PEDS practice T5
The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply.
1. Place the infant in a private room. 2. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.
a physician orders ABGs on a 5 year old client admitted with severe asthma. which s/s noted during a nurse's assessment of the child are consistent with the blood gas findings of pH 7.30, PaCO2 49, HCO3 24 1. diaphoresis, headache, tachycardia, confusion, restlessness, apprehension, and flushed face 2. rapid and deep respirations, parathesia, lightheadedness, twitching, anxiety and fear 3. rapid and deep breathing, bruity breath, fatigue, headache, lethargy, drowsiness, nausea, vomiting, abdominal pain 4. slow and shallow breathing, hypertonic muscle, restlessness, twitching, confusion, iritability, apathy, tetany, seizures
1. diaphoresis, headache, tachycardia, confusion, restlessness, apprehension, and flushed face
a clinic nurse receives a call fromt he mother of a 2 year old child. the mother states the child has a temp of 104F a sore throat and has been drooling for a few days. the child is now sleepy. which is he best advce by the nurse? 1. take your child to an Emergency Department immediately 2. bring your child into the clinic to be seen as soon as possible 3. administer acetaminophen for the temperature and allow your chid to sleep 4. use a spoon to look inside our child's mouth and throat and tell me what you see
1. take your child to an Emergency Department immediately
A teen with chest pain goes to the school nurse. The nurse determines that the teen has a history of asthma but has been asymptomatic for years. What should the nurse do next? A/ Call their parents B/ Have the teen lie down for 30 minutes C/ Obtain a peak flow reading D/ Have the teen take 2 puffs from their prescribed short-acting bronchodilator
?
The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?
A chronic multisystem disorder affecting the exocrine glands
The nurse is reviewing the laboratory results for a child scheduled for tonsillectomy. The nurse determines that which laboratory value is most significant to review? A/ Creatinine Level B/ Prothrombin Time C/ Sedimentation Rate D/ BUN Level
B/ Prothrombin Time
a nurse is formulating a plan of care for a 22 month old child with a diagnosis of laryngotracheobronchitis. which symptoms should indicate to the nurse that the child is experiencing impending respiratory failure: restless and irritabilitiy retraction of the accessory chest muscles decreased inspiratory breath sounds hoarseness
decreased inspiratory breath sounds
A pediatric nurse in the ambulatory surgery unit is caring for a child following a tonsillectomy. The child is complaining of a dry throat. Which item should the nurse offer to the child?
green jello
a 3 year old underwent a tonsillectomy this morning. as the nurse giving discharge instructions, which comment by the child's mother suggests that she understands the care requirements: 1. i plan to take her back to her play group tomorrow. i know she won't want to stay home 2. i have bought popsicles to give her later today 3. i will give her aspirin if she gets irritable 4. she is just waiting for the ice cream we promised her before she came to the hospital
i have bought popsicles to give her later today
the nurse is caring for a child who had a tonsillectomy performed 4 hours ago. which of the following is an abnormal finding and a cause for concern: emesis of dried blood increased swallowing pink-tinged mucus the child complains of a very sore throat
increased swallowing
a 3 month old child is hospitalized with acute laryngotracheobronchitis. in formulating a nursing care plan, which dursing diagnosis should be a nurse's priority: 1. anxiety 2. risk for deficient fluid volume 3. ineffective breathing pattern 4. deficient knowledge
ineffective breathing pattern
an 18 month old presents with nasal flaring, intercostal and substernal retractions, and a respiratory rate of 50. what is the most appropriate ND: knowledge deficit ineffective breathing pattern ineffective individual coping high risk for altered body temperature: hyperthermia
ineffective breathing pattern
an 11 year old is admitted for treatment of an asthma attack. which of the following indicates immediate intervention is needed: thin opious mucous secretions productive cough intercostal retractions respiratory rate of 20
intercostal retractions
A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?
obtain a throat culture
a 2 year old presents to an urgent care center with respiratory distress and cyanosis. parents report an initial episode of choking. what is the best inital action for the nurse to take: 1. call 911 and have parents wait for an ambulance to transport the child to a pediatric hospital 2. administer oxygen by face mask and call the child's pediatrician 3. perform abdominal thrusts as described in the heimlich maneuver 4. start cpr after the child loses consciousness
perform abdominal thrusts as described in the heimlich maneuver
A child is scheduled for a tonsillectomy. A nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery?
presence of loose teeth
After a tonsillectomy, a child is brought to the pediatric unit. The nurse should appropriately place the child in which position?
prone
an albuterol nebulizer treatment is ordred for a 6 month old infant hospitalized with laryngotracheobronchitis. a nurse should understand that albuterol when used as a nebulizer treatment: 1. relaxes smooth muscles in the airways 2. reduces inflammation and mucosal edema in airways 3. removes excess fluid from the lungs 4. loosens and thins pulmonary secretions
relaxes smooth muscles in the airways
a triage nurse determines that a child brought to the ED is experiencing severe respiratory distress when observing: 1. diaphoresis, restlessness, tachypnea, anorexia 2. pallor, coughing, wheezing, and confusion 3. retractions, grunting, cyanosis, and bradycardia 4. agitations decreased level of conciousness, diarrhea, tachypnea
retractions, grunting, cyanosis, and bradycardia
A nurse is reviewing the health care provider's prescriptions for a child following a tonsillectomy. Which prescription should the nurse question?
suction the child frequently if coughing
A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate?
"Bad mouth odor is normal and may be relieved by drinking more liquids."
A nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching?
"I should place a steam vaporizer in my child's room."
A mother calls the pediatrician's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother?
"Is your child telling you at this time he is having trouble breathing?"
A nurse is monitoring a 1 year old who has diarrhea for dehydration and needs to take the child's temp. Which method should be avoided? A.Rectal, B. Axillary, C. Electronic, D.Tympanic
A.Rectal
A nurse is caring for a 4 year old child who was just diagnosed with cystic fibrosis. The child has been passing loose, bulky, foul-smelling stools and is in the third percentile for weight, What is the best explanation of the growth failure? A/ Impaired digestion and absorption because of the lack of pancreatic enzymes B/ Dyspnea and SOB, which cause anorexia and disinterest in food C/ Increased bowel motility and diarrhea which leads to inadequate absorption of nutrients D/ Pulmonary obstruction, which causes an oxygen deficit and inadequate tissue nourishment
A/ Impaired digestion and absorption because of the lack of pancreatic enzymes
A nurse in a paediatric clinic is testing a 4 year old with recurrent otitis media for signs of hearing loss. The mother asks what can be done is there is a hearing loss. The nurse responds that the most common tx is: A/ Myringotomy B/ Adenoidectomy C/ Neomycin ear drops D/ Systemic steroid therapy
A/ Myringotomy
A child undergoes tonsillectomy and adenoidectomy for numerous recurrent respiratory tract infections. After the surgery, the nurse should teach the parents to: A/ Offer ice chips B/ Encourage the intake of ice cream C/ Keep the child in supine position D/ Gargle with diluted mouthwash solution
A/ Offer ice chips
The parents of an infant recently diagnosed with cystic fibrosis ask a nurse what causes the foul-smelling, frothy shit. What is the best response by the nurse? A/ Undigested Fats B/ Sodium and Chloride C/ Partially digested Carbohydrates D/ Lipase, Trypsin, and amylase release
A/ Undigested Fats
An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instruction(s) on the list? Select all that apply
Avoid hot fluids. Avoid raw vegetables. Rest in bed or on a couch for 24 hours.
A nurse reviewing a child's chart with a diagnosis of pyloric stenosis would expect to note what as having been documented in the chart? A.Watery diarrhea, B.Projectile vomiting, C.Increased urine output, D.Vomiting large amounts of bile
B. Projectile vomiting
A nurse is assigned to care for a child who is scheduled for an appendectomy. Which are likely to be prescribed: A.Enema, B.IV line, C.NPO, D.IV antibiotics, E.Preoperative meds, F.Heating pad on the abdomen
B.IV line, C.NPO, D.IV antibiotics, E.Preoperative meds,
A 5 year-old child is admitted to the paediatric unit complaining of colicky abdominal pain with guarding, nausea, anorexia, and a low-grade fever. Palpation of the right lower quadrant of the abdomen elicits pain. What is the likely diagnosis for this patient? A/ Ulcerative Colitis B/ Acute Appendicitis C/ Hirschsprung Disease D/ Hookworm Infestation
B/ Acute Appendicitis
While teaching a parents' group about acute otitis media, the nurse includes the fact that among infants and children, acute otitis media is an infection commonly caused by: A/ virus B/ Bacteria C/ fungus D/ Rickettsia
B/ Bacteria
A nurse is teaching the mother of a toddler with celiac disease the specific foods allowed on the Gluten-free diet. What information is important for the nurse to help the mother understand? A/ Corn flour is NOT included in the diet B/ Labels of prepared foods must be read carefully C/ Caloric intake is increased to compensate for deficiency of proteins D/ The gluten-free diet is discontinued when the affected child starts kindergarten
B/ Labels of prepared foods must be read carefully
What is the priority nursing intervention for a 6-month-old infant with bronchiolitis? A/ Discouraging parental visits to conserve energy B/ Monitoring skin colour, anterior fontanel, and vitals C/ Wearing gown, cap, mask, and gloves while rendering care D/ Promoting stimulating activities to meet developmental needs
B/ Monitoring skin colour, anterior fontanel, and vitals
After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question? A/ Monitor for bleeding B/ Suction every two hours C/ Give no milk or milk products D/ Give clear, cool liquids when awake and alert
B/ Suction every two hours
An infant returns to the unit after surgical repair of a cleft lip located on the right side. The best position is: A.Prone, B.Supine, C.Left side, D.Right side
C.Left side
The parents of a 2 year-old boy are watching the nurse administer the Denver II developmental Screening test to their son. They ask, "Why did you make him draw on paper? We don't let him draw much at home." What is the best response? A/ "I should have asked you about drawing first" B/ "These drawings help us determine his intelligence" C/ "It lets us test his ability to perform tasks requiring his hands" D/ "Why in the hell would you not allow your bastard son to draw? Like seriously, you guys are straight up negligent".
C/ "It lets us test his ability to perform tasks requiring his hands"
The nurse reviews the record of a newborn infant and notes that a diagnosis of esophageal atresia with tracheoesophageal fistula is suspected. The nurse expects to note which most likely sign of this condition documented in the record? A/ Incessant Crying B/ Coughing at night time C/ Choking with feedings D/ Severe projectile Vomiting
C/ Choking with feedings
During the assessment of a hospitalized infant, the nurse notes dry mucous membranes, the absence of tears when the infant cries, and poor skin turgor. Which parameter should help the nurse further evaluate these findings? A/ Daily serum electrolytes B/ Respiratory rate and rhythm C/ Intake and output over past 24 hours D/ Alterations in heart sounds since admission
C/ Intake and output over past 24 hours
A 5-month-old infant is brought to the paediatric clinic for a routine monthly exam. What assessment finding alerts the nurse to notify the primary HCP? A/ HR of 100bpm B/ BP of 75/48 mm Hg C/ Respiratory rate of 70/min D/ Temp 37.5C
C/ Respiratory rate of 70/min
A nurse reinforcing instructions about diet to a mother of a 5 year old lactose intolerant child would tell the mother which supplement will be required? A.Fats, B.Zinc, C.Protein, D.Calcium
D. Calcium
A nurse reviews a 3wk old infant's record and notes the physician documented a Dx of suspected Hirschsprung's disease. The nurse knows which symptom led mom to seek health care? A.Diarrhea B.Vomiting C.Regurgitation D.Foul smelling, ribbon like stool
D.Foul smelling, ribbon like stool
What teaching must the nurse emphasize to the family when preparing a school-aged child with persistent asthma for discharge? A/ A cold, dry environment is desirable B/ Limits should not be placed on their behaviour C/ The health problem is gone when symptoms subside D/ Medications should be used even when the child is asymptomatic
D/ Medications should be used even when the child is asymptomatic
A 2-year-old is brought to the ER with fever, drooling, and agitation. The child is not coughing and is sitting upright and leaning forward. Which nursing intervention is a priority? A/ IV fluids and antibiotics B/ Immediate removal of the parents from the room to keep the child calm C/ Maintenance of the child in a prone position during transportation to radiology D/ Procurement of a crash cart and Emergency airway management tools to be kept on hand during examination of the throat.
D/ Procurement of a crash cart and Emergency airway management tools to be kept on hand during examination of the throat.
A nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. In which position should the nurse place the infant?
Head and chest at a 30-degree angle with the neck slightly extended
A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?
Let the mother hold the child and direct the cool mist over the child's face.
The student nurse is caring for an infant with a tracheostomy and preparing to suction the infant. The nursing instructor should intervene if the nursing student stated she would take which action to perform this procedure?
Limit insertion and suctioning time to 15 seconds to prevent hypoxia.
The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action?
Move the infant to a room with another child with RSV.
Breathing exercises and postural drainage are prescribed for a hospitalized child with cystic fibrosis (CF). What instruction should the nurse include in the client's teaching plan?
Perform the postural drainage first and then the breathing exercises
The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?
The child is leaning forward, with the chin thrust out.
A nurse has provided instructions to the mother of a child with cystic fibrosis (CF) about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures?
The diet needs to be high in calories."
During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about cystic fibrosis?
This disease causes dilation of the passageways of many organs.
a 4 yar old is admitted to the hospital for the treatment of an acute asthma attack. she received nebulized albuterol in the ED and was transferred to the pediatric unit with an aminophylline infusion. what significant finding will inform the nurse that the treatment is effective: a decrease in mucus production a decrease in wheezing an increase in blood pressure a sleeping child
a decrease in wheezing
an 11 month old is admitted to the hospital with bronchiolitis. he is currently in a croup tent with supplemental oxygen. which toy is most appropriate for the nurse to recommend to the child's parents: a stuffed animal made from a washable fabric a soft plastic stacking toy with multicolored rings a set of wooden blocks a pull toy
a soft plastic stacking toy with multicolored rings
The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding?
airway obstruction
An adolescent with cystic fibrosis has been hospitalized several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and failure to thrive. Which initial nursing actions are most important? a) inserting an IV line and initiating antibiotic therapy b) placing the client on bed rest and obtaining a prescription for a blood gas analysis c) applying an oximeter and initiating respiratory therapy d) implementing a high-calorie, high-protein, low-fat, vitamin-enriched diet and pancreatic granules
c) applying an oximeter and initiating respiratory therapy
