Pediatrics final
A nurse is educating new parents about risk factors for sudden infant death syndrome (SIDS). Which of the following statements should indicate to the nurse the need for additional teachings
"Our baby will sleep in our bed because I am breastfeeding. We will give my baby a pacifier Suring naps and at bedtime. 'We will remove blankets and toys from the crib." "We will place my baby on her back when sleeping."
a nurse is admitting a 6 month old infant who has dehydration. which of the following amounts of urinary output should indicate to the nurse that the treatment has corrected the fluid imbalance.
2 ml/kg/hour
therapy for kawasaki disease included iv gamma globulin . prescribed at 400 mg/kg/day for 4 days. the child weighs 10 kg. how much is given per dose?
4000 mg
Which child does NOT need a urinalysis to evaluate for a urinary tract infection (UTI)?
A 4-month-old female presenting with a 2-day history of fussiness and poor appetite, current vital signs include temperature 100.8 F (38.2 C). HR 120 beats per minute A 4-year-old female who states: "It hurts when I pee", she has been urinating every 30 minutes, vital signs are within normal range. An 8-year-old male presenting with finger laceration, mother states he has had a history of frequent UTI infections 2 years ago. A 12-year-old female complaining of pain to her lower right back, she denies any burning or frequency at this time, temperature of 101.5 F (38.6
It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition?
Acute rheumatic fever Diabetes insipidus (DI) Nephrotic syndrome Otitis media
The nurse is caring for a 3-month-old being evaluated for possible Hirschsprung disease. His parents call the nurse and show her his diaper containing a large amount of mucus and bloody diarrhea. The nurse notes that the infant is irritable and his abdomen appears very distended. Which should be the nurse's next action:
Call a code for a potential cardiac arrest and stay with the infant. Reassure the parents that this is an expected finding and not uncommon. ) Immediately obtain all vital signs with a quick head-to-toe assessment. Obtain a stool sample for occult blood.
A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse's next action?
Cancel the ultrasound and prepare to administer an intravenous bolus. Immediately notify the healthcare provider of the child's status. Cancel the ultrasound and obtain an order for oral ondansetron (Zofran). Prepare for probable discharge of the patient.
nurse receives a telephone call from the admitting office and is told that the child rheumatic fever will be arriving in the nursing unit for admission. On admission, the nurse prepares to ask the mother which question to elicit assessment information specific to the development of rheumatic fever
Did the child have a sore throat or fever within the last 2 months?" Has the child had any nausea or vomiting?" "Has the child complained of headaches? Has the child complained of back pain?"
How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)?
Eating too many foods high in fiber. Not compliant with taking their encites Not compliant with taking their vitamins. Eating too many foods high in fat.
Cystic fibrosis may affect singular or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is which of the following?
Mechanical obstruction caused by increased viscosity of mucus gland secretions Atrophic changes in mucosal wall of intestines Hypoactivity of microcilla in the lungs Hyperactivity of sweat glands
The nurse is taking care or for a school age girl who has had a cardiac catheterization . The child tells the nurse that her bandage is too wet the nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially:
Notify the Physician Apply direct pressure above the catheterization site Apply a new bandage with more pressure Place the child in Trendelenburg
child had tonsillectomy 2 days ago and was seen in ER due to post-operative hemorrhage. The parent noted that the child was swallowing a lot and finally began vomiting large amounts of blood. The child's vital signs are as follows: T 99.5 F (37.5 C), HR124, BP 84/48. RR 26. The nurse knows that this chid is at risk for which type of renal failure?
Post-renal failure due to hypotensive state Acute renal failure (ARF) due to deyhdration Chronic renal failure (CRF) due to advanced disease process Primary kidney damage due to lack of urine flowing through the system.
The nurse is caring for a 4-year-old child who weights 15 kg. At the end of 10-hour period, the nurse notes the urine output to be 180 ml. What action does the nurse take?
Records the child's urine output in the chart because this urine output is within the expected range Administers isotonic fluids IV to help with rehydration. Encourages the child to increase oral intake to increase urine output. Notifies the physician because this urine output is too low.
nurse is caring for a newborn whose mother voices concerns about sudden infant death syndrome (SIDS). The nurse should include which of the following statements in a discussion with the mother?
SIDS is directly correlated with the diphtheria. tetanus, and pertussis vaccines." "SIDS rates have been rising over the last 10 years." Placing your child on her back when sleeping will decrease the risk of SIDS." Sleep apnea is the main cause of SIDS.
The nurse is caring for a 9-month-old with diarrhea secondary to a viral pathogen. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching.
The infant may return to day care 24 hours after antibiotics have been started Continue breastfeeding per routinely Administer bismuth subsalicylate (Pepto-Bismol) as needed. Administer loperamide (Imodium) as needed.
Which statement expresses accurately the genetic implications of cystic fibrosis?
There is a 50% chance that siblings of an affected child will also be affected. it is a genetic defect found primary in nonwhite population groups. It is inherited as an autosomal dominant trait. If it is present in a child. both parents are carriers of this defective gene.
A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to-right shunting. This assessment data is characteristic of what? •
Ventricular septal defect coarctation of the aorta Pulmonary stenosis Tetralogy of Fallot
which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching their breath
albuterol
a nurse is admitting a toddler who has RSV. which of the following actions should the nurse take?
allow toddler to play in the common room keep thermostat in the toddlers room initiate airborne precautions place the toddler in a room that has negative air pressure
a 3 month old infant with tetralogy of Fallot develops hypercyanotic spell. which should be the nurse first action
assess for neurologic defects begin cardiopulmonary resuscitation place the child in the knee to chest position prepare the family for imminent death
which of the following is NOT correct cardiac catheterization post procedure nursing care?
assess temperature and color of the affected extremity monitor vital signs every 15 minutes with emphasis on heart rate and BP assess pulses above the catheterization site for equality and symmetry monitor IV and oral fluid intake to ensure adequate hydration
whichi medication is given to preterm infants to close patent ductus arteriosus
cardiac catheterization indomethacin surgical litigation prostaglandin E
assessment of a term neonate at 8 hours after birth reveals tachypnea, dyspnea, sternal retractions, diminished femoral pulses poor lower body perfusion and cyanosis of the lower body and extremities with a pink upper body. these symptoms are most likely associated with which of the following
coarction of the aorta pulmonary atresia transposition of the great arteries atrioventricular septal defect
you, the nurse are assessing a child with croup. Examining the childs throat using a tongue depressor may precipitate which of the following
complete airway obstruction accessory muscle use sore throat inspiratory stridor
a child is admitted with a suspected diagnosis of wilms turmor. the nurse should place a sign with which of the following warnings over the childs bed?
contact precautions do not palpate abdomen collect all urine no venipuncture or blood pressure in left arm
a nurse is caring for a child who is 2 hour postoperative following a tonsillectomy. which of the following fluid items should the nurse offer at this time
crushed ice
the nurse is caring for a 2 month old with transposition of the great vessels. which of the following interventions has higher priority
documenting vital signs encourage family visits maintaining proper caloric intake maintain adequate oxygenation
a nurse is caring for a 6 month old infant who has a prescription for clear liquids by mouth after a repair of an intussusception which of the following fluids should the nurse select for the infant
half strength infant formula half strength orange juice sterile water oral electrolyte solution
which assessment finding is expected when assessing a child with tetralogy of fallot
higher pressure in upper extremities than to lower extremities increasing cyanosis with crying or activity machine like murmur increased pulmonary blood floow
the nurse is taking care of the 7 year old child hospitalized with renal failure. which complications related to the childs diagnosis the nurse can expect in this child. select all that apply
hyperkalemia-x metabolic acidosis-x oliguria-x metabolic alkalosis anemia-x hypotension
a 2 year old child is being monitored after cardiac surgery. Which sign represents decrease in cardiac output
hypertension capillary refill time less than 2 seconds increased urine output weak peripheral pulses
a nurse is providing teaching to the parent of an infant who has gastroesophageal reflux. which of the following statements by the parent indicates an understanding of the teaching
i should position my baby side lying during the sleep i will have to feed my baby formula rather than breast milk i will keep my baby in an upright position after feedings my babys formula can be thickened with oatmeal
an 11 year old is admitted for a treatment of asthma attack. which of the following indicates immediate intervention is needed
intercostal retraction
what is the diagnostic for epiglottis?
lateral neck x-ray of the soft tissue
the healthcare provider suggests surgery be performed for ventricular septal defect to prevent what complications
left ventricular pulmonary embolism pulmonary hypertension right to left shunt of blood
an important nursing intervention to support therapeutic management of a child with acute glomerulonephritis should include which action
monitor the child for signs of hyperkalemia(not sure hypo?) measuring daily weight increasing oral fluid intake providing sodium supplements
a nurse is caring for a child who has otitis media. the nurse should identify that which of the following is a manifestation of this condition
nasal congestion bulging fontanel elevated temp as high as 104F rash
a child in the emergency room is being treated with albuterol aerosol treatments for an acute asthma attack. she requires treatments every two hours. which adverse effect of the medication would the nurse expect?
nervousness and tachycardia decreased blood pressure and dizziness increased blood pressure and fatigue lethargy and bradycardia
a nurse is reviewing the ABG values of a child who has chronic kidney disease. which of the following sets of values should the nurse expect?
ph 7.25, hco3 19 meq/l, paco2 35 mm hg
a nurse is asessing a child who has nephrotic syndrome. which of the following should the nurse expect
polyuria hypertension smokey brown urine facial edema
The nurse will soon receive a 4-month-old who has been diagnosed with intussusception. The infant is described as very lethargic with the following vital signs: T 101.8 F (38.8 C), HR 181, BP 68/38. The reporting nurse states the infant's abdomen is very rigid. What is the most appropriate action for the receiving nurse
prepare to start a second iv line to administer fluids and antibiotics prepare to accompany the infant to a computed tomography scan to confirm the diagnosis prepare to get the infant ready for immediate surgical correction prepare to accompany the infant to the radiology department for a reducing enema
surgical closing of the ductus arteriosus would do which of the following
prevent the return of oxygenated blood to the lungs increase the oxygenation of blood decrease the edema in the legs and feet stop the loss of deoxygenated blood to the systemic circulation
which of the following structural defects constitute tetralogy of fallot
pulmonic stenosis, VSD, overriding aorta, right ventricular hypertrophy
the nurse encourages the mother of a toddler with acute laryngotracheobrochitis to stay at the bedside as much as possible. your rationale for this action is primarily which of the following
separation from mother is a major developmental threat at this age mother can provide constant observation of the child's respiratory efforts mothers of hospitalized toddlers often experience guilt mother's presence reduces anxiety to ease the child's respiratory efforts
a child with heart failure is on digoxin (lanoxin) what laboratory value should be closely monitored by the nurse
serum potassium serum sodium serum chloride serum glucose
a nurse is providing teaching to a school aged child who has new diagnosis of asthma. which of the following statements should the nurse include in the teaching.
take cromolyn sodium at the first sign of breathing difficulty use the peak expiratory flow meter once per week avoid triggers that cause an attack you should stop playing basketball but you can swim instead
which assessment is of greatest concern in a 15-month old
the child is lying down and has moderate retractions, a low grade fever and nasal congestion the child is sitting up and has coarse breath sounds coughing and fussiness the child is restless and crying ,has bilateral wheezes, and he is feeding poorly the child is in the tripod position and has diminished breath sounds and a muffled cough
the nurse is caring for an infant who has been diagnosed with short bowel syndrome (SBS). the parent asks how the disease will affect the child. which is the nurses best response
the prognosis and course of the disease have changed because hyperalimentation is available because your child has a shorter intestine than most, he will not be able to absorb all the nutrients and vitamins in food and will need to get nutrients in other ways unfortunately, most children with this diagnosis do not do very well because your child has a shorter intestine than most, your child will likely experience constipation and will need to be placed on a bowel regimen
As part of the treatment for congestive heart failure, the child takes a Furosemide (Lasix) diuretic. As part of teaching home care, you, the nurse, encourage the family to give foods, such as, bananas, oranges, and leaty vegetables. These foods are recommended for this child because they are high in which of the following?
vitamins mimerais potassium sodium
The nurse is caring for a newborn with a cleft lip and palate. The mother states, "I will not be able to breastfeed my baby.* Which is the nurse's best response
we usually discourage breastfeeding babies with cleft lip and palate as it puts them at increased risk for aspiration it sounds like you are feeling discouraged. Would you like to talk about it? Sometimes breastfeeding is still an option for babies with a clef lip and palate. Would you like more information? "Although breastfeeding is not an option. you can pump your milk and then feed it to your baby with a special nipple.
