pediatric exam questions
A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which action would be most appropriate? A) Ventilating the child with a bag-valve-mask B) Estimating the child's weight using a Broselow tape C) Providing therapy using automated external defibrillation D) Using rescue breathing and chest compressions
A
The parents bring their 3-year-old son to the emergency department after he ingested some of his mother's medicine. Which assessment would be of critical importance for this child? A) Assessing mental status and skin moisture and color B) Evaluating the effectiveness of the child's breathing C) Noting the child's pulse rate and quality D) Auscultating all lung fields for signs of edema
A
The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A) Deep-breathing exercises B) Upright positioning C) Coughing D) Chest percussion
A 6-year-old boy with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A) "Would you like me to bring you a blanket and pillow?" B) "You are doing such a wonderful job with your son." C) "He's in good hands; consider going home to get some sleep." D) "Are you planning to spend the night or to go home?"
vThe nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A) "I will help you become comfortable in caring for your daughter." B) "You must learn how to care for your daughter at home." C) "You will need to learn to collaborate with all the caregivers." D) "There is a lot to learn, and you need a positive attitude."
Ans: A Feedback: The nurse needs to empower families to become the experts on their child's needs and conditions via education and participation in care. The most positive approach is to let the mother know the nurse will support her and help her become an expert on her daughter's care. Telling the mother that she must learn how to care for her daughter or that she must have a positive attitude is not helpful. Telling her that she needs to collaborate with the caregivers is true, but does not address her fears.
A child is scheduled to undergo radiation therapy as part of his treatment plan for newly diagnosed cancer. After teaching the child and parents about this treatment, the nurse determines that additional teaching is needed when the parents state: A) "We should not wash off the markings on his skin." B) "He can use petroleum jelly if the skin becomes reddened." C) "He needs to use a sunscreen with an SPF of 30 or more." D) "He should not apply deodorant to the treatment site."
B
A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. What action should the nurse take first? A) Inspect the child's skin color. B) Assess for a patent airway. C) Observe for symmetric breathing. D) Palpate the child's pulse.
B
The mother of a 5-year-old child with eczema is getting a check-up for her child before school starts. What will the nurse do during the visit? A) Change the bandage on a cut on the child's hand. B) Assess the compliance with treatment regimens. C) Discuss systemic corticosteroid therapy. D) Assess the child's fluid volume.
B
The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which response indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."
B
The nurse is reviewing the chart of a child with juvenile idiopathic arthritis. The nurse notes that there is involvement of five joints symmetrically. What is the technical name for this type of arthritis? a. Pauciarticular b. Polyarticular c. Systemic d. Primary
B
The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching? A) "A family history of alcoholism is a risk factor for substance abuse." B) "Just because his friends are experimenting does not mean that he will." C) "If my husband or I have a substance abuse problem it could increase his risk." D) "Negative life events are a potential risk factor."
B
The nurse is caring for a 3-day-old girl with Down syndrome whose mother had no prenatal care. What is the priority nursing diagnosis? A) Imbalanced nutrition, less than body requirements related to the effects of hypotonia B) Deficient knowledge related to the presence of a genetic disorder C) Delayed growth and development related to a cognitive impairment D) Impaired physical mobility related to poor muscle tone
D
The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to incorporate into the plan of care when working with this family? A) Gathering information from at least three generations B) Informing the family of the need for a wide range of information C) Maintaining the confidentiality of the information D) Presenting the information in a nondirective manner
D
The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? A) The child has above-normal growth for his age. B) The child is active and playful. C) The skin is pink and healthy looking. D) It is difficult to keep the child awake.
D
What finding would the nurse expect to assess in a child with hypothyroidism? A) Nervousness B) Heat intolerance C) Smooth velvety skin D) Weight gain
D weight gain
Is the following statement true or false? The nurse teaching parents of a child with diabetes about insulin administration correctly informs them that short-acting insulin has an onset within 15 minutes and lasts for 3 to 5 hours.
False. Rapid-acting insulin has an onset within 15 minutes and lasts for 3 to 5 hours. Rationale: Short-acting insulin has an onset within 30 to 60 minutes and lasts for 5 to 8 hours.
Is the following statement true or false? The nurse caring for a child with bulimia explains to the parents that bulimia refers to a cycle of normal food intake, followed by binge-eating and then purging.
True. Bulimia refers to a cycle of normal food intake, followed by binge-eating and then purging. Rationale: A similar eating disorder is anorexia nervosa, which is characterized by dramatic weight loss as a result of decreased food intake and sharply increased physical exercise.
The nurse is caring for a child with anemia caused by a deficiency in vitamin B12. What type of anemia is this child experiencing? a. Pernicious anemia b. Thalassemia c. Folic acid deficiency anemia d. Sickle cell anemia
a. Pernicious anemia. Pernicious anemia is caused by a deficiency in vitamin B12. Rationale: Thalassemia and sickle cell anemia are a result of hemolytic disorders and folic acid deficiency is caused by low dietary intake of green leafy vegetables, liver, citrus, or malabsorption of medication.
The nurse is assessing a child for a genetic disorder and notes that a musty odor emanates from the child. What disorder would the nurse suspect? a. Phenylketonuria b. Maple syrup urine disease c. Tyrosinemia d. Trimethylaminuria
a. Phenylketonuria. A musty odor emanating from the child is associated with phenylketonuria. Rationale: A maple syrup odor is associated with maple syrup urine disease, a cabbage-like odor is associated with tyrosinemia, and a rotting fish smell is associated with trimethylaminuria.
The nurse caring for children with neuromuscular disorders knows that which of the following is the most common movement disorder of childhood? a. Spina bifida b. Cerebral palsy c. Muscular dystrophy d. Spinal muscular atrophy
b. Cerebral palsy. Cerebral palsy is the most common movement disorder of childhood. Rationale: Cerebral palsy is the most common movement disorder of childhood; it is a lifelong condition and one of the most common causes of physical disability in children (Johnston, 2016). The incidence is about 2 in every 1,000 live births and is higher in premature and low-birth‐weight infants (Barkoudah & Glader, 2018b).
The nurse caring for a child with a learning disability documents that the child has difficulty with manual dexterity and coordination. What learning disability would the nurse suspect? a. Dyslexia b. Dyspraxia c. Dysgraphia d. Dyscalculia
b. Dyspraxia. Children with dyspraxia have problems with manual dexterity and coordination. Rationale: Children with dyslexia have difficulty with reading, writing, and spelling. Children with dysgraphia have difficulty producing the written word. Children with dyscalculia have problems with mathematics and computation.
The nurse is caring for a child with respiratory distress who is being treated with narcotics for pain related to leukemia. For what condition should the nurse monitor in this child? a. Hyperventilation b. Hypoventilation c. Tachypnea d. Periodic breathing
b. Hypoventilation. A child who is being treated with narcotics for pain related to leukemia should be monitored for hypoventilation. Rationale: Hypoventilation, a decrease in the depth and rate of respirations, is noted in very ill children or children who have central respiratory depression secondary to narcotics. Tachypnea (increased respiratory rate) is often noted in children in respiratory distress. If the child is a young infant (younger than 2 months) or premature, periodic breathing may occur.
A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. What action should the nurse to take first? A) Set clear limits on the child's behavior B) Teach the child problem-solving skills C) Encourage a discussion of the child's thoughts and feelings D) Role model appropriate social and conversation skills
c
The nurse is providing education in response to questions from new parents concerned about keeping their child safe from infections. Which phrase would be most appropriate for the nurse to include in the teaching plan? a. The baby's immune system is fully developed at birth. b. The child must be kept away from everyone but parents until the child has a fully functional immune system. c. Breastfeeding provides passive immunity to the infant that formulas cannot provide. d. The baby has specialized cells called phagocytes that can protect the newborn from any infections.
c
The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster immunization. Which is the priority nursing diagnosis? A) Pain related to adverse effects of treatment verbalized by the child B) Nausea related to side effects of chemotherapy verbalized by the child C) Constipation related to the use of opioid analgesics for pain D) Risk for infection related to neutropenia and immunosuppression
d
The nurse is caring for a child diagnosed with juvenile diabetes. Which of the following medical treatments would be appropriate for this child? a. Surgery b. Irradiation c. Radioactive iodine d. Glucose monitoring
d. Glucose monitoring. Glucose monitoring is an intervention appropriate for managing diabetes. Rationale: Surgery would be used to remove a mass from a gland and irradiation/radioactive iodine would be used to influence hormone secretion of the thyroid gland. Glucose monitoring and medical nutrition therapy are appropriate interventions for juvenile diabetes.
Is the following statement true or false? The nurse is caring for a child who underwent a stem cell transplant. This procedure involves the transfer of healthy bone marrow into the bones of a person with immune malfunction.
false
Is the following statement true or false? The nurse accessing a vein to manage a child while CPR is in progress uses the recommended route, the saphenous vein.
false. The femoral route is best for obtaining central venous access while CPR is in progress. Rationale: The femoral route is best for obtaining central venous access while CPR is in progress because the insertion procedure will not interfere with life-saving interventions involving the airway and cardiac compressions. The saphenous vein (found in the ankle) is an alternative route for venous access that is obtained using a surgical incision
Is the following statement true or false? The nurse performing CPR on an infant by herself correctly applies 15 compressions to 2 breaths.
false: 30 to 2
Is the following statement true or false? The nurse working in the ER knows that trauma or unintentional injury is a leading cause of childhood morbidity and mortality in the United States.
vTrue. Trauma or unintentional injury is a leading cause of childhood morbidity and mortality in the United States. vRationale: Injuries are the leading cause of death in children younger than 1 year of age and account for a significant percentage of childhood morbidity. The child is at increased risk for trauma based on the developmental factors of physical and emotional immaturity; additionally, adolescents display belief of invincibility.
The nurse is assessing a child who presents with patches of scaling on the scalp and central hair loss. What fungal rash does this condition signify? a. Tinea cruris b. Tinea versicolor c. Tinea corporis d. Tinea capitis
vd. Tinea capitis. Patches of scaling on the scalp and central hair loss are signs of tinea capitis. vRationale: Signs of tinea cruris are erythema, scaling, and maceration of inner thighs. Tinea versicolor presents as superficial tan or hypopigmented oval scaly lesions on upper back, chest, and proximal arms. Tinea corporis is ringworm, an annular lesion with raised scaling that looks like a ring.