A. Monitor your child's temperature daily B. Restrict outdoor play activity to 1 hour per day C. Offer fluids to your child multiple times every day D. Apply cold compresses when your child expresses pain

Offer fluids to your child multiple times every day

The nurse caring for a child with osteomyelitis assesses poor appetite. Which inter- vention(s) is/are most appropriate for this child? Select all that apply. 1. Offer high-calorie liquids. 2. Offer favorite foods. 3. Do not worry about intake, as appetite loss is expected. 4. Suggest intravenous removal to encourage oral intake. 5. Decrease pain medication that might cause nausea. 6. Offer frequent small meals

Offer high-calorie liquids. Offer favorite foods. Offer frequent small meals

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? A. High Fever B. Bradycardia C. Pain D. Constipation

Pain

A 9-year-old is in a spica cast and complains of pain 1 hour after receiving intravenous opioid analgesia. What should the nurse do first? 1. Give more pain medication. 2. Perform a neuromuscular assessment. 3. Call the surgeon for orders. 4. Tell the child to wait another hour for the medication to work.

Perform a neuromuscular assessment.

A nurse is caring for a child who has Legg-calve-perthes disease and is in Buck extension traction. which of the following actions should the nurse take?

Reposition every 2 hours

A nurse is assessing a 1-year-old toddler notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect?

Wilm's tumor

A nurse is caring for a child on the oncology unit. The child's parents are asking the nurse about the cancer diagnosis. Which of the following information should the nurse provide the parents about the most common malignant renal and intra-abdominal tumor of childhood?

Wilm's tumor

A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider ?

Yellow Nasal Drainage

A nurse is creating a plan of care for a child who has sickle cell anemia. Which of the following interventions should the nurse include in the plan? A. discourage a high level of fluid intake B. apply cold compresses to painful, swollen joints C. observe for indications of hypokalemia D. administer meperidine every 4 hours for pain

observe for indications of hypokalemia

The nurse is caring for a child being treated for ALL. Laboratory results indicate that the child has a white blood cell count of 5000/mm3 with 5% segs and 3% bands. Which of the following analyses is most appropriate? A. the absolute neutrophil count is 5800/mm3 and the child is not neutropenic B. the absolute neutrophil count is 800/mm3 and the child is neutropenic C. the absolute neutrophil count is 400/mm3 and the child is neutropenic D. the absolute neutrophil count is 4000/mm3 and the child is not neutropenic

the absolute neutrophil count is 400/mm3 and the child is neutropenic

A nurse is teaching a parent of a child who has hemophilia how to control a minor bleeding episode. Which of the following statements by the parent indicates a need for further teaching? A. "I will have my child rest." B. "I will elevate the affected part." C. "I will compress the site." D. "I will apply heat."

"I will apply heat"

The nurse is caring for a 10-year-old with leukemia who is receiving chemotherapy. The child is on neutropenic precautions. Friends of the child come to the desk and ask for a vase for flowers they have picked from their garden. Which of the following is the best response? 1. "I will get you a special vase that we use on this unit." 2. "The flowers from your garden are beautiful but should not be placed in the room at this time." 3. "As soon as I can wash a vase, I will put the flowers in it and bring it to the room." 4. "Get rid of the flowers immediately. You could harm the child."

"The flowers from your garden are beautiful but should not be placed in the room at this time."

A school nurse identifies that a child has pediculosis capitis and educates the child's parents about the condition. Which of the following statements by the parents indicates an understanding of the teaching? A. "All recently used clothing, bedding, and towels must be washed in hot water." B. "My child must be free from nits before returning to school." C. "I will treat all the family members to be on the safe side." D. "Toys that can't be dry cleaned or washed must be thrown out."

"All recently used clothing, bedding, and towels must be washed in hot water."

When teaching parents about osteosarcoma, the nurse knows instruction has been successful when a parent says that this type of cancer is common in which age group? 1. Infancy. 2. Toddlers. 3. School-aged children. 4. Adolescents.

Adolescents

Which of the following measures should the nurse instruct to do at home?

Administer factor 78 per home protocol

A nurse is providing discharge instructions to a parent and his school-age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include? A. Encourage the child to take a 45 min nap daily. B. Allow the child to stay at home on days when her joints are painful. C. Apply cool compresses for 20 min every hour. D. Administer prednisone on an alternate-day schedule.

Administer prednisone on an alternate-day schedule.

A child is admitted to the hospital for treatment of suspected bacterial meningitis. What the priority of care for this child? Providing environmental stimulation to keep child awake Administering antibiotic therapy as soon as it is available Initiating isolation precautions as soon as diagnosis is confirmed Administering sedatives and analgesics on a preventative schedule to manage pain

Administering antibiotic therapy as soon as it is available

A 10-year-old with severe factor VIII deficiency falls, injures an elbow, and is brought to the ER. The nurse should prepare which of the following? 1. An IM injection of factor VIII. 2. An IV infusion of factor VIII. 3. An injection of desmopressin. 4. An IV infusion of platelets.

An IV infusion of factor VIII

The parents of a child diagnosed with osteomyelitis asks how the child acquired the illness. which is the nurses best response 1. direct inoculation of the bone from stepping barefoot on a sharp stick 2. an infection from a scratched mosquito bite carried the infection through the bloodstream to the bone 3. the blood supply to the bone was disrupted bc of the childs diabetes 4. an infection of the UR

An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone

The nurse is caring for a child with leukemia. The nurse should be aware that children being treated for leukemia may experience which of the following complications? Select all that apply. 1. Anemia. 2. Infection. 3. Bleeding tendencies. 4. Bone deformities. 5. Polycythemia.

Anemia. Infection. Bleeding tendencies.

Which of the following measures should be implemented for a child with von Willebrand disease who has a nosebleed? A. Apply pressure to the nose for at least 10 minutes. B. Have the child lie supine and quiet. C. Avoid packing of the nostrils. D. Encourage the child to swallow frequently.

Apply pressure to the nose for at least 10 minutes

When a child is suspected of having osteomyelitis, the nurse can prepare the family to expect which of the following? Select all that apply. 1. Pain medication is contraindicated so that symptoms are not masked. 2. Blood cultures will be obtained. 3. Pus will be aspirated from the subperiosteum. 4. An intravenous line with antibiotics will be started. 5. Surgery will be necessary

Blood cultures will be obtained. Pus will be aspirated from the subperiosteum. An intravenous line with antibiotics will be started.5. Surgery will be necessary

Which is most important to discuss with an adolescent who is going to have a leg amputation for osteosarcoma? 1. Pain. 2. Spirituality. 3. Body image. 4. Lack of coping.

Body image

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? A. Identity crisis B. Body image changes C. Feelings of displacement D. Loss of privacy

Body image changes

The parent of a 3-week-old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. Which intervention should the nurse suggest the parent do first? 1. Give pain medication. 2. Reposition the infant in the crib. 3. Check the neurocirculatory status of the foot. 4. Use a cool blow-dryer to blow into the cast to control itching.

Check the neurocirculatory status of the foot

An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1. Cough 2. Liver failure 3. Watery stool 4. Nuchal rigidity

Cough

Which needs to be present to diagnose hemolytic uremic syndrome (HUS)? A. Increased red blood cells with a low reticulocyte count, increased platelet count, and renal failure. B. Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure. C. Increased red blood cells with a high reticulocyte count, increased platelet count, and renal failure. D. Decreased red blood cells with a low reticulocyte count, decreased platelet count, and renal failure

Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure

A child is admitted with a suspected diagnosis of Wilms' tumor. The nurse should place a sign with which of the following warnings over the child's bed? A. Do not palpate abdomen. B. No venipuncture or blood pressure in left arm C. Contact precautions D. Collect all urine.

Do not palpate abdomen

A teen is seen in clinic for a possible diagnosis of Hodgkin disease. The nurse is aware that which of the following symptoms should make the health-care provider suspect Hodgkin disease? 1. Fever, fatigue, and pain in the joints. 2. Anorexia with weight loss. 3. Enlarged, painless, and movable lymph nodes in the cervical area. 4. Enlarged liver with jaundice.

Enlarged, painless, and movable lymph nodes in the cervical area.

A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect?

Facial edema

A nurse is checking a school-age child for pediculosis capitis. The nurse understands that which of the following manifestations is a definitive indication of this condition

Firmly attached white particles on the hair

What is the best method to prevent the spread of infection to an immunosuppressant child ?

Have people wash hands prior to contact

A nurse on an oncology unit is assessing a child who has a brain tumor. Which of the following findings should the nurse expect? A. Negative babinski reflex. B. Increased appetite. C. Hyporeflexia. D. Tachycardia.

Hyporeflexia

The clinical manifestation of minimal change nephrotic syndrome are due to which of the following? a. chemical changes in the composition of albumin. b. increased permeability of the glomeruli. c. obstruction of the capillaries of the glomeruli. d. loss of the kidney's ability to excrete waste and concentrate urine.

Increased permeability of the glomeruli

A child with HUS is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglobin and hematocrit levels. The child has not had any urine output in the last 24 hrs. The nurse expects administration of blood products and what else to be added to the plan of care? A. Initiation of dialysis. B. Close observation of the child's hemodynamic status. C. Diuretic therapy to force urinary output. D. Monitoring of urinary output.

Initiation of dialysis

A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make?

Normal bone growth can be affected

A school nurse conducting a screening for pediculosis capitis identifies several children who require treatment. Which of the following instructions should the nurse give the children's parents? A. Soak all combs and hairbrushes in alcohol. B. Inspect any dogs or cats at home for lice. C. Seal nonwashable items in airtight plastic bags. D. Spray countertops and sinks with insecticide.

Seal nonwashable items in airtight plastic bags.

A 12-year-old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that long? 1. Pain from the brace. 2. Difficulty in putting the brace on. 3. Self-consciousness about appearance. 4. Not understanding what the brace is for.

Self-consciousness about appearance

The nurse expects the blood culture report of an 8-year-old with septic arthritis to grow which causative organism? 1. Streptococcus pneumoniae. 2. Escherichia coli. 3. Staphylococcus aureus. 4. Neisseria gonorrhoeae.

Staphylococcus aureus

Which of the following activities should a nurse suggest for a client diagnosed with hemophilia? Select all that apply. 1. Swimming. 2. Golf. 3. Hiking. 4. Fishing. 5. Soccer

Swimming. Golf. Hiking. Fishing.

A nurse is caring for a toddler who has a fractured right femur and is in Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following? A. Skin straps maintain the leg in an extended position. B. Weights are attached to a pin that is inserted into the femur. C. A padded sling is under the knee of the affected leg. D. The buttocks is elevated slightly off the bed

The buttocks is elevated slightly off the bed

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. 1. The extremity should be immobilized. 2. The extremity should be elevated. 3. Warm moist compresses should be applied to decrease pain. 4. Passive range-of-motion exercises should be administered to the extremity. 5. Factor VIII should be administered.

The extremity should be immobilized The extremity should be elevated Factor VIII should be administered

A diagnosis of Hodgkin's disease is suspected in a 12 year old child. Several diagnostic studies are performed to determine the presence of this disease. Which dx test result will confirm Hodgkin's disease? a. elevated vanillylmandelic acid urinary levels b. the presence of blast cells in the bone marrow c. the presence of epstein-barr virus in the blood d. the presence of Reed-Sternberg cells in the lymph nodes

The presence of Reed-Sternberg cells in the lymph nodes

Which would the nurse most likely find in the history of a child with HUS? Select all that apply. A. Frequent UTIs and possible VUR B. Vomiting and diarrhea before admission C. Bee sting and localized edema of the site for 3 days D. Previously healthy with no signs of illness E. Anorexia and bruising

Vomiting and diarrhea before admission Anorexia and bruising