PEDS EXAM 3
After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time
Notify the practitioner.
What statement best describes Hirschsprung disease
The colon has an aganglionic segment
Which is one of the first signs of overwhelming sepsis in a child with burn injuries
disorientation
A preschool child is being admitted to the hospital with dehydration and a urinary tract infection (UTI). Which urinalysis result should the nurse expect with these conditions
WBC >2; specific gravity 1.030
Which clinical manifestation would be the most suggestive of acute appendicitis
abdominal pain most intense at McBurney point
During the first few days after surgery for cleft lip, which intervention should the nurse do
remove restraints periodically to cuddle infant
An 8-month-old infant is restrained to prevent interference with the IV infusion. The nurses action is to
remove restraints whenever possible
A 6-year-old child is hospitalized for intravenous (IV) antibiotic therapy. He eats little on his regular diet trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. Which is the best nursing action
request these favorite foods for him
Which is the most common cause of acute renal failure in children
severe dehydration
Which is a major complication in a child with chronic renal failure
sodium and water retention
Which is usually the only symptom of pediculosis capitis (head lice)
itching
Which should the nurse recommend for the diet of a child with chronic renal failure
low phosphorus
An infant with pyloric stenosis experiences excessive vomiting that can result in
metabolic alkalosis
Nitrous oxide is being administered to a child with extensive burn injuries. Which is the purpose of this medication
provide anesthesia
The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations should be expected? (Select all that apply.)
vomiting, failure to gain weight, persistent diaper rash
Which is an important consideration for the nurse when changing dressings and applying topical medication to a childs abdomen and leg burns
wash hands and forearms before and after dressing change
The nurse wore gloves during a dressing change. When the gloves are removed, the nurse should
wash hands thoroughly
The nurse must do a heel stick on an ill neonate to obtain a blood sample. Which is recommended to facilitate this
wrap foot in a warm washcloth
A parent is concerned because her son was exposed to varicella at preschool. The nurse would tell this parent that the incubation period for varicella is
14-21 days
Pertussis vaccination should begin at which age
2 months
A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain
A topical anesthetic can be applied before injections are given
When giving instructions to a parent whose child has scabies, what should the nurse include
Be prepared for symptoms to last 2 to 3 weeks
The nurse is conducting a staff in-service on renal ultrasounds. Which statement describes this diagnostic test
CT uses external radiation to visualize the renal system
The school nurse is conducting a class for school-age children on Lyme disease. Which is characteristic of Lyme disease
Caused by a spirochete that enters the skin through a tick bite
A young child has sustained a minor burn to the foot. Which is recommended for treatment of a minor burn
Cleanse the wound with a mild soap and tepid water.
What clinical manifestation should be the most suggestive of acute appendicitis
Colicky, cramping, abdominal pain around the umbilicus
Using knowledge of child development, which is the best approach when preparing a toddler for a procedure
Demonstrate the procedure on a doll
Which best describes a full-thickness (third-degree) burn
Destruction of all layers of skin evident with extension into subcutaneous tissue
Which muscle is contraindicated for the administration of immunizations in infants and young children
Dorsogluteal
What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls
Ensure clear liquid intake of 2 L/day
Which condition in a child should alert a nurse for increased fluid requirements
Fever
A 3-year-old child has a fever associated with a viral illness. Her mother calls the nurse, reporting a fever of 102 F even though she had acetaminophen 2 hours ago. The nurses action should be based on which statement
Fevers such as this are common with viral illnesses
A child was sent to the school nurse because of a rash. The nurse noted the rash was present on the trunk, extremities, and face. The childs cheeks were bright red. The nurse is aware this type of rash is consistent with
Fifth disease
Which is the most appropriate nursing diagnosis for the child with acute glomerulonephritis
Fluid Volume Excess related to decreased plasma filtration
When the 8-year-old asks the nurse how she got the antibodies that kept her from getting whooping cough, the nurse explains that those shots
Gave her a tiny case of whooping cough and then she made her own antibodies
Which is a parasite that causes acute diarrhea
Giardia lamblia
The nurse is conducting teaching for an adolescent being discharged to home after a renal transplant. The adolescent needs further teaching if which statement is made
I am glad I only have to take the immunosuppressant medication for two weeks
A school-age child with diarrhea has been rehydrated. The nurse is discussing the childs diet with the family. Which statement by the parent would indicate a correct understanding of the teaching
I should have my child eat a normal diet with easily digested foods for the next 48 hours
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child
It is essential because it will be an adjustment
Which statement is descriptive of renal transplantation in children
It is the preferred means of renal replacement therapy in children
The nurse is conducting an admission assessment on a school-age child with acute renal failure. Which are the primary clinical manifestations the nurse expects to find with this condition
Oliguria and hypertension
Which therapeutic management should the nurse prepare to initiate first for a child with acute diarrhea and moderate dehydration
Oral rehydration solution (ORS)
Which is an advantage of peritoneal dialysis
Parents and older children can perform treatments.
A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube
Prevent abdominal distention
Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome
Reduce excretion of urinary protein
What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome
Reduced serum albumin
Which is an important nursing consideration in the care of a child with celiac disease
Refer to a nutritionist for detailed dietary instructions and education
An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which is important in her immediate care
Remove her burned clothing and jewelry
A nurse must do a venipuncture on a 6-year-old child. Which is an important consideration in providing atraumatic care
Restrain child only as needed to perform venipuncture safely
The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?
Restricting fluids
Which therapeutic management treatment is implemented for children with Hirschsprung disease
Surgical removal of affected section of bowel
The nurse is planning to prepare a 4-year-old child for some diagnostic procedures. Guidelines for preparing this preschooler should include which action
Tell the child that procedures are never a form of punishment
The school reviewed the pediculosis capitis (head lice) policy and removed the no nit requirement. The nurse explains that now, when a child is found to have nits, the parents must do which before the child can return to school
The child can remain in school with treatment done at home
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include
Which should the nurse consider when having consent forms signed for surgery and procedures on children
The risks and benefits of a procedure are part of the consent process
A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent
Thicken feedings and enlarge the nipple hole
A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition
UTI
Which clinical manifestation would be seen in a child with chronic renal failure
Unpleasant uremic breath odor
The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause
Urinary stasis
The nurse is caring for an unconscious child. Skin care should include which action
Use draw sheet to move child in bed to reduce friction and shearing injuries
The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis
Visible peristalsis and weight loss
The nurse is talking to the parents of a child with pediculosis capitis. Which should the nurse include when explaining how to manage pediculosis capitis
You will need to remove nits with an extra-fine tooth comb or tweezers
An appropriate method for administering oral medications that are bitter to an infant or small child would be to mix them with
a small amount (1 teaspoon) of a sweet-tasting substance such as jam or ice cream
The nurse is caring for an adolescent who has just started dialysis. The child seems always angry, hostile, or depressed. The nurse should recognize that this is most likely related to
adolescents often resenting the control and enforced dependence imposed by dialysis
The type of precaution that is necessary when caring for a toddler with varicella is
airborne
The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. Which is appropriate to relieve the abdominal discomfort
allow child to assume position of comfort
Katie, 4 years old, is admitted to outpatient surgery for removal of a cyst on her foot. Her mother puts the hospital gown on her, but Katie is crying because she wants to leave on her underpants. The most appropriate nursing action is to
allow her to wear her underpants
The nurse is doing a prehospitalization orientation for a 7-year-old child who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is
an appropriate part of the childs preparation
The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing? (Select all that apply.)
analgesics, IV fluids, clear liquids for first feeding
Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse should further ask the parents if the toddler has which associated factor that is causing the acute diarrhea
antibiotic therapy
A school-age child is admitted to the hospital with acute glomerulonephritis and oliguria. Which dietary menu items should be allowed for this child? (Select all that apply.)
apples, carrot sticks, strawberries
A critically ill child has hyperthermia. The parents ask the nurse to give an antipyretic such as acetaminophen (Tylenol). The nurse should explain that antipyretics
are of no value in treating hyperthermia
Calcium carbonate is given with meals to a child with chronic renal disease. The purpose of this is to
bind phosphorus
The nurse is explaining to a parent how to care for a school-age child with vomiting associated with a viral illness. Which action should the nurse include
brush teeth or rinse mouth after vomiting
The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia
cardiac arrhythmia
The nurse takes into consideration that the child most susceptible to an opportunistic infection is the one taking
corticosteroids
Which is instituted for the therapeutic management of minimal change nephrotic syndrome
corticosteroids
Which should the nurse recommend to prevent urinary tract infections in young girls
cotton panties
The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate
creatinine
Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds. Which is the primary purpose of hydrotherapy
debride the wounds
One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term
deposits of uremic crystals on the skin
A mother who intended to breastfeed has given birth to an infant with a cleft palate
encouraging and helping mother to breastfeed
A newborn was admitted to the nursery with a complete bilateral cleft lip and palate. The physician explained the plan of therapy and its expected good results. However, the mother refuses to see or hold her baby. Initial therapeutic approach to the mother should be
encouraging her to express her feelings
A school-age child has been admitted to the hospital with an exacerbation of nephrotic syndrome. Which clinical manifestations should the nurse expect to assess? (Select all that apply.)
facial edema, fatigue, frothy urine
An appropriate intervention to encourage food and fluid intake in a hospitalized child is to
give high-quality foods and snacks whenever child expresses hunger
Which is an effective strategy to reduce the stress of burn dressing procedures
give the child as many choices as possible
The nurse is preparing a 12-year-old girl for a bone marrow aspiration. The girl tells the nurse she wants her mother with her like before. The most appropriate nursing action is to
grant her request
The nurse would delay the administration of DTaP when the mother says that her infant
had a temperature of 105 from the previous inoculation
The nurse explains to the parents that their child is in the prodromal stage of varicella. This means that the child
has varicella but has not yet broken out
A venipuncture will be performed on a 7-year-old girl. She wants her mother to hold her during the procedure. The nurse should recognize that this behavior is
helpful to relax the child
A child is admitted with acute glomerulonephritis. The nurse should expect the urinalysis during this acute phase to show
hematuria and proteinuria
A toddler sustains a minor burn on the hand from hot coffee. Which is the first action the nurse should recommend in treating this burn
hold burned areas under cool running water
Pyloric stenosis can best be described as
hypertrophy of the pyloric muscle
Which is a common side effect of short-term corticosteroid therapy
increased appetite
Which explains physiologically the edema formation that occurs with burns
increased capillary permeability
After the acute stage and during the healing process, the primary complication from burn injury is
infection
The nurse closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication
infection
A child is admitted with extensive burns. The nurse notes that there are burns on the childs lips and singed nasal hairs. The nurse should suspect that the child has a(n)
inhalation injury
Invagination of one segment of bowel within another is called which of the following?
intussusception
The family of a 4-month-old infant will be vacationing at the beach. Which should the nurse teach the family about exposure of the infant to the sun
keep the infant in total shade at all times
The nurse can be assured that parents understand how long a child who has varicella is contagious when they state
my child should stay home from school for 6 days after the pox appear
A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is
necessary because it will be an adjustment
A child is admitted with bacterial gastroenteritis. Which lab results of a stool specimen confirm this diagnosis
neutrophils and RBCs
Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. The enema solution should be
normal saline
A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurses response should be based on knowledge that this drug is:
not indicated
The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate
notify practitioner
Biologic dressings are applied to a child with partial-thickness burns of both legs. Which nursing intervention should be implemented
observing wound for signs of infection
Which observation made of the exposed abdomen is most indicative of pyloric stenosis
olive-like mass
What urine test result is considered abnormal
pH 4.0
The nurse would document a rash that has erythematous circular raised lesions as
papular
An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect
poor skin turgor
Which is a high-fiber food that the nurse should recommend for a child with chronic constipation
popcorn
A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. Which is an appropriate nursing goal related to this
prevent infection
Caring for the newborn with a cleft lip and palate before surgical repair includes
providing satisfaction of sucking needs
The nurse is taking care of a child with scabies. Which primary clinical manifestation should the nurse expect to assess with this disease
pruritus
A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with GER. The purpose of this is to
reduce gastric acid production
A child with extensive burns requires dbridement. The nurse should anticipate which priority goal related to this procedure
reduce pain
The nurse notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. This is most likely the result of
reduction of edema
Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children
rotavirus
Which is included in the diet of a child with minimal change nephrotic syndrome
salt restriction
The most immediate threat to life in children with thermal injuries is
shock
The nurse is teaching parents about prevention of urinary tract infections in children. Which factor predisposes the urinary tract to infection
short urethra in young girls
The nurse would base a response to a parent about how his child got hepatitis A on the information that the child
shrimp in mexico
When caring for a child with probable appendicitis, the nurse should be alert to recognize that which condition or symptom is a sign of perforation
sudden relief from pain
The emergency department nurse is cleaning multiple facial abrasions on a 9-year-old child whose mother is present. The child is crying and screaming loudly. The nurses action should be to
tell the child it is okay to cry and scream
A parent of a child with major burns asks the nurse why a high-calorie and high protein diet is prescribed. Which response should the nurse make
the diet will avoid protein breakdown
A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. Which should the nurse suggest to minimize reflux
thicken formula with rice cereal
When a child has chronic renal failure, the progressive deterioration produces a variety of clinical and biochemical disturbances that eventually are manifested in the clinical syndrome known as
uremia
A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. The nurses best response should be that the
urinary output will increase
The nurse determined the parent understood the information when he stated
we will wear long pants and long sleeved shirts in the woods
The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching
you will need to avoid adding salt to your childs food
Which serious reaction should the nurse be alert for when administering vaccines
Allergic reaction
A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child should begin with
IV fluids
Which best describes acute glomerulonephritis
Occurs after a streptococcal infection
A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the childs prognosis is related to what factor
Response to steroid therapy
In some genetically susceptible children, anesthetic agents can trigger malignant hyperthermia. The nurse should be alert in observing that, in addition to an increased temperature, an early sign of this disorder is
muscle rigidity
The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply
Acute hypertension is a concern that requires monitoring
When liquid medication is given to a crying 10-month-old infant, which approach minimizes the possibility of aspiration
Administer the medication with a syringe (without needle) placed along the side of the infants tongue
