Peds Test 2
The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is "too wet". The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is which of the following?
-apply direct pressure above the catheterization site
When should children with cognitive impairment be referred for stimulation and educational programs?
-as young as possible
A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggest which of the following?
-asthma
Which of the following may be beneficial in reducing the risk of the Reye syndrome?
-avoidance of aspirin and ibuprofen for children with varicella or those suspected of having influenza
A child with CF receives aerosolized bronchodilator medication. This medication should be administered:
-before chest physiotherapy (CPT)
Which of the following is a common, serious complication of rheumatic fever?
-cardiac valve damage
The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called:
-conductive
The nurse should recommend emergency medial attention if a child with a slight head injury experiences which of the following?
-confusion or abnormal behavior
When caring for a newborn with down syndrome, the nurse should be aware that the most common congenital anomaly associated with down syndrome is which of the following?
-congenital heart disease
Which of the following is used to treat moderate to severe inflammatory bowel disease?
-corticosteroids
The primary nursing intervention to prevent bacterial endocarditis is which of the following?
-counsel parents of high-risk children about prophylactic antibiotics
An infant is brought to the emergency department with poor skin turgor, weight loss, lethargy, and tachycardia. This is suggestive of which of the following?
-dehydration
An important nursing intervention when caring for a child who is experiencing a seizure would be which of the following?
-describe and record the seizure activity observed
Beta-adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action?
-dilate the bronchioles
A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which of the following?
-down syndrome
The nurse is caring for a neonate with a suspected tracheosophageal fistula. Nursing care should include which of the following?
-elevating the head but giving nothing by mouth
An appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler would be which of the following?
-encourage parents to room in
Which of the following types of croup is always considered a medical emergency?
-epiglottitis
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which of the following medication for immediate administration?
-epinephrine
An appropriate intervention to encourage food and fluid intake in a hospitalized child is which of the following?
-give high-quality foods and snacks whenever child expresses hunger
What is an appropriate nursing intervention when caring for an infant with an upper respiratory tract infection and elevated temperature?
-give small amounts of favorite fluids frequently to prevent dehydration
The most common clinical manifestations of brain tumors in children is which of the following?
-headaches and vomiting
Which of the following is an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets?
-idiopathic thrombocytopenic purpura
The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which of the following should the nurse consider when dealing with this issue?
-individuals with cognitive impairment need a well-defined, concrete code of sexual conduct
The nurse is recommending how to prevent iron deficiency anemia in a healthy, term, breast-fed infant. Which should be suggested?
-iron-fortified infant cereal can be introduced at approx. 6 months of age
The nurse is assessing a child who was just admitted to the hospital or observation after a head injury. Which of the following is the most essential part of the nursing assessment to detect early signs of a worsening condition?
-level of consciousness
Which of the following drugs would be used to treat a child who has increased ICP resulting from cerebral edema?
-mannitol
A child with CF is receiving recombinant human deoxyribonuclease (rhDNase), This drug:
-may cause voice alterations
Meperidine (Demerol) is not recommended for children in sickle cell crisis because it:
-may induce seizures
Which of the following immunizations should not be given to a child receiving chemotherapy for cancer?
-measles, rubella, mumps
What is most commonly the earliest recognizable clinical manifestation of CF?
-meconium ileus
The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as which of the following?
-neurosurgical emergency
Which of the following are the primary clinical manifestation of acute renal failure?
-oliguria -hypertension
Therapeutic management of the child with acute diarrhea and dehydration usually begins with which of the following?
-oral rehydration solution (ORS)
Which of the following clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis?
-painful swelling of hands and feet, painful joints
Which of the following is an advantage of peritoneal dialysis?
-parents and older children can perform treatments
Which of the following is a clinical manifestation of the systemic venous congestion that can occur with congestive heart failure?
-peripheral edema
Which of the following is a major clinical manifestations of rheumatic fever?
-polyarthritis
A hospitalized child with nephrosis is receiving high doses of prednisone. Which of the following is an appropriate nursing goal related to this?
-prevent infection
Which of the following structural defects constitute tetralogy of Fallot?
-pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
Which is the following actions by the school nurse is important in the prevention of rheumatic fever?
-refer children with sore throats for throat cultures
Which of the following is the viral pathogen that frequently causes acute diarrhea in young children?
-rotavirus
Which of the following represents the major stressor of hospitalization for children from middle infancy throughout preschool years?
-separation anxiety
Which of the following factors predisposes the urinary tract to infection?
-short urethra in young girls
A 10-year old child, without a history of seizures, experiences a tonic-clonic seizure lasting 6 minutes at school. breathing is not impaired, but some postictal confusion occurs. The most appropriate initial action by the school nurse is which of the following?
-stay with child and have someone else call emergency medical services
The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which of the following is the most appropriate nursing action?
-stop drug infusion immediately
Several complications can occur when a child receives a blood transfusion. Which is an immediate sign or symptom of an air embolus?
-sudden difficulty in breathing
When caring for a child with probable appendicitis, the nurse should be alert to recognize that which of the following is a sign of perforation?
-sudden relief from pain
Which of the following tests aids in the diagnosis of CF?
-sweat chloride test -stool for fat -chest radiograph films
A 3-year old child is hospitalized after a near-drowning accident. The child's mother complains to the nurse, "This seems unnecessary when he is perfectly fine." The nurse's best reply would be which of the following?
-the reason for this is that complications could still occur
Which of the following is the preferred site for intramuscular injections in infants?
-vastus lateralis
Which of the following is a major complication in a child with chronic renal failure?
-water and sodium retention
The nurse is caring for a child who has been diagnosed with extrcellular fluid volume excess related to congestive heart failure. The child's parents ask the nurse what can be done to treat the condition. What is the correct response from the nurse? (select all that apply)
-your child may be placed on meds to strengthen the heart -your child may be given diuretic
An 11 month old child has an upper respiratory tract infection with a low grade fever for several days and then became irritable with increasing cough and wheezing. This is most suggestive of which of the following?
RSV
Which of the following is the most appropriate nursing diagnosis for a child with anemia?
-activity intolerance related to generalized weakness
A school-age child is admitted in vaso-occlusive sickle cell crisis. The child's care should include which of the following?
-adequate hydration and pain management
A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. Which of the following is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?
-administer an antiemetic before chemotherapy begins
Which of the following types of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
-anaphylactic
The child with down syndrome should be evaluated for which of the following before participating in sports?
-antiantoaxial instability
A 6-month old infant is receiving digoxin. The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which of the following?
-90-110
Which of the following is characterized by a chronic inflammatory process that may involve any part of the GI tract from mouth to anus?
-Crohn's disease
What painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis?
-Osler nodes
A mother calls the outpatient clinic requesting information on appropriate dosing for over-the-counter medications for her 13-month-old who has symptoms of an upper respiratory tract infection and fever. The box of acetaminophen says to give 120 mg q4h when needed. At his 12-month visit, the nurse practitioner prescribed 150 mg. The nurse's best response is:
-The nurse practitioner ordered the drug based on weight, which is a more accurate way of determining a therapeutic dose
Which of the following clinical manifestations would be the most suggestive of acute appendicitis?
-abdominal pain that is most intense at Mcburney's point
