Pediatric Nursing Exam 2

A child in respiratory distress is admitted to the hospital and diagnosed with acute spasmodic laryngitis. at the time of discharge, the mother asks how to handle another attack at home. which would the nurse recommend? 1. place him near a cool-mist humidifier 2. bring him to the ED 3. give him an OTC cough syrup 4. offer him warm tea sweetened with homen

1

A male adolescent with CF, whose parents are both carriers of the disease, asks the nurse, "when I have children, could they have cystic fibrosis like me?" which information would the nurse consider before responding? 1. men with CF usually are sterile, although sexual function is not affected 2. men with CF generally have a 50% chance of having children with the disease 3. women will pass this disease to their children because it is carried on the sex chromosome 4. women have a 25% chance of passing the disease to their children if the parents are carriers

1

The nurse is conducting discharge teaching with an adolescent with hemophilia. which statement by the client indicates a need for further teaching? 1. "I'll use a straight razor when I start shaving" 2. "I plan on trying out for the swim team next year" 3. "If I injure a joint, I'll keep it still, elevate it, and apply ice" 4. "If I get a little scratch, I can apply gentle pressure for 10-15 minutes"

1

a client is admitted to the hospital with chronic asthma. which complication would the nurse monitor in this client? 1. atelectasis 2. pneumothorax 3. pulmonary edema 4. respiratory alkalosis

1

a nurse is caring for a school-aged child with CF. which pathophysiologic factor has the greatest effect on the child's health status? 1. extremely thick mucus causing obstructed airways 2. acute inflammation of the lung parenchyma 3. endocrine glands secreting increased levels of hormones 4. increased irritability of the airways resulting in obstruction

1

the nurse concludes that the teaching about sickle cell anemia has been understood when an adolescent with the disorder makes which statement? 1. "I'll start to have symptoms when I drink less fluid" 2. "I'll start to have symptoms when I have fewer platelets" 3. "I'll start to have symptoms when I decrease the iron in my diet" 4. "I'll start to have symptoms when I have fewer white blood cells"

1

the nurse is obtaining the health history of a 7-month-old infant who has had repeated episodes of otitis media. which question is most important for the nurse to include in the interview with the mother? 1. "please describe how you position your child during feedings" 2. "tell me how often your child has had ear infections" 3. "what medicine do you give your child for ear infections?" 4. "please describe your oral health practices"

1

when a client develops iron-deficiency anemia, which of the client's laboratory test results would the nurse expect to be decreased? 1. ferritin level 2. platelet count 3. WBC count 4. total iron-binding capacity

1

which behavior would be typical for a child with autism? 1. lack of eye contact 2. crying for attention 3. catatonia-like rigidity 4. engaging in parallel play

1

which clinical finding would the nurse recognize as an early sign of CF in a neonate? 1. Meconium ileus 2. imperforate anus 3. Hg level of 20 g/dL 4. total bilirubin level of 8 mg/dL

1

which discharge education would the nurse provide the parents of an infant who had been receiving humidified oxygen because of dyspnea caused by acute spasmodic laryngitis 1. "there are no restrictions after your baby goes home" 2. "keep visitors away from your home for several days" 3. "give the baby 2 oz of water after each formula feeding" 4. "you'll need to avoid allergen producers such as animals"

1

which education would the nurse provide the parents of a 3-year-old child who has recurrent acute spasmodic laryngitis (spasmodic croup) about why this is a disorder of young children? 1. they have small airways 2. they are mouth breathers 3. they have immature immune systems 4. they are prone to upper respiratory infections

1

which treatment would the nurse anticipate for an infant admitted with bronchiolitis caused by respiratory syncytial virus. 1. humidified cool air and adequate hydration 2. postural drainage and oxygen by hood 3. bronchodilators and cough suppressants 4. corticosteroids and broad-spectrum antibiotics

1

the parents of a child who has just been diagnosed with hemophilia A ask the nurse what symptoms of bleeding they should look for in the future. which symptoms would the nurse list? select all that apply. 1. nosebleeds 2. blood in the urine 3. painful and swollen joints 4. easy bruising 5. frequent fevers 6. fast clotting of injuries 7. dark-colored tarry stools

1, 2, 3, 4, 7

a worried parent informs the nurse, "my 6-year-old is otherwise healthy but still wets the bed at night". the nurse is teaching the parent necessary steps to manage the child's nocturnal enuresis. which statement made by the parent indicates effective learning? SATA 1. I should avoid giving my child fruit juice after 4pm 2. I should encourage my child to drink lots of water during the day 3. I should make my child wear diapers during day hours while at school. 4. I should give my child diet soda instead of regular soda in the evening. 5. I should wake my child at the same time every night to use the bathroom

1, 2, 5

after the nurse has taught a client with asthma about the use of a peak flow meter, which client statements indicate that the teaching has been effective? SATA. 1. readings in the green zone mean that my asthma is under control 2. if I get a reading in the yellow zone, I need to stop what I'm doing and rest for a while 3. if I get a reading in the red zone, then I need to use the quick relief inhaler and have my family take me to the hospital 4. I should check the peak flow readings at least twice a day until my baseline is established 5. I don't need to check my peak flow readings if I use the quick relief medication

1, 3, 4

which complications would the nurse recognize as associated with frequent episodes of otitis media in infants? SATA. 1. mastoiditis 2. heart failure 3. hearing loss 4. gastroenteritis 5. bacterial meningitis

1, 3, 5

when reviewing the results of a toddler's complete blood count, the nurse notes decreased Hgb and Hct levels. which other laboratory findings would the nurse expect in iron-deficiency anemia? SATA 1. microcytic RBCs 2. hyper chromic RBCs 3. low total iron-binding capacity 4. slightly reduced reticulocyte count 5. increased erythrocyte sedimentation rate (ESR)

1, 4

the nurse is assessing a school-age child who suffers from encopresis. which advice provides effective treatment for this condition? SATA 1. "you should drink lots of fluid" 2. "you should include milk in your diet" 3. "you should delay the urge to defecate" 4. "you should include cereals in your diet" 5. "you should eat fresh fruit for breakfast"

1, 4, 5

a 5-year-old child complains of abdominal pain with nausea, anorexia, and a low-grade fever. palpation of the RLQ of the abdomen elicits pain. which condition would the nurse suspect? 1. ulcerative colitis 2. acute appendicitis 3. Hirschsprung disease 4. Hookworm infestation

2

a primary HCP diagnosis the client's condition as otitis media. which assessment finding supports that diagnosis? 1. nodules on the pinna 2. redness of the eardrum 3. lesions in the external canal 4. excessive cerumen in the external canal

2

when a parent asks about a sudden issue with bedwetting, which would the nurse document in the child's health record? 1. primary enuresis 2. secondary enuresis 3. primary encopresis 4. secondary encopresis

2

which action would the nurse include in the plan for care for a 6-month-old infant with respiratory syncytial virus (RSV) who is in respiratory distress? 1. begin a clear fluid diet 2. maintain droplet and contact precautions 3. administer prescribed antibiotic immediately 4. allow parents and siblings to room in with the infant

2

which assessment would the nurse perform while caring for an infant with a tentative diagnosis of hypertrophic pyloric stenosis? 1. quality of the cry 2. signs of dehydration 3. coughing up of feedings 4. characteristics of stool

2

which clinical finding would the nurse expect when assessing an infant with a tentative diagnosis of hypertrophic pyloric stenosis (HPS)? 1. visible peristalsis waves across the lower abdomen 2. palpable mass in the epigastric area to the right of the umbilicus 3. tenderness over the epigastric region not relieved by heat application 4. lower abdominal distention with vomiting of bile-stained gastric contents

2

which complication of CF is related to frequent stools and tenacious muscles? 1. anal fissures 2. rectal prolapse 3. intussusception 4. meconium ileus

2

which condition would the nurse suspect in a 6-year-old child who was admitted with abdominal pain and guarding, nausea, anorexia, and pain with palpation of the RLQ? 1. viral infection 2. inflamed appendix 3. irritable bowel 4. parasitic infection

2

which condition would the nurse suspect when assessing an 11-month-old infant sitting on the parent's lap crying and tugging at the right ear? 1. child abuse 2. otitis media 3. hearing impairment 4. upper respiratory infection

2

which diagnostic testing is most useful in evaluating the effectiveness of treatment for asthma? 1. chest x-ray 2. pulmonary function tests 3. serum eosinophil counts 4. immunoglobulin E levels

2

which education would the nurse provide the parents of an infant with pyloric stenosis? 1. it is unlikely that surgery will be necessary 2. this is a condition with an excellent prognosis 3. this condition results form an error of metabolism 4. special feedings will be needed for a few weeks after surgery

2

which parent education would the nurse provide the pregnant mother whose son was recently diagnosed with hemophilia about the chances that her next child will also be affected? 1. 5% chance the baby is affected 2. 25% chance the baby is affected 3. 50% chance the baby is affected 4. 75% chance the baby is affected

2

which parental statement would prompt the nurse that the parents of a 3-year-old child with CF need further teaching? 1. "we will need to carefully track our child's caloric intake" 2. "we'll have to move to a very warm climate" 3. "our child will be taking pancreatic enzymes with meals" 4. "our child will need skin care after each bowel movement"2

2

which procedure would the nurse anticipate to confirm the diagnosis of Hirschsprung disease (congenital ganglionic megacolon) In a 1-month-old infant? 1. colonoscopy 2. rectal biopsy 3. multiple saline enemas 4. fiberoptic nasoenteric tube

2

which rationale would lead the nurse to question an order for a tap water enema for a 6-month-old infant with suspected Hirschsprung disease? 1. necessary nutrients could be lost 2. it could cause a fluid and electrolyte imbalance 3. it could increase the fear off intrusive procedures 4. the result could cause shock from a sudden drop in temperature

2

why is the vomitus of an infant with pyloric stenosis white rather than bile-stained? 1. the pyloric sphincter obstructs the bile duct 2. there is an obstruction above the opening of the common bile duct 3. the bile duct sphincter is connected to the hypertrophied pyloric muscle 4. there is a constriction of the cardiac sphincter that obstructs the flow of bile

2

which throat manifestations are the key features in a client with acute viral pharyngitis? SATA 1. petechiae on the soft palate 2. scant or no tonsillar exudate 3. slight erythema of the pharynx and tonsils 4. severe hyperemia of the pharyngeal mucosa 5. erythema of the tonsils with yellow exudates

2, 3

when assessing a toddler with autism spectrum disorder, which characteristic findings or behaviors would the nurse expect? SATA. 1. the desire to hug the nurse 2. flat, blank facial expression 3. laughing when pulse is taken 4. inability to maintain eye contact 5. enjoys climbing on stairs and furniture

2, 3, 4

which infections would the nurse monitor for in the toddler based on structural characteristics at this age? SATA 1. bronchiolitis 2. ear infection 3. acute sinusitis 4. laryngotracheobronchitis 5. inflammation of the tonsils

2, 3, 5

during a chest assessment with idiopathic pulmonary fibrosis, the nurse hears bilateral short, discontinuous, high-pitched sounds in the lower lung lobes. the sounds are similar to hair roles between the fingers just behind the ear. which respiratory disorders may also manifest these sounds as a pathophysiological sign? SATA. 1. croup 2. atelectasis 3. CF 4. bronchospasm 5. pulmonary edema

2, 5

which positioning would the nurse provide a 2-month-old infant admitted with a dx of respiratory syncytial virus infection? SATA. 1. prone 2. semi-fowler 3. trendeleburg 4. hyper-extending head 5. head in sniffing position

2, 5

at which age are the signs of autism initially evident? 1. 1-3 months 2. 6 months 3. 2 years 4. 6 years

3

the nurse is providing preoperative teaching to the parents of a toddler who is to undergo myringotomy. the nurse explains that the type of infection most common in children that are prone to otitis media is which? 1. viral 2. fungal 3. bacterial 4. rickettsial

3

when a client who has sickle cell anemia has been admitted with acute chest syndrome, which prescribed treatment would the nurse question? 1. oxygen administration 2. daily folic acid tablet 3. daily iron supplement 4. morphine sulfate prn

3

which cause of anemia would the nurse recognize as the most common cause of anemia in 1-year-olds? 1. thalassemia 2. lead poisoning 3. iron deficiency 4. sickle shape of blood cells

3

which diagnostic test would the nurse expect for a 3-month old infant with chronic constipation and suspected Hirschsprung disease? 1. sweat test 2. Guthrie test 3. rectal biopsy 4. blood glucose level

3

which education would the nurse provide the parents of a 3-year-old child with sickle cell anemia about splenomegaly during a pain crisis? 1. common in infancy 2. difficult to palpate in children 3. triggered by a vasoocclusive crisis 4. most common during late childhood

3

which information concerning a safe feeding technique would the nurse provide to a mother whose newborn infant son has a cleft lip and palate? 1. because he tires easily, it's best to have him lying in bed while he is being fed 2. hold him in a horizontal position and feed him slowly to help prevent aspiration 3. give him frequent rest periods and frequent burping during feedings so he can get rid of swallowed air 4. try using a soft nipple with an enlarged opening so he can get the milk through a chewing motion

3

which initial action would the nurse take when a male toddler with autism spectrum disorder suddenly runs to the wall and starts banging his head on it? 1. allow the toddler to act out of feelings 2. ask the toddler to stop this behavior 3. restrain the toddler to prevent head injury 4. tell the toddler that the behavior is unacceptable

3

which nursing intervention would the nurse provide a 3-week-old infant immediately after surgery for esophageal atresia? 1. restarting oral feedings slowly 2. reporting vomiting to the HCP 3. checking the potency of the ng tube 4. monitoring the child for signs of infection at the incision site

3

which pathophysiological process would the nurse recognize as leading to the clinical manifestations commonly seen in CF? 1. airway irritability causes spasms 2. lung parenchyma becomes inflamed 3. excessively thick mucus obstructs airways 4. endocrine glands secrete surplus hormones

3

which position would the nurse use for a newborn with a diagnosis of tracheoesophageal fistula? 1. prone, to reduce risk of aspiration 2. trendelenberg, to drain stomach contents 3. semi-fowler, to reduce the risk of chemical pneumonia 4. supine, to reduce the risk of sudden infant death syndrome

3

which primary symptoms would the nurse assess for in a boy who has encopresis? 1. practicing self-mutilation 2. practicing self-inducing vomiting 3. passing feces either voluntary or involuntarily into inappropriate places 4. passing urine either voluntarily or involuntarily into inappropriate places

3

which assessment findings would indicate a possible asthma exacerbation? SATA 1. Fever 2. stridor 3. wheezing 4. tachycardia 5. hypotension

3, 4

which clinical findings would the nurse recognize as indicative of possible neglect of a 5-year-old child? SATA 1. enuresis 2. lacerations 3. malnutrition 4. poor hygiene 5. sleep disturbances

3, 4

which signs and symptoms would the nurse observe in a child with autism spectrum disorder? SATA 1. lack of appetite 2. depressed mood 3. repetitive activities 4. inability to adapt to change 5. lack of communication with others

3, 4, 5

A mother asks why her 2-year-old toddler's cleft palate was not repaired at the same time that the cleft lip was repaired. What is the best response by the nurse? 1. "waiting leaves time for other birth defects to be detected and corrected" 2. "the cleft lip was so disfiguring that surgery was done as quickly as possible" 3. "your surgeon prefers to separate the operations to minimize the potential for complications" 4. "the palate usually is repaired before a child starts to speak. some surgeons prefer to wait up to 2 years"

4

a 4-year-old child is found to have Hirschsprung disease. which diet recommendations would the nurse provide the parents? 1. high-fat 2. high-fiber 3. low-calorie 4. low-residue

4

a client is admitted with an acute onset of RLQ pain at McBurney point. Appendicitis is suspected. For which clinical indicator would the nurse assess the client to determine if the pain is secondary to appendicitis? 1. urinary retention 2. gastric hyperacidity 3. rebound tenderness 4. increased lower bowel motility

4

a man and woman both have CF. the male asks the nurse about the chances of them having a child with CF. which response would the nurse provide? 1. women with CF aren't fertile 2. use condoms for protection from pregnancy 3. your children will be carriers of CF 4. your children will have CF

4

an adolescent child with sickle cell anemia is admitted to the pediatric unit during a vast-occlusive crisis. which pathophysiology is correct? 1. severe depression of the circulating thrombocytes 2. diminished RBC production by the bone marrow 3. pooling of blood in the spleen with splenomegaly as a consequence 4. blockage of small blood vessels as a result of clumping of RBCs

4

hydramnios is diagnosed in a primigravida at 35 weeks' gestation. for which condition would the nurse assess the newborn? 1. cardiac defect 2. kidney disorder 3. diabetes mellitus 4. esophageal atresia

4

the nurse is discussion sexuality with a teenage female who has CF. which statement best reflects the teenager's understanding of healthy sexuality? 1. I can never get pregnant 2. having sex is not possible for me 3. my best protection is a diaphragm 4. I won't have sex unless I use a condom

4

the parents of a child with CF tell the nurse they have switched to natural pancreatic enzymes because of financial issues. which response by the nurse is most appropriate? 1. you don't need to give the enzymes now that your child is in school 2. natural enzymes don't have any side effects and can be taken without regard to meals 3. if you are using generic enzymes, you will need to give twice as many to achieve the required effect 4. natural enzymes are not as affective as the brand-name product. this is something you need to discuss with your health care provider

4

when a child is newly diagnosed with hemophilia a, the nurse will teach family members that hemophilia A is linked to a deficiency in which clotting factor? 1. Factor I 2. Factor XII 3. Factor IX 4. Factor VIII

4

which assessment finding in a newborn is suggestive of CF? 1. rapid heart rate 2. excessive crying 3. sternal retractions 4. abdominal distention

4

which education would the nurse provide the parents of an infant with a cleft lip and palate about the infant's predisposition to infection? 1. waste products accumulate along the defect 2. circulation to the defective area is insufficient 3. inefficient feeding behaviors result in inadequate nutrition 4. mouth breathing dries the oropharyngeal mucous membranes

4

which factor would the nurse consider when the parent of a 10-month-old infant expresses frustration that this is the baby's third otitis media in 3 months? 1. analgesics are contraindicated 2. oral antibiotics will be prescribed 3. the labyrinth and cochlea are inflamed 4. the Eustachian tube is short and horizontal

4

which finding in a client with asthma exacerbations requires the most rapid action by the nurse? 1. report of chest tightness 2. HR of 112 bpm 3. expiratory wheezes in both lungs 4. markedly decreased breath sounds

4

which home management strategies would the nurse teach the parents of an infant with croup 1. antitussive medications 2. albuterol nebulizer treatments as needed 3. over-the-counter topical menthol under the nostrils 4. warm mist humidifier

4

which is the primary cause of otitis media in young children? 1. sinusitis 2. recurrent tonsilitis 3. an inflamed mastoid process 4. an obstructed eustachian tube

4

which parent education would the nurse provide for a 4-month-old infant with a newly diagnosed acute otitis media and fever? 1. anti-inflammatory medications 2. typically antiviral medications are given 3. wait 72 hours to see whether the condition resolves 4. antibiotics are recommended for infants younger than 6 months with acute otitis media

4

which physiological alteration would the nurse expect when assessing a 6-month-old infant with bronchiolitis? 1. decreased heart rate 2. inspiratory stridor 3. increased breath sounds 4. prolonged expiratory phase

4

which teaching would the nurse include for parents of Ian infant with a cleft lip and palate? 1. anticipation that these children will have psychological problems 2. emphasis that the two defects follow the laws of Mendelian genetics 3. assurance that the defect is rare and probably will not occur twice in the same family 4. expectation that once feeding is established, they should otherwise be healthy

4

which topic would the nurse plan to include in teaching a client with a new diagnosis of asthma? 1. home oxygen therapy 2. antibiotic treatment 3. incentive spirometer use 4. use of peak flow meter

4