PEDS-TEST 3

When developing the plan of care for a child with cystic fibrosis (CF) who is scheduled to receive postural drainage, the nurse should anticipate performing postural drainage at which times? After meals before meals after rest periods before inhalation treatments

before meals

The parents of an infant with bronchiolitis ask the nurse why their baby's room has a sign on the door that says "Contact Precautions." and why the nurses wear gown and gloves when they hold him. What is the nurse's best response? "Extra precautions prevent the virus from spreading to other babies." "Your baby is very ill, we don't want to have another baby catch what he has." "It's because we need to protect your baby from other illnesses." "We always wear gowns when babies are coughing."

"Extra precautions prevent the virus from spreading to other babies." FEEDBACK:RSV is the cause of bronchiolitis in most cases; RSV can live for several hours on nonporous surfaces, and can be transferred by the hands; gowns and gloves will prevent the nurses from spreading the RSV to other clients. the infant with RSV does not need to be protected fro other illnesses; the objective is to protect the virus from spreading to other children. The nurse's statement should be therapeutic and not cause the parents additional stress.

A 6-year-old child is brought to the health clinic for a routine checkup. To assess the child's vision, the nurse should ask: "Do you have any problems seeing different colors?" "So you have trouble seeing at night?" "Do you have problems with glare?" "How are you doing in school?"

"How are you doing in school?" FEEDBACK: A child's poor progress in school may indicate a visual disturbance. Most children do not have 20/20 vision until after six years of age, visual acuity between the eyes.

What would be most important to include in the teaching plan for parents of a child with pinworm? "Seal the child's clothing in a plastic bag for at least 10 days." "Be sure your child wears shoes at all times" "Make sure the child washes his hands after using the bathroom." After applying this special cream, leave it on for about 8 to 10 hours."

"Make sure the child washes his hands after using the bathroom." FEEDBACK: The most effective measure to prevent pinworm or recurrence is good hand hygiene, especially after using the bathroom and before eating. Sealing the child's clothing in a plastic bag is appropriate for pediculosis capitis. Having the child wear shoes at all times is helpful in preventing hookworm. Use of a cream that remains of for a specified time is associated with scabies

The parents of a 7-month-old child with an infection ask the nurse about how to treat their child's fever. After providing teaching, the parents voice understanding with which statements select all that apply "Unless my child develops a fever over 102.2 F, I don't need to make and appointment with a healthcare provider" "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection" "Having a temperature over 38 C puts my child at risk for the infection spreading to the bloodstream" "Even though people get frighten, fevers are not a bad thing during an infection unless it gets too high" "Any fever is dangerous and can cause serious damage to brain cells if it goes on too long."

"Unless my child develops a fever over 102.2 F, I don't need to make and appointment with a healthcare provider" "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection" "Even though people get frighten, fevers are not a bad thing during an infection unless it gets too high"

The nurse is seeing a client in the clinic for a sore throat. The client asks for an antibiotic. How should the nurse respond? select all that apply "you can try gargling with warm saline to relieve the discomfort." "You should use a dehumidifier to dry out the air, which will soothe the throat." "Most sore throats are caused by viruses, which cannot be treated with antibiotics." "There are three or four antibiotic that we prescribe for a sore throat, so the doctor will decide which one you need." "You should increase your fluid intake. Drink lots of water and try warn soup to help with the discomfort."

"you can try gargling with warm saline to relieve the discomfort." "Most sore throats are caused by viruses, which cannot be treated with antibiotics." "You should increase your fluid intake. Drink lots of water and try warn soup to help with the discomfort."

A nurse is contributing to the plan of care for a child who has tinea capitis. which of the following actions should the nurse recommend? Select all that apply Treat infected pets use selenium sulfide shampoo cleanse area with silver nitrate administer antiviral medication use moist, warm compresses

(ANOTHER CONFUSED QUESTION BY TEACHER) FEEDBACK: pets, especially cats cans transmit tinea capitis to persons. the client should treat infected animals. Selenium sulfate shampoo is indicated for children wh0 have tinea capitis

The triage nurse in the emergency department must prioritize the children waiting to be seen. Which child is in the greatest need of emergency medical treatment? A 6-year-old with a fever of 104 F a muffles voice, no spontaneous cough , and drooling a 3-year-old with a fever of 100 F a barky cough, and mild intercostal retractions a 4-year-old with with a fever of 101 F a hoarse cough, inspiratory stridor, and restlessness 1 13-year-old with a fever of 104 F chilis and a cough with thick yellow secretions

A 6-year-old with a fever of 104 F a muffles voice, no spontaneous cough , and drooling FEEDBACK:This child is exhibiting signs and symptoms of epiglottitis, which is a medical emergency due to the risk of complete airway obstruction. The 3- and4-year-olds are exhibiting signs and symptoms of croup. Symptoms often diminish after the child has been taken out in the cool night air. If symptoms do not improve the child may need a single dose of dexamethasone. Fever should also be treated with antipyretics. The 13-year-oldis exhibiting sign and symptoms of bronchitis. Treatment includes res, antipyretics, and hydration.

A child with suspected rheumatic fever, is admitted to the pediatric unit. When obtaining the child's history the nurse considers which information to be the most important? A fever that started 3 days ago Lack of interest in food A recent episode of pharyngitis vomiting for 3 days

A recent episode of pharyngitis FEEDBACK: A recent episode pf pharyngitis is the most important factor in establishing the diagnosis of rheumatic fever. Activation of the innate immune system begins with a pharyngeal infection that leads to the presentation of S. pyogenes antigens to T and B cells

A nurse is providing discharge teaching for a child who has cystic fibrosis. Which of the following instructions should the nurse include ? Provide a low-calorie, low-protein diet Administer pancreatic enzymes with meals and snacks Implement a fluid restriction during times of infection Restrict physical activity

Administer pancreatic enzymes with meals and snacks

The nurse observes an 18-month -old who has been admitted with a respiratory tract infection who is drooling. The child is sitting up, leaning forward, with his neck extended, with an open mouth, drooling. What should the nurse do first? Position the child supine Call the rapid response team Suction the airway Administer oxygen

Call the rapid response team FEEDBACK:The nurse should suspect epiglottitis in any young child with a respiratory infection who sits leaning forward with an open mouth and a protruding tongue and is drooling. Epiglottitis is a medical emergency. The rapid response team should be notified to secure the airway. While waiting for the team, the child should remain sitting upright to facilitate breathing : complete obstruction may occur if the child is placed prone of becomes agitated. Therefore, it is important to avoid any procedures that upset the child such as suctioning or applying oxygen

An adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for what ? Chlamydia Syphilis Genital herpes Trichomoniasis

Chlamydia

What symptom should the nurse monitor for to indicate that the treatment for acute epiglottitis in a child was effective? Pale lips and mucus membranes Maintains tripod position Tachypneic and dysphonic Clear, bilateral breath sounds

Clear, bilateral breath sounds FEEDBACK:Clear breath sounds indicate effective airway clearance and decreased mucosal swelling and obstruction. Pale lips and mucous membranes could indicate hypoxia. Tripod position is a clinical manifestation of a child in distress due to epiglottitis

The nurse anticipates using postural drainage as a treatment modality for which of the following conditions? Epiglottitis Foreign body aspiration Cystic Fibrosis Bronchopulmonary dysplasia

Cystic Fibrosis FEEDBACK:Chest physiotherapy and postural drainage for children with cystic fibrosis help loosen pulmonary secretions and facilitate removal from airways

The nursing instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students can identity which action as the primary primary action of this medication? Cause vasodilation to promote heat loss Decrease the temperature set point Block release of histamine promote prostaglandin production

Decrease the temperature set point

A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication not to be prescribed for this child Ibuprofen Acyclovir Penicillin V Doxycycline

Doxycycline

After a tonsillectomy and adenoidectomy, which finding should alert the nurse to suspect early hemorrhage in a 5-year-old child? Droolng of bright red secretions' Pulse rate of 95 bpm vomiting of 25 ml of dark brown emesis blood pressure of 95/56 mm Hg

Droolng of bright red secretions'

The parents of a 5-year-old boy have just found out that their child has head lice. Which statement by the parents would not support the nursing diagnosis of deficient knowledge? "I can't believe it. We're not unclean, poor people" "We'll have to get that special shampoo" "Everybody in the house will need to be checked" "That explains is complaints of itching on his neck"

FEEDBACK: (THIS WAS THE CONFUSED QUESTION) Head lice is not an indication of poor hygiene or poverty. It occurs in all socioeconomic groups. Thus, the parents' statement about being unclean and poor reflects a lack of knowledge about the infection. pediculicide is used to wash the hair to treat the infection. Household contacts need to be examined and treated if affected. Extreme pruritus is the most common symptom, with nits or lice especially behind the ears or at the nape of the neck

A nurse is caring for a child who is in the post operative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding? Hgb 11.6 and Hct 37% inflamed and reddened throat Frequent swallowing and clearing of the throat Blood-tinged mucus

Frequent swallowing and clearing of the throat

A women gives birth to a healthy newborn. As part of the newborn's care the nurse instills erythromycin ophthalmic ointment as a preventive measure for which sexually transmitted infection? Gentile Herpes Hepatitis B Syphilis Gonorrhea

Gonorrhea FEEDBACK: To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most stated. The ointment is not used to prevent conditions related to genital herpes, hepatitis B or syphilis

Which of the following organisms is responsible for the development of rheumatic fever? Staphylococcus aureus Group A beta-hemolytic streptococcus Haemophilus influenza Streptococcal pneumonia

Group A beta-hemolytic streptococcus

A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? Select all that apply Hoarse and difficulty speaking difficulty swallowing low-grade fever drooling dry, barking cough stridor

Hoarse and difficulty speaking difficulty swallowing drooling stridor

A group of nursing students are reviewing The six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection to the susceptible host ? Keeping the linens dry and clean Maintaining skin integrity Washing hands frequently Coughing into a Handkerchief

Maintaining skin integrity FEEDBACK: Maintaining the integrity of the child's skin and mucous membranes is a precaution that will break the chain of infection at the susceptible host. Keeping linens dry and clean is a precaution to take at the reservoir link. Washing hands frequently breaks the chain at the mode of transmission. Coughing into a handkerchief is a precaution for the portal of exit

A mother brings her 8-year-old son in for evaluation because of a rash on his lower leg. Which findings would not support the suspicion of Lyme disease? Select all that apply Playing in the woods about a week ago Rash is papular and vesicular High fever occurring about 4 days before the rash Complaints of extreme pruritus with visible nits

Playing in the woods about a week ago

The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which nursing interventions should be questioned? Administer antipyretics as ordered Keep the child's fingernails short Monitor fluid intake and output Provide alcohol baths as needed

Provide alcohol baths as needed Feedback Treatments such as sponging the child or cold water are not appropriate interventions for fever management. Rather, the nurse would use tepid sponge baths and cool compresses. Administering antipyretics. keeping the child's fingernails short, and monitoring intake and output are appropriate.

A 9-year-old girl diagnosed with cystic fibrosis. Which of the following must the nurse keep in mind when developing a care plan for the child? Elevated levels of potassium are found in sweat. Pulmonary secretions are abnormally thick. Obstruction of the endocrine glands occurs. CF is an autosomal dominant hereditary disorder.

Pulmonary secretions are abnormally thick. FEEDBACK: CF is identified by abnormally thick pulmonary secretions. Researchers now know that cystic fibrosis is an autosomal recessive disorder of exocrine gland function most commonly affecting persons of Northern European descent at a rate of 1 in 3500. It is a chronic disease that frequently leads to chronic sinopulmonary infections and pancreatic insufficiency. The most common cause of death is end-stage lung disease.

The client has a heavily draining wound for which there is an order to change the dressing every 4 hours. The nurse becomes busy and does not change the dressing as ordered. Which link in the chain of infection has the nurse allowed to flourish? Susceptible host Reservoir Mode of transmission Portal of exit

Reservoir FEEDBACK: The reservoir is the area where a pathogen grows and reproduces. Leaving the dressing unchanged allows for a dark, warm, nutrient-rich, and moist environment where many organisms will thrive. The mode of transmission is the way the pathogen travels

A school-aged child with an infectious disease is placed on transmission-based precautions. Which nursing diagnosis would be the priority? Impaired skin integrity related to trauma secondary to pruritus and scratching Fluid volume deficit related to increased metabolic demands and insensible losses Social isolation related to infectivity and inability to go to the playroom Deficient knowledge related to how infection is tranmitted

Social isolation related to infectivity and inability to go to the playroom FEEDBACK: Children who are placed on transmission-based precautions are not allowed to leave their rooms and are not allowed to go to common areas such as the playroom or school rooms. Thus, they are at risk for social isolation. Impaired skin integrity, fluid volume deficit and deficient knowledge may be appropriate but would depend of the infectious disease diagnosis.

The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? Swollen lymph nodes Strawberry tongue Infected Tonsils Swollen neck

Swollen lymph nodes FEEDBACK: Lymph nodes, especially under the arms, can become painful and swollen due to cat-scratch disease. Strawberry tongue is typical of scarlet fever. Infected tonsils and en edematous neck are symptoms of dipteral

A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early sign of hypoxia? Nonproductive cough Hypoventilation Tachypnea Nasal stuffiness

Tachypnea

When taking the nursing history of a child with cystic fibrosis what piece of information about the child's newborn period would the nurse expect the mother to report? That the child required resuscitation in the delivery room The labor was longer than 24 hours That the Child had a meconium ileus The labor was less than 4 hours

That the Child had a meconium ileus FEEDBACK: Meconium ileus in the newborn period is often the first indication of cystic fibrosis. the other options are not indications of cystic fibrosis

A child with cystic fibrosis does not like taking a pancreatic enzyme supplement with meals and snacks. The parent does not like to force the child to take the supplement. What is the most important reason for the child to take the pancreatic enzyme supplement with meals and snacks? The child will become dehydrated if the supplement is not taken with meals and snacks. The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates, and proteins The child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear the child will experience severe diarrhea if the supplement is not taken as prescribed

The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates, and proteins

The mother of a 4-year-old has contacted the healthcare provider's office. She reports her son was exposed to someone with chickenpox. She has inquired about when her son may show if he has gotten the disease. What information should be provided? The incubation period for the disease is between 10-21 days Younger children will have a longer periods of incubation The illness should be seen in a week if her has been exposed Symptoms of the disease should show up within 24to 48 hours of exposure

The incubation period for the disease is between 10-21 days FEEDBACK: Chickenpox is the common name for varicella. This condition has an incubation period of 10 to 21 days

All of the following statements regarding scarlet fever are true except scarlet fever can be treated with antibiotics a vaccine is available to protect against scarlet fever scarlet fever is caused by an erythrogenic toxin rheumatic fever is a possible complication of scarlet fever

a vaccine is available to protect against scarlet fever

A nurse is reinforcing discharge teaching with the parents of a child who has cystic fibrosis. Which of the following instructions would the nurse include? Provide a low-calorie, low-protein diet administer pancreatic enzymes with meals and snacks. implement a fluid restriction during times of infection. restrict physical activity

administer pancreatic enzymes with meals and snacks.

Which of the following would be considered appropriate in the treatment of a child with Lyme disease ? contact precautions a clear liquid diet promotion of bed rest administration of antibiotics

administration of antibiotics FEEDBACK: Lyme disease is caused by by the bacteria Borrelia burgdorferi. It is a vector-borne disease that is contracted secondary to the bite of an infected tick. Administration of antibiotics is crucial to recovery. Standard precautions are adequate. Restricting fluids, diet, or activity is not necessary

Which factor if described by the parents of a child with cystic fibrosis (CF), indicates understanding the underlying problem of the disease? an abnormality in the body's mucus-secreting glands formation of fibrous cysts in various body organs failure of the pancreatic ducts to develop properly reaction to the formation of antibodies against streptococcus

an abnormality in the body's mucus-secreting glands FEEDBACK:CF is characterized by a dysfunction in the body's mucus-producing exocrine glands. the mucus secretions are thick and sticky rather than thin and slippery. the mucus obstructs the bronchi, bronchioles, and pancreatic ducts. Mucus plug in the pancreatic ducts can prevent pancreatic digestive enzymes from reaching the small intestine, resulting in poor digestion and poor absorption of various food nutrients. Fibrous cysts do not form in various organ. Cystic fibrosis in an autosomal recessive inherited disorder and does not involve any reaction to the formation of antibodies against streptococcus

An adolescent with cystic fibrosis has been hospitalized several times. On the latest admission, the client has labored respiration, fatigue, malnutrition, and failure to thrive. Which initial nursing actions are most important? Placing the client on bed rest and obtaining a prescription for a blood gas analysis Implementing a high-calorie, high-protein ,low-low fat, vitamin-enriched diet and pancreatic granules applying an oximeter and initiating respiratory therapy Inserting and IV line and initiating antibiotic therapy

applying an oximeter and initiating respiratory therapy FEEDBACK:Clients with cystic fibrosis commonly die from respiratory problems. The mucus in the lungs is tenacious and difficult to expel, leading to lung infections and interference with oxygen and carbon dioxide exchange. The client will likely need supplemental oxygen and respiratory treatments to maintain adequate gas exchange, , as identified by the oximeter reading. The child will be on bed rest due to respiratory distress. However, although blood gases will probably be prescribed, the oximeter readings will be used to determine oxygen deficit and are therefore more of a priority A diet high in calories, proteins and vitamins with pancreatic granules added to all foods ingested will increase nutrient absorption and help the malnutrition: however this intervention is not the priority at this time. Inserting an IV to administer antibiotics is important and can be done after ensuring adequate respiratory function

A nurse is giving instructions to parents of a child who had a tonsillectomy. Which instruction is the most important? drink orange juice to reduce the discomfort drink extra milk to reduce the discomfort avoid drinking with a straw rinse twice a day with antiseptic mouthwash

avoid drinking with a straw FEEDBACK: Drinking from a straw in is very problematic post-tonsillectomy for two reasons: First, the sucking motion may disrupt the clot at the operative site. Second, insertion of the straw into the mouth will irritate the tissue at the operative site. Orange juice and antiseptic mouthwash will irritate the tissue at the operative site. milk promotes mucus production, which increases the need to swallow, potentially irritating the operative site. Still drinking from a straw present the most potential harm

During a 2 month well visit with a patient and her mother you educate the parent on the most common cause of epiglottitis. You explain to the mother the most common cause of this condition is the _______________. In addition, you explain _________ can help prevent most cases of this condition?* rotavirus, RV vaccine haemophilus influenzae type b, Hib vaccine respiratory syncytial virus, palivizumab influenza virus, annual flu shot

haemophilus influenzae type b, Hib vaccine

A child with cystic fibrosis has been admitted to the pediatric unit. What type of diet should the nurse request for the client? High-fat, high charbohydrate high-calorie, high-protein high- calorie, high high-carbohydrate high-carbohydrate, high-protein

high-calorie, high-protein FEEDBACK:High-calorie, high-protein diet is necessary too ensure adequate growth. Some children require up to two times the recommended daily allowance of calories (increased calorie diet includes foods high in fat and balanced carbohydrates). Pancreatic enzyme activity is lost and malabsorption of fats, proteins, and carbohydrates

An 11-year-old is admitted for treatment of an asthma attack. Which finding indicates immediate intervention is needed? thin, copious mucous secretions Productive cough intercostal retractions respiratory rate of 20 breaths/minute

intercostal retractions FEEDBACK: Intercostal retractions indicate and increased respiratory effort. which is a sign of respiratory distress. During an asthma attack, secretions are thick, the cough is tight and the respiration is difficult (and shortness of breath may occur) If mucous secretions are copious but thin, the client can expectorate them, which indicates an improvement in the condition. If the chough is productive, is means the bronchospasms and the inflammation have been resolved to the extent that the mucus can be expectorated. A respiratory rate of 20 bpm would be considered normal and no intervention would be needed

A nurse is assessing a client who has pertussis. Which of the following findings should the nurse expect? select all that apply runny nose mild fever cough with a whooping sound swollen salivary glands red rash

mild fever cough with a whooping sound swollen salivary glands

A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? Oxygen saturation 95% Wheezing Retraction of sternal muscles warm extremities nasal flaring

nasal flaring

A nurse is teaching a group of family members about communicable diseases. The nurse should include that which of the following is the best method to prevent a communicable disease? handwashing avoiding persons who have active diseases covering your cough obtaining immunizations

obtaining immunizations

A 12-year-old with asthma wants to exercise. Which activity should the nurse suggest to improve breathing? Soccer swimming track gymnastics

swimming FEEDBACK:Swimming is appropriate for this child because it requires controlled breathing, assists in maintaining cardiac health, enhances skeletal muscle strength and promotes ventilation and perfusion. Stop and start activities, such as soccer, track and gymnastics, commonly trigger symptoms in asthmatic clients

A nurse is caring for a child who is experiencing respiratory distress. Which of the following are early manifestations or respiratory distress? bradycardia peripheral cyanosis tachycardia diaphoresis restlessness

tachycardia diaphoresis restlessness

Four 6-month-old children arrive at the clinic for diphtheria-pertussis-tetanus immunization. Which child care safely receive the vaccine. the child with a runny nose the child who experienced a seizure after the last immunization the child who experienced a life-threatening allergic reaction after the last immunization the child with the temperature of 102 F

the child with a runny nose FEEDBACK: A child with a mild illness, such as a runny nose may be vaccinated. The child who experienced a seizure after the last immunization should not get another dose of pertussis vaccine but may get the diphtheria and tetanus vaccine. A child who experienced a life-threatening allergic reaction after the las immunization should not get another dose. The child who has a high temperature should wait until her recovers before getting immunization.

A nurse performing an admission assessment for a child who has cystic fibrosis. which of the following findings should the nurse expect? wheezing Clubbing of fingers and toes barrel-shaped chest thin, watery mucus rapid growth spurts

wheezing Clubbing of fingers and toes barrel-shaped chest

A nurse is providing education about introducing new foods to the guardian of a 4-month-old infant. Which food should the nurse not recommend ? Stained yellow vegetables iron-fortified cereals pureed fruits whole milk

whole milk