Peds Exam 2 Practice Questions

A 10-year-old child is admitted to the pe- diatric unit in sickle cell crisis. What should the nurse do first? 1. Obtain vital signs, including temperature. 2. Determine the degree of pain using a pain scale. 3. Determine the rate of the I.V. fluids. 4. Obtain pertinent history information from the parents.

1

The nurse is teaching the mother of a pedi- atric client with sickle cell anemia. Which statement by the mother indicates a need for further teaching? 1."My child can't possibly have sickle cell anemia. He's 4 months old and he's never been sick before." 2."I know my child should receive a pneumococcal vaccine when the doctor suggests." 3. "I know I should call the pediatrician immediately if my child begins to vomit." 4. "I know I should try to keep my child's body temperature normal by keeping him away from fluctuations in temperature."

1

What instructions should the nurse give the parent of a child with a seizure disorder to promote growth & development? 1. the child will likely have normal intelligence & attend regular school 2. the child will need activity limitation & may not perform as well as peers 3. there is potential for learning disability & tutoring may be reqiured 4. problems assocaited with social stigma may occur & require home schooling

1

Which statement indicates a need for further teaching for a parent of a child with diabetes insipidus? 1. this condition could be familial or congenital 2. inflammation of the pancreas is why this is happening to her 3. as infection such as meningitis may be the reason she has this problem 4. my child may have a tumor causing this problem

2

a school-age client in the 2nd percentile of height & weight for age due to an endocrine disorder will be treated with: 1. DDAVP 2. biosynthetic growth hormone 3. estrogen 4. testosterone

2

A 10-month-old infant is admitted to the hospital from the clinic with a history of 2 days of fever, anorexia, crying, and poor sleeping. The infant is diagnosed with possible meningitis. In which situation should the nurse place the infant? 1. In strict isolation 2. In respiratory isolation 3. With other older infants 4. With another infant with meningitis

2

A child is admitted to the pediatric unit with a fever of 102.5o F (39.2o C), shaking chills, and flank pain. From these data collection findings, the nurse would most likely suspect which diagnosis? 1. UTI 2. Nephritis 3. Nephroblastoma 4. Urolithiasis

2

A child with an EVD has a headache & nausea after breakfast. The EVD tube is clamped. What action should the nurse take? 1. immediately notify the healthcare provider 2. unclamp the tubing that leads to the drainage bag 3. take vital signs 4. Administer acetaminophen

2

A child with nephrotic syndrome has these prescriptions: 1. D/C prednisone 40 mg po daily 2. prednisone 30 mg po QOD: 2. the nurse will call the provider for clarification of the orders 3. the nurse will start the 30 mg dose of prednisone tomorrow 4. the nurse will check MAR to see when the last dose of prednisone was given

2

A neonate experiences prolonged bleeding after his circumcision and has multiple bruises without petechiae. These data collection findings suggest: 1. iron deficiency anemia. 2. hemophilia. 3. sickle cell anemia. 4. leukemia.

2

The nurse is caring for a child with leukemia who has an absolute granulocyte count of 400 uL. Which intervention should the nurse implement? 1. Place the child in strict isolation. 2. Notify the physician immediately. 3. Restrict visitors with active infections. 4. Begin antibiotics according to protocol.

3

The nurse is collecting data on a young girl who may have a UTI. A girl is more susceptible to UTIs than a boy because she has: 1. smaller kidneys. 2. a smaller bladder. 3. a shorter urethra. 4. no pubic hair.

3

The nurse would be surprised if the parents of a child with leukemia report which one was the first sign observed? 1. loss of appetite 2. paleness of the skin 3. sores in the mouth 4. purplish spots on the skin

3

A child has been having periods of unawareness with short periods of staring. The child is probably experiencing: 1. complex partial seizures 2. absence seizures 3. myoclonic seizures 4. tonic seizures

3

A child has just returned from surgery for removal of a kidney for Wilms' tumor. Which would be an appropriate nursing action? 1. Offer the child ice chips when awake. 2. Administer pain medication when the child requests it. 3. Monitor the child's vital signs. 4. Provide games at the child's develop- mental level.

3

A child receiving chemo develops mucositis and refuses to eat. What should the nurse recommend to the provider? 1. viscous lidocaine 2. acetominophen and codeine 3. Benadryl and Maalox 4. 1/2 strength hydrogen peroxide

3

You're providing education to a group of nursing students about nephrotic syndrome. A student describes the signs and symptoms of this condition. Which signs and symptoms verbalized by the student require you to re-educate the student about this topic? Select-all-that-apply: A. Slight proteinuria B. Hypoalbuminemia C. Edema D. Hyperlipidemia E. Tea-colored urine F. Hypertension

A, E, and F

The nursing is caring for a patient suspected of Anemia. What objective data supports this diagnosis? 1. history of pica 2. tonsillectomy 3 days ago 3. daily aspirin therapy 4. cheilosis and glossitis

4

A 24-month-old toddler is seen in the clinic for a well-child checkup. The mother reports that she's in the process of toilet training her child but it isn't going well. The toddler has many accidents during the day. Which question should the nurse ask the mother? 1. "Does your child understand what's expected?" 2. "How many accidents a day does your child have?" 3. "Does your child seem to be in pain right before the accident?" 4. "What does your child's urine smell like?"

4

The nurse is assessing a 14-year-old girl with a tumor. Which of the following findings would indicate Ewing' sarcoma? a. Child complains of dull bone pain just above the knee. b. Palpation reveals non-tender swelling on the right ribs. c. Parents report a mass on the abdomen that crosses the midline. d. Palpation reveals asymptomatic mass on the upper back.

b

A 10-year-old child who is admitted with sickle cell disease and acute severe pain is started on a PCA pump for pain management. Which of the following systems is most important for the nurse to assess? a. Respiratory b. Cardiovascular c. Neurological d. Musculoskeletal

a

The nurse is caring for a child diagnosed with hydronephrosis. Which of the following manifestations is consistent with complications of the disorder? a. Hypertension b. Hypotension c. Hypothermia d. Tachycardia

a

A 5 year-old male patient is experiencing acute glomerulonephritis. What signs and symptoms may you observe with this condition? A. Swelling in the face B. Hyperlipidemia C. Tea-colored urine D. Elevated BUN and creatinine level E. >3 Grams of protein loss in the urine per day

a c d

A pediatric client is being treated for hyperthyroidism with propylthiouracil. The nurse suspects that the dose of medication is inadequate when assessing which signs and/or symptoms. Select all that apply. a. Tachycardia b. Diarrhea c. Cold intolerance d. Irritability e. Weight gain

a, b, d

A child with idiopathic nephrotic syndrome is receiving corticosteroids. What statements by the parent about corticosteroids indicate further instruction is needed? Select all that apply. a. "My child's appetite is decreased because of the steroids." b. "My child will need 7 to 10 days of steroids for nephrotic syndrome." c. "Steroids help decrease how much protein is being lost in the urine." d. "Steroids increase the risk of my child getting an infection." e. "Steroids are commonly prescribed and have few side effects."

a, b, e

Which observation when plotting height and weight on a growth chart would indicate that a 4 year-old child has a growth hormone deficiency? a. Upward shift of 1 percentile or more b. Upward shift of 5 percentiles or more c. Downward shift of 2 percentiles or more d. Downward shift of 5 percentiles or more

c

Which of the following statements is true regarding assessment of the fontanels of a 2-month-old? a. Place the infant in the supine position to assess the fontanels. b. A sunken, depressed fontanel indicates the infant has decreased cognitive functioning. c. A bulging, tense fontanel indicates increased intracranial pressure. d. The anterior fontanel should be closed be almost closed by age 2-months.

c

What is the most important intervention for the nurse to include in the care plan for a male infant following surgical repair of hypospadias? a. Sterile dressing changes every 4 hours b. Frequent assessment of the tip of the penis c. Removal of the suprapubic catheter on the 2nd postoperative day d. Urethral catheterization if voiding does not occur over an 8-hour period

b

When obtaining a child's daily weight, the nurse notes a 6 lb. (2.7 kg) loss after 3 days of hospitalization for acute glomerulonephritis. The nurse determines that this is most likely the result of which factor? a. Poor appetite b. Reduction of edema c. Decreased salt intake d. Restriction to bedrest

b

A child with a UTI is being treated with co-trimoxazole (Bactrim) for 10 days. What would the nurse teach the mother? 1. "With this medication, it's important that your child drink lots of water." 2. "When your child has taken this medication for 5 days, call the clinic." 3. "While taking this medication, it's important for your child to stay out of the sun." 4. "If your child won't take this medication, mix it in 3 ounces of fruit juice."

1

Which of the following assessment findings would indicate vaso-occlusive crisis in a child with sickle cell disease? a. Painful urination b. Pain with ambulation c. Complaints of sore throat d. Fever with associated rash

b

Which of the following findings would be most indicative of retinoblastoma for an 18-month old child? a. Orbital inflammation of the right eye and head tilt when standing. b. Cat's eye reflex and yellow discharge from the left eye. c. Leukokoria and hyphema noted for the right eye. d. Strabismus in the left eye and light sensitivity in the opposite eye.

b

Which treatment would be most appropriate for a child diagnosed with iron-deficiency anemia? a. Packed red blood cell transfusion b. Oral ferrous sulfate c. An iron-fortified cereal d. Intramuscular iron dextran

b

A school-age child is diagnosed with acute glomerulonephritis (nephritis). Which nursing action takes priority when caring for this child? 1. Monitoring blood pressure every 4 hours 2. Checking urine specific gravity every 8 hours 3. Offering the child fluids every hour 4. Providing the child with a regular diet and snacks

1

A toddler is admitted to the pediatric unit with a diagnosis of nephroblastoma (Wilms tumor). When providing routine care for this toddler, the nurse should avoid: 1. palpating the toddler's abdomen. 2. positioning the toddler on his side. 3. bathing the toddler. 4. loosening the toddler's clothing.

1

The nurse is providing dietary teaching for the mother of a child with iron deficiency anemia. Which iron-rich foods should the mother include in her child's diet? 1. Liver , dark leafy vegetables, and whole grains 2. Dark leafy vegetables, chicken,and whole grains 3. Whole grains, citrus fruit, and yogurt 4. Citrus fruit, liver, and whole grains

1

The nurse is teaching the parents of a 15-year-old who is being treated for acute myelogenous leukemia about the side effects of chemotherapy. For which of the following symptoms should the parents seek medical care immediately? a. Earache, stiff neck or sore throat b. Blisters, ulcers or a rash appear c. A temperature of 101.5 degrees Fahrenheit d. Difficulty or pain when swallowing

c

The nurse is assisting with the creation of a teaching plan for a school-age child with a UTI. Which should be evaluated first? 1. The child's dietary intake 2. The child's toileting habits 3. The child's calcium intake 4. The child's activity level

2

The nurse is teaching the mother of a toddler with iron deficiency anemia about dietary modifications. Which statement by the mother indicates that she understands the teaching? 1. "I can let my child have four glasses of milk every day." 2. "I will feed my child fortified cereal and lots of green leafy vegetables." 3. "I plan to offer my child juice and cereal for snacks." 4. "I think my child will drink milk and juice easily."

2

A parent reports finding a mass in her child's abdomen. After the diagnosis of nephroblastoma is confirmed, the nurse should prepare the child and family for: 1. immediate chemotherapy. 2. immediate radiation therapy. 3. nephrectomy within 24 to 48 hours of diagnosis. 4. discharge to home with hospice care

3

A school-age child with hydrocephalus is admitted for a revision of his ventriculoperitoneal shunt. When he returns from surgery, how should the nurse position him? 1. On his abdomen where he's comfortable 2. In semi-Fowler's position to prevent aspiration 3. With the bed flat to prevent a subdural hematoma 4. On the same side as the shunt repair

3

The physician prescribes iron supplements for a child with iron deficiency anemia. Which adverse reactions may occur as a result of iron supplementation? 1. Tachycardia, hypotension, and vomiting 2. Tachycardia, hypertension, and vomiting 3. Vomiting, severe stomach pain, and diarrhea 4. Vomiting, severe stomach pain, and petechiae

3

A child with hemophilia is hospitalized with bleeding into the knee. Which action should the nurse take first? 1.Prepare to administer a whole blood transfusion. 2. Prepare to administer a plasma transfusion. 3. Immediately perform active ROM exercises on the knee 4. Elevate and immobilize the knee.

4

An infant is admitted to the pediatric unit for surgical repair of hypospadias. The infant's urine output is 7 ml/hour. What nursing action is most appropriate? 1. Notify the physician immediately. 2. Prepare to administer I.V. fluids. 3. Offer the infant formula every hour. 4. Continue to monitor urine output.

4

The nurse is teaching a child with sickle cell anemia and the child's mother about activities that may promote a vaso-occlusive crisis. Which activity is acceptable for this child? 1. Skiing 2. Mountain climbing 3. Deep-sea diving 4. Softball in the park

4

The nurse is teaching parents of an infant with hypospadias. The nurse should tell the parents to avoid: 1. using disposable diapers. 2. positioning the infant on his back to sleep. 3. bathing the infant in an infant bath- tub. 4. having the infant circumcised.

4

When educating the family of a child with seizures, it is appropriate to tell them to call emergency medical services (911) if the child has a seizure and which of the following findings listed below? a. Continuous vomiting for 30 minutes after the seizure. b. Stereotypic or automatous body movements during the onset. c. Lack of expression, pallor, or flushing of the face during the seizure. d. Unilateral or bilateral posturing of one or more extremities during the onset.

a

The nurse is reviewing lab results of a neonate who has the possible diagnosis of congenital hypothyroidism. The nurse is most concerned by which results? a. High level of T4 and low level of TSH b. Low level of T4 and high level of TSH c. Normal TSH and high level of T4 d. Normal T4 and low level of TSH

b

. A 6-year-old child is admitted to the pediatric intensive care unit (PICU) after suffering a severe closed head injury on the left temporal area. An intracranial pressure (ICP) monitor is in place and reveals and ICP of 40 mm Hg. Based on this assessment data, would of the following would be the best position for the child to be placed? a. Supine with head midline. c. Supine with the head turned to the right. d. Supine with the head turned to the left. e. Side-lying on the left with the head turned to the right.

a

A 10-year-old child with acute glomerulonephritis is admitted to the pediatric unit. The nurse should ensure that which action is part of the child's care? a. Taking vital signs every 4 hours and obtaining daily weight. b. Ensuring that albumen infusions are administered every evening. c. Checking every urine specimen for protein and specific gravity. d. Ensuring that the child has accurate input and output and eats a high-protein diet.

a

A 3-month old infant has a ventriculoperitoneal (VP) shunt inserted. What intervention should the nurse plan to perform? a. Teach the parents the signs of increased intracranial pressure. b. Keep the infant in the prone position. c. Observe for signs of leakage of cerebrospinal fluid. d. Apply a sterile moist dressing to the incision.

a

A 4 year-old child is admitted after being hit in the head by a baseball. Which portion of the head is it most important for the nurse to assess due to the potential for injury to the middle meningeal artery? a. Temporal areas. b. Occipital area. c. Frontal areas. d. Basilar area

a

The nurse is palpating the head of a 5-month-old infant and expects to find: a. The anterior fontanel open and the posterior fontanel closed. b. The anterior fontanel closed and the posterior fontanel open. c. Both the anterior fontanel and posterior fontanel closed. d. Both the anterior fontanel and posterior fontanel are open.

a

The nurse is assessing a child that experienced a traumatic injury to the head. What statement identifies a difference between children and adults that may produce a life-threatening complication for a child? a. Cerebral tissues in children are softer, thinner, and more flexible. b. A child's skull can expand more than an adult's can. c. Greater portions of a child's blood volume flows to the head. d. Hematomas in children can include subdural, epidural, and intracerebral.

b

A child returns to the unit from the PACU after undergoing placement of an internal VP shunt on the left side. Which nursing interventions are appropriate for the client's postoperative care? Select all that apply. a. Place a pillow under the child's head so the neck is flexed. b. Turn the child on the right side. c. Place pillows under the child's legs to promote venous return. d. Maintain the child in a supine position. e. Apply a soft collar to keep the child's neck in a neutral position.

b e

An adolescent is admitted to the hospital with a head injury and possible temporal skull fracture sustained when riding a bicycle without a helmet. On admission, the client was conscious but lethargic. The vital signs indicated temperature 990F, pulse 100 bpm, respirations 18 breaths/min, and BP 130/80. The nurse should report which changes to the provider if they occur? Select all that apply. a. Decreasing urinary output b. Decreasing systolic BP c. Bradycardia d. Widening pulse pressure e. Increasing diastolic BP

c d

A 2-year-old child is admitted to the neurosurgical unit following a head injury. The nurse is using the pediatric Glasgow Coma Scale to measure neurological function. Which assessment finding indicates the lowest level of functioning for this child?a. Confusion. b. Irritable and cries. c. Eyes open only to pain. d. No response to painful stimuli.

d

An 18-month-old child is observed having a seizure. The nurse notes that the child's jaws are clamped. What is the priority responsibility of the nurse at this time? a. Start oxygen via a face mask and apply a pulse oximeter. b. Insert a padded tongue blade and turn child to side. c. Restrain the child and put the side rails up. d. Protect the child from harm from the environment.

d

The nurse knows that which is a risk factor for developing Reye syndrome? 1. recent history of bacterial otitis media 2. recent history of viral gastroenteritis 3. recent history of Haemophilus influenza meningitis

2

Which nursing intervention should be included in the care of an unconscious child with Reye's syndrome? 1. keep the child's arm and legs flexed 2. place the child on a sheepskin 3. avoid using lotions on the skin 4. place the child in a supine position

2

After a head injury, a child experiences enuresis, polydipsia, and weight loss. Based on these findings, the nurse should monitor closely for signs and symptoms of: 1. hypercalcemia. 2. hyperglycemia. 3. hyponatremia. 4. hypokalemia.

3

An adolescent client was diagnosed with acute glomerulonephritis 1 day ago. Which requires immediate attention? 1. a large amount of periorbital edema 2. large amount of RBCs in the urine 3. urine specific gravity of 1.030 4. 24 hour output of 1000 mL

3

The nurse assists the parents of a child on a ketogenic diet to make which menu selection? 1. baked potato 2. creamed corn 3. pecan pie with ice cream 4. roast beef sandwich

3

A 9-year-old scheduled for an LP is fearful & worried about holding still. What will the nurse recommend to the provider? 1. the use of conscious sedation

1

After talking with the parents of a child with Down syndrome, the nurse should help the parent establish which goal? 1. encourage self-care skills in the child 2. achieve age-appropriate social skills 3. teach the child something new each day 4. encourage more lenient behavior limits for the child

1

Which assessment leads the nurse to suspect extensive upper brain stem damage in a child with a head injury? 1. hyperextension of both arms and legs 2. hyperflexion of both arms and legs 3. hyperextension of the arms and hyperflexion of the legs 4. hyperflexion of the arms and hyperextension of the legs

1

Which instructions should be provided when a child with diabetes insipidus will be receiving desmopressin nasal spray? 1. call the provider if the child has an allergic or upper respiratory infection 2. clean the skin around the nares

1

In a child with diabetes insipidus, the nurse could expect which characteristics of the urine? a. Pale in color; specific gravity less than 1.006 b. Concentrated; specific gravity less than 1.006 c. Concentrated; specific gravity greater than 1.033 d. Pale in color; specific gravity greater than 1.033

a

A 5-year-old child is admitted with sickle cell disease. Which assessment finding is most concerning to the nurse? a. Heart rate 135 b. Blood pressure 125/79 c. Pulse oximeter reading 90% d. Temp 100.5 orally

c

To help prevent complications from sickle cell disease during ages 2 months to 5 years, which medication is prescribed on a daily basis? a. diphenhydramine b. acetaminophen c. penicillin d. hydroxyurea

c

Which complications are the three main consequences of leukemia? a. Bone deformities, spherocytosis and infection. b. Anemia, infection, and bleeding tendencies. c. Lymphocytopoiesis, growth delays, and hirsutism. d. Polycythemia, decreased clotting time, and infection.

b

A child with glomerulonephritis has elevated BP & low urinary output for 12 hours. What should the nurse do next? 1. assess the child's neurological system 2. advise the child to eat a low sodium breakfast 3. encourage child to drink more water 4. help the child ambulate in the hallway

1

An infant has a tense bulging fontanel, sunset eyes and lethargy. Which diagnostic procedure is contraindicated? 1. ABG blood draw by RN 2. LP with sedation 3. MRI without sedation 4. CT scan with contrast media

2

The nurse knows that teaching is required when the new nurse states which finding is expected with nephrotic syndrome? 1. elevated trigycerides 2. hyperalbuminemia 3. proteinuria 4. elevated cholesterol

2

Which finding is a possible side effect of being treated with daily oral levothyroxine for congenital hypothyroidism? 1. anorexia 2. constipation 3. sweating 4. sleepiness

3

Which statement from the parent of a toddler should alert the nurse to suspect that the child has had a febrile seizure? 1. my child has had a low-grade fever for several weeks 2. no one in our family has ever had a convulsion 3. my child has had an upper respiratory infection for 2 days 4. my child stopped breathing when the seizure happened

3

A child who has recent surgery for hypospadias had a urinalysis. Which result should be reported to the provider? 1. urine specific gravity of 1.017 2. urine pH of 6 3. ten RBCs per high powered field 4. 25 WBCs per high powered field

4

The nurse is teaching the mother of a child diagnosed with iron deficiency anemia. Which statement is true? 1. Iron shouldn't be administered with foods containing ascorbic acid because they delay absorption. 2. Iron should be administered with milk products because they enhance absorption. 3. Liquid iron should be administered to an infant toward the front of the mouth using an oral syringe. 4. Iron shouldn't be administered with milk products because they delay absorption.

4

The nurse is caring for an adolescent client postoperatively after having a portion of the thyroid gland removed 6 hours prior. The client rates incisional pain 6/10. The prescribed orders include morphine 1 to 2 mg IV every hour as needed for pain. The client is alert with vital signs within normal limits. How will the nurse best manage the client's pain? a. administer morphine 1 mg IV and reassess pain level in 20 minutes b. administer morphine 2 mg IV and reassess pain level in 1 hour c. administer morphine 1 mg IV and repeat the dose in 1 hour d. administer morphine 1 mg IV followed by morphine 2 mg IV in 1 hour

a

The nurse is providing postoperative care to a pediatric patient with sickle cell disease. What is the most important intervention for the nurse to include in the plan of care? a. Increasing fluids b. Preparing the child psychologically c. Discouraging coughing d. Limiting the use of morphine

a

The nurse is providing preoperative care for a 7-year-old patient with a brain tumor. Which of the following is the priority intervention? a. Assessing the child's level of consciousness b. Providing a tour of the intensive care unit for the child and parents c. Educating the child and parents about shunts d. Having the child talk to another child who has had this surgery

a

The nurse is providing teaching for parents who are planning to administer prescribed growth hormone to their child at home. The parents ask the nurse what the best time is to give the medication. What is the best response? a. At bedtime b. Allow the child to choose the time c. In the morning with breakfast d. After dinner

a

A young school-aged child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The school nurse should recommend that the parents have the child evaluated for which possible problem? a. Urinary tract infection b. Structural defect of kidneys c. School phobia d. Separation anxiety

a

In patients who are experiencing acute glomerulonephritis, the glomerulus is permeable to what substances? A. Red blood cells and protein B. Protein and white blood cells C. Red blood cells, protein, and lipids D. Proteins

a

The nurse is administering cyclophosphamide as ordered to a 12-year-old child with nephrotic syndrome. Which of the following instructions is most accurate regarding administration of this cytotoxic drug? a. Administer in the evening on an empty stomach and cannot void for 30 minutes after administration b. Provide adequate hydration and encourage voiding as needed during administration c. Administer in the morning, encourage fluids and voiding during and after administration d. Encourage fluids, adequate food intake and voiding before and after administration

a

. A 3-year-old girl with a Wilms tumor is returning to the unit after a simple nephrectomy. Which of the following actions have the highest priority in caring for this child? a. Maintaining NPO. b. Monitoring the BP every 2 hours. c. Turning her every 2 hours. d. Administering pain medication every 4 hours.

b

A 10-year-old boy is being prepared for a bone marrow transplant. The nurse can determine that the child understands this treatment when he says: a. "I'll be much better after this blood goes to my bones." b. "I won't feel too good until my body makes healthy cells." c. "This will help all of the medicine they give me to work better." d. "You won't have to wear a mask and gown after my transplant."

b

A 5-year-old child is brought to the emergency department unconscious after being hit by a car. The most helpful information for the nurse performing the neurological assessment is the nurse's knowledge of: a. Normal growth and development. b. The child's usual behavior and status. c. The child's past medical history. d. The child's growth and developmental progress during infancy.

b

Select the most common type of medications that may be ordered by a physician to treat nephrotic syndrome: A. Cardiac glycosides B. Corticosteroids C. Antibiotics D. Antihypertensives E. Diuretics F. Anticholinergics

b e

The nurse is assessing a child with juvenile hypothyroidism. The nurse documents which of the assessment findings that is consistent with this condition? a. Accelerate growth b. Diarrhea c. Dry skin d. Yellow sclera

c

A mother believes her son developed osteosarcoma due to playing football. What education should the nurse provide?

osteosarcoma doesn't result from sports injuries

You're collecting a urine sample on a patient who is experiencing proteinuria due to nephrotic syndrome. As the nurse, you know the urine will appear: A. Tea-colored B. Orange and frothy C. Dark and foamy D. Straw-colored

c

The nurse is assessing an infant with diabetes insipidus. What initial observation would the nurse expect? a. Dehydration b. Inability to be aroused c. Extreme hunger d. Irritability

d

A child is seen in the pediatrician's office for complaints of bone and joint pain. Which other assessment finding may indicate leukemia? a. Abdominal pain b. Increased activity level c. Increased appetite d. Petechiae

d

A child is brought to the emergency department with a head injury. When assessing a child with an acute head trauma, which of the following would the nurse initially check? a. Ocular signs. b. Level of consciousness. c. Muscular strength. d. Superficial injuries to the head.

b

A child hospitalized with hydrocephalus is being treated with an externalized ventricular drain (EVD). A nurse begins the afternoon assessment and discovers that the drain is positioned several inches below the level of the child's external meatus. What should be the nurse's priority action? a. Raise the drain to the level of the child's external meatus. b. Clamp the drain and complete a neurological assessment. c. Quickly elevated the head of the bed. d. Leave the drain as is and monitor the CSF drainage hourly.

b

A nurse is caring for a 9-year-old boy with nocturnal enuresis with no physiologic cause. He says he is embarrassed and wishes that he could stop wetting his pants and the bed at night. How should the nurse respond? a. "You will outgrow this in a few years. You just need to be patient with your body as it grows." b. "There are several things we can do to help you achieve your goal." c. "There are almost 5 million people that have your problem." d. "The pull-ups look just like underwear. No one has to know."

b

A nurse is developing a teaching plan for parents of a toddler who has just been diagnosed with sickle cell disease. Which statement is important to emphasize in the teaching plan? a. If they have any children, those children will probably have sickle cell disease too. b. Knowing how to prevent vaso-occlusive crisis is an important part of the parent's role. c. The child will have a greater tendency to bleed and should avoid contact sports. d. Vaso-occlusive crisis will occur eventually, requiring medical care in the emergency department.

b

A parent of a child with Wilms tumor asks the nurse about surgery. Which statement concerning the type of surgery for Wilms tumor is most accurate? a. Surgery is only done if chemotherapy and radiation fail. b. Surgery is usually performed within 24 to 48 hours of admission. c. Surgery is the least favorable therapy for the treatment of Wilms tumor. d. Surgery will be delayed until the child's overall health status improves.

b

An adolescent is admitted to the hospital with a diagnosis of acute lymphocytic leukemia. Which clinical manifestations require the most urgent nursing interventions? a. Fatigue & anorexia b. Fever & petechiae c. Swollen neck lymph nodes & lethargy d. Enlarged liver & spleen

b

An immune-compromised client with cancer is being treated for a leg wound infection that has minimal redness and is unchanged since admission. The child's temperature has increased to 99.9 F orally. What should be the nurse's next action? a. Document the findings in the medical record. b. Assess today's white blood cell count. c. Administer 325 mg acetaminophen orally. d. Elevate the leg on two pillows.

b

A nurse and nursing student are caring for a child who sustained a head injury as a result of a fall from a play structure. Which statement by the nursing student best indicates that the student is prepared to care for the child? a. "I will be sure to let you know if the child's pupils become fixed and dilated." b. "I will keep the child straight in the supine position." c. "I will notify the physician if the child becomes sleepy." d. "I will look for any changes in the child's respirations, pulse or blood pressure."

d

The nurse is caring for an infant who is born with hydrocephalus and has a shunt inserted. Which of the following signs indicates that the shunt is functioning properly? a. Positive sunset sign. b. A bulging fontanel. c. Widened suture lines. d. Decreasing daily head circumference.

d

The nurse is preparing an adolescent diagnosed with leukemia for a lumbar puncture. The nurse determines that the child understands the reason for the procedure when the child states that the procedure is done to: a. "Make sure I don't have meningitis along with my cancer." b. "Relieve some of the pressure on my brain." c. "Remove the blood cancer cells so I don't have to have surgery." d. "Check to see if the cancer has spread through my spinal cord and brain."

d

The nurse is reviewing the interventions listed in the plan of care for a child in vaso-occlusive crisis. What is the most important intervention for the nurse to implement? a. Administering analgesics b. Monitoring fluid restrictions c. Encouraging activity as tolerated d. Administering oxygen as ordered

d

Which condition assessed by the nurse would be an early warning sign of childhood cancer? a. Difficulty swallowing b. Frequent cough or hoarseness c. Change in bowel and bladder habits d. Swellings, lumps or masses anywhere on the body.

d

Which of the following conditions most warrants the pediatric patient with sickle cell disease to receive a blood transfusion? a. Hemoglobin 6.9 b. Pain unrelieved by morphine c. Elevated reticulocyte count d. Coughing and respiratory difficulty

d

Which of the following interventions would be best for the child who has developed mucositis as a side effect of chemotherapy? a. Using lemon glycerin swabs for oral hygiene. b. Keeping the child NPO until all sores are healed. c. Having the child swish and swallow viscous lidocaine. d. Giving the child pudding for breakfast.

d

The nurse is caring for a 6-month-old just admitted to the unit who is irritable, has bulging fontanels, and has been vomiting for the last six hours. The nurse knows that these clinical manifestations are indicative of which of the following? a. Increased intracranial pressure. b. Skull fracture. c. Myleomeningocele d. Meningocele

a

Which of the following is the priority for the nurse to assess in the plan of care for a child who had a closure of a neural tube defect? a. The presence of a urinary tract infection. b. An alteration in bowel function. c. An increased intracranial pressure. d. An alteration in the motor function in the legs.

c

A patient is diagnosed nephrotic syndrome. What signs and symptoms below are common in this condition? Select-all-that-apply: A. Hypertension B. Decreased Glomerular Filtration Rate C. Foamy, frothy urine D. Massive Proteinuria E. Hyperlipidemia F. Edema G. Hematuria H. Hypoalbuminemia

c d e f h

The nurse is assessing a patient in the ED suspected of being in vaso-occlusive crisis. Which assessment findings would indicate that the patient is having a vaso-occlusive crisis? a. Hypotension and thready pulse b. Pallor and poor capillary refill c. Anemia, jaundice and reticulocytosis d. Acute leg pain and swelling of both hands

d

An iron dextran (INFeD) injection has been ordered for an 8-month-old infant with iron deficiency anemia. How should the nurse administer the injection? a. Subcutaneously to avoid a Z-track method b. Intramuscularly using the Z-track method c. Intramuscularly at a 45-degree angle d. Subcutaneously at a 90-degree angle

b

The nurse is caring for a child who was not wearing a helmet, fell off of a bike, and sustained a head injury. Which of the following clinical manifestations would indicate the child is experiencing increased intracranial pressure? a. Hypotension b. Widened pulse pressure. c. Narrow pulse pressure. d. Tachycardia.

b

The nurse recognizes that the parent of a 5-year-old female patient who was recently diagnosed with precocious puberty needs additional education about the pharmacologic management when which of the following statement is made? a. "I feel better knowing that she can stop taking those shots for her disease in 2 years." b. "If she misses one of her monthly shots, then her breasts will start growing again." c. "My husband and I will take turns giving her the shot for this problem." d. "I will let my daughter practice giving fake shots to her stuffed animal."

a

Which of the following assessment findings in the 5-year-old child with diabetes insipidus would warrant the nurse contacting the physician immediately? a. Urinary output of greater than 100 mL/hr b. Serum sodium of 135 mEq/L c. Weight unchanged for 2 consecutive days d. Blood pressure of 90/60.

a

Which statement by a nurse would be the best response to a mother who wants to know what the first indication will be that her child's acute glomerulonephritis is improving? a. "Your child's urine output will increase." b. "Your child's urine will be free from protein." c. "Your child's blood pressure will stabilize." d. "Your child's energy will increase a lot."

a

The nurse is educating the parents of a child being treated with an antiepilepsy drug. Which statement by the parent indicates that the teaching has been effective? a. "My child will wear a medical identification bracelet." b. "I will keep a seizure frequency chart for my child." c. "My child will stay away from potentially hazardous activities." d. "I will stop the drug immediately if my child has a side effect."

b

The nurse is providing discharge teaching to the parents of a 3-year-old girl on how to obtain a clean-catch urine specimen. What is the most appropriate statement by the nurse? a. "Collect the urine sample right after her nap." b. "Never collect the first voided specimen of the day." c. "Collect the urine sample at the beginning of urination." d. "We no longer recommend washing the perianal area before collecting the specimen."

b

A child with sickle cell anemia is being discharged after treatment for a crisis. Which instructions for avoiding future crises would the nurse provide to the child and family? Select all that apply. a. Avoid foods high in folic acid. b. Drink plenty of fluids. c. Use cold packs to relieve joint pain. d. Report a sore throat to an adult immediately. e. Restrict activity to quiet board games. f. Wash hands before meals and after playing.

b d f

A 12-year-old child was admitted to the neurosurgical unit for observation after receiving a head injury. The details of how the injury occurred are unknown. It is now 12 hours after the injury and the child has demonstrated no signs or symptoms of a head injury. Which of the following would be the priority intervention for the nurse to perform? a. Promote rest by creating a quiet environment. b. Administer opioids for complaints of a headache. c. Monitor the level of consciousness every hour as ordered. d. Question the child about the circumstances leading to the injury.

c

A nurse is questioned by a nursing student about the difference between hypospadias and epispadias. Which response by the nurse is best? a. "Episadias defects can only occur in males, affects sterility and the urethra is longer than normal. Hypospadias defects can occur in either sex, never affects sterility or the urethral meatus is proportionally larger than the length of the meatus." b. "The difference between the defects is the length of the urethra, size of the urethral meatus, the sex of the child, and the position of the opening. In hypospadias, the abnormal opening occurs dorsal to the penis. In epispadias, the abnormal opening occurs below the vagina." c. "Hypospadias is an abnormal opening on the ventral side of the penis and epispadias is an abnormal opening of the dorsal side of the penis." d. "Hypospadias is an abnormal opening on the dorsal side of the penis and epispadias is an abnormal opening on the ventral side of the penis."

c

A teenage mother arrives at the clinic with her newborn infant who was recently diagnosed with congenital hypothyroidism. When instructing the mother about administering levothyroxine, what information should the nurse include? a. Crush the medication and place it in a full bottle of formula or breast milk to disguise the taste. b. Administer the medication every 3rd day for 2 weeks, then every other day for 2 weeks and then prn. c. Give the crushed medication in a syringe or in the nipple mixed with a small amount of formula. d. Explain that the medication will no longer be needed after the child reaches 5 years of age.

c

The nurse assesses an 8-month-old infant for a possible head injury and skull fracture after a fall of about 3 feet. The child is awake, alert and crying. The vital signs are within normal limits. What action should the nurse take next? a. Interview the parents about the fall. b. Obtain immediate intravenous access. c. Assess the infant's pupillary response. d. Apply 100% supplemental oxygen.

c

The nurse is administering methimazole (Tapazole) to a 12-year-old recently diagnosed with hyperthyroidism. The child has been receiving the medication 3 times a day for 2 weeks. She suddenly reports onset of a severe sore throat. What would be the appropriate nursing action? a. Continue to give the medication or she will continue to exhibit signs of hyperthyroidism. b. Offer lozenges for the relief of the sore throat. c. Withhold the dose and report this to the physician. d. Ask the child's parents to rate the pain on a scale from 0 - 10.

c

The nurse is assessing an infant with suspected hemolytic uremic syndrome. Which of the following characteristics of this condition would the nurse expect to assess, including information from the electronic medical record? a. Hemolytic anemia, acute renal failure, & hypotension b. Dirty green colored urine, elevated erythrocyte sedimentation & depressed serum complement level c. Hemolytic anemia, thrombocytopenia & acute renal failure d. Thrombocytopenia, hemolytic anemia, & nocturia several times each night

c

The nurse is caring for a 4-year-old child following surgical removal of a stage I neuroblastoma. Which of the following interventions will be most appropriate for this child? a. Applying aloe vera lotion to irradiated areas of skin b. Administering antiemetics as prescribed for nausea c. Giving medications as ordered via least invasive route d. Maintaining isolation as prescribed to avoid infection

c

The nurse is caring for a 9-year-old girl presenting with fever, dysuria, flank pain, urgency and hematuria. The nurse would expect which of the following tests to be ordered first to reveal preliminary information about the urinary tract? a. Total protein, globulin and albumin b. Creatinine clearance c. Urinalysis d. Urine culture and sensitivity

c

The nurse is caring for a young infant who has been admitted with a possible diagnosis of meningitis. Which of the following assessment findings should the nurse report? a. Generalized floppiness. b. Subnormal temperature. c. Change in feeding pattern. d. Low-pitched cry

c

The nurse is caring for an 11-year-old boy diagnosed with acute glomerulonephritis. When reviewing the boy's health history, which of the following will likely be noted? a. The boy has a history of recurrent urinary tract infections b. The boy has a family history of renal disorders c. The boy has a recent history of an upper respiratory infection d. The boy has a history of hypotension

c

What statement made by the parents of a child undergoing hypospadias repair implies the need for further teaching about the primary objective of surgical correction? a. "The purpose is to improve the physical appearance of the genitalia for psychological reasons." b. "The purpose is to enhance the child's ability to void in the standing position." c. "The purpose is to decrease the chance of developing urinary tract infections." d. "The purpose is to preserve a sexually adequate organ."

c

A school-aged child with acute glomerulonephritis has a nursing diagnosis of impaired urinary elimination related to fluid retention and impaired glomerular filtration. Which patient goal best addresses the expected outcome for this diagnosis? a. Exhibits no evidence of infection b. Engages in activities appropriate to capabilities c. Demonstrates no periorbital, facial or body edema d. Maintains a fluid intake of more than 2000 mL in a 24-hour period

c

Which nuring intervention should be included to support the goal of avoiding injury, respiratory distress, and aspiration during a seizure? a. Placing a rolled blanket or towel under the neck to hyperextend the head. b. Placing a hand under the child's head for support. c. Using pillows to prop the child into the sitting position. d. Place a padded tongue blade or small plastic airway between the teeth.

c

The nurse is assessing a 3-year-old child whose mother complains that he is listless and has been having trouble swallowing. Which of the following findings would suggest the child has a brain tumor? a. Observation reveals nystagmus and head tilt b. Vital signs show blood pressure measures 120/80 c. Examination shows temperature of 38.50C and headache d. Observation reveals a cough and labored breathing

a

The nurse is being observed by a group of nursing students while assessing a child in vaso-occlusive crisis. A student asks the nurse why he did not palpate the child's abdomen. What is the most appropriate response by the nurse? a. Risk of splenic rupture b. Risk of inducing vomiting c. Increase in abdominal pain d. Risk of blood cell destruction

a