Peds Exam 1 Labs

Alexi, who has separation anxiety disorder, has not attended school for three (3) weeks, and she cries and exhibits clinging behaviors when her mother encourages attendance. The priority nursing action by the home-care psychiatric nurse would be to: A. Assist the child in returning to school immediately with family support. B. Arrange for a home-school teacher to visit for two (2) weeks C. Encourage family discussion of various problem areas. D. Use play therapy to help the child express her feelings.

A. Assist the child in returning to school immediately with family support.

A child with thalassemia was given deferoxamine (Desferal); which of the following should alert the nurse to notify the physician? A. Decreased hearing B. Hypertension C. Red urine D. Vomiting

A. Decreased hearing Deferoxamine is ototoxic.

Patient S is a sexually active adolescent. Which of the following instructions would be included in the preventive teaching plan about urinary tract infections? A. Drinking acidic juices B. Avoiding urinating before intercourse C. Wearing nylon underwear D. Wiping back to front

A. Drinking acidic juices

Which of the following should be included when developing a teaching plan to prevent urinary tract infection? Select all that apply. A. Maintaining adequate fluid intake B. Avoiding urination before and after intercourse C. Emptying bladder with urination D. Wearing underwear made of synthetic material such as nylon E. Keeping urine alkaline by avoiding acidic beverages F. Avoiding bubble baths and tight clothing

A. Maintaining adequate fluid intake C. Emptying bladder with urination F. Avoiding bubble baths and tight clothing

While examining a 2-year-old child, Nurse Victoria sees that the anterior fontanel is open. She should: A. Notify the doctor B. Look for other signs of abuse C. Recognize this as a normal finding D. Ask about a family history of Tay-Sachs disease

A. Notify the doctor Anterior fontanel normally closes between ages 12 and 18 months

Nurse Walter should expect a 3-year-old child to be able to perform which action? A. Ride a tricycle B. Tie the shoelaces C. Roller-skates D. Jump rope

A. Ride a tricycle

Mr. Lopez has a 7-year-old son with growth hormone (GH) deficiency. He shares to the nurse the desire of his son to play ball games. However, his wife feels the child will be in danger since he is smaller than the other children. In planning anticipatory guidance for these parents, the nurse should keep in mind which of the following? A. The child should be allowed to play because doing so can foster healthy self-esteem. B. The risk for fractures is increased because a GH deficiency results in fragile bones. C. Activity could aggravate insulin sensitivity, causing hyperglycemia. D. Activity would aggravate the child's joints, already over tasked by obesity.

A. The child should be allowed to play because doing so can foster healthy self-esteem.

Which of the following instructions would Nurse Courtney include in a teaching plan that focuses on initial prevention for Sheri who is diagnosed with rheumatic fever? A. Treating streptococcal throat infections with an antibiotic B. Giving penicillin to patients with rheumatic fever C. Using corticosteroid to reduce inflammation D. Providing an antibiotic before dental work

A. Treating streptococcal throat infections with an antibiotic

Which of the following situations increase the risk of lead poisoning in children? A. playing in the park with heavy traffic and with many vehicles passing by B. playing sand in the park C. playing plastic balls with other children D. playing with stuffed toys at home

A. playing in the park with heavy traffic and with many vehicles passing by

Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely? A. At 1 to 2 years of age B. At I week to 1 year of age, peaking at 2 to 4 months C. At 6 months to 1 year of age, peaking at 10 months D. At 6 to 8 weeks of age

B. At I week to 1 year of age, peaking at 2 to 4 months

Nurse Kathy is assessing infantile reflexes in a 9-month-old baby; which of the following would she identify as normal? A. Persistent rooting B. Bilateral parachute C. Absent moro reflex D. Unilateral grasp

B. Bilateral parachute

How does the nurse appropriately administer Mycostatin suspension in an infant? A. Have the infant drink water, and then administer myostatin in a syringe B. Place Mycostatin on the nipple of the feeding bottle and have the infant suck it C. Mix Mycostatin with formula D. Swab Mycostatin on the affected areas

D. Swab Mycostatin on the affected areas

A nurse provides medication instructions to a first-time mother. Which statement made by the mother indicates a need for further instructions? A. "I should mix the medication in the baby food and give it when I feed the child". B. "I should administer the oral medication sitting in an upright position and with the head elevated". C. "I will give my child a toy after giving the medication". D. "I will offer my child a juice drink after swallowing the medication".

A. "I should mix the medication in the baby food and give it when I feed the child".

Cherry, the mother of an 11-month-old girl, Elizabeth, is in the clinic for her daughter's immunizations. She expresses concern to the nurse that Elizabeth cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is: A. 12 months. B. 15 months. C. 10 months. D. 14 months.

A. 12 months.

What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock? A. 20 ml/kg B. 10 ml/kg C. 30 ml/kg D. 15 ml/kg

A. 20 ml/kg

Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggest a fluid volume deficit? A. A sunken fontanel B. Decreased pulse rate C. Increased blood pressure D. Low urine specific gravity

A. A sunken fontanel

In growing children, growth hormone deficiency results in short stature and very slow growth rates. Short stature may result from which of the following? A. Anterior pituitary gland hypofunction B. Posterior pituitary gland hyperfunction C. Parathyroid gland hyperfunction D. Thyroid gland hyperfunction

A. Anterior pituitary gland hypofunction

A 4 month-year-old infant has just received diphtheria, tetanus, and acellular pertussis (DtaP). Hours later, the mother reports to the clinic because her child develops redness and swelling at the injection site. The nurse instructs the mother to do which of the following? A. Application of cold compress B. Application of hot compress C. Monitor for signs of fever D. Report to the clinic for a repeat injection on the other site

A. Application of cold compress

Hydrocortisone cream 1% is given to a child with eczema. The nurse gives instruction to the mother to apply the cream by? A. Apply a thin layer of cream and spread it into the area thoroughly. B. Avoid cleansing the area before the application. C. Apply a thick layer of the cream to affected areas only. D. Apply the cream to other areas to avoid occurrence.

A. Apply a thin layer of cream and spread it into the area thoroughly.

Mrs. Cooper is concerned about her 4-month-old son's unusual condition; which of the following statements made by her would indicate that the child may have cerebral palsy? A. "He holds his left leg so stiff that I have a hard time putting on his diapers." B. "My baby won't lift his head up and look at me; he's so floppy." C. "My baby's left hip tilts when I pull him to standing position." D. "I'm very worried because my baby has not rolled all the way over yet."

B. "My baby won't lift his head up and look at me; he's so floppy."

The 6-year-old son of Mr. and Mrs. Peters is admitted to the healthcare facility with the diagnosis of idiopathic hypopituitarism. His height is measured below the third percentile and weight at the 40th percentile. Which of the following would be the first action of his attending nurse? A. Recommend orthodontic referral for underdeveloped jaw. B. Collaborate with a dietician to access his caloric needs. C. Provide for a tutor for his precocious intellectual ability. D. Place him in a room with a 2-year-old boy.

B. Collaborate with a dietician to access his caloric needs.

Nurse Sophia is teaching the parents of a child with pervasive developmental disorder about how to deal with the child when his behavior escalates and he begins throwing things and screaming. Which guideline would be most helpful for the parents to deal with the situation? A. Accept the child's limitations and ignore this behavior B. Decrease stimulation in the environment and provide a time-out C. Seek help when feeling overwhelmed by the child's behavior D. Tell the child to calm down, and encourage quiet activity

B. Decrease stimulation in the environment and provide a time-out

Will is being assessed by Nurse Lucas for possible intussusception. Which of the following would be least likely to provide valuable information? A. Abdominal palpation B. Family history C. Pain pattern D. Stool inspection

B. Family history

When educating parents regarding known antecedent infections in acute glomerulonephritis, which of the following should the nurse cover? A. Scabies B. Impetigo C. Herpes simplex D. Varicella

B. Impetigo

Martin Sanchez is a nine (9)-year-old child admitted to a psychiatric treatment unit accompanied by Mr. and Mrs. Sanchez. To establish trust and position of neutrality, which action would the nurse take? A. Encourage Mr. and Mrs. Sanchez to leave while Martin is being interviewed. B. Interview Martin with his parents together, observing their interaction. C. Provide diversion for Martin, and interview Mr. and Mrs. Sanchez alone. D. Review the clinical record prior to interviewing Mr. and Mrs. Sanchez.

B. Interview Martin with his parents together, observing their interaction.

Lily , age 5, with an intelligence quotient of 65 is admitted to the hospital for evaluation. When planning care, the nurse should keep in mind that this child is: A. Within the lower range of normal intelligence B. Mildly retarded but educable C. Moderately retarded but trainable D. Completely dependent on others for care

B. Mildly retarded but educable

When developing a plan of care for a hospitalized child, nurse Mary knows that children in which age group is most likely to view illness as a punishment for misdeeds? A. Infancy B. Preschool age C. School age D. Adolescence

B. Preschool age

Nurse Olenna is performing community assessment; which of the following age-groups would be inappropriate for her to monitor iron deficiency anemia? A. Toddlers B. School-age children C. Adolescents D. Pregnant women

B. School-age children

Nurse Nancy is teaching Mr. and Mrs. Diaz about the early signs and symptoms of lead poisoning. Which of the following if stated by the couple would indicate the need for further understanding of the case? A. Anemia B. Seizures C. Irritability D. Anorexia

B. Seizures

While Lawrence is being assessed at the clinic, Nurse Rachel observed that the child appears to be small, with an immature face and chubby body build. Her parents stated that their child's rate of growth of all body parts is somewhat slow, but her proportions and intelligence remain normal. As a knowledgeable nurse, you know that the child has a deficiency of which of the following? A. Antidiuretic hormone (ADH) B. Parathyroid hormone (PTH) C. Growth hormone (GH) D. Melanocyte-stimulating hormone (MSH)

C. Growth hormone (GH)

Mandy, age 12, is brought to the clinic for evaluation for a suspected eating disorder. To best assess the effects of role and relationship patterns on the child's nutritional intake, the nurse should ask: A. "What activities do you engage in during the day?" B. "Do you have any allergies to foods?" C. "Do you like yourself physically?" D. "What kinds of food do you like to eat?"

C. "Do you like yourself physically?"

Nurse Charlotte suspects that a child, age 4, is being neglected physically. To best assess the child's nutritional status, the nurse should ask the parents which question? A. "Has your child always been so thin?" B. "Is your child a picky eater?" C. "What did your child eat for breakfast?" D. "Do you think your child eats enough?"

C. "What did your child eat for breakfast?"

Which of the following is the most common permanent disability in childhood? A. Scoliosis B. Muscular dystrophy C. Cerebral palsy D. Developmental dysplasia of the hip (DDH)

C. Cerebral palsy

Nurse Elizabeth is administering medication via the intraosseous route to a child. Intraosseous drug administration is typically used when a child is: A. Under age 3 B. Over age 3 C. Critically ill and under age 3 D. Critically ill and over age 3

C. Critically ill and under age 3

Which of the following blood study results would the nurse expect as most likely when caring for the child with iron deficiency anemia? A. Increased hemoglobin B. Normal hematocrit C. Decreased mean corpuscular volume (MCV) D. Normal total iron-binding capacity (TIBC)

C. Decreased mean corpuscular volume (MCV)

Mr. and Mrs. Andrews' child was diagnosed with Duchenne's muscular dystrophy; which of the following usually is the first indication of the condition? A. Inability to suck in the newborn B. Lateness in walking in the toddler C. Difficulty running in the preschooler D. Decreasing coordination in the school-age child

C. Difficulty running in the preschooler

Immunization of children with Haemophilus influenzae type B (Hib) vaccine decreases the incidence of which of the following conditions? A. Bronchiolitis B. Laryngotracheobronchitis (LTB) C. Epiglottitis D. Pneumonia

C. Epiglottitis

Which of the following organisms is the most common cause of urinary tract infection (UTI) in children? A. Klebsiella B. Staphylococcus C. Escherichia coli D. Pseudomonas

C. Escherichia coli

Which of the following is not true regarding the varicella vaccine? A. It is administered subcutaneously. B. Children 13 years and older (With no history of chickenpox or have not previously vaccinated) need two doses given at least 28 days apart. C. Give aspirin for any injection-related pain. D. The most common mild side effects are pain, redness, or swelling at the injection site.

C. Give aspirin for any injection-related pain.

Which behavioral assessment in a child is most consistent with a diagnosis of conduct disorder? A. Arguing with adults B. Gross impairment in communication C. Physical aggression toward others D. Refusal to separate from caretaker

C. Physical aggression toward others

Preferred nurses at the Nurseslabs Medical Center are about to perform a procedure related to a genitourinary (GU) problem to a group of pediatric patients. Which of the following groups would find it especially extra stressful? A. Infants B. Toddlers C. Preschoolers D. School-age children

C. Preschoolers

The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis? A. Myoglobinuria B. Ketonuria C. Pyuria D. Low white blood cell (WBC) count

C. Pyuria

During a well-baby visit, Liza asks the nurse when she should start giving her infant solid foods. The nurse should instruct her to introduce which solid food first? A. Applesauce B. Egg whites C. Rice cereal D. Yogurt

C. Rice cereal

Baby Jonathan was born with cleft lip (CL); Nurse Barbara would be alert that which of the following will most likely be compromised? A. GI function B. Locomotion C. Sucking ability D. Respiratory status

C. Sucking ability

The nurse is assessing a 9-month-old boy for a well-baby check-up. Which of the following observations would be of most concern? A. The baby cannot say "mama" when he wants his mother. B. The mother has not given him finger foods. C. The child does not sit unsupported. D. The baby cries whenever the mother goes out.

C. The child does not sit unsupported.

A female child, age 6, is brought to the health clinic for a routine checkup. To assess the child's vision, the nurse should ask: A. "Do you have any problems seeing different colors?" B. "Do you have trouble seeing at night?" C. "Do you have problems with glare?" D. "How are you doing in school?"

D. "How are you doing in school?"

Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child? A. To increase blood pressure B. To reduce inflammation C. To decrease proteinuria D. To prevent infection

C. To decrease proteinuria

A child with a poor nutritional status and weight loss is at risk for a negative nitrogen balance. To help diagnose this problem, the nurse in charge anticipates that the doctor will order which laboratory test? A. Total iron-binding capacity B. Hemoglobin C. Total protein D. Serum transferrin

C. Total protein

A nurse prepares to administer a 3ml injection via intramuscular injection to a 5-year-old child. The nurse selects which site to administer the medication? A. Rectus femoris B. Deltoid C. Ventrogluteal D. Vastus lateralis

C. Ventrogluteal

A mother tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother? A. make the child seat with the family in the dining room until he finishes his meal B. provide a quiet environment for the child before meals C. do not give snacks to the child before meals D. put the child on a chair and feed him

C. do not give snacks to the child before meals

When performing a physical examination on an infant, the nurse in charge notes abnormally low-set ears. This finding is associated with: A. Otogenous tetanus B. Tracheoesophageal fistula C. Congenital heart defects D. Renal anomalies

D. Renal anomalies Ears set below this line are associated with renal anomalies or mental retardation.

A child is diagnosed with Wilms' tumor. During assessment, the nurse in charge expects to detect: A. Gross hematuria B. Dysuria C. Nausea and vomiting D. An abdominal mass

D. An abdominal mass The most common sign of Wilms' tumor is a painless, palpable abdominal mass, sometimes accompanied by an increase in abdominal girth

Which of the following instructions should Nurse Cheryl include in her teaching plan for the parents of Reggie with otitis media? A. Placing the child in the supine position to bottle-feed B. Giving prescribed amoxicillin (Amoxil) on an empty stomach C. Cleaning the inside of the ear canals with cotton swabs D. Avoiding contact with people who have upper respiratory tract infections

D. Avoiding contact with people who have upper respiratory tract infections

Which of the following infants is least probable to develop sudden infant death syndrome (SIDS)? A. Baby Angela who was premature B. A sibling of Baby Angie who died of SIDS C. Baby Gabriel with prenatal drug exposure D. Baby Gabby who sleeps on his back

D. Baby Gabby who sleeps on his back

When assessing a child's cultural background, the nurse in charge should keep in mind that: A. Heritage dictates a group's shared values B. Physical characteristics mark the child as part of a particular culture C. Cultural background usually has little bearing on a family's health practices D. Behavioral patterns are passed from one generation to the next

D. Behavioral patterns are passed from one generation to the next

When a child injures the epiphyseal plate from a fracture, the damage may result in which of the following? A. Rheumatoid arthritis B. Permanent nerve damage C. Osteomyelitis D. Bone growth disruption

D. Bone growth disruption

Which of the following is the best method for performing a physical examination on a toddler A. From head to toe B. Distally to proximally C. From abdomen to toes, the to head D. From least to most intrusive

D. From least to most intrusive

Nurse Emma is planning a client education program for sickle cell disease (SCD); What topic should be included in the plan of care? A. Aerobic exercise to improve oxygenation B. Fluid restraint to 1 qt (1 L)/day C. A high-iron, high-protein diet D. Proper hand washing and infection avoidance

D. Proper hand washing and infection avoidance

Hannah, age 12, is 7 months pregnant. When teaching parenting skills to an adolescent, the nurse knows that which teaching strategy is least effective? A. Providing a one-on-one demonstration and requesting a return demonstration, using a live infant model B. Initiating a teenage parent support group with first and second-time mothers C. Using audiovisual aids that show discussions of feelings and skills D. Providing age-appropriate reading materials

D. Providing age-appropriate reading materials

A mother asks the nurse how to handle her 5-year-old child, who recently started wetting the pants after being completely toilet trained. The child just started attending nursery school 2 days a week. Which principle should guide the nurse's response? A. The child forgets previously learned skills B. The child experiences growth while regressing, regrouping, and then progressing C. The parents may refer less mature behaviors D. The child returns to a level of behavior that increases the sense of security.

D. The child returns to a level of behavior that increases the sense of security.

Reye's syndrome is a rare and severe illness affecting children and teenagers. Its development has been linked with the use of aspirin and which of the following? A. Meningitis B. Encephalitis C. Strep throat D. Varicella

D. Varicella

A nurse prepares to administer an intramuscular injection to a 6-month-old infant. The nurse selects which site to administer the medication? A. Rectus femoris B. Dorsal gluteal C. Ventrogluteal D. Vastus lateralis

D. Vastus lateralis

When administering an I.M. injection to an infant, the nurse in charge should use which site? A. Deltoid B. Dorsogluteal C. Ventrogluteal D. Vastus lateralis

D. Vastus lateralis

Mrs. Baker was instructed by the nurse on foods to encourage her child's diet concerning the latter's iron deficiency anemia. which of the following if stated by the mother would indicate the need for further instruction? A. Fish B. Lean meats C. Whole-grain breads D. Yellow vegetables

D. Yellow vegetables

The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn? A. uneven head shape B. respirations are irregular, abdominal, 30-60 bpm C. (+) Moro reflex D. heart rate is 80 bpm

D. heart rate is 80 bpm

The adolescent patient has symptoms of meningitis: nuchal rigidity, fever, vomiting, and lethargy. The nurse knows to prepare for the following test: A. blood culture. B. throat and ear culture. C. CAT scan. D. lumbar puncture.

D. lumbar puncture.