Peds Exam 2

A nurse is providing teaching to the parents of a child who has had a VP shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement?

"He will need more surgeries to replace the shunt as he grows"

A child weighs 10kg. The physician prescribes ampicillin 100-200 mg/kg/24 hours divided into 4 doses. Calculate the individual dose for ampicillin.

250-500mg/dose

The patient with suspected rheumatic fever, is admitted to the pediatric unit. When obtaining the child's history, the nurse considers which information to be most important? A) Lack of interest in food B) A fever that started 3 days ago C) Vomiting for 2 days D) A recent episode of pharyngitis

A recent episode of pharyngitis

The nurse caring for infants in the neonate intensive care unit (NICU) relies on the use of behavioral and physiologic indicators for determining pain. Which of the following are examples of behavioral indicators? Select all answers that apply. A) The infant grimaces B) The infant's rate is elevated C) The infant flails his arms and legs D) The infant's respiratory rate is elevated E) The infant is crying uncontrollably F) The infant's oxygen saturation is low

A, C, E

The nurse is providing home care for the family of an 8-year-old boy who is transitioning to hospice care. Which action will be most supportive to the parents of the child?

Advocating for the parents needs and respecting the commitments they have made to their child

Which of the following in the health history would alert the nurse to hearing loss in a child? A) Communicates needs through gestures B) Delay in language requisition C) Speaks loudly D) All of the above

All of the above

When considering nurse assignments on a pediatric ward, the charge nurse should AVOID assigning a nurse caring for a toddler with respiratory syncytial virus (RSV) to also care for:

An infant with a heart defect

A nurse is caring for a child with severe pain receiving morphine. What is a priority nursing intervention?

Assess respiratory status frequently

After teasing a class about the hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class igenditifes which defect as an example of a disorder involved increased pulmonary blood flow? A) Tetralogy of Fallot B) Atrial septal defect C) Hypoplastic left heart syndrome D) Transposition of the great vessels

Atrial septal defect

Which of the following can be described as an abnormal opening between the atria that causes an increased flow of oxygenated blood into the right side of the heart? A) Atrial septal defect B) Atrioventricular defect C) Pulmonary artery defect D) Aortie defect

Atrial septal defect

In teaching parents about risk factors for acute otitis media the nurse understands that further teasing is necessary when one of the parents states the a risk factor for otitis media is: A) recurrent URI B) Day Care Attendance C) Being an only child D) Exposure to passive smoke

Being an only child

An 18-month old child present with significant clubbing of the fingers. Which of the following best describes the cause of this condition?

Clubbing implies chronic hypoxia due to severe congenital heart disease

The nurse is providing care to a child with an intussusception. The child has a bowel movement and the nurse inspects the stool. The nurse would document the stool's appearance most lily as which of the following? A) Greasy B) Clay-colored C) Currant jelly-like D) Specks of blood

Currant jelly-like

The nurse administering an antipyretic agent in children knows that the medication works by:

Decreasing the temperature set point by inhibiting prostaglandin production

A child is being assessed for allergic rhinitis and the nurse notes that se also has evidence of atopic dermatitis on her arms. What would be the most appropriate information to investigate during the health history?

Determine if the child has a history of asthma and if there is any family history of atropy

Children that are diagnosed with hypertension are at an increased risk of cardiovascular disease. What would be an important part of the nurse's review of diagnostic testing in these children based on this?

Echocardiogram showing left ventricular hypertrophy

The nurse is caring for a 4 year old boy with conjunctivitis. Which intervention would be least appropriate to include in the child's plan of care?

Encouraging using Visine to get rid of redness

A child with an asthma exacerbation visits the school nurse. The nurse auscultates wheezing on physical exam and peak expiratory flow rate is at 80%. Which of the following would be the priority intervention?

Give him the Albuterol and call parents and provider

The parents of a boy diagnosed with Hirschprung disease are anxious and fearful of an upcoming surgery. The mother states, "I'm worried about heaving to care for our son's stony." Which intervention would be most helpful for the parents?

Having a wound, stony, and continence nurse meet with them

The nurse knows that children ave larger heads in relation to the body. When developing a teaching plan for parents, the nurse includes information about an increased risk for which of the following problems?

Head injury from falls

The nurse is caring for a neonate who is suspected of having sepsis. Which of the following assessment findings would the nurse interpret as most indicative of sepsis?

Hypothermia

The nurse is educating a parent on medication administration. Which statement indicates a need for further instruction? A) I Can cuddle by child after I give the medication B) I can squirt the medication fast straight to the back of the mouth C) I can give my child their favorite drink after they take the medication D) I will give my child the full 10 days of antibiotic

I can squirt the medication fast straight to the back of the mouth

A child is brought to the emergency department by his parents because he suddenly developed a barking cough. Further assessment leads the nurse to suspect that the child is experiencing croup. Which of the following would the nurse have most likely assessed? A) High fever B) Dysphagia C) Toxic appearance D) Inspiratory stridor

Inspiratory stridor

The pediatric oncology nurse is aware that pediatric cancers (Select all that apply)

More commonly found in blood, lymph, brain, bone, kidney, muscle Has minimal environmental factors

A group of parents ask what strabismus is. The nurse best response include all of the following except: A) Most common types are esotropia and exotropin B) It is a misalignment of the eyes C) Can lead to amblyopia D) Most common cause of vision loss if left untreated in children and young adults

Most common cause of vision loss if left untreated in children and young adults

A child is admitted with gastroenteritis. To prevent the spread of this disease, which is the priority nursing intervention?

Observe standard precautions

The nurse is auscultation the bowel sounds of a 4-year-old child and documents hypoactive bowel. What might this finding indicated?

Obstruction

A teenaged cystic fibrosis client presents to the clinic. The health care provider (HCP) knows that cystic fibrosis (CF) causes severe chronic respiratory disease in children. In addition, the HCP should also focus his or her assessment on which of the other body systems affected by CF?

Pancreatis

A nurse is conducting a health history for a 1-month-old with an infection disorder. Which segment of the health history would be most helpful for the nurse when determining if the infant developed the infection from the mother?

Past medical history

Within the first weeks of life this particular shunt typically closes, failure to close causes a connection between the aorta and pulmonary artery

Patent Duetus Arteriosus

A 3-month-old is diagnosed with tetralogy of Fallot. When your all into the room you assess that the baby's color is extremely cyanotic. His respiratory rate is also increased. Which of the following action would you do first?

Place the baby in a knee chest position

The fetus derives its oxygen from which of the following structures from conception to birth?

Placenta

A 17 year old patient has been admitted with bacterial meningitis. Which of the following would a nurse expect

Positive Kernig's sign

The nurse is aware that the most common assessment finding in a child with ulcerative colitis is

Profuse Diarrhea

The nurse is aware that the most common assessment finding in a child with ulcerative colitis is?

Profuse diarrhea and abdominal pain

A 4-year-old boy is admitted to the hospital due to first episode of febrile seizure. Which of the following is a priority to educate the parents on should the child have another seizure?

Protecting the child from harm during the seizure

The nurse is preparing to administer ear drops to a 6-year-old. To ensure that the medication is instilled properly, the nurse does which of the following?

Pulls the Pina upward and back

The nurse is examining an 8-year-old boy with tachycardia and tachypnea. The nurse anticipates which of the following as most helpful in determining the extent of the child's hypoxia?

Pulse oximetry

After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify which of the following as the most common cause of visual difficulties in children?

Refractive errors

After teaching a group of students about visual disorders, the instructor determines that the teaching was successful when the students identify which of the following as the most common cause of visual difficulties in children? A) Glaucoma B) Strabismus C) Refractive errors D) Nystagmus

Refractive errors

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

Sluggish deep tendon reflexes

The nurse is preparing to perform ap physical examination of a child with asthma. Which technique would the nurse be least likely to perform? A) Inspection, percussion, auscultation B) Sputum culture C) Pulse oximetry D) Vital signs

Sputum culture

When conducting a physical examination of a child with suspected Kawasaki disease, which of the following would the nurse expect to assess?

Strawberry tongue

While assessing a newborn with cleft lip, the nurse would be alert that which of the following will most likely be compromised?

Sucking ability

Which of the following assessment findings on a child's eyes is indicative of increased intracranial pressure?

Sunsetting of the eyes

The nurse is caring for a 3-month-old with nasolacrimal duct obstruction. Which intervention would be most appropriate for the nurse to implement?

Teaching the parents how to gently massage the duct

A group of students are reviewing information about the anatomic differences in the eyes and ears of a child in comparison to an adult. The students demonstrate a need for additional study when they identify which of the following?

The ability to discriminate colors is completed by birth

The nurse caring for infants in the neonatal intensive care unit (NICU) relies on the use of behavioral and physiological indicators for determining pain. Which of the following examples are behavioral indicators? (Select all answers that apply.)

The infant grimaces The infant flails his arms and legs The infant is crying uncontrollably.

Which of the following statements represent what happens to circulatory system as the infant transitions from intra-uterine to extra-uterine life?

The lungs inflate, reducing pulmonary vascular resistance to blood flow

When the nurse is assessing a child's pain, which of the following is most important?

Using the same tool to assess the child's pain each time

Which of the following would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure?

Vomiting possibly projectile

A child hospitalized from influenza is in the convalescent stage and preparing for discharge. Which statement from the family indicates the need for further instruction? A) We will encourage our child to drink plenty of fluids and stay hydrated B) We will maintain Air-Borne precautions in our home for the next month C ) We will monitor our child for worsening of symptoms D) We will promote comfort for our child until all symptoms have disappeared

We will maintain Air-Borne precautions in our home for the next month

What would the nurse include when teaching parents how to prevent otitis external?

Wearing ear plugs when swimming

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, which of the following would the nurse most likely find? a) Sausage-shaped mass in the upper midabdomen b) Hard, moveable, olive-shaped mass in the right upper quadrant c) Tenderness over the McBurney point in the right lower quadrant d) Abdominal pain in the epigastric or umbilical region

b) Hard, moveable, olive-shaped mass in the right upper quadrant - Palpable, hard, moveable, olive-shaped mass in the RUQ

A group of nursing students are reviewing information about the variations in respiratory anatomy and physiology in children in comparison to adults. The students demonstrate understanding of the information when they identify which of the following?

children develop hypoxemia more rapidly than adults do