Peds exam 2

The nurse is caring for a 7-year-old with Guillain-Barré syndrome (GBS). Which of the following would be the most effective intervention to monitor for respiratory deterioration? A. Serial measurement of tidal volume B. Pulse oximetry C. Ineffective cough D. Diminished breath sounds

A. Serial measurement of tidal volume

The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? A. Sluggish deep tendon reflexes B. Full range of motion in extremities C. Absence of hypotonia D. Lack of purposeful muscular control

A. Sluggish deep tendon reflexes

The nurse is providing care to a child with a congenital heart defect. Which of the following would lead the nurse to suspect that the child is developing heart failure? Select all that apply. A. Tachycardia B. Sacral edema C. Bradypnea D. Inability to sweat E. Splenomegaly

A. Tachycardia B. Sacral edema

A voiding cystourethrogram (VCUG) is prescribed for a child. What education should be provided to the parents? A. The VCUG will rule out vesicoureteral reflux. B. The VCUG will detect if the infection is gone. C. The VCUG will rule out kidney stones. D. The VCUG will prevent further complications of the urinary tract infection (UTI).

A. The VCUG will rule out vesicoureteral reflux.

A school-age child is hospitalized with a fractured left femur. The child is in balanced skeletal traction and is in pain. Orders read "Morphine 2.5 mg IV q 3 hours for severe pain." How many mL of morphine would the nurse administer if the medication on hand is morphine 8 mg/1 mL? Record your answer using two decimal places.

0.31

The child has been diagnosed with rickets. The child's mother is educated about the importance of providing the child with 10 micrograms (400 International Units) of an oral vitamin D supplement each day. The child's mother purchases over-the-counter vitamin D drops. The supplement is noted to contain 5 mcg of vitamin D in each 0.5 mL. How much of the supplement should the mother administer to the child each day? Record your answer using one decimal place.

1

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate? A. "Let's put you in touch with some other girls who are also having the same body changes." B. "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C. "Your real friends do not care about your appearance and just want you to get well." D. "You are beautiful in your own way; what matters is what is on the inside."

A. "Let's put you in touch with some other girls who are also having the same body changes."

A 4-year-old child is scheduled for an echocardiogram. The nurse is explaining this procedure to the child's parents. Which information would the nurse likely include? Select all that apply. A. "This test uses sound waves to check the heart structures." B. "This test should not cause your child any pain." C. "This test exposes your child to radiation so we need to be careful." D. "This test checks the electrical conduction of your child's heart." E. "This test will require us to give your child a small amount of anesthesia."

A. "This test uses sound waves to check the heart structures." B. "This test should not cause your child any pain."

A 3-year-old demonstrates lateral bowing of the tibia. Which signs would indicate that the boy's condition is Blount disease rather than the more typical developmental genu varum? A. A sharp, beaklike appearance to the medial aspect of the proximal tibia on x-ray B. The medial surfaces of the knees are more than 2 in apart C. The malleoli are touching D. The condition is bilateral

A. A sharp, beaklike appearance to the medial aspect of the proximal tibia on x-ray

How would the nurse best describe Gowers sign to the parents of a child with muscular dystrophy? A. A transfer technique B. A waddling-type gait C. The pelvis position during gait D. Muscle twitching present during a quick stretch

A. A transfer technique

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which condition should the nurse suspect? A. Acute glomerulonephritis B. Kidney agenesis C. Polycystic kidney D. Nephrosis

A. Acute glomerulonephritis

The nurse is providing teaching to the parents of a child whose blood pressure is in the 90th percentile. Which of the following would the nurse expect to include? Select all that apply A. Family lifestyle modification B. Sodium restriction C. Aerobic exercise D. Stress reduction E. Antihypertensive therapy.

A. Family lifestyle modification B. Sodium restriction C. Aerobic exercise D. Stress reduction

The nurse is caring for a 1-day-old newborn with patent ductus arteriosus with the following vital signs: pulse 160, respirations 80, oxygen saturation 92%, retractions, and crackles noted in bilateral lungs. Which nursing actions are appropriate at this time? Select all that apply. A. Administer furosemide. B. Initiate intravenous access. C. Apply oxygen via oxyhood. D. Feed a high-calorie formula. E. Begin indomethacin infusion.

A. Administer furosemide. B. Initiate intravenous access. C. Apply oxygen via oxyhood. E. Begin indomethacin infusion.

A 10-year-old girl is experiencing acute renal failure due to dehydration. The nurse is preparing to administer IV fluid. Which of the following interventions should the nurse take in caring for this child? A. Administer the IV fluid slowly B. Make sure the IV fluid contains potassium C. Increase oral intake of fluid D. Provide a diet high in protein and sodium

A. Administer the IV fluid slowly

A nurse is working with a 12-year-old girl with osteomyelitis who is recovering from surgery. What nursing interventions should be implemented? Select all that apply. A. Administration of IV antibiotics at the hospital B. Instruct the parents on how to care for an IV line at home C. Instruct the parents regarding the importance of maintaining bed rest D. Institute infection-control precautions related to drainage tubes E. Cast care of the affected limb F. Instruction to the parents regarding proper traction of the limb

A. Administration of IV antibiotics at the hospital B. Instruct the parents on how to care for an IV line at home C. Instruct the parents regarding the importance of maintaining bed rest D. Institute infection-control precautions related to drainage tubes

The nurse is caring for a child diagnosed with a sprain of the lower extremity. Which health care prescription(s) would the nurse clarify with the provider before implementing? Select all that apply. A. Apply a heating pad four times daily for 20 minutes per application B. Offer aspirin (ASA) three times daily orally to the child for pain and inflammation C. Avoid bearing weight on the affected extremity for 3 to 4 days D. Compress the site using an elastic bandage to wrap the area E. Assure the parents understand when to return and to call or follow-up with concerns

A. Apply a heating pad four times daily for 20 minutes per application B. Offer aspirin (ASA) three times daily orally to the child for pain and inflammation

The nurse is creating a care plan for a child with a leg cast. What interventions would be appropriate for the nursing diagnosis of Risk for ineffective peripheral tissue perfusion related to pressure from cast? Select all that apply. A. Assess foot and toes every 4 hours for color, warmth, and presence of pedal pulses. B. Keep leg elevated by a pillow at all times. C. Remind the parents to not allow the child to put anything in the cast. D. Assess capillary refill of toes every 4 hours. E. Educate the child's parents on use of good body mechanics when repositioning the child.

A. Assess foot and toes every 4 hours for color, warmth, and presence of pedal pulses. B. Keep leg elevated by a pillow at all times. D. Assess capillary refill of toes every 4 hours.

After teaching a group of students about medications commonly used for neuromuscular disorders, the nursing instructor determines that the teaching was successful when the students identify which agent as a centrally acting skeletal muscle relaxant? A. Baclofen B. Prednisone C. Lorazepam D. Botulin toxin

A. Baclofen

Parents of a preschooler with cerebral palsy ask the nurse what the surgeon plans to implant in their child's body to control spasticity. What is the nurse's answer? A. Baclofen pump B. Vagal nerve stimulator C. Central venous catheter D. Botulinum toxin

A. Baclofen pump

The nurse is teaching the parent of a child with chronic renal failure on high-potassium foods that should be restricted. Which foods will the nurse include in this teaching? Select all that apply. A. Bananas, carrots, nuts, and milk B. Peaches, broccoli, and red meat C. Oranges, potatoes, wheat, and bran D. Spinach, chicken, fish, and green beans

A. Bananas, carrots, nuts, and milk

The student nurse is preparing a presentation on bones and bone growth. What information should the student include? Select all that apply. A. Calcium and vitamin D play important roles in bone growth and bone breakdown. B. Calcitonin plays a role in remodeling of bone. C. Adipose cell formation happens in the red bone marrow. D. Periosteum is the outer covering of the bone. E. The diaphysis is the rounded end portion of the bone.

A. Calcium and vitamin D play important roles in bone growth and bone breakdown. B. Calcitonin plays a role in remodeling of bone. D. Periosteum is the outer covering of the bone.

The nurse is caring for a child diagnosed with rheumatic fever. When addressing the child's pain, the nurse should perform which intervention(s)? Select all that apply. A. Carefully handle the child's knees, ankles, elbows and wrists when moving the child. B. Administer salicylates after meals or with milk. C. Teach the child how to use a patient-controlled analgesia system. D. Administer intravenous morphine as prescribed. E. Prioritize nonpharmacologic interventions over pharmacologic interventions.

A. Carefully handle the child's knees, ankles, elbows and wrists when moving the child. B. Administer salicylates after meals or with milk.

A nurse is conducting a presentation for a community parent group about respiratory conditions in children. The nurse determines that the teaching was successful when the group identifies which of the following as one of the most common conditions seen during early childhood? A. Croup B. Bronchiolitis C. Asthma D. Pneumonia

A. Croup

When caring for a child with acute bronchiolitis which nursing interventions should be included in the plan of care. Select all that apply. A. Encourage fluids B. Administer oxygen C. Place child in mist tent D. Administer antibiotics E. Follow contact precautions F. Encourage activity

A. Encourage fluids B. Administer oxygen C. Place child in mist tent E. Follow contact precautions

A nurse is developing a teaching plan for the parents of an 8-year-old experiencing nocturnal enuresis. The nurse determines that additional teaching is needed when the parents identify what as an appropriate measure? A. Encouraging fluid intake after dinner B. Practicing bladder-stretching exercises C. Giving desmopressin intranasally D. Engaging the child in stress reduction measures

A. Encouraging fluid intake after dinner

The nurse is assessing a child with spastic cerebral palsy. What findings would the nurse expect to assess? Select all that apply. A. Exaggerated deep tendon reflexes B. Hemiplegia C. Poor control of balance D. Hypertonicity E. Drooling F. Dysarthria

A. Exaggerated deep tendon reflexes

A nurse is assessing the history of a 7-year-old boy who is suspected of having a cardiovascular disorder. Which of the following findings would tend to indicate a cardiovascular disorder in this child? Select all that apply. A. Fatigues easily after a short walk home from school B. A tendency to squat C. Periorbital edema D. A lack of perspiration E. Frequent voiding F. Bouts of hyperactivity

A. Fatigues easily after a short walk home from school B. A tendency to squat C. Periorbital edema

The child has a meningocele and a neurogenic bladder. Which of the following topics should the nurse include in the teaching plan when educating the child and the child's caregivers? Select all that apply. A. How and when to administer oxybutynin chloride B. The importance of antibiotic use to prevent urinary tract infections from occurring C. How and when to perform clean intermittent urinary catheterization D. Signs and symptoms of a urinary tract infection E. Different types of surgeries used to treat this condition

A. How and when to administer oxybutynin chloride C. How and when to perform clean intermittent urinary catheterization D. Signs and symptoms of a urinary tract infection E. Different types of surgeries used to treat this condition

A nurse is developing a teaching plan for the parents of a child with myasthenia gravis. Which of the following would the nurse include? A. How to administer anticholinergic drugs B. Establishment of plans for rest periods C. Signs and symptoms of infection D. Stress management techniques E. Ways to increase the temperature of the child's environment

A. How to administer anticholinergic drugs B. Establishment of plans for rest periods C. Signs and symptoms of infection D. Stress management techniques

A child who is experiencing an exacerbation of asthma is brought to the emergency department by his parents. When reviewing the child's laboratory and diagnostic test results, which is consistent with the diagnosis? A. Hyperinflation of lungs on chest radiograph B. Increased peak expiratory flow rate C. Low arterial blood carbon dioxide level D. Decreased pulmonary function tests

A. Hyperinflation of lungs on chest radiograph

The nurse is conducting a routine physical examination of a newborn to screen for developmental DDH. The nurse correctly assesses the infant by placing the infant: A. In a prone position, noting asymmetry of the thigh or gluteal folds. B. With both legs extended and observes the hip and knee joint relationship. C. With both legs extended and observes the feet. D. In a supine position with both legs extended and observes the tibia/fibula.

A. In a prone position, noting asymmetry of the thigh or gluteal folds.

A child with a suspected airway obstruction is brought to the emergency room. He produces a harsh, strident sound on inspiration (stridor). Where is the obstruction likely to be located, based on this information? A. In the larynx B. Lower trachea C. Bronchioles D. Pharynx

A. In the larynx

A nurse is assessing a child who may have peritonitis. Which of the following would be signs of this problem? A. Increased white blood cell count of dialysate outflow B. Diarrhea C. Increased red blood cell count of dialysate outflow D. Syncope

A. Increased white blood cell count of dialysate outflow

An infant has been born and diagnosed with a meningocele. Which action will the nurse incorporate into each contact with this infant? A. Inspection of the cystic sac on the child's back for leakage B. Auscultation for bowel sounds C. Listening for a shrill cry D. Careful supine positioning

A. Inspection of the cystic sac on the child's back for leakage

A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? Select all that apply. A. Intravenous immunoglobulin B. Ibuprofen C. Acetaminophen D. Aspirin E. Alprostadil

A. Intravenous immunoglobulin C. Acetaminophen D. Aspirin

An infant with poor feeding is suspected of having a congenital heart defect. The parents are asking why a chest x-ray is necessary in their infant. What is the best response from the nurse? A. It will determine if the heart is enlarged. B. It will determine disturbances in heart conduction. C. It will show if blood is being shunted. D. This image will clarify the structures within the heart.

A. It will determine if the heart is enlarged.

The nurse is caring for a school-age child recovering from an open reduction for a fractured femur. Which assessment findings indicate that the child is developing an infection? Select all that apply. A. Lethargy B. Increased pulse rate C. Reduced pulse in the ankle D. Cyanosis of the casted foot E. Increased body temperature

A. Lethargy B. Increased pulse rate E. Increased body temperature

At a well-child visit, a urine specimen is obtained from a child for testing. The nurse is reviewing the results which reveal positive leukocytes. The nurse interprets this as indicating which of the following? A. Possible urinary tract infection B. Diabetes C. Renal disease D. Bleeding

A. Possible urinary tract infection

Which collaborative actions will the nurse perform when caring for an infant with transposition of the great arteries scheduled for surgical repair of the defect? Select all that apply. A. Provide education to the parents. B. Auscultate lung sounds frequently. C. Apply a continuous pulse oximeter. D. Keep oxygen saturation above 75%. E. Administer indomethacin intravenously.

A. Provide education to the parents. B. Auscultate lung sounds frequently. C. Apply a continuous pulse oximeter. D. Keep oxygen saturation above 75%.

The nurse is caring for a child who has been admitted with a possible diagnosis of tuberculosis. Which laboratory/diagnostic tools would most likely be used to help diagnose this child? A. Purified protein derivative test B. Sweat sodium chloride test C. Blood culture and sensitivity D. Pulmonary functions test

A. Purified protein derivative test

A child has been admitted to the inpatient unit to rule out acute Kawasaki disease. A series of laboratory tests have been ordered. Which findings are consistent with this disease? Select all that apply. A. Reduced hemoglobin levels B. Reduced white blood cell count C. Elevated erythrocyte sedimentation rate (ESR) D. Negative C reactive protein levels E. Reduced platelet levels

A. Reduced hemoglobin levels C. Elevated erythrocyte sedimentation rate (ESR)

The nurse is assisting in the development of a plan of care for a child with asthma. In planning care, many goals would be appropriate for this child and/or family caregiver. Which two goals would be the highest priority for this child or family? A. The child will maintain a clear airway. B. The child will have adequate fluid intake. C. The child and family will connect with families living with the same diagnosis. D. The child and family will improve knowledge and understanding of varied pharmacologic options. E. The child will maintain adequate pain control.

A. The child will maintain a clear airway. B. The child will have adequate fluid intake

The nurse is providing education to parents of a child with a blood pressure in the 90th percentile. What would be included in the intervention strategies? A. The nurse would review the child's 24-hour diet recall. B. The child should not be allowed to participate in sports. C. Blood pressures should be measured daily. D. Beta blocker education should be given to the parents.

A. The nurse would review the child's 24-hour diet recall.

The nurse is reviewing the health history and physical examination of a child diagnosed with heart failure. What would the nurse expect to find? Select all that apply. A. Tiring easily when eating B. Shortness of breath when playing C. Crackles on lung auscultation D. Bradycardia E. Hypertension

A. Tiring easily when eating B. Shortness of breath when playing C. Crackles on lung auscultation

The nurse is caring for a child diagnosed with a urinary tract infection. The caregiver asks the nurse why it is so important for the child to have so much fluid. What is the most important reason the child needs increased fluids? A. To dilute the urine and flush the bladder B. To fill the bladder so a specimen can be obtained C. To prevent the child from developing a fever D. To decrease the pain of urination

A. To dilute the urine and flush the bladder

A parent calls the "on call" line stating that her infant has had a bark-like cough for the past three nights. The parent states no fever or cold symptoms. Which suggestions may save a trip to the emergency department? Select all that apply. A. Use a cool mist humidifier in the infant's room. B. Take the infant into a steamy bathroom. C. Provide the infant cold oral fluids. D. Use the coolness of the night air. E. Assess throat for throat obstruction.

A. Use a cool mist humidifier in the infant's room. B. Take the infant into a steamy bathroom. D. Use the coolness of the night air.

A school-age child with asthma has cromolyn sodium added to the medication regimen. What should the nurse include when teaching the child and parents about this medication? Select all that apply. A. Use this medication with a metered-dose inhaler B. Take this medication before an inhaled bronchodilator. C. Repeat doses of this medication until symptoms subside. D. This medication is to be used for an acute asthma attack. E. Wait 1 to 2 minutes between puffs when taking this medication.

A. Use this medication with a metered-dose inhaler E. Wait 1 to 2 minutes between puffs when taking this medication.

The nurse is working with a child with altered genitourinary status. The child demonstrates excess fluid volume. Which of the following would the nurse most likely do? A. Weigh the child 2 times a day on the same scale. B. Hold all medication until the fluid retention improves. C. Avoid administering IV fluids. D. Measure the amount of nitrates present in the urine.

A. Weigh the child 2 times a day on the same scale.

The nurse is working with a child with altered genitourinary status. Which intervention would be included in the plan of care for the client with excess fluid volume? A. Weigh the child daily on the same scale. B. Hold all medication until the fluid retention is improving. C. Avoid administering IV therapies. D. Measure the amount of nitrates present in the urine.

A. Weigh the child daily on the same scale.

The nurse is caring for a 2-year-old diagnosed with bacterial pneumonia. The child has been placed in a mist tent. In caring for the child, it is important for the nurse to: A. monitor the child regularly for signs of cyanosis. B. avoid contact with the mist if the nurse is a sexually active female of childbearing age. C. use contact transmission precautions. D. check for hyperthermia related to enclosure in the tent.

A. monitor the child regularly for signs of cyanosis

A 5-year-old girl who was already admitted to the hospital for an unrelated condition suddenly becomes irritable, restless and anxious. These may be early signs of respiratory distress in a child if accompanied by: A. tachypnea. B. retractions. C. cyanosis. D. clubbing of fingers

A. tachypnea.

A nurse is caring for a 13-year-old boy with end-stage renal disease who is preparing to have his hemodialysis treatment in the dialysis unit. Which nursing action is appropriate? A. Administer his routine medications as scheduled B. Take his blood pressure measurement in extremity with AV fistula C. Withhold his routine medication until after dialysis is completed D. Assess the Tenckhoff catheter site

C. Withhold his routine medication until after dialysis is completed

The nurse is conducting a wellness examination of a 6-month-old child. The mother points out some dimpling and skin discoloration in the child's lumbosacral area. How should the nurse respond? A. "This could be an indicator of spina bifida; we need to evaluate this further." B. "This can be considered a normal variant with no indication of a problem; however, the doctor will want to take a closer look." C. "Dimpling, skin discoloration, and abnormal patches of hair are often indicators of spina bifida occulta." D. "This is often an indicator of spina bifida occulta as opposed to spina bifida cystica."

B. "This can be considered a normal variant with no indication of a problem; however, the doctor will want to take a closer look."

The nurse is reinforcing teaching with the family caregivers of a child diagnosed with tuberculosis who is being treated with the drug rifampin. Which statement made by the caregivers indicates an understanding of this medication? A. "My son will have to take this medication the rest of his life." B. "While she is taking this medication, I won't worry if her tears look orange." C. "This medication may cause slight bleeding when she urinates." D. "He will not be able to attend school for the first few months that he is on this medication."

B. "While she is taking this medication, I won't worry if her tears look orange."

The nurse is assessing an infant at a well-check visit. The infant's mother states that she is worried about her child's feet because they are so flat and wide. What the appropriate response by the nurse? A. "You don't need to worry about your child's feet. They will change as your child grows." B. "Your child's feet are normal for an infant. A child's longitudinal arch will not develop until the child is walking for several months." C. "Flat feet are normal in infants. Their longitudinal arch doesn't appear until they are 3 to 5 years old." D. "When your child starts walking, encourage walking on the heels. This will help to develop the arch more so your child doesn't have a problem with flat feet as an adult."

B. "Your child's feet are normal for an infant. A child's longitudinal arch will not develop until the child is walking for several months."

The emergency department nurse is caring for a client with cystic fibrosis who is dyspneic and has a productive cough. Place in order the nursing interventions performed upon arrival to improve breathing. A. Notify respiratory therapy. B. Assess respiratory status. C. Obtain oxygen saturation reading. D. Place in bed in a semi-Fowler's position. E. Place on oxygen at 2 liters. F. Instruct on energy conservation measures.

B. Assess respiratory status. C. Obtain oxygen saturation reading. D. Place in bed in a semi-Fowler's position. E. Place on oxygen at 2 liters. A. Notify respiratory therapy. F. Instruct on energy conservation measures.

Which assessment findings should the nurse expect to see in the infant diagnosed with pulmonary stenosis and heart failure? Select all that apply. A. Crackles (rales) B. Cyanosis C. Left ventricular hypertrophy D. Murmur E. Right ventricular hypertrophy

B. Cyanosis D. Murmur E. Right ventricular hypertrophy

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding? A. Decreased blood urea nitrogen (BUN) and creatinine B. Decreased platelets and leukocytosis C. Hypernatremia and hypokalemia D. Respiratory acidosis and proteinuria

B. Decreased platelets and leukocytosis

When performing physical assessments of children with musculoskeletal disorders, the nurse distinguishes normal variations in children's muscles versus adult muscles. Which of the following would be most important for the nurse to keep in mind? A. The infant's muscles account for 45% of total body weight as opposed to 25% of adult body weight. B. During adolescence, muscle growth is influenced by increased production of androgenic hormones. C. The young child has rigid soft tissue, so dislocations and sprains are common occurrences. D. Rapid bone and muscle growth in adolescents increase their agility, thereby decreasing the incidence of injuries.

B. During adolescence, muscle growth is influenced by increased production of androgenic hormones.

A school-age child with a supracondylar fracture of the humerus has been placed in a partial cast with the elbow region wrapped with an elastic bandage. What should the nurse explain to the parents and child regarding the reason for this type of casting approach? A. Encourages healing B. Ensures edema does not press on the nerves C. Keeps the bones of the forearm in alignment D. Provides additional stability until the bone heals

B. Ensures edema does not press on the nerves

The mother of a 3-year-old with a myelomeningocele is thinking about having another baby. The nurse should inform the woman that she should increase her intake of which acid? A. Folic acid to 0.4 mg/day B. Folic acid above 0.4 mg/day C. Ascorbic acid to 0.4 mg/day D. Ascorbic acid to 4 mg/day

B. Folic acid above 0.4 mg/day

The nurse caring for a toddler immediately after a fall from a grocery cart will avoid moving which body area as the child is examined? A. Lower extremities B. Head and neck C. Torso D. Clavicle

B. Head and neck

The nurse is assessing a child with suspected rheumatic fever. What assessment findings are consistent with the disease process? Select all that apply. A. Diastolic murmur B. Involuntary limb movement C. Macular rash on trunk D. Tender swollen joints E. Nonpalpable subcutaneous nodules

B. Involuntary limb movement C. Macular rash on trunk D. Tender swollen joints

A nurse is caring for an infant with spinal muscle atrophy (SMA) type 1. What will the nurse note when assessing the child? A. Spastic upper and lower extremities B. Narrow chest and protuberant abdomen C. Enlarged head with low-set ears D. Lusty cry with voracious appetite

B. Narrow chest and protuberant abdomen

Which nursing intervention is the priority for the immobilized child in an acute care setting? A. Ambulate the child up and down the hall twice a day. B. Offer age-appropriate toys and diversional activities. C. Take the child to the playroom at least once a day. D. Encourage active and passive range of motion exercises once a day

B. Offer age-appropriate toys and diversional activities.

The nurse is caring for a child with history of asthma who presents to the emergency department with wheezing, tachypnea, and dyspnea. What will the nurse do first? A. Ask what may have triggered the attack. B. Place the child in high-Fowler's position. C. Assess the child's pulse oximetry reading. D. Apply oxygen via nasal cannula at 2 liters.

B. Place the child in high-Fowler's position.

The nurse is assessing a child with suspected infective endocarditis. Which assessment finding would the nurse interpret as a sign of extracardiac emboli? A. Pruritus B. Roth spots C. Delayed capillary refill D. Erythema marginatum

B. Roth spots

The nurse is teaching a 14-year-old child on the proper use of a metered-dose inhaler to control symptoms of asthma. Which teaching points should the nurse include in these instructions? Select all that apply. A. Take two puffs at a time. B. Shake the canister before using. C. Wait 5 minutes between puffs. D. Hold the breath for 5 to 10 seconds. E. Activate the inhaler while taking a deep breath.

B. Shake the canister before using. D. Hold the breath for 5 to 10 seconds. E. Activate the inhaler while taking a deep breath.

Which diagnostic measure is most accurate in detecting neural tube defects? A. Flat plate of the lower abdomen after the 23rd week of gestation B. Significant level of alpha-fetoprotein present in amniotic fluid C. Amniocentesis for lecithin-sphingomyelin (L/S) ratio D. Presence of high maternal levels of albumin after 12th week of gestation

B. Significant level of alpha-fetoprotein present in amniotic fluid

The child has been diagnosed with slipped capital femoral epiphysis. Which of the following characteristics about the patient is risk factor associated with the development of this condition? Select all that apply. A. The child is noted to be underweight by the nurse. B. The child is 13 years old. C. The child is African American. D. The child's parents state that the child has recently experienced a "growth spurt." E. The child is mal

B. The child is 13 years old. C. The child is African American. D. The child's parents state that the child has recently experienced a "growth spurt." E. The child is mal

The young child has been diagnosed with Guillain-Barré syndrome and it is progressing in a classic manner. Rank the following sequence of events in the order that they typically occur. A. The child is having difficulty producing facial expressions. B. The child states that it is difficult to move his legs. C. The child reports numbness and tingling in his toes. D. The child states that it is difficult to move his arms.

B. The child states that it is difficult to move his legs. C. The child reports numbness and tingling in his toes. D. The child states that it is difficult to move his arms. A. The child is having difficulty producing facial expressions.

The NICU nurse is caring for a preterm neonate with respiratory distress syndrome on mechanical ventilation. Which assessment data would alert the nurse that a pneumothorax might have developed? Select all that apply. A. Neonate's blood pressure is 80/50. B. The neonate's respiratory rate is 68. C. Oxygen saturation is 92% and heart rate is 130. D. Neonate is exhibiting nasal flaring and grunting. E. Chest radiography reveals low lung volume and a ground glass appearance . F. The neonate's chest is asymmetrical. with decreased breath sounds on one side.

B. The neonate's respiratory rate is 68. D. Neonate is exhibiting nasal flaring and grunting. F. The neonate's chest is asymmetrical. with decreased breath sounds on one side.

A child is having their urine checked for complaints of polyuria. When analyzing the results, what would positive glucose indicate? A. This may indicate a urinary tract infection. B. This determines the presence of sugar in the urine. C. This indicates renal disease. D. This determines the presence of bacteria in the urine.

B. This determines the presence of sugar in the urine.

The nurse is caring for a child who is undergoing peritoneal dialysis. Immediately after draining the dialysate, which action should the nurse should take immediately? A. Empty the old dialysate B. Weigh the old dialysate C. Weigh the new dialysate D. Start the process over with a fresh bag

B. Weigh the old dialysate

The nurse receives the shift report of multiple pediatric clients. Which pediatric client will the nurse see first? A. an infant whose parents report difficulty feeding with a temperature of 100.1°F (38°C) B. a toddler with tetralogy of Fallot squatting quietly in the corner of the room C. a child with history of hypertension and a current blood pressure of 130/90 mm Hg D. an adolescent with coarctation of the aorta with reports of coughing and coryza

B. a toddler with tetralogy of Fallot squatting quietly in the corner of the room

A nurse is teaching the parents of a child who has been diagnosed with spina bifida. Which statement by the nurse would be the most accurate description of spina bifida? A. "It has little influence on the intellectual and perceptual abilities of the child." B. "It's a simple neurologic defect that's completely corrected surgically within 1 to 2 days after birth." C. "Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately." D. "It's a complex neurologic disability that involves a collaborative health team effort for the entire first year of life."

C. "Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately."

The nurse has been teaching the parents of a child diagnosed with osteogenesis imperfecta about the use of bisphosphonates for this condition. What statement by a parent indicates a need for further education? A. "This medication will help to increase bone mineral density." B. "My child's risk for fractures will hopefully be decreased as by taking this medication." C. "This medication will cure my child of this disorder." D. "This medication doesn't prevent fractures from happening."

C. "This medication will cure my child of this disorder."

The nurse instructs a school-age patient and the parents on continuous cycling peritoneal dialysis. Which statement indicates that teaching has been effective? A. "The solution should be infused cold." B. "Redness and warmth around the tube insertion site is expected." C. "We should notify the health care provider if the drainage is cloudy." D. "Weight gain and a productive cough are expected with the treatments."

C. "We should notify the health care provider if the drainage is cloudy."

18. The nurse is assessing a toddler. The mother states that he constantly is tripping over his own feet. What is the best response by the nurse? A. "At this age, your child is still learning how to control all of the muscles in the legs. As your child grows older, this clumsiness will get better." B. "Tripping over feet is a symptom of a severe bone disorder, metatarsus adductus. We will need to refer you to an orthopedic surgeon." C. "We will have your child stand on a copier and make a print of the feet. It will show us if the feet are turning in. If they are, your child may need some stretching exercises for the feet." D. "Turning in of feet or toeing in, is common at this age. As your child keeps walking, it will correct on its own."

C. "We will have your child stand on a copier and make a print of the feet. It will show us if the feet are turning in. If they are, your child may need some stretching exercises for the feet."

Which piece of equipment is most helpful in determining airway obstruction in the client with asthma? A. A nebulizer B. An inhaler C. A peak flow meter D. An incentive spirometer

C. A peak flow meter

The nurse caring for an infant with myelomeningocele before surgical intervention will prioritize care in what way? A. Keep the mass uncovered and dry B. Prevent cold stress using an Isolette and blankets C. Cover the sac with a saline-moistened dressing D. Change position from side to side hourly

C. Cover the sac with a saline-moistened dressing

A 3-year-old child is admitted to the hospital with osteomyelitis of the right femur. The nurse would expect to start an IV and antibiotic after blood is drawn for which lab test? A. Hemoglobin and hematocrit B. White blood cell count C. Culture D. Platelets

C. Culture

The nurse is collecting data on a 5-year-old child admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment would be consistent with this diagnosis? A. Jerking movements of the arms and legs B. Scissoring of the legs with toes pointed down C. Failure to gain weight D. Spooning of the finger nails

C. Failure to gain weight

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which characteristics of this condition should the nurse expect to assess or glean from chart review? A. Hemolytic anemia, acute renal failure, and hypotension B. Dirty green colored urine, elevated erythrocyte sedimentation, and depressed serum complement level C. Hemolytic anemia, thrombocytopenia, and acute renal failure D. Thrombocytopenia, hemolytic anemia, and nocturia several times each night

C. Hemolytic anemia, thrombocytopenia, and acute renal failure

A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A. Oral B. Subcutaneous injection C. Intramuscular injection D. Intravenous infusion

C. Intramuscular injection

In the emergency room, the nurse is assessing a toddler who is currently being treated for a radius fracture and has a history of multiple fractures. The assessment reveals short stature, blue sclera, and no bruising or swelling at the fracture site. The nurse suspects: A. Child abuse. B. Attention deficit/hyperactivity disorder. C. Osteogenesis imperfecta. D. Lack of parental supervision.

C. Osteogenesis imperfecta.

A nurse assesses a client who is complaining of calf pain, has a temperature of 101°F (38.3°C) and reports that his leg is very sore. X-rays do not reveal any abnormalities but the client's white count is 21,000 cells and his erythrocyte sedimentation rate is elevated. What problem do these symptoms suggest? A. Muscular dystrophy B. Legg-Calves-Perth disease C. Osteomyelitis D. Compartment syndrome

C. Osteomyelitis

What will be the nurse's next action after noting dimpling and a tuft of hair located in the lumbosacral area of the preschool child during examination? A. Snip the tuft of hair off close to the skin for hygienic reasons B. Move on to other assessments without calling attention to the difference C. Record and refer the finding for follow-up to the pediatrician D. Inspect for precocious hair growth in the genital and underarm areas

C. Record and refer the finding for follow-up to the pediatrician

The nurse is caring for a female preschool-aged patient with a urinary tract infection. What measures should the nurse teach the mother to prevent future infections? A. Suggest the child drink less fluid daily to concentrate urine. B. Encourage the child to be more active to increase urine output. C. Teach the child to wipe the perineum front to back after voiding. D. Teach the child to take frequent tub baths to clean the perineal area.

C. Teach the child to wipe the perineum front to back after voiding.

A female preschool patient with a urinary tract infection is scheduled to have a voiding cystourethrogram. What should the nurse include when teaching the patient about this procedure? A. A headache is a common occurrence after the procedure. B. A local anesthetic will be injected prior to the procedure. C. The patient will be expected to void during the procedure. D. The patient will have to drink three glasses of water during the procedure.

C. The patient will be expected to void during the procedure.

The nurse is performing a well-child assessment on a 2-week-old infant. The nurse asks why her baby only breathes out of his nose and does not seem to mouth breathe. What information can the nurse provide to the mother? A. "Babies breathe from both their nose and mouth around 2 or 3 weeks of age." B. "Breathing from the nose only will be noted in newborns for about the first 6 weeks of life." C. "Your baby is breathing normally for his age." D. "Babies are nose breathers for about the first 4 weeks of life."

D. "Babies are nose breathers for about the first 4 weeks of life."

The nurse is administering digoxin as ordered and the child vomits the dose. What should the nurse do next? A. Contact the physician. B. Offer a snack and administer another dose. C. Immediately administer another dose. D. Administer next dose as ordered in 12 hours.

D. Administer next dose as ordered in 12 hours.

When assessing a infant born at 32 weeks' gestation, which finding would lead the nurse to suspect to suspect that the newborn has a patent ductus arteriosus (PDA)? A. Weak, thready pulse B. Decreased pulse rate C. High diastolic arterial pressure D. Continuous murmur on auscultation

D. Continuous murmur on auscultation

Other than providing direct care to children, what is the major role of nurses in the care of nearly all children with neuromuscular disorders? A. Consoling parents B. Teaching children self-care C. Helping with specialized equipment D. Coordinating care by specialists

D. Coordinating care by specialists

A nurse is performing an assessment on a child. What would be indicative of a potential for a urinary tract infection? A. Washing the genital area with water daily B. Not using cleansing towelettes routinely C. Not using soap when cleaning the urethral area D. Holding urine while at school

D. Holding urine while at school

The nurse receives a report from the admission department that a child with a slipped femoral epiphysis is en route to the care area. For which type of child should the nurse begin to plan care? A. Tall, thin female B. Preadolescent female C. Active school-age male D. Obese preadolescent male

D. Obese preadolescent male

When assessing a child for the probable cause of acute bronchiolitis, the nurse focuses on which factor? A. Bacterial infections B. Environmental allergies C. Prenatal complications D. Viral infections

D. Viral infections

The nurse has received morning report on a group of pediatric clients. Which pediatric client will the nurse see first? A. an infant with rhinorrhea, coughing, and oxygen saturation of 92% B. a toddler with a temperature of 100.1°F (38°C), and a harsh, barking cough C. a preschool child with crackles in the right lower lobe and chest pain D. a school-age child with dysphagia, drooling, and a hoarse voice

D. a school-age child with dysphagia, drooling, and a hoarse voice

In developing a plan of care for the child diagnosed with rheumatic fever, the nursing intervention that takes highest priority for this child is to: A. position the child to relieve joint pain. B. monitor the C-reactive protein and ESR levels. C. provide age-appropriate diversional activities. D. promote rest periods and bed rest.

D. promote rest periods and bed rest.

When caring for children with respiratory issues in relationship to the anatomy and physiology of the child's respiratory system, it is important to recognize which of the following? A. The diameter of the child's trachea is about the size of the child's little finger. B. As soon as the child is born, respiratory passages needed during fetal life close. C. Full development of the lungs and respiratory organs involved does not occur until the child is an adolescent. D. The newborn uses the thoracic muscles to breathe, and as they grow they begin using the abdominal muscles to breathe.

The diameter of the child's trachea is about the size of the child's little finger