PEDs Quiz 4
A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate? a. "Both the mother and the father have the sickle cell trait." b. "The mother has the trait, but the father doesn't." c. "The father has the trait, but the mother doesn't." d. "The mother has sickle cell disease, but the father doesn't have the disease or the trait."
A
The nurse educator is teaching a group of nursing students the pathophysiologic reasons related to genitourinary (GU) disorders in the pediatric population. Which statements are appropriate for the nurse educator to include in the teaching session? Select all that apply. a. "Incomplete organ development during fetal development is the cause of many GU disorders." b. "Improper placement of the urethra in vagina is one cause of GU disorders." c. "GU disorders in the pediatric population can be caused by hydronephrosis." d. "GU disorders in the pediatric population are not caused by infections." e. "Anatomic obstruction or incomplete nerve innervation can cause GU disorders."
A C E
A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate? a. Check the urine to see if hematuria has increased. b. Obtain a blood pressure on the child; notify the healthcare provider. c. Reassure the child, and encourage bed rest until the headache improves. d. Obtain serum electrolytes, and send a urinalysis to the lab.
B
A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment? a. Hematuria, bacteriuria, weight gain b. Gross hematuria, albuminuria, fever c. Massive proteinuria, hypoalbuminemia, edema d. Hypertension, weight loss, proteinuria
C
The nurse is preparing to discharge a toddler-age client who just had an orchiopexy. Which discharge instruction is appropriate for this client? a. Information to the parents about the child's resuming normal vigorous activities b. Discussion with the parents about the low incidence of testicular malignancy and no further need for any follow-up c. Explanation to the parents about the need for loose, nonrestrictive clothing d. Reassurance to the parents that infertility is not a future risk
C
Which clinical manifestations should the nurse anticipate upon assessment for a preschool-age child with a urinary tract infection (UTI)? a. Headache, hematuria, and vertigo b. Foul-smelling urine, elevated blood pressure (BP), and hematuria c. Urgency, dysuria, and fever d. Severe flank pain, nausea, and headache
C
The nurse is caring for the 5-year-old just diagnosed with von Willebrand disease after a tooth extraction with increased bleeding. The family asks the nurse how the signs and symptoms of von Willebrand disease are manifested. What will the nurse tell the family? Select all that apply. a. Decreased partial thromboplastin time b. Factor VI deficiency c. Frequent nosebleeds d. Bleeding from mucous membranes e. Frequent bruising
C D E
A child who has beta-thalassemia is receiving numerous blood transfusions. The child is also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine will help their child. Which rationale does the nurse use when responding to the parents? a. It prevents blood transfusion reactions. b. It stimulates RBC production. c. It provides vitamin supplementation. d. It prevents iron overload.
D
A nurse is assessing in a school-aged child who has acute glomerulonephritis. Which of the following manifestations should the nurse expect? a. Hypokalemia b. Decreased blood pressure c. Increased urine volume d. Periorbital edema
D
A nurse is caring for a child who has sickle cell anemia. Which of the following actions should the nurse plan to take to help decrease the risk of vaso-occlusive crisis? a. Provide adequate fluid intake throughout the day b. Provide oxygen at 2 L/min via nasal cannula c. Administer a blood transfusion d. Give ibuprofen to manage pain
A
A nurse is caring for an adolescent who has sickle cell anemia. Which of the following manifestations is/are the result of chronic vaso-occlusive phenomena? (Select all that apply) a. Enlarged heart b. Enuresis c. Leg ulcers d. Extraheptic cholestasis e. Retinal detachment
A B C E
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions should the nurse take? a. Maintain the child on strict bed rest b. Check the child's blood pressure every 4 hours c. Administer albumin to the child every 8 hours d. Provide the child with a low-carb diet
B
A nurse is caring for a client who has acute glomerulonephritis and a prescription for furosemide. The nurse should monitor the client for which of the following therapeutic effects of this medication? a. Hypotension b. Diuresis c. Increased blood glucose level d. Weight gain
B
A nurse is caring for a client who has chronic glomerulonephritis with oliguria. For which of the following electrolyte imbalances should the nurse monitor for? a. Hypercalcemia b. Hyperkalemia c. Hypomagnesemia d. Hypophosphatemia
B
A nurse is providing teaching about home care to the guardian of an adolescent who has hemophilia. Which of the following pieces of information should the nurse provide? a. Encourage the adolescent to participate in non-contact sports b. Provide the adolescent with a firm-bristled toothbrush c. Administer aspirin to the adolescent for episodes of pain d. Provide disposable razors to the adolescent for shaving
A
Which urinalysis result should the nurse anticipate for a child who is admitted with acute glomerulonephritis? a. Bacteriuria and increased specific gravity b. Hematuria and proteinuria c. Proteinuria and decreased specific gravity d. Bacteriuria and hematuria
B
A nurse is caring for a female adolescent who is being treated for frequent urinary tract infections (UTIs). Which of the following statements by the adolescent indicates a possible cause of the UTIs? a. "I have bowel movements every 4 to 5 days." b. "My mom taught me to wipe from front to back after going to the bathroom." c. "I urinate every 2 tp 3 hours during the day." d. "I dont wear nylon underwear."
A
A nurse is caring for a school-aged child who has sickle cell anemia and was admitted for a vaso-occlusive crisis. Which of the following findings should the nurse report to the provider immediately? a. Slurred speech b. Hemoglobin level of 9g/dL c. Hematuria d. Pain level of 7 on FACES scale
A
A nurse is planning care for a 4-year-old child who had nephrotic syndrome. Which of the following actions should the nurse take? a. Provide thorough skin care b. Test for the blood type and cross-match c. Allow ample hydrating fluids d. Maintain low-carb diet
A
A preschool-age client diagnosed with nephrotic syndrome is placed on prednisone for several weeks. Which teaching point is appropriate for the nurse to include in the teaching plan for this client? a. Never stop the medication suddenly. b. This drug is taken once a week on Sunday. c. The child should always take the medication at night before bed. d. This drug should be taken with meals.
A
The adolescent is admitted to the hospital in sickle cell crisis with a pain level of 10/10. The physician orders: Morphine sulfate 5 mg IV q 2 hr prn Medication on hand: morphine sulfate 10 mg/mL Calculate how many ml of morphine sulfate will be given IV. a. 1 mL b. 0.5 mL c. 0.05 mL d. 5 mL
B
A nurse is planning care for an adolescent who has sickle cell anemia and is experiencing a vaso-occlusive crisis. Which of the following interventions should the nurse include in the plan? A. Apply cold compresses to the child's extremities b. Administer meperidine every 4 hours until the crisis has resolved c. Maintain the child on bed rest d. Decrease the child's fluid intake for 8 hours.
C
A nurse is caring for a school-aged child who has hemophilia and fell on the playground. The child reports a pain level of 4 on a scale of 0 to 10. Which of the following actions should the nurse take? a. Administer an NSAID b. Perform passive range-of-motion c. Administer cryoprecipitate d. Apply an ice pack to the joint
D
A nurse is providing discharge teaching to the parents of a child who has nephrotic syndrome. Which of the following instructions should the nurse include in the teaching? a. Restrict the child's potassium intake b. Administer acetaminophen to the child twice daily c. Weigh the child once each week d. Keep the child away from people who have an infection
D
A preschool-age child is admitted to the hospital with acute postinfectious glomerulonephritis (APIGN) and is admitted to the hospital. Which is the priority nursing diagnosis for this child? a. Risk for Injury related to hypertension. b. Altered Growth and Development related to a chronic disease. c. Risk for Infection related to hypertension. d. Fluid Volume Excess related to decreased plasma filtration.
A
The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client? a. Morphine sulfate b. Meperidine c. Acetaminophen d. Ibuprofen
A
The nurse is providing care to a school-age client with neutropenia. Which clinical manifestations does the nurse anticipate when assessing this client? Select all that apply. a. Fever b. Fatigue c. Tachycardia d. Hypertension e. Tachypnea
A B C E
The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation? Select all that apply. a. Fever b. Dehydration c. Regular exercise d. Altitude e. Increased fluid intake
A B D
A preschool-age client is diagnosed with acute glomerulonephritis and is admitted to the hospital. Which nursing diagnosis is most appropriate for this client? a. Risk for Injury Related to Loss of Blood in Urine b. Fluid-Volume Excess Related to Decreased Plasma Filtration c. Risk for Infection Related to Hypertension d. Altered Growth and Development Related to a Chronic Disease
B
The nurse is administering packed RBCs to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame? a. Six hours after the transfusion is given b. Within the first 20 minutes of administration of the transfusion c. At the end of the administration of the transfusion d. Never; children with SCD do not have reactions
B
Which instructions should be provided to the parents of a 4-year-old girl who has experienced chronic urinary tract infections (UTIs) in the last 2 years? Select all that apply. a. Wear only nylon underwear for better air flow. b. Teach the child to wipe from front to back. c. Encourage the child to take long baths by allowing the child bubbles and toys in the tub. d. Encourage the child to drink additional fluids throughout the day. e. Plan potty breaks every 2 hours throughout the day.
B D E
A nurse on the pediatric unit is caring for a group of clients. Which of the following findings should be nurse's priority? a. A child who has asthma and a pulse oximetry of 94% b. A child who has nephrotic syndrome and 1+ protein on urine dipstick c. A child who has sickle cell anemia and a urine specific gravity of 1.030 d. A child who has insulin-dependent diabetes mellitus and a fingerstick glucose reading of 110 mg/dL
C
A school-age child with hemophilia falls on the playground and goes to the nurse's office with superficial bleeding above the knee. Which action by the nurse is the most appropriate? a. Apply a warm, moist pack to the area. b. Perform some passive range of motion to the affected leg. c. Apply pressure to the area for at least 15 minutes. d. Keep the affected extremity in a dependent position.
C
The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child? a. Giving comfort measures, such as back rubs b. Suggesting diversional activities, such as coloring c. Administering pain medication d. Preparing the child for painful procedures
C
A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate? a. Consider a swim club instead of the bicycling club. b. Wear kneepads, elbow pads, and a helmet while bicycling. c. Participate only in the social activities of the club. d. Not join the club.
B
A home health nurse is developing a plan of care for a toddler that has hemophilia. Which of the following instructions should the nurse include in the plan? a. Administer low-dose aspirin for pain b. Inspect the toddler's toys for sharp edges c. Perform passive range-of-motion of the affected joint during the bleeding episode d. Avoid contact with people who have respiratory infections
B
A nurse is caring for a child who has glomerulonephritis. Which of the following actions should the nurse take? a. Maintain the child's blood pressure twice per day b. Maintain the child on bed rest for 3 days c. Weigh the child once each day d. Increase the child's daily intake of sodium
C
A nurse is reviewing the lab reports of a child with acute nephrotic syndrome who has been receiving prednisone by mouth for the past week. Which of the following findings should the nurse report to the provider? a. Serum sodium 142 mEq/L b. Serum potassium 4 mEq/L c. WBC count 3,000 d. Platelet count 298,000
C
A nurse is providing teaching to a 12-year-old client who is recovering from an acute episode of hemophilia A. Which of the following statements should the. nurse include in the teaching? a. "Have your parent stretch and move your legs for you." b. "Apply heat to joints that become painful, stiff, and swollen." c. "Take aspirin at the first sign of a headache." d. "You will be able to participate in physical exercises."
D
The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client? a. Semiprivate room b. Reverse-isolation room c. Contact-isolation room d. Private room
D
Which clean-catch urinalysis finding should the nurse be most concerned for a child who is admitted to an urgent care center to rule out a urinary tract infection? a. 2+ white blood cells b. 1+ red blood cells c. Urine appearance: cloudy d. Specific gravity: 1009
D
