PEDS NextGen Prep-U
A nurse in a primary care provider's office is performing a comprehensive assessment on a 16-year-old adolescent diagnosed with anorexia. Click to highlight the findings that will require follow up. Adolescent is awake, alert, and oriented. Lungs are clear, abdomen is concave with hyperactive bowel sounds. Pulses are weak and thready. Vital signs: temperature, 95.9 F (35.5 C); heart rate, 55 beats/min; blood pressure, 88/49 mm Hg; oxygen saturation, 98% on room air. Adolescent has a body mass index (BMI) of 15.2. Laboratory values: sodium, 149 mEq/l (149 mmol/l); potassium, 2.9 mEq/l (2.9 mmol/l); hemoglobin, 9 g/dl (90 g/l); hematocrit, 45% (0.45).
abdomen is concave hyperactive bowel sounds. Pulses are weak and thready temperature, 95.9 F (35.5 C); heart rate, 55 beats/min; blood pressure, 88/49 mm Hg body mass index (BMI) of 15.2 sodium, 149 mEq/l (149 mmol/l); potassium, 2.9 mEq/l (2.9 mmol/l); hemoglobin, 9 g/dl (90 g/l); hematocrit, 45% (0.45).
A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. Complete the following sentence(s) by choosing from the lists of options. The nurse should first ____________ followed by ____________.
ensure proper oxygenation administer intravenous (IV) or intramuscular (IM) benzodiazepine
Click to highlight the finding(s) that will require follow-up. The client has had cold symptoms for the past few days including coughing, sneezing, and a runny nose. Today coughing has increased, with decreased appetite and increasing fussiness. Parents administered acetaminophen for a fever of 102.2 F (39 C) last night with effect. Lips and mucous membranes are dry and cracked; skin very warm, ruddy, and intact. Parents state they have only changed diapers once since last night with very little urine, no bowel movement. Physical assessment reveals lethargy, opens eyes to voice, nonproductive cough, rhinorrhea that is clear, and expiratory wheezes in bilateral upper lobes. Vital signs: temperature, 101.2 F (38.4 C); heart rate, 130 beats/min; blood pressure, 82/42 mm Hg; respiratory rate, 28 breaths/min; oxygen saturations 96% on room air.
for the past few days including coughing, sneezing, and a runny nose. coughing has increased, with decreased appetite and increasing fussiness. administered acetaminophen for a fever of 102.2 F (39 C) last night with effect. Lips and mucous membranes are dry and cracked; skin very warm, ruddy have only changed diapers once since last night with very little urine, no bowel movement. lethargy, opens eyes to voice, nonproductive cough, rhinorrhea that is clear expiratory wheezes in bilateral upper lobes temperature, 101.2 F (38.4 C) oxygen saturations 96% on room air.
The parent of a newborn diagnosed with Turner syndrome asks the nurse about the treatment that will be required for their newborn. Complete the following sentence(s) by choosing from the lists of options. The nurse should educate the parents on the primary treatments used in the treatment of Turner syndrome, which includes ____________ and ____________.
growth hormone estrogen therapy
The nurse is caring for a 6-year-old male child who was brought to the pediatrician's office by the parent for a fever for the past few days. Click to highlight the findings that will require follow-up. Assessment reveals the client has also been experiencing increased urinary frequency , dysuria , and costovertebral pain . Vital signs: temperature, 101.2°F (38.4°C) ; heart rate, 110 beats/min ; blood pressure, 88/48 mm Hg; respiratory rate, 22 breaths/min ; oxygen saturation, 98% room air. Laboratory results: urinalysis, positive for leukocytes; white blood cell (WBC) count, 12 × 103/mm3 (12 × 109/l)
increased urinary frequency dysuria costovertebral pain temperature, 101.2°F (38.4°C) urinalysis, positive for leukocytes; white blood cell (WBC) count, 12 × 103/mm3 (12 × 109/l)
A nurse in a pediatrician's office is assessing a 4-year-old child. What assessment techniques will the nurse use with a preschool-age child? Complete the following sentence(s) by choosing from the lists of options. To improve the assessment process with a preschool-age child, the nurse will _____________ and ____________.
involve the child in the assessment allow the child to play with safe medical equipment
A nurse in the emergency department (ED) is assessing a 2-year-old male child. The parents state the child "has been very feverish the past few days, and today the child developed a purple rash on the chest. The child is now very sleepy." Click to highlight the findings that will require immediate follow-up. The assessment reveals the child is lethargic but opens eyes and answers yes and no to questions. The child is unable to lie with hips flexed and straighten the leg out, and states their neck hurts when trying to move it. Vital signs: temperature, 102.4°F (39.1°C); heart rate, 120 beats/min; blood pressure, 78/45 mm Hg; respirations, 28 breaths/min; oxygen saturation, 92% on room air
lethargic unable to lie with hips flexed and straighten the leg out neck hurts 102.4°F (39.1°C) 92% on room air
A nurse is caring for a 4-year-old male child brought to the emergency department (ED) for symptoms of influenza. The parents state the child has "had high fevers for the past 3 days even though we have been giving our child acetaminophen and they do not really want to eat or drink anything and has been very sleepy." Client opens eyes to voice, follows simple commands, and skin is very warm, ruddy, and dry. Vital signs: 101.5°F (38.6°C); heart rate, 138 beats/min; oxygen saturation, 95% on room air. Laboratory values: white blood cell (WBC) count, 43 × 103 cells/mm3 (43 × 109/l); hemoglobin, 10 mg/dl (100 g/l); hematocrit, 32% (0.32); platelets, 20,000/ml (20 × 109/l); neutrophil bands, 48/mcl (0.05 × 109/l); lymphoblasts, 33 (NA). Complete the following sentence(s) by choosing from the lists of options. The nurse should first address ____________ by ____________.
risk for bleeding implementing bleeding precautions
A nurse in a pediatrician's office is performing a comprehensive assessment on an 8-year-old male client at a scheduled wellness visit. Click to highlight the findings that will require follow-up. Past medical history: Cleft lip repair, ulnar fracture, innocent heart murmur. The assessment reveals the child is alert and oriented, speech is clear but child is soft spoken. Lungs are clear to auscultation and respirations are regular, unlabored. Heart murmur heard and unchanged. Capillary refill less than 3 seconds in all extremities. The client's abdomen is round, protruding; last bowel movement (BM) 2 days ago. Vital signs: temperature, 97.8°F (36.5°C); heart rate, 105 beats/min; blood pressure, 100/70 mm Hg; respiratory rate, 20 breaths/min. The parent expresses a concern, stating that "my child seems to be having difficulty in school even though they sit in the front of the class. My child also seem to trip and fall frequently".
round, protruding The parent expresses a concern, stating that "my child seems to be having difficulty in school even though they sit in the front of the class. My child also seem to trip and fall frequently".
A nurse working in the emergency department (ED) is caring for a newborn brought to the ED for increased respiratory rate and subcostal retractions. The nurse performs an assessment on the newborn. Findings include: awake, alert, periods of irritability, subcostal retractions that increase when crying, cardiac murmur auscultated. Vital signs: temperature 97.8°F (36.5°C); heart rate, 180 beats/min; blood pressures: left arm, 68/43 mm Hg; right arm, 67/40 mm Hg; left leg, 73/38 mm Hg; right leg, 75/40 mm Hg; respiratory rate, 62 breaths/min; oxygen saturation, 93% on room air. Complete the following sentence(s) by choosing from the lists of options. The nurse suspects the client is exhibiting signs of ____________ as evidenced by ____________ and ____________.
ventricular septal defect (VSD) blood pressure decreased oxygen saturation
A nurse in a pediatrician's office is educating a parent of a 2-month-old infant about developmental milestones. Drag words from the choices below to fill in each blank in the following sentence. The parent requires further education when the parent states
"My infant should be able to sit on their own by 3 months." "At 6 months, my baby should be able to feed themselves." "I will be able to play games like peek-a-boo with my infant when they are 4 months old"
A nurse on a pediatric unit finds a 3-year-old child unconscious. The child does not respond to stimuli. The nurse calls a code and starts to perform cardiopulmonary resuscitation (CPR). Complete the following sentence(s) by choosing from the lists of options. The nurse should first address the child's ____________ followed by the child's ____________, then ____________.
Airway Breathing Perfusion
The nurse working in a pediatrician's office is caring for a 5-year-old child whose parent brings the child to the office for a possible skin infection. A focused assessment reveals warm, swollen, and painful area on the child's lower leg. The child states that they feel cold. The nurse assesses palpable cervical lymph nodes. Vital signs: temperature, 100.4°F (38°C); heart rate, 110 beats/min; respiratory rate, 24 breaths/min; oxygen saturation, 98% on room air. For each assessment finding, click to specify if the finding indicates impetigo, cellulitis, or folliculitis. Each finding may support more than 1 disease process.
Cellulitis (All selections) Folliculitis (erythema only) Impetigo ( erythema, lymphedema)
A parent brings their 4-year-old male child to the pediatrician's office for a scheduled wellness appointment. The assessment reveals weight loss since the last visit. The client looks malnourished and pale, with dry lips and mucous membranes. The client appears lethargic. The parent reports numerous liquid stools and abdominal cramping daily. Complete the following sentence(s) by choosing the best answers from the lists of options. The nurse suspects that the client may have
Crohn's disease malnutrition frequent liquid stools
Parents bring their 5-year-old child to the pediatrician's office for reports of difficulty defecating, distended abdomen, abdominal and rectal pain, decreased appetite, liquid stool-soiled underwear, and increased frequency of urinary tract infections (UTIs). For each assessment finding, click to specify if the finding indicates Hirschsprung disease, encopresis, or intussusception.
Encopresis (All selections) Hirschsprung Disease (All except rectal pain and UTI) Intussusception (All except rectal pain and UTI)
A nurse is caring for a 10-week-old male infant in the emergency department. Assessment reveals: congestive cough, crackles in the lower lung fields, cyanosis of extremities, capillary refill >2 seconds, diaphoretic, respiratory rate of 80 breaths/min with subcostal and suprasternal retractions, oxygen saturations of 90% on room air, heart rate 190 beats/min, murmur auscultated, blood pressure left arm 86/45 mm Hg, and temperature 96.8°F (36°C). Weight 15.2 lb. (6900 g). Parents state weight is up from 13.4 lb. (6100 g) the other day. Laboratory values: brain-type natriuretic peptide is elevated; sodium (serum), 128 mEq/l (128 mmol/l); potassium (serum), 4.3 mEq/l (4.3 mmol/l); blood urea nitrogen (BUN), 3 mg/dl (1.09 mmol/l). The nurse suspects the infant's condition may be related to a congenital heart condition. For each finding, click to specify if the finding indicates an increased pulmonary blood flow heart defect, a decreased pulmonary blood flow heart defect, or a mixed flow heart defect.
Increased Pulmonary Blood Flow Heart Defect (All selections) Decreased Pulmonary Blood Flow Heart Defect (No selections) Mixed Flow Heart Defect crackles in the lung fields blood pressure of 86/45 mm Hg
A nurse in a pediatrician's office performs a focused assessment on a 6-year-old child for reports of swollen, painful joints. The assessment reveals bilateral swollen knees and elbows, malaise, poor appetite, and poor growth and asymmetrical leg bone growth. For each finding, click to specify if the finding indicates pauciarticular arthritis, polyarticular arthritis, or systemic arthritis. Each finding may support more than one disease classification.
Pauciarticular Arthritis (All selections) Polyarticular Arthritis involves several joints poor weight gain Systemic Arthritis involves several joints
A 15-year-old female adolescent visits the school nurse. The client appears anxious and states they have been dating a couple of different friends. The client states that they went to a party the other night and does not remember the entire night. The client states "I woke up and some of my clothes were missing. Now I have been experiencing some pain when I pee and there is yellow, green drainage that smells awful." Complete the following sentence(s) by choosing from the lists of options. The nurse suspects the client has ____________ as evidenced by ____________.
a sexually transmitted infection yellow, green odorous drainage
A 9-year-old female child was brought to the emergency department after experiencing wheezing and shortness of breath while playing soccer. The parents administered two puffs of albuterol metered dose inhaler (MDI) with little effect, and 911 was notified. Paramedics applied oxygen 2 liters by nasal cannula for oxygen saturation of 90% on room air, and administered an albuterol nebulizer treatment. Audible wheezing was heard, and a 20-gauge intravenous (IV) catheter was inserted. Vital signs upon arrival at the emergency room: temperature, 98.8°F (37.1°C); heart rate, 125 beats/min; blood pressure, 88/50 mm Hg; respiratory rate, 32 breaths/min; oxygen saturation, 92% on simple face mask. Child appears anxious. Complete the following sentence(s) by choosing from the lists of options. The emergency room nurse should first ____________ then ____________.
assess airway administer intravenous (IV) methylprednisolone
The emergency department nurse is assessing a 13-year-old male child. The child's parents report the child "has been very tired lately" and that the child has been "very thirsty and urinating frequently" and has not had "any fever or appetite." Nursing assessment reveals very dry, warm skin with dry, cracked mucous membranes. Vital signs: temperature, 99.9°F (37.7°C); heart rate, 123 beats/min; blood pressure, 80/42 mm Hg; respiratory rate, 24 breaths/min; oxygen saturation, 97% on room air. Laboratory values: sodium, 148 mEq/l (148 mmol/l); blood urea nitrogen (BUN), 22 mg/dl (7.85 mmol/l); hemoglobin, 13 g/dl (130 g/l); hematocrit, 48% (0.48); urine specific gravity, 1.001. For each assessment finding, click to specify if the finding indicates diabetes mellitus, syndrome of inappropriate antidiuretic hormone (SIADH), or diabetes insipidus. Each finding may support more than 1 disease process.
Diabetes Mellitus (All selections except decreased appetite) Syndrome of Inappropriate Antidiuretic Hormone (SIADH) (decreased level of consciousness only) Diabetes Insipidus (All selections except decreased appetite)
The nurse is caring for a 6-year-old male child who was brought to the pediatrician's office by the parent for a fever for the past few days. Click to highlight the findings that will require follow-up. Assessment reveals the client has also been experiencing increased urinary frequency, dysuria, and costovertebral pain. Vital signs: temperature, 101.2 F (38.4 C); heart rate, 110 beats/min; blood pressure, 88/48 mm Hg; respiratory rate, 22 breaths/min; oxygen saturation, 98% room air. Laboratory results: urinalysis, positive for leukocytes; white blood cell (WBC) count, 12000
increased urinary frequency dysuria costovertebral pain temperature, 101.2 F (38.4 C) urinalysis, positive for leukocytes; white blood cell (WBC) count, 12000
A nurse is caring for a newborn with Down syndrome. Drag words from the choices below to fill in each blank in the following sentence. The nurse educates the parents regarding potential complications that their newborn is at higher risk for developing such as ___________, ____________, and ____________.
autoimmune disorders spinal problems endocrine problems
A nurse is assessing a 6-year-old male child brought to the pediatrician's office for sore throat and fever. Assessment reveals lethargy; dry, warm skin; capillary refill time <3 seconds; lungs clear to auscultation. Vital signs: temperature, 100.1°F (37.8°C); heart rate, 128 beats/min; respiratory rate, 28 breaths/min. The nurse performs a throat culture, which is positive for group A streptococcus (GAS). Urine sample results: dark concentrated urine; urine specific gravity 1.04. Complete the following sentence(s) by choosing from the lists of options. The child is at highest risk for developing ____________ as evidenced by ____________.
carditis group A streptococcus
An 8-year-old child is admitted to a medical-surgical unit with a diagnosis of syndrome of inappropriate antidiuretic syndrome (SIADH). Drag words from the choices below to fill in each blank in the following sentence. The nurse will closely monitor the client's
fluid balance serum sodium level of consciousness
A school nurse is called to the school cafeteria after a 13-year-old child is reported to have sudden difficulty breathing. The child has a history of asthma and allergies to peanuts. The focused nursing assessment reveals difficulty breathing, inspiratory and expiratory wheezing, swelling of lips, and a rash on the face. The child reports feeling nauseated, having chest tightness, and feeling faint. Complete the following sentence(s) by choosing from the lists of options. The nurse should first address the child's ____________ then ____________.
wheezing swelling of lips
