peds final

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The nurse is preparing to post a sign above the crib of an infant with a Wilms tumor. Which statement should the nurse post?

"Do not palpate abdomen."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with iron-deficiency anemia. One of the caregivers tells the group, "I give my child ferrous sulfate." Which statement made by the caregivers is correct regarding giving ferrous sulfate?

"My husband gives our daughter orange juice when she takes her ferrous sulfate, so she gets Vitamin C."

normal UOP

1-3ml/kg/hr

nasal cannula

1-6L

The nurse is caring for children at a local hospital. Which child warrants immediate attention from the nurse?

1-week-old newborn whose oxygenation is not improving with oxygen

non-rebreather

10-16L

fluid requirements

100 mL per kg for the first 10kg 50 mL per kg for second 10kg 20 mL per kg for the remainder of kg Divide total by 24 hours to get mL/hr

A nurse is providing care to a child diagnosed with cerebral palsy who is experiencing painful muscle spasms. The health care provider has prescribed baclofen 40 mg/day PO in three divided doses. How many milligrams should the nurse administer in each dose? Record your answer using one decimal place.

13.3

perrla assesses what cranial nerve

3

A health care provider has prescribed cephalexin 30 mg/kg PO daily in 4 divided doses for a child diagnosed with impetigo. The child weighs 30 lb (14 kg). How many milligrams should the child receive each day?

420

The nurse is administering digoxin as prescribed and the child vomits the dose. What should the nurse do?

Administer next dose as prescribed in 12 hours.

A group of nursing students are reviewing the medications used to treat asthma. The students demonstrate understanding of the information when they identify which agent as appropriate for an acute episode of bronchospasm?

Albuterol

The nurse is caring for a 6-month-old with a cleft lip and palate. The mother of the child demonstrates understanding of the disorder with which statements? Select all that apply.

"I know my baby takes a lot longer to feed than most children this age." "It really worries me that my baby may have some other disorders that haven't been detected yet." "I wonder if my baby will develop speech problems when language development begins?" "Thankfully there are doctors that specialize in correcting this type of disorder."

The nurse is working with a group of caregivers of children diagnosed with asthma. Which statement made by a caregiver is most accurate regarding the triggers that may cause an asthma attack?

"My sister and her family love animals, and when we go to their house my daughter always has an asthma attack."

cpr ratio for child

15:2 for 2man

BSA formula

1600ml/m2/day

Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis?

Avoid making noise when in the child's room.

A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in an isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and avoiding sharing equipment between clients?

Contact precautions

DDST

Denver Developmental Screening Test - describes tasks children should be able to complete

The student nurse is preparing a presentation on ways to prevent medication errors in children. What information should the student include? Select all that apply.

Double-check medication calculations prior to administration. Utilize the Joint Commission's "Do Not Use" abbreviation list. Verify orders for dosages that are unusually large or small. Use 2 client identifiers prior to administering medications.

increased ICP s/s

HA, vomiting

bacterial infections

HIB, pneumococcal conjugate

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for?

Irritability, fever, and vomiting

Which characteristic is true of cerebral palsy?

It appears at birth or during the first 2 years of life.

Airborne precautions

N95 mask

appendicitis comfort

NG tube, inflammtion of appendix, removal

A 16-year-old boy reports to the school nurse with headaches and a stiff neck. Which sign or symptom would alert the nurse that the child may have bacterial meningitis?

Sunlight is "too bright"

The nurse is caring for a school-age child with reports of generalized joint pain and a pharyngitis. During assessment, the nurse notes a cardiac murmur. Which action by the nurse is priority?

Swab throat for culture.

rescue asthma med

albuterol

erikson school age

industry vs inferiority

stage 5 tanner

mature

stage 4 tanner

projection of areola and nipple - continued penile growth

standard precautions

used for all patients, wash hands, wear gloves

most common IM site for children

vastus lateralis

9m toy

with button and pulls

The nurse is teaching an in-service program to a group of nurses on the topic of children diagnosed with rheumatic fever. The nurses in the group make the following statements. Which statement is most accurate regarding the diagnosis of rheumatic fever?

"Children who have this diagnosis may have had strep throat."

The nurse is taking a health history of a toddler with a suspected congenital heart defect. Which response by the mother could indicate that the child is experiencing hypercyanotic spells?

"He likes to stop and squat wherever he walks."

A child has an order for an erythrocyte sedimentation rate (ESR). The child's mother asks what the purpose of the test is. What is the best response by the nurse?

"This test will tell if your child has an infection or inflammation somewhere in their body."

The nurse is reinforcing teaching with a group of caregivers of children diagnosed with asthma. Which statement best indicates an understanding of the management and treatment for this diagnosis?

"We have taken the carpet out of our house and let my mom take our dog."

suck and swallow assesses what cranial nerve

5,7,9,12

Which assessment finding by the nurse would warrant immediate action?

A child with periorbital cellulitis reports changes in vision and pain with eye movement.

wilms tumor s/s

HTN, abd pain, pallor, cough, chest pain, abd pain, abd mass, hematuria

A nurse is caring for a child with Kawasaki disease. Which assessment finding would the nurse expect to see?

Peeling hands and feet; fever

The nurse is providing staff education regarding the use of the BroselowTM tape for pediatric emergencies. What would the nurse include in the education plan?

The tape is useful to estimate the child's weight based on the length.

The nurse is teaching a growth and development class to parents of school-age children. What does the nurse teach the parents about the cognitive abilities of their children?

They are able to classify objects.

The nurse has received the morning report on a group of pediatric clients. Which pediatric client will the nurse see first?

a child reporting dark brown urine and a fine sandpaper rash

cerebellar effcts

ataxia, weakness, paresis, loss of motor control, ^BP, decreased HR and RR, unstable temp

increased pulmonary BF

atrial septal defect, ventricular septal defect, patent ductus arteriosis, atrioventricular canal defect

obstruction to BF TX

cardiac cath, risk for valve replacement, endocarditis prophylaxis.

cytotoxan

cause hemorrhagic cystitis

vincristine

causes constipation, may cause foot drop

polycythemia

increased RBC - CVA risk

infratentorial brain tumor post op

lie flat, side-lying, keep head and neck midline

iron deficient anemia labs

low HGB HCT, FE and feritin

8y toy

nerf gun

Hirchsprung's disease

obstruction due to inadequate motility

A 6-month-old infant is admitted with a diagnosis of bacterial meningitis. Which room is appropriate for this infant?

private room near the nurses' station

HLHS, transposition TX

shunt

mixed BF

transposition of great arteries/vessels, truncus arteriosis, HLHS

hypotonic

treats cellular dehydration - 1/2 NS

surgical shunt

tricuspid atresia TX

birth-1y erikson

trust vs mistrust

comfort care measures

tylenol, med admin, topical

duchene MD

x-linked recessive

face mask

5-10L

acetaminophen tox

>150mg/kg

Which collaborative action(s) 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.

Provide education to the parents. Auscultate lung sounds frequently. Apply a continuous pulse oximeter. Keep oxygen saturation above 80%.

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

Pulse oximetry

decreased pulmonary BF s/s

TET spells, cyanosis, tachycardia, dyspnea, clubbing

The pediatric nurse practitioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this?

The boy rises from the floor by walking his hands up his legs.

A 16-year-old child is admitted to the hospital for treatment after a motor vehicle crash. Review of the child's record reveals that the child is an emancipated minor. What does this mean?

The child has the legal right to consent to and make decisions for treatment.

When examining a child with congenital heart disease, an organ in the upper right quadrant of the abdomen can be palpated at 4 cm below the rib cage. What would most likely explain this assessment finding?

The liver size increases in right-sided heart failure.

down syndrome

The most common chromosomal abnormality, causing mental retardation, susceptibility to heart disease, and other health problems; and distinctive physical characteristics, such as slanted eyes and stocky build.

tumor lysis syndrome

USG 1.003, potassium of 5.6, decreased calcium

A health care provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion? Select all that apply.

Ventricular septal defect Patent ductus arteriosus Atrioventricular canal defect

Which nursing intervention(s) are appropriate for the plan of care designed for a child diagnosed with hemophilia who is experiencing an episode of active bleeding? Select all that apply.

administering acetaminophen as prescribed for pain applying splints to extremities scheduling physical therapy for 48 hours after bleeding stops encouraging self performance of active range-of-motion exercises

leukemia drugs

allopurinol, neupogen, epogen, zofran, corticosteroids, cytosine, arabinside, doxorubicin

leukemia s/s

anemia, bruising, recurrent URI, bone pain, fever, abd pain, pancytopenia

Cystic fibrosis is an example of which type of inheritance?

autosomal recessive

A child being treated for leukemia is diagnosed with neutropenia. What nursing instructions directly prevent client infections? Select all that apply.

avoid large crowds inspect the skin dialy for scratches or scrapes remove house plants, flowers and goldfish from the hme environment stay away from people who have obvious colds, rashes or other infections

systolic murmur

best heard over 3rd and 4th intercostal and L sternal border

Allupurinol

blocks uric acid formation, treat TLS

how to get child to take a deep breath

blow out pen light

mononucleosis

contact, fatigue, malaise, fever, abd pain, anorexia - avoid contact sports - +epstein barr

8-12m cognitive

coordination of secondary schemes

obstruction to BF s/s

cyanosis, murmur, fatigue, SOB

hypothyroidism

decreased T3, T4

VSD repair

defect between ventricles is patched to keep blood from going to lungs, pressure gradiant shunt improved to right ventricle

The nurse is planning to teach the parents of a child with newly diagnosed muscular dystrophy about the disease. Which definition should the nurse use to best describe this condition?

degeneration of muscle fibers

burns risk

dehydration, infection, pain

lasix

diuretic of choice - monitor for dehydration

celft lip post op

elbow restraints, elevate HOB, no shaprs, supine, dont lay on operative side

The nurse is collecting data on a child admitted with a respiratory concern. The nurse notes that the child is anxious and sitting forward with the neck extended to breathe. The signs the nurse noted indicate the child likely has:

epiglottitis.

communicable diseases

erythma infectiosum, impetigo

TEF (Tracheoesophageal Fistula)

failure of esophagus to develop

Hirchsprung's disease signs

failure to pass meconium, FTT

colic

feeding and crying disorder

trasfusion reactions

fever, chills, low back pain, tachycardia, hypotension, tachypnea, shock, flushing, wheezing, dyspnea, NV, headache, JVD

meningitis s/s

fever, increased ICP, kernig and brudzinski, photophobia, rash

VP shunt s/s of infection or blockage

fever, malaise, ^WBC, CSF bacteria, low glucose, nuchal rigitity

croup s/s

fever, resp failure, seal cough

asthma prevention

flovent, advair, pulmicort

burns dietary

fluids and increased protein

11-adult cognitive

formal operationla thought

how to confirm NG placement

gastric secretion w/ PH of 5, abd xray, listen for aspiration of air

contact precautions

gown and gloves

The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem?

head trauma

cleft lip follow up

hearing, speech, sinus, dental

viral infections

hep a-e, roseola, erythema infectiosum, pharyngitis

s/s right sided HF

hepatosplenomegaly, ascites, JVD, weight gain

methotrexate

high dose can be lethal, may require antidote

neuroblastoma s/s

racoon eyes, supraorbital ecchymosis

cognitive birth-1m

sensorimotor

A nurse is caring for a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating distress?

subcostal retraction at the time of feeding

SCD crisis s/s

sudden headache, impaired speech, decreased arm movement

dehydration s/s

sunken eyes, absence of tears

why do TEF patients have GT tube

surgery is done in steps, this allows nutrition

cancer treatment

surgery, radiation, chemo, corticosteroids

Droplet precautions

surgical mask, gown, gloves

The nurse is preparing to administer albuterol to a 14-year-old client for the first time. Prior to administration, which adverse reaction is priority for the nurse to educate the client?

tachycardia

glomerulonephritis

tea colored urine, ^BP, edema

roseola s/s

temp, pinkish flat rash

gowers sign

tests for MD, showing weak muscles

blalock taussig shunt

tetrology of fallot TX

The nurse is caring for a 12-year-old with cerebral palsy who is unable to communicate verbally. Which pain assessment tool is the most appropriate for the nurse to use when assessing pain in this client?

Face, leg, activity, cry, and consolability (FLACC) descriptors

A nurse is reviewing blood work for a child with a cyanotic heart defect. What result would most likely be seen in a client experiencing polycythemia?

Increased RBC

A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?

Maintaining fluids through an intravenous line

A nurse is teaching the parents of a child diagnosed with cystic fibrosis about medication therapy. Which would the nurse instruct the parents to administer orally?

Pancreatic enzymes

Parents are told their infant has a hypoplastic left heart. How would the nurse explain this condition to the family?

This is a problem where the left side of the heart did not develop properly.

ondansetron

give before chemo

iron deficient anemia s/s

underweight, milk baby, irritable, fatigue, innocent mumur

increased pulmonary BF s/s

wet lungs, cough, wheezing, abc breath sounds, SOB, tachypnea, poor feeding, FTT, poor wt gain, fatigue, possible murmur

when to administer oxygen

when sat is below 90

hemophilia

x-linked gentic disorder - female carrier, male effected

While assessing a neonate with a ventricular septal defect (VSD), the nurse notes crackles and retractions. The nurse obtains the following vital signs: temp 100.2°F (38°C), pulse 134 bpm, respirations 64 breaths/minute, oxygen saturation 97% on room air. What will the nurse do first?

Give furosemide intravenously.

A parent brings an infant in for poor feeding and listlessness. Which assessment data would most likely indicate a coarctation of the aorta?

Pulses weaker in lower extremities compared to upper extremities

A 6-month-old boy is brought to the doctor's office with a high fever. The physician diagnoses the child as having a viral infection of some kind and recommends acetaminophen to reduce the fever. After 3 days, the mother returns with the child. The fever is gone, but a rash of discrete, rose-pink macules approximately 2 to 3 mm and flat with the skin surface appears. Which condition should the nurse suspect?

Roseola

To decrease childhood mortality, pediatric nurses need to consistently engage in what activity throughout all age groups?

Teach injury prevention and proper safety practices.

beta thealassemia CM

anemia, pallor, poor feeding, bronzed freckles complexion, enlarged spleen/liver

periorbital cellulitis intervention

antibiotics and anelgesics

interventions for colic baby

assess, movement, alternate positions, reduce stimuli, alter intake

scoliosis

asymmetry of shoulders

neupogen

bone marrow stim

stage 3 tanner

breast buds form to mounds and pubic hair is scant

hemoptysis in CF

complication of coughing up blood from lungs

CAB

compressions, airway and breathing

7-11 cognitive

concrete operational

4y toy

connect 4

Priority in vasoocclusive crisis

hyhdration

adolescence erikson

identity vs role confusion

erikson preschooler

initiative vs guilt

iron deficient anemia TX

intake more iron

varicella s/s

macules, papules, vesicles, crusts

rights of med admin

med, patient, time, route, dose

DDAVP

monitor UOP, anti-diuretic hormone

mixed BF s/s

murmur, cyanosis, clubbing, CHF, ashen skin

FTT nonorganic

not due to medical issues

acne aggravating factors

oily hair, oil-based makeup, hands on face, heredity, stress

strabismus

one eye deviated

stage 2 tanner

onset of puberty - breast buds and pubic hair

intussusception s/s

pain, currant jelly stool, sausage-shape mass in intestine

rheumatic fever

results from not completing strep antibiotics

The nurse is positioning an infant who has just had his left-sided cleft lip repaired. What positions are acceptable for this infant? Select all that apply.

right side-lying supine

Hirchsprung's disease TX

saline enema, high calorie diet, low fiber -- colostomy care

common rashes

scarletina - sandpaper, MMR - measles, rubella - discrete, varicella - centripetal, shingles - vesicular, erythema infectiosum - lacy

4-8m cognitive

secondary circular reactions

The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for:

seizures.

A child with a cardiac structural defect is receiving oxygen therapy. In which position should the child be placed to promote optimal benefits?

semi-Fowler

child with recurrant ear infections

should be screened for hearing loss

decreased pulmonary BF TX

shunt

6-7m social interaction

sits erect, bounces when held, transfers objects between hands

36m toy

small building blocks

3m toy

small teething ring

Asthma triggers

smoke, fumes, strong odor, pet dander, exercise, hormones, URI, allergies

The nurse is caring for a 2-year-old boy with cerebral palsy (CP). The medical record indicates "hypertonicity and permanent contractures affecting both extremities on one side." Based on these findings, the nurse identifies this type of CP as:

spastic.

neutropenia precautions

strict hand washing - avoid ill people, large crowds, raw veggies, live plants

A child enters the acute care setting following a burn injury. The nurse should check for which immunization booster?

tetanus

The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip (DDH). Which finding would help confirm this diagnosis?

A distinct "clunk" is heard with Barlow and Ortolani maneuvers.

things to do before entering toddler space

brief eye contatc, smile, soft voice, get down on childs level

dehydration risk factors

children due to greater surface area to body mass, metabolism, immature kidneys functin, greaters fluid requirement

The student nurse is collecting data on a child diagnosed with cystic fibrosis and notes the child has a barrel chest and clubbing of the fingers. In explaining this manifestation of the disease, the staff nurse explains the cause of this symptom to be:

chronic lack of oxygen.

obstruction to BF

coarctation of aorta, aortic stenosis/atresia, pulmonic stenosis/atresia

CP characteristics

hypertonicity, poor control of posture, balance and coordinated motion

pyloric stenosis

hypertrophy of pyloris muscle - olive shaped mass in RUQ

rheumatic fever labs

increased ESR, increased Creactice protein, elevated ASp

top 2 signs of increased ICP in infatns

increased HC, bulging fontanelle

bacterial menigitis

increased neutrophil and protein, low glucose

leukemia TX

induction, intesification or consolidation, CNS prophylactic therapy

croup TX

maintain airway, o2, hydration, cool mist, racemic epi, corticosteroids, albuterol

increased ICP goals

maintain airway, osmotic diuretics, eye care, nutrition

digoxin

monitor for toxicity - arrhythmias, NV, anorexia -- 0.8-2. give over at least 5. min

increased pulmondary BF TX

mostly spontaneous, or surgical reconstruction

hypertonic

moves fluid out of cells - D5 1/2

neuroblastoma

nervous sytem tumor

myelomeningocele

neural tube defect

isotonic fluids

neutral - LR and NS

pyloric stenosis s/s

no weight gain, hungry, vomtiting

CP definition

nonprogressive disorder of posture and movement due to an insult to brain - CANNOT be cured

The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity?

painting pictures in the art corner of the room

The nurse is implementing the plan of care for a child with acute rheumatic fever. What treatment(s) would the nurse expect to administer if prescribed? Select all that apply.

penicillin corticosteroids nonsteroidal anti-inflammatory drugs

head lice treatment

permethrin, pyrethrin

Which condition is a part of normal newborn screening?

phenylketonuria

24m toy

playing dress up

intussusception

portion of intestine invaginates or telescopes into itself

when to use log roll

post op harrington rods - post spinal fusion

2-7 cognitive

preoperational

stage 1 of tanner

prepuberty

Which child(ren) will the nurse avoid immunizing with a live-virus vaccine? Select all that apply.

preschool-age child receiving radiation therapy toddler with a severe acute illness

1-4m cognitive

primary circular reactions

mixed BF TX

prostaglandin E, septosotomy, heart meds

A nurse is developing the plan of care for a 7-year-old child diagnosed with congenital heart disease and a history of hypercyanotic spells. Which interventions would the nurse include in the child's plan of care to address these spells? Select all that apply.

provide supp. oxygen give parenteral morphine sulfate

12-18m toy

pull and go car

how to deal with temper tantrum

remain close and do not make eye contatc, do not restrain

decrease pulmonary BF

tetrology of fallot, tricuspid atresia

The nurse is performing a physical examination on a sleeping newborn. Which body system should the nurse examine last?

throat

The nurse is caring for a child with a skin disorder. The child presented with papules that progressed to vesicles with a honey-colored exudate. What treatment would the nurse expect to be ordered to treat this disorder? Select all that apply.

topical mupirocin ointment cool compresses to assist in removing crusts on vesicles regular hygiene measures

school age social interaction

understands reversibility of matter, identifies objects, adding and subtracting

erikson toddler

autonomy vs shame & doubt

The nurse is providing education to the parents of a child diagnosed with pinworms. Which statement is most important for the nurse to include in the teaching?

"Make sure your child washes hands before eating."

A nurse is taking care of a teenager who reports involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?

Educate the client about the changes that occur during adolescence.


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