peds review
A nurse at a playground witnesses a child fall off a swing. The nurse rushes to the child's aid and suspects the child has a broken right leg. The nurse should take which priority action? 1. Immobilize the leg 2. Call for an ambulance 3. Remove the child's shoes 4. Tell the child everything will be fine
1
After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action? 1. Turn the child to the side 2. Administer the prescribed antiemetic 3. Notify the health care provider 4. Maintain NPO (nothing by mouth) status
1
An infant of a mother infected with human immunodeficiency virus (HIV) is seen in the clinic each month and is being monitored for symptoms indicative of HIV infection. With knowledge of the most common opportunistic infection of children infected with HIV, the nurse assesses the infant for which sign? 1. Cough 2. Liver failure 3. Watery stool 4. Nuchal rigidity
1
The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus infection (HIV). Which statement, if made by the parent, indicates the need for further instruction? 1. "I will clean up any spills from the diaper with diluted alcohol." 2. I will wash baby bottles, nipples and pacifiers in the dishwasher." 3. " I will be sure to prepare foods that are high in protein and calories." 4. " I will be sure to wash my hands carefully before and after caring for my infant."
1
The mother of a 4 year old child tells the pediatric nurse that the child's abdomen seems to be swollen. During further assessment, the mother tells the nurse that the child is eating well and that the child's activity level is unchanged. The nurse suspecting a nephroblastoma (Wilm's tumor) would avoid which of the following assessments? 1. Palpating the abdomen for a mass 2. Assessing the urine for the presence of hematuria 3. Monitoring the temperature for the presence of fever 4. Monitoring the blood pressure for the presence of hypertension
1
The nurse is caring for a child with Juvenile idiopathic arthritis (JIA). The nurse should identify which of the following as the priority? 1. Complaints of acute pain 2. Unsteadiness when ambulating 3. Embarrassment about appearance 4. Inability to perform self-hygienic measures
1
The nurse provides home care instructions to the parents of a child with celiac disease. The nurse should teach the parents to include which food item in the child's diet? 1. Rice 2. Oatmeal 3. Rye toast 4. Wheat bread
1
The nurse is creating a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. 1. Time the seizure 2. Restrain the child 3. Stay with the child 4. Please the child in a prone position 5. Move furniture away form the child 6. Insert a n airway in the child's mouth
1,3,5
The nurse is caring for a child who sustained a head injury from a fall. The nurse should perform which actions in the care of the child? (Select all that apply) 1. Restrict oral intake 2. Elevate the head of the bed 3. Perform neurological assessments 4. Encourage coughing and deep breathing 5. Place the child in a flat position during sleep
123
A 10 year old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 beats per minute 4. Respirations of 18 breaths per minute
2
An adolescent just had a plaster cast removed from his arm. The nurse assesses the skin to ensure it is intact and then would perform which action? 1. Soak the arm in warm water for an hour. 2. Wash the skin gently and apply lotion. 3. Scrub the skin vigorously with soap and water. 4. Instruct the client that continuous skin soaking will be necessary for the next 24 hours.
2
The mother of a 6 year old child who has type 1 diabetes mellitus calls a clinic nurse and tells the nurse that the child has been sick. The mother reports that she checked the child's urine and it was positive for ketones. The nurse should instruct the mother to take which action? 1. Hold the next dose of insulin. 2. Come to the clinic immediately. 3. Encourage the child to drink liquids. 4. Administer an additional dose of regular insulin.
2
The nurse has provided home care instructions to parents of a child who is being discharged after cardiac surgery. Which statement made by the parents indicates a need for further instruction? 1. "A balance of rest and exercise is important". 2. "I can apply lotion or powder to the incision if it is itchy". 3. "Activities in which my child could fall need to be avoided for 2 to 4 weeks". 4. "Large crowds of people need to be avoided for at least 2 weeks after surgery".
2
The nurse is monitoring a child for bleeding after surgery for removal of a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which intervention should the nurse perform immediately? 1. Reinforce the dressing 2. Notify the health care provider (HCP) 3. Document the findings and continue to monitor 4. Circle the area of the drainage and continue to monitor
2
The nurse is preparing to care for a pediatric client with an Intravenous solution infusing. The nurse should ensure that which item is in place to prevent fluid overload in this client? 1. Armboard 2. Infusion pump 3. Macrodrip infusion set 4. Large-bore intravenous catheter
2
The nurse is reviewing the assessment findings and laboratory results of a child diagnosed with new-onset glomerulonephritis. Which finding would the nurse most likely note? 1. Hypotension 2. Tea-colored urine 3. Low serum potassium 4. Elevated creatinine levels
2
The nurse is reviewing the record of an infant admitted to the newborn nursery. The health care provider documented bladder extrophy. On data collection, the nurse expects to note which of the following? 1. Undescended or hidden testes 2. Urinary bladder on the outside of the body 3. Opening of the urethral meatus on the ventral side of the glans penis 4. Opening of the urethral meatus below the normal placement on the glans penis
2
The nurse provides a teaching session to the nursing staff regarding osteosarcoma. Which statement by a member of the nursing staff indicates a need for further information? 1. "The femur is the most common site for this disorder". 2. "The child does not experience pain at the primary tumor site". 3. "Limping, if a weight bearing limb is affected, is a clinical manifestation". 4. "The symptoms if the disease in the early stage are almost always attributed to normal growing pains".
2
Which interventions should the nurse include when creating a care plan for a child with hepatitis? Select all that apply 1. Providing a low-fat, well balanced diet 2. Teaching the child effective handwashing techniques 3. Scheduling play time in the playroom with other children 4. Notifying the health care provider (HCP) if jaundice is present 5. Instructing the parents to avoid administering medications unless prescribed 7. Arranging for indefinite home schooling because the child will not be able to return to school
2,5
A child has a fluid volume deficit. The nurse performs an assessment and determines that the child is improving and the deficit is resolving if which of the following is noted? 1. The child has no tears 2. Urine specific gravity is 1.035 3. Capillary refill is less than 2 seconds 4. Urine output is less than 1ml / kg/ hour.
3
A child is admitted with a diagnosis of pertussis (whooping cough). As soon as the child is admitted to the pediatric unit, the nurse would perform which first? 1. Weigh the child 2. Take the child's temperature 3. Place the child on the oximeter 4. Administer the prescribed antibiotic
3
A child is hospitalized because of persistent vomiting. The nurse should monitor the child closely for which problem? 1. Diarrhea 2. Metabolic Acidosis 3. Metabolic Alkalosis 4. Hyperactive bowel sounds
3
A child with hemophilia is brought to the emergency department after being hit in the neck with a baseball. The nurse should check immediately for which finding? 1. Headache 2. Slurred speech 3. Airway obstruction 4. Spontaneous hematuria
3
A client with a diagnosis of sickle cell crisis is being admitted to the hospital. The nurse anticipates that which priority intervention will be prescribed? 1. Laboratory studies 2. Genetic counseling 3. Oxygen administration 4. Electrolyte replacement therapy
3
A four year old child is admitted to the hospital for surgery. The nurse should ask the parents which priority question to identify the adequacy of support for the child's psychosocial needs? 1. "What are the child's favorite toys?" 2. "What signs and symptoms has your child been having?" 3. "Will a family member be able to stay with the child most of the time?" 4. "How much do you know about the surgery and its expected outcome?"
3
A lumbar puncture is performed on a child suspected to have bacterial meningitis and cerebrospinal fluid (CSF) is obtained for analysis. The nurse reviews the results of the CSF analysis and determines that which results would verify the diagnosis? 1. Clear CSF, decreased pressure, and elevated protein level 2. Clear CSF, elevated protein, and decreased glucose levels 3. Cloudy CSF, elevated protein and decreased glucose levels 4. Cloudy CSF, decreased protein, and decreased glucose levels.
3
A school aged child with newly diagnosed type I diabetes mellitus is receiving insulin and suddenly experiences signs of a hypoglycemic reaction. Which item should the nurse give the child immediately? 1. 8 ounces (235 ml) of skim milk 2. ½ cup of diet cola 3. 1 teaspoon of honey 4. 1 teaspoon of sugar
3
The nurse provides home care instructions for parents of a toddler newly diagnosed with hemophilia. Which statement by the parents indicates a need for further instruction? 1. "We need to pad crib rails and table corners." 2. "We need to obtain a medical identification bracelet for or child." 3. "If our child has pain, it is acceptable to give him aspirin." 4. "We need to have our child use a soft-bristled, small toothbrush."
3
The nurse reviews the record of a child just seen by a health care provider and diagnosed with suspected aortic stenosis. The nurse expects to see which clinical manifestation specifically found with this disorder? 1. Pallor 2. Hyperactivity 3. Exercise intolerance 4. Gastrointestinal distubances
3
The nurse should implement which interventions for a child older than 2 years of age with type 1 diabetes mellitus who has a blood glucose level of 60 mg/dl (3.4 mmol / L) 1. Administer regular insulin 2. Encourage the child to ambulate 3. Give the child a teaspoon of honey 4. Provide electrolyte replacement therapy intravenously 5. Wait 30 minutes and confirm the blood glucose level 6. Prepare to administer glucagon subcutaneously if unconsciousness occurs.
3
A 16 year old client who underwent emergency surgery for a ruptured appendix refuses to allow the nurse to change the abdominal dressing saying. "Go away. There is nothing wrong with this dressing." Which nursing response would be best? 1. "Please do not be upset with me. I am just doing my job." 2. "I promise to do this quickly, and then I will leave you alone." 3. "You can refuse the dressing change at this time, but your friends cannot visit until the dressing is changed." 4. "I will draw the curtain and expose only the area on your abdomen that is needed. Can I go ahead with that?"
4
A health care provider prescribes an intravenous (IV) solution of 5% dextrose and half- normal saline (0.45%) with 40 meq of potassium chloride for a child with hypotonic dehydration. The nurse performs which priority assessment before administering this IV prescription? 1. Obtains a weight 2. Takes the temperature 3. Takes the blood pressure 4. Checks the amount of urine output
4
A mother tells the clinic nurse that she does not want her child to receive any immunizations because she has heard that they cause serious illnesses. The nurse should make which appropriate statement to the mother? 1. "Are you afraid your child will die from the immunization?" 2. "Why are you afraid? Children are immunized every day without a problem." 3. "There will be a slight discomfort at the time of injection but that is all that will happen." 4. "I can see that you are very concerned about your child. What do you think might happen after an immunization is given?"
4
A newborn is admitted with a suspected subdural hematoma. The nurse should perform which action to check for the major symptom of associated with a subdural hematoma? 1. Monitor the urine for blood 2. Monitor the urinary output pattern 3. Test for contractures of the extremities 4. Test for equality of extremities when stimulating reflexes
4
A school aged child with Type I diabetes mellitus has soccer practice and the school nurse provides instructions regarding how to prevent hypoglycemia during practice. Which should the school nurse tell the child to do? 1. Eat twice the amount normally eaten at lunch time. 2. Take half the amount of prescribed insulin on practice days. 3. Take the prescribed insulin at noontime rather than in the morning. 4. Eat a small box of raisins or drink a cup of orange juice before soccer practice.
4
An adolescent client with type I diabetes mellitus is admitted to the ED with a diagnosis of diabetic ketoacidosis. Which assessment finding would the nurse expect to note? 1. Sweating and tremors 2. Hunger and hypertension 3. Cold and clammy skin and irritability 4. Fruity breath odor and decreasing level of consciousness
4
An infant has just returned to the nursing unit from surgery for repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? 1. Prone 2. Supine 3. Left Lateral 4. Right Lateral
4
The clinic nurse is instructing the parent of a child with human immunodeficiency virus (HIV) infection regarding immunizations. The nurse should provide which instruction to the parent? 1. The hepatitis B vaccine will not be given to the child 2. The inactivated influenza vaccine will be given yearly 3. The varicella vaccine will be given before 6 months of age. 4. A Western blot test needs to be performed and the results evaluated before immunizations.
4
The clinic nurse reviews the record of an infant and notes that the health care provider has documented a diagnosis of suspected Hirschprung's disease (aganglionic megacolon). The nurse reviews the assessment findings documented knowing that the sign that most likely led the mother to seek health care for the infant was: 1. Diarrhea 2. Projectile vomiting 3. Regurgitation of feedings 4. Foul-smelling ribbon-like stools
4
The nurse is caring for a client in Buck's extension traction. The nurse should identify which client problem as a priority? 1. Expressed feelings of isolation 2. Observed inability to distract oneself 3. Verbalized anger about the need for immobility 4. Observed skin redness around the edges of the boot appliance
4
The nurse is monitoring a newborn of a mother with diabetes mellitus. The nurse understands that the newborn is at risk for which complication? 1. Hypercalcemia 2. Hyperglycemia 3. Hypobilirubinemia 4. Respiratory distress syndrome
4
The nurse just administered ibuprofen to a child with a temperature of 102 degrees F (38.8C). The nurse should also take which action? 1. Withhold oral fluids for 8 hours. 2. Sponge the child with cold water. 3. Plan to administer a salicylate in 4 hours 4. Remove excess clothing and blankets from the child.
4
The nurse notes that a child with Hirschsprung's disease who is scheduled for surgery has inadequate fluid volume. The nurse should plan to implement which intervention to stabilize the child's hydration status before surgery? 1. Monitor daily weight 2. Monitor intake and output 3. Administer tap water enemas 4. Administer intravenous fluids and electrolytes
4
The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instructions? 1. "We need to encourage our child to drink fluids". 2. "Coughing spells may be triggered by dust or smoke". 3. "Vomiting may occur when our child has coughing episodes." 4. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks".
4
The clinic nurse has provided instructions to the mother of a child with a urinary tract infection. Which statements by the mother indicates a need for further instruction? (Select all that apply) 1. "I should increase my child's fluid intake." 2. "I should not use bubble baths with my child." 3. "I should wipe my child's bottom from front to back after urination or a bowel movement." 4. "I should encourage my child to hold their urine and void only four times per day." 5. "I should administer the antibiotics to my child until urinary tract infection symptoms disappear."
4,5