ALL Things Peds :)

The parents of a child with CP are learning how to feed their child to avoid aspiration. The nurse should question which of the following when reviewing the teaching plan? A. "We will keep our child in an upright position while feeding." B. "We will feed our child slowly." C. "We will place the food on the tip of his tongue." D. "We will feed our child soft and blended foods."

C. "We will place the food on the tip of his tongue."

A mother arrives at an emergency department with her 5-year-old child and states that the child fell off a bunk bed. A head injury is suspected, and the nurse checks the child's airway status and assesses the child for early and late signs of increased intracranial pressure (ICP). Which is a late sign of increased ICP? A. Nausea B. Irritability C. Bradycardia D. Headache

C. Bradycardia

Which activity should an adolescent just diagnosed with epilepsy avoid? A. Swimming, even with a friend. B. Participating in any strenuous activities. C. Driving a car at night. D. Returning to school right away

C. Driving a car at night.

The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? 1. Chemical changes in the composition of albumin. 2. Increased permeability of the glomeruli. 3. Obstruction of the capillaries of the glomeruli. 4. Loss of the kidney's ability to excrete waste and concentrate urine.

2. Increased permeability of the glomeruli. Increased permeability of the glomeruli allows large substances (proteins) to pass through and be excreted in the urine.

Healthcare providers are considered mandatory reporters in cases of identified or suspected child abuse. TRUE or FALSE

TRUE

The home health nurse visits a child with infectious mononucleosis and provides home care instructions to the parents about the care of the child. Which instructions should the nurse give to the parents? Select all that apply. A. Maintain the child on bed rest for 2 weeks. B. Notify the health care provider if the child develops abdominal pain or left shoulder pain. C. Maintain respiratory isolation for 1 week. D. Notify the health care provider if the child develops a fever. E. The child should refrain from contact sports until splenomegaly resolves

B & E

The parent of a child with osteomyelitis asks how the child acquired the illness. Which is the best response by the nurse? A. "Direct inoculation of the bone from stepping barefoot on a sharp stick." B. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone." C. "The blood supply to the bone was disrupted because of the child's diabetes." D. "An infection of the upper respiratory tract."

B. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone."

When providing dietary guidance to a child with spina bifida with a known latex allergy, the nurse should encourage the child/caretaker to avoid which foods? A. Oranges, apples, and brussel sprouts B. Broccoli, corn, and strawberries C. Kiwi fruit, avocados, and bananas D. Carrots, onions, and blueberries

C. Kiwi fruit, avocados, and bananas Apples, strawberries, tomatoes are others

During hemodialysis, the nurse notes that a 10-year-old becomes confused and restless. The child complains of a headache and nausea and has generalized muscle twitching. This can be prevented by which of the following? 1. Slowing the rate of solute removal during dialysis. 2. Ensuring the patient is warm during dialysis. 3. Administering antibiotics before dialysis. 4. Obtaining an accurate weight the night before dialysis.

1. Slowing the rate of solute removal during dialysis.

A 3-year-old is attending her grandfather's funeral. Her parents told her that her grandfather is in heaven with God. Which statement describes a 3-year-old child's understanding of spirituality? 1. "The body is here with us on Earth, and the spirit is in heaven." 2. "He is in heaven. Is this heaven?" 3. "The spirit is no longer in his body." 4. "He won't need his body in heaven."

2. "He is in heaven. Is this heaven?"

A 10-kg toddler is diagnosed with acute renal failure (ARF), is afebrile, and has a 24-hour urine output of 110 mL. After calculating daily fluid maintenance, which would the nurse expect the toddler's daily allotment of fluids to be? 1. Sips of clear fluids and ice chips only. 2. 350 mL of oral and intravenous fluids. 3. 1000 mL of oral and intravenous fluids. 4. 2000 mL of oral and intravenous fluids.

2. 350 mL of oral and intravenous fluids. Acute phase allows for only 1/3 of total daily fluid requirements Typical fluid req = 1,000 Divide it by 3, 333 mL

A 9-year-old girl builds a clubhouse in her backyard. She hangs a sign outside her clubhouse that says "No boys allowed" printed on it. The child's parents are concerned that she is excluding their neighbor's son, and they are upset. What should the school nurse tell the child's parents? 1. Her behavior is cause for concern and should be addressed. 2. Her behavior is common among school-age children. 3. Her feelings about boys will subside within the next year. 4. They should have their daughter speak with the school counselor.

2. Her behavior is common among school-age children.

The diet for a child with chronic renal failure (CRF) should be high in calories and include: 1. Low protein, and all minerals and electrolytes. 2. Low protein and minerals. 3. High protein and calcium and low potassium and phosphorus. 4. High protein, phosphorus, and calcium and low potassium and sodium.

3. High protein and calcium and low potassium and phosphorus.

Which of the following describe(s) idiopathic thrombocytopenia purpura (ITP)? Select all that apply. A. ITP is a congenital hematological disorder. B. ITP causes excessive destruction of platelets. C. Children with ITP have normal bone marrow. D. Platelets are small in ITP. E. Purpura is involved in ITP.

B, C, & E I: Increased Immature platelets T: Thrombocytopenia = LOW platelets (destruction of platelets) P: Purpura = Petechial rash

A 4-year-old has just had a plaster cast applied to a fractured left arm. The nurse provides instructions to the parents regarding care for the cast. Which statement by the parent indicates a need for further instruction? A. "The cast may feel warm as it dries." B. "I can use lotion or powder around the cast edges to relieve itching." C. "A small amount of white shoe polish can touch up a soiled white cast." D. "If the cast becomes wet, a blow dryer set on the cool setting may be used to dry it."

B. "I can use lotion or powder around the cast edges to relieve itching."

Parents bring their 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot was made at birth. Which statement by the parent indicated the need for further teaching regarding this disorder? A. "Treatment needs to be started as soon as possible." B. "I need to bring my child back to the clinic in 1 month for a new cast." C. "I need to come to the clinic every week with my infant for the casting." D. "I realize my infant will require follow-up care until he reaches skeletal maturity."

B. "I need to bring my child back to the clinic in 1 month for a new cast."

A child has been diagnosed with a midline brain tumor. In addition to showing signs of increased intracranial pressure (ICP), she has been voiding large amounts of very dilute urine. Which medication should the nurse anticipate administering? A. Mannitol B. Vasopressin C. Lasix D. Dopamine

B. Vasopressin

The nurse is aware that cloudy cerebral spinal fluid (CSF) most likely indicates. A. viral meningitis. B. bacterial meningitis. C. no infection since CSF is usually cloudy. D. sepsis.

B. bacterial meningitis.

The nurse knows that young infants are at risk for injury from shaken baby syndrome because: A. the anterior fontanel is open. B. they have insufficient musculoskeletal support and a disproportionate head-to-body ratio. C. they have an immature vascular system with veins and arteries that are more superficial. D. there is immature myelination of the nervous system in a young infant.

B. they have insufficient musculoskeletal support and a disproportionate head-to-body ratio.

The nurse is working with a child who has just had a fracture reduction and casting. The nurse knows that the child is at risk for compartment syndrome. What OBJECTIVE assessment items will the nurse monitor for while completing the nursing assessment? Select all that apply. A. Burning B. Fever C. Weak pulse D. Tingling E. Pale grey extremity

C & E

A child with osteosarcoma is going to receive chemotherapy before surgery. Which statement by the parents indicates they understand the side effect of neutropenia? A. "My child will be more at risk for diarrhea." B. "My child's hair will fall out." C. "My child will be more at risk for infection." D. "My child will need to remain hydrated."

C. "My child will be more at risk for infection."

The parents of a child recently diagnosed with cerebral palsy ask the nurse about the disorder. Which is the best response by the nurse? A. "It is an infectious disease of the central nervous system." B. "It is an inflammation of the brain resulting from a viral illness." C. "It is a congenital condition that results in moderate to severe retardation." D. "It is a chronic disability characterized by impaired muscle movement and posture."

D. "It is a chronic disability characterized by impaired muscle movement and posture."

A child had a urinary tract infection (UTI) 3 months ago and was treated with an oral antibiotic. A follow-up urinalysis revealed normal results. The child has had no other problems until this visit when the child was diagnosed with another UTI. Which is the most appropriate plan? 1. Urinalysis, urine culture and VCUG. 2. Evaluate for renal failure. 3. Admit to the pediatric unit. 4. Discharge home on an antibiotic.

1. Urinalysis, urine culture and VCUG.

A 13-month-old is discharged following repair of his epispadias. Which statement made by the parents indicates they understand the discharge teaching? 1. "If a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage." 2. "If a mucous plug forms in the urinary drainage tube, we will allow it to pass on its own because this is a sign of healing." 3. "We will make sure the dressing is loosely applied to increase the toddler's comfort." 4. "If we notice any yellow drainage, we will know that everything is healing well."

1. "If a mucous plug forms in the urinary drainage tube, we will irrigate it gently to prevent a blockage."

A nurse educator is providing a teaching session for the nursing staff. Which of the following individuals is at greatest risk for developing beta-thalassemia (Cooley anemia)? 1. A child of Mediterranean descent. 2. A child of Mexican descent. 3. A child whose mother has chronic anemia. 4. A child who has a low intake of iron.

1. A child of Mediterranean descent.

The nurse is caring for a child who is receiving a transfusion of packed red blood cells. The nurse is aware that if the child had a hemolytic reaction to the blood, the signs and symptoms would include which of the following? Select all that apply. 1. Fever. 2. Rash. 3. Oliguria. 4. Hypotension. 5. Chills.

1. Fever 3. Oliguria 4. Hypotension Sx: fever, pain at insertion site, hypotension, renal failure, tachycardia, oliguria, and shock.

Chronic hypertension in the child who has chronic renal failure (CRF) is due to which of the following? 1. Retention of sodium and water. 2. Obstruction of the urinary system. 3. Accumulation of waste products in the body. 4. Generalized metabolic alkalosis.

1. Retention of sodium and water.

A 10-year-old with severe factor VIII deficiency falls, injures an elbow, and is brought to the ER. The nurse should prepare which of the following? 1. An IM injection of factor VIII. 2. An IV infusion of factor VIII. 3. An injection of desmopressin. 4. An IV infusion of platelets.

2. An IV infusion of factor VIII.

The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems is (are) associated with sickle cell disease? Select all that apply. 1. Polycythemia. 2. Hemarthrosis. 3. Aplastic crisis. 4. Thrombocytopenia. 5. Splenic sequestration. 6. Vaso-occlusive crisis.

3, 5, & 6

A renal transplantation is which of the following? 1. A curative procedure that will free the child from any more treatment modalities. 2. An ideal treatment option for families with a history of dialysis noncompliance. 3. A treatment option that will free the child from dialysis. 4. A treatment option that is very new to the pediatric population.

3. A treatment option that will free the child from dialysis.

One week after kidney transplant, a child complains about abdominal pain, and the parents note that the child has been very irritable. The nurse notes a 10% weight gain as well as elevated BUN and creatinine levels. Which of the following medications would the child most likely be taking? 1. Codeine tablets. 2. Furosemide. 3. MiraLAX powder. 4. Corticosteroids.

4. Corticosteroids. Increases BUN levels & the patient would be on this medication as part of a antirejection regime for the transplant.

An expectant mother asks the nurse if her new baby will have an umbilical hernia. The nurse bases the response on the fact that it occurs: 1. More often in large infants. 2. In white infants more than in African American infants. 3. Twice as often in male infants. 4. More often in premature infants.

4. More often in premature infants.

The nurse expects which of the following clinical manifestations in a child diagnosed with SCID? 1. Prolonged bleeding. 2. Failure to thrive. 3. Fatigue and malaise. 4. Susceptibility to infection.

4. Susceptibility to infection.

The nurse is caring for an infant with myelomeningocele. The parents ask the nurse why she measures the infant's head every day. Which is the best response by the nurse? A. "Babies' heads are measured to ensure growth is on track." B. "Many infants with myelomeningocele have microcephaly, which can show up as a decrease in head size." C. "Because your baby has an opening on the spinal cord, your infant is at risk for meningitis, which can show up as an increase in size." D. "Babies with myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size."

D. "Babies with myelomeningocele are at risk for hydrocephalus, which shows up as an increase in head size."

Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay? 1. "My child is able to stand but is not yet taking steps independently." 2. "My child has a vocabulary of approximately 15 words." 3. "My child is still sucking his thumb." 4. "My child seems to be quite wary of strangers."

1. "My child is able to stand but is not yet taking steps independently."

A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse's best response is: 1. "Your mommy and daddy will be back after your nap." 2. "Your mommy and daddy will be back at 6:00 p.m." 3. "Your mommy and daddy will be back later this evening." 4. "Your mommy and daddy will be back in 3 hours."

1. "Your mommy and daddy will be back after your nap."

A 16-year-old is having a discussion with the nurse about the teen's recent diagnosis of lupus. In explaining the child's prognosis, the nurse uses the knowledge that adolescents are: 1. Preoccupied with thoughts of the here and now. 2. Able to understand and imagine possibilities for the future. 3. Capable of thinking only in concrete terms. 4. Overly concerned with past events and relationships.

2. Able to understand and imagine possibilities for the future.

The nurse is caring for a newborn who has just been diagnosed with tracheoesophageal fistula and is scheduled for surgery. Which should the nurse expect to do in the pre-operative period? 1. Keep the child in a monitored crib, obtain frequent vital signs, and allow the parents to visit but not hold their infant. 2. Administer intravenous fluids and antibiotics. 3. Place the infant on 100% oxygen via a non-rebreather mask. 4. Have the mother feed the infant slowly in a monitored area, stopping all feedings 4 to 6 hours before surgery.

2. Administer intravenous fluids and antibiotics. Patient will be placed on NPO status, fluids are needed to prevent dehydration, antibiotics are needed to prevent pneumonia

The nurse is caring for a 7-week-old scheduled for a pyloromyotomy in 24 hours. Which would the nurse expect to find in the plan of care? 1. Keep infant NPO; begin intravenous fluids at maintenance. 2. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube (NGT) to low wall suction. 3. Obtain serum electrolytes; keep infant NPO; do not attempt to pass NGT due to obstruction. 4. Offer infant small frequent feedings; keep NPO 6 to 8 hours before surgery.

2. Keep infant NPO; begin intravenous fluids at maintenance; place nasogastric tube (NGT) to low wall suction.

The nurse is caring for a neonate with an anorectal malformation. The nurse notes that the infant has not passed any stool per rectum but the infant's urine contains meconium. The nurse can make which assumption? 1. The child likely has a low anorectal malformation. 2. The child likely has a high anorectal malformation. 3. The child will not need a colostomy. 4. This malformation will be corrected with a nonoperative rectal pull-through.

2. The child likely has a high anorectal malformation.

A 12-month-old boy weighed 8 lb 2 oz at birth. Understanding developmental mile- stones, what should the nurse caring for the child expect the current weight to be? 1. 16lb 4oz 2. 20lb 5oz 3. 24lb 6oz 4. 32lb 8oz

3. 24lb 6oz Weight triples

A 4-month-old has had vomiting and diarrhea for 24 hours. The infant is fussy, and the anterior fontanel is sunken. The nurse notes the infant does not produce tears when crying. Which task will help confirm the diagnosis of dehydration? 1. Urinalysis obtained by bagged specimen. 2. Urinalysis obtained by sterile catheterization. 3. Analysis of serum electrolytes. 4. Analysis of cerebrospinal fluid.

3. Analysis of serum electrolytes.

The nurse is caring for a 3-month-old being evaluated for possible Hirschsprung disease. His parents call the nurse and show her his diaper containing a large amount of mucus and bloody diarrhea. The nurse notes that the infant is irritable and his abdomen appears very distended. Which should be the nurse's next action? 1. Reassure the parents that this is an expected finding and not uncommon. 2. Call a code for a potential cardiac arrest, and stay with the infant. 3. Immediately obtain all vital signs with a quick head-to-toe assessment. 4. Obtain a stool sample for occult blood.

3. Immediately obtain all vital signs with a quick head-to-toe assessment.

The nurse is caring for a 5-year-old who has just returned from having an appendectomy. Which is the optimal way to manage pain? 1. Intravenous morphine as needed. 2. Liquid Tylenol (acetaminophen) with codeine as needed. 3. Morphine administered through a PCA pump. 4. Intramuscular morphine as needed.

3. Morphine administered through a PCA pump.

The mother of a newborn asks the nurse why the infant has to nurse so frequently. Which is the best response? 1. Formula tends to be more calorically dense, and formula-fed babies require fewer feedings than breastfed babies. 2. The newborn's stomach capacity is small, and peristalsis is slow. 3. The newborn's stomach capacity is small, and peristalsis is more rapid than in older children. 4. Breastfed babies tend to take longer to complete a feeding than formula-fed babies.

3. The newborn's stomach capacity is small, and peristalsis is more rapid than in older children. They require small frequent feedings, small stomach but increased metabolism

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response? 1. "It is very rare for a child to have a relapse after having fully recovered." 2. "Unfortunately, many children have cycles of relapses, and there is very little that can be done to prevent it." 3. "Your child is much less likely to get sick again if sodium is decreased in the diet." 4. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

4. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

The bladder capacity of a 3-year-old is approximately how much? 1. 1.5 fl. oz. 2. 3 fl. oz. 3. 4 fl. oz. 4. 5 fl. oz.

4. 5 fl. oz. Child's bladder capacity is age + 2

A nurse is doing discharge education with a parent who has a child with beta-thalassemia (Cooley anemia). The nurse informs the parent that the child is at risk for which of the following conditions? 1. Hypertrophy of the thyroid. 2. Polycythemia vera. 3. Thrombocytopenia. 4. Chronic hypoxia and iron overload.

4. Chronic hypoxia and iron overload. There is increased destruction of red blood cells, causing anemia. This results in chronic anemia and hypoxia. They are treated with multiple blood transfusions, which can cause iron overload and damage to major organs.

A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the time. The nurse's best response to the child's parents who are concerned about this behavior is that the child is in the: 1. Detachment phase of separation anxiety, which is normal for children during hospitalization. 2. Despair stage of separation anxiety, which is normal for children during hospitalization. 3. Bargaining stage of separation anxiety, which is normal for children during hospitalization. 4. Protest stage of separation anxiety, which is normal for children during hospitalization.

4. Protest stage of separation anxiety, which is normal for children during hospitalization.

According to developmental theories, which important event is essential to the development of the toddler? 1. The child learns to feed self. 2. The child develops friendships. 3. The child learns to walk. 4. The child participates in being potty-trained.

4. The child participates in being potty-trained.

A nurse is reviewing the health care provider's orders for a child with sickle cell anemia being admitted to the pediatric floor for treatment of vaso-occlusive crisis. Which orders should the nurse question? Select all that apply. A. Restrict fluid intake B. Position for comfort C. Avoid strain on painful joints D. Apply nasal oxygen at 2L/minute E. Provide a high calorie, high protein diet F. Give Meperidine (Demerol) intravenously, every four hours for pain

A & F Fluids should be promoted & the nurses priority intervention during a sickle cell anemia crisis. Narcotics should be given for pain, this is very painful.

A child with hemophilia (A) fell and injured a knee while playing outside. The knee is swollen and painful. Which of the following measures should be taken to stop the bleeding? Select all that apply. 1. The extremity should be immobilized. 2. The extremity should be elevated. 3. Warm moist compresses should be applied to decrease pain. 4. Passive range-of-motion exercises should be administered to the extremity. 5. Factor VIII should be administered.

1, 2, & 5 Remember RICE for acute bleeding in hemophilia

Which of the following can lead to a possible diagnosis of human immunodeficiency virus (HIV) in a child? Select all that apply. 1. Repeated respiratory infections. 2. Intermittent diarrhea. 3. Excessive weight gain. 4. Irregular heartbeat. 5. Poor weight gain.

1, 2, & 5

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? 1. Maternal polyhydramnios. 2. Pregnancy lasting more than 38 weeks. 3. Poor nutrition during pregnancy. 4. Alcohol consumption during pregnancy.

1. Maternal polyhydramnios.

A 4-year-old hospitalized with FTT has orders for daily weights, strict intake and output, and calorie counts. Which action by the nurse would be a concern? 1. The nurse weighs the child every morning after breakfast. 2. The nurse weighs the child with no clothing except for undergarments. 3. The nurse sits with the child while the child eats her meals. 4. The nurse weighs the child using the same scale every morning.

1. The nurse weighs the child every morning after breakfast.

A 13-year-old boy is hospitalized for a femur fracture. He was hit by a car while he and his friends were racing bikes near a major intersection. The child's parents are concerned about his judgment. The nurse should tell the parents that the behavior is: 1. Typical of young teens. 2. Related to hormonal surges during adolescence. 3. An isolated incident and will not likely happen again. 4. Related to teen rebellion.

1. Typical of young teens.

A 3-year-old boy has been hospitalized because he fell down the stairs. His mother is crying and states, "This is all my fault." Which is the nurse's best response? 1. "Accidents happen. You shouldn't blame yourself." 2. "Falls are one of the most common injuries in this age group." 3. "It may be a good idea to put a baby gate on the stairs." 4. "Your son should be proficient at walking down the stairs by now."

2. "Falls are one of the most common injuries in this age group."

A first-time mother brings in her 5-day-old baby for a well-child visit. The nurse weighs the infant and reports a weight of 7 lb 5 oz to the mother. The mother looks concerned and tells the nurse that her baby weighed 7 lb 10 oz when she was discharged 4 days ago. The nurse's best response to the mother is: 1. "I will let the doctor know, and he will talk with you about possible causes of your infant's weight loss." 2. "A weight loss of a few ounces is common among newborns, especially for breast- feeding mothers." 3. "I can tell you are a first-time mother. Don't worry; we will find out why she is losing weight." 4. "Maybe she isn't getting enough milk. How often are you breastfeeding her?"

2. "A weight loss of a few ounces is common among newborns, especially for breast- feeding mothers." Newborns can lose up to 10% of their birth weight but should regain their birth weight by 2wks

The nurse is administering Prilosec (omeprazole) to a 3-month-old with gastroesophageal reflux (GER). The child's parents ask the nurse how the medication works. Select the nurse's best response. 1. "Prilosec is a proton pump inhibitor that is commonly used for reflux in infants." 2. "Prilosec decreases stomach acid, so it will not be as irritating when your child spits up." 3. "Prilosec helps food move through the stomach quicker, so there will be less chance for reflux." 4. "Prilosec relaxes the pressure of the lower esophageal sphincter."

2. "Prilosec decreases stomach acid, so it will not be as irritating when your child spits up."

The nurse is caring for a newborn with a cleft lip and palate. The mother states, "I will not be able to breastfeed my baby." Select the nurse's best response. 1. "It sounds like you are feeling discouraged. Would you like to talk about it?" 2. "Sometimes breastfeeding is still an option for babies with a cleft lip and palate. Would you like more information?" 3. "Although breastfeeding is not an option, you have the option of pumping your milk and then feeding it to your baby with a special nipple." 4. "We usually discourage breastfeeding babies with cleft lip and palate as it puts them at an increased risk for aspiration."

2. "Sometimes breastfeeding is still an option for babies with a cleft lip and palate. Would you like more information?"

An 18-year-old with a rash and itching in the groin area is concerned that he has contracted a sexually transmitted disease and does not want his parents to find out. The nurse's best response is: 1. "We will need to contact your parents to let them know." 2. "We will not contact your parents regarding this visit." 3. "Who would you like us to contact about your visit here today?" 4. "We cannot promise that the hospital will not contact your parents."

2. "We will not contact your parents regarding this visit."

A 16-year-old male is hospitalized for cystic fibrosis. He will be an inpatient for 2 weeks while he receives IV antibiotics. Which action taken by the nurse will most enhance his psychosocial development? 1. Fax the teen's teacher, and have her send in his homework. 2. Encourage the teen's friends to visit him in the hospital. 3. Encourage the teen's grandparents to visit frequently. 4. Tell the teen he is free to use his phone to call or text friends.

2. Encourage the teen's friends to visit him in the hospital.

The nurse is caring for a 4-month-old who has just had a R-side cleft lip repaired. Select the best position for the child in the immediate post-operative period. 1. Right side-lying. 2. Left side-lying. 3. Supine. 4. Prone.

2. Left side-lying.

Which foods would the nurse recommend to the mother of a 2-year-old with anemia? 1. 32 oz of whole cow's milk per day. 2. Meats, eggs, and green vegetables. 3. Fruits, whole grains, and rice. 4. 8 oz of juice, three times per day.

2. Meats, eggs, and green vegetables.

A nurse instructs the parent of a child with sickle cell anemia about factors that might precipitate a pain crisis in the child. Which of the following factors identified by the parent as being able to cause a pain crisis indicates a need for further instruction? 1. Infection. 2. Overhydration. 3. Stress at school. 4. Cold environment.

2. Overhydration. Fluids should be promoted for Sickle Cell Anemia (cells sickle because the body does not have enough fluids) Fluids will be our priority intervention during a crisis (this should correct the sickling) Oxygen can be administered AFTER fluids are promoted.

A mother requests that her child receive the varicella vaccine at the 9-month well-child checkup. The nurse tells the mother that: 1. Children who are vaccinated will likely develop a mild case of the disease. 2. The vaccine cannot be given at that visit. 3. The vaccine will be administered after the physician examines the child. 4. A booster vaccination will be needed at 18 months of age.

2. The vaccine cannot be given at that visit. This vax is not given prior to 1yr

The nurse anticipates that the child who has had a kidney removed will have a high level of pain and will require invasive and noninvasive measures for pain relief. The nurse anticipates that the child will have pain because of which of the following? 1. The kidney is removed laparoscopically, and there will be residual pain from accumulated air in the abdomen. 2. There is a post-operative shift of fluids and organs in the abdominal cavity, leading to increased discomfort. 3. The chemotherapy makes the child more sensitive to pain. 4. The radiation therapy makes the child more sensitive to pain.

2. There is a post-operative shift of fluids and organs in the abdominal cavity, leading to increased discomfort.

A child who has undergone spinal fusion for scoliosis complains of abdominal discomfort and has periods of vomiting. On further assessment, the nurse notes abdominal distention. The priority action by the nurse at this time would be to: A. administer an antiemetic B. Increase the intravenous fluids. C. Notify the health care provider (HCP). D. Place the child in Sim's position

C. Notify the health care provider (HCP).

A 6-month-old male is at his well-child checkup. The nurse weighs him, and his mother asks if his weight is normal for his age. The nurse's best response is: 1. "At 6 months his weight should be approximately three times his birth weight." 2. "Each child gains weight at his or her own pace." 3. "At 6 months his weight should be approximately twice his birth weight." 4. "At 6 months a child should weigh about 10 lb more than his or her birth weight."

3. "At 6 months his weight should be approximately twice his birth weight."

The nurse is caring for a newborn with an anorectal malformation and a colostomy. The nurse knows that more education is needed when the infant's parent states which of the following? 1. "I will make sure the stoma is red." 2. "There should not be any discharge or irritation around the outside of the stoma." 3. "I will keep a bag attached to avoid the contents of the small intestine coming in contact with the baby's skin." 4. "As my baby grows, a pattern will develop over time, and there should be predictable bowel movements."

3. "I will keep a bag attached to avoid the contents of the small intestine coming in contact with the baby's skin." Colostomy = Large intestine Ileostomy = Small intestine

The nurse is using the FLACC scale to rate the pain level in a 9-month-old. Which is the nurse's best response to the father's question of what the FLACC scale is? 1. "It estimates a child's level of pain utilizing vital sign information." 2. "It estimates a child's level of pain based on parents' perception." 3. "It estimates a child's level of pain utilizing behavioral and physical responses." 4. "It estimates a child's level of pain utilizing a numeric scale from 0 to 5."

3. "It estimates a child's level of pain utilizing behavioral and physical responses."

The nurse is caring for a 5-month-old infant with a diagnosis of intussusception. The infant has periods of irritability during which the knees are brought to chest and the infant cries, alternating with periods of lethargy. Vital signs are stable and within age-appropriate limits. The physician elects to give an enema. The parents ask the purpose of the enema. Select the nurse's most appropriate response. 1. "The enema will confirm the diagnosis. If the test result is positive, your child will need to have surgery to correct the intussusception." 2. "The enema will confirm the diagnosis. Although very unlikely, the enema may also help fix the intussusception so that your child will not immediately need surgery." 3. "The enema will help confirm the diagnosis and has a good chance of fixing the intussusception." 4. "The enema will help confirm the diagnosis and may temporarily fix the intussusception. If the bowel returns to normal, there is a strong likelihood that the intussusception will recur."

3. "The enema will help confirm the diagnosis and has a good chance of fixing the intussusception."

An infant is scheduled for a hypospadias and chordee repair. The parent tells the nurse, "I understand why the hypospadias repair is necessary, but do they have to fix the chordee as well?" Which is the nurse's best response? 1. "I understand your concern. Parents do not want their children to undergo extra surgery." 2. "The chordee repair is done strictly for cosmetic reasons that may affect your son as he ages." 3. "The repair is done to optimize sexual functioning when he is older." 4. "This is the best time to repair the chordee because he will be having surgery anyway."

3. "The repair is done to optimize sexual functioning when he is older."

A child diagnosed with a Wilms tumor is scheduled for an MRI scan of the lungs. The parent asks the nurse the reason for this test as a Wilms tumor involves the kidney, not the lung. Which is the nurse's best response? 1. "I'm not sure why your child is going for this test. I will check and get back to you." 2. "It sounds like we made a mistake. I will check and get back to you." 3. "The test is done to check to see if the disease has spread to the lungs." 4. "We want to check the lungs to make sure your child is healthy enough to tolerate surgery."

3. "The test is done to check to see if the disease has spread to the lungs."

A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 44, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse's best response is: 1. "Your son's blood pressure is elevated, but the other vital signs are within the normal range.." 2. "Your son's temperature is elevated, but the other vital signs are within the normal range.." 3. "Your son's respiratory rate is elevated, but the other vital signs are within the normal range." 4. "Your son's heart rate is elevated, but the other vital signs are within the normal range."

3. "Your son's respiratory rate is elevated, but the other vital signs are within the normal range." RR should be 20-30 per minute (ages 3-6)

The nurse is caring for a 4-month-old with gastroesophageal reflux (GER). The infant is due to receive Zantac (rantadine). Based on the medication's mechanism of action, when should this medication be administered? 1. Immediately before a feeding. 2. 30 minutes after the feeding. 3. 30 minutes before the feeding. 4. At bedtime.

3. 30 minutes before the feeding.

The nurse is caring for a 2-year-old child who was admitted to the pediatric unit for moderate dehydration due to vomiting and diarrhea. The child is restless, with periods of irritability. The child is afebrile with a heart rate of 148 and a blood pressure of 90/42. Baseline laboratory tests reveal the following: Na 152, Cl 119, and glucose 115. The parents state that the child has not urinated in 12 hours. After establishing a saline lock, the nurse reviews the physician's orders. Which order should the nurse question? 1. Administer a saline bolus of 10 mL/kg, which may be repeated if the child does not urinate. 2. Recheck serum electrolytes in 12 hours. 3. After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L. 4. Give clear liquid diet as tolerated.

3. After the saline bolus, begin maintenance fluids of D5 1/4 NS with 10 mEq KCl/L. Potassium is contraindicated until kidney function has been verified.

A 5-year-old is admitted to the hospital with complaints of leg pain and fever. On physical examination, the child is pale and has bruising over various areas of the body. The physician suspects that the child has ALL. The nurse informs the parent that the diagnosis will be confirmed by which of the following? 1. Lumbar puncture. 2. White blood cell count. 3. Bone marrow aspirate. 4. Bone scan.

3. Bone marrow aspirate.

The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? 1. Administer Imodium as needed. 2. Administer Kaopectate as needed. 3. Continue breastfeeding per routine. 4. The infant may return to day care 24 hours after antibiotics have been started.

3. Continue breastfeeding per routine.

The best method to explain a procedure to a hospitalized preschool-age child is to: 1. Show the child a pamphlet with pictures showing the procedure. 2. Have the 5-year-old next door tell the 4-year-old about the experience. 3. Demonstrate the procedure on a doll. 4. Show the child a video of the procedure

3. Demonstrate the procedure on a doll.

A child is diagnosed with chronic constipation that has been unresponsive to dietary and activity changes. Which pharmacological measure is most appropriate? 1. Natural supplements and herbs. 2. Stimulant laxative. 3. Osmotic agent. 4. Pharmacological measures are not used in pediatric constipation.

3. Osmotic agent. Osmotic agents are stool softeners, this is the drug of choice

The mother of a child 2 years 6 months has arranged a play date with the neighbor and her child 2 years 9 months. During the play date the two mothers should expect that the children will do which of the following? 1. Share and trade their toys while playing. 2. Play with one another with little or no conflict. 3. Play alongside one another but not actively with one another. 4. Only play with one or two items, ignoring most of the other toys.

3. Play alongside one another but not actively with one another. Toddlers engage in parallel play

Symptoms that define anaphylaxis include (select all that apply): A. Lip and tongue edema B. Urticarial and pruritis C. Shortness of breath D. Nonadventitious breath sounds E. Hypertension F. Stridor G. Wheezing

A, B, C, F & G

The nurse is caring for a 14-year-old with celiac disease. The nurse knows that the patient understands the diet instructions by ordering which of the following meals? 1. Eggs, bacon, rye toast, and lactose-free milk. 2. Pancakes, orange juice, and sausage links. 3. Oat cereal, breakfast pastry, and nonfat skim milk. 4. Cheese, banana slices, rice cakes, and whole milk.

4. Cheese, banana slices, rice cakes, and whole milk.

A 10-year-old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the right lower quadrant. An abdominal ultrasound is scheduled, and a blood count has been obtained. The child vomits, finds the pain relieved, and calls the nurse. Which should be the nurse's next action? 1. Cancel the ultrasound, and obtain an order for oral Zofran (ondansetron). 2. Cancel the ultrasound, and prepare to administer an intravenous bolus. 3. Prepare for the probable discharge of the patient. 4. Immediately notify the physician of the child's status.

4. Immediately notify the physician of the child's status.

In addition to increased blood pressure, which findings would most likely be found in a child with hydronephrosis? 1. Metabolic alkalosis, polydipsia, and polyuria. 2. Metabolic acidosis, and bacterial growth in the urine. 3. Metabolic alkalosis, and bacterial growth in the urine. 4. Metabolic acidosis, polydipsia, and polyuria.

4. Metabolic acidosis, polydipsia, and polyuria. Acidosis cause the body cannot concentrate urine HTN because the body is trying to compensate for decreased GFR

Which factors are associated with slipped capital femoral epiphysis (SCFE)? Select all that apply. A. Obesity B. Female gender C. African descent D. Age of 5-10 years E. Pubertal hormonal changes F. Endocrine disorders

A, E, & F

Clinical manifestations of sepsis in infants with septicemia include (select all that apply): A. Temperature instability B. Hypotonia C. Lethargy D. Weight loss E. Decreased urine output

A, B, & C

A child with hemophilia A fell and injured a knee while playing outside. The knee is swollen and painful. Which of the following measures should be taken to stop the bleeding? Select all that apply. A. The extremity should be immobilized. B. The extremity should be elevated. C. Warm, moist compresses should be applied to decrease pain. D. Passive range of motion should be administered to the extremity. E. Factor VIII should be administered.

A, B, & E Hemophilia A --> A & 8 RICE: rest, ice, compress, elevate

Which has the potential to alter a child's level of consciousness? Select all that apply. A. Metabolic disorders B. Trauma C. Hypoxic episode D. Dehydration E. Endocrine disorder

A, B, C, D & E

The nurse is conducting staff in-service training on von Willebrand's disease. Which should the nurse include as characteristics of von Willebrand's disease? Select all that apply. A. Easy bruising occurs B. Gum bleeding occurs C. It is a hereditary bleeding disorder. D. Treatment and care are similar to that for hemophilia. E. It is characterized by high white blood cell levels. F. The disorder causes platelets to adhere to damaged endothelium. G. Excessive menstruation in post-pubertal female

A, B, C, D, F, & G Tip: V- very easy bruising & bleeding (nose, gums, periods, minor procedures) platelet adhesion = low platelets treatment = V for ddaVp

Sepsis results from the effects of circulating bacterial toxins & is mediated by: A. IgM B. Cytokines C. Hemoglobin D. Proteins

B. Cytokines

The nurse is planning care for a child recently admitted for Guillain-Barré Syndrome has paralysis affecting the respiratory muscles and requires mechanical ventilation. When the parents ask about the paralysis, what is the best response by the nurse? A. "It must be difficult to accept the permanency of your child's paralysis." B. "Your child will first regain the use of their legs and then their arms." C. "In addition to the paralysis, your child will experience sensory loss." D. "The paralysis caused by this disease is temporary but the recovery can take up to 2 years."

D. "The paralysis caused by this disease is temporary but the recovery can take up to 2 years."

A child is receiving morphine sulfate to control her postoperative pain after scoliosis repair. Which of the following findings is a side effect of morphine? A. Bradycardia B. Respiratory distress C. Severe hypotension D. Pruritis

D. Pruritis

A child is diagnosed with Reye's Syndrome. The nurse develops a nursing care plan for the child and should include which priority intervention in the plan? A. Assessing hearing loss B. Providing a quiet atmosphere with dimmed lighting C. Changing body position every 6 hours D. Obtain daily weight

B. Providing a quiet atmosphere with dimmed lighting

The nurse expects which of the following clinical manifestations in a child diagnosed with SCID? A. Prolonged bleeding B. Failure to thrive C. Fatigue and malaise D. Susceptibility to infection

D. Susceptibility to infection

A 4-month-old is brought to the emergency department with severe dehydration. The heart rate is 198, and her blood pressure is 68/38. The infant's anterior fontanel is sunken. The nurse notes that the infant does not cry when the intravenous line is inserted. The child's parents state that she has not "held anything down" in 18 hours. The nurse obtains a finger-stick blood sugar of 94. Which would the nurse expect to do immediately? 1. Administer a bolus of normal saline. 2. Administer a bolus of D10W. 3. Administer a bolus of normal saline with 5% dextrose added to the solution. 4. Offer the child an oral rehydrating solution such as Pedialyte.

1. Administer a bolus of normal saline. Dehydration is corrected with isotonic solutions.

A nurse is caring for a child with von Willebrand disease. The nurse is aware that which of the following is a (are) clinical manifestation(s) of von Willebrand disease? Select all that apply. 1. Bleeding of the mucous membranes. 2. The child bruises easily. 3. Excessive menstruation. 4. The child has frequent nosebleeds. 5. Elevated creatinine levels. 6. The child has a factor IX deficiency.

1. Bleeding of the mucous membranes. 2. The child bruises easily. 3. Excessive menstruation. 4. The child has frequent nosebleeds. The disorder causes adherence of platelets to damaged endothelium and a mild deficiency of factor VIII.

A child receiving peritoneal dialysis has not been having adequate volume in the return. The child is currently edematous and hypertensive. Which would the nurse anticipate the physician to do? 1. Increase the glucose concentration of the dialysate. 2. Decrease the glucose concentration of the dialysate. 3. Administer antihypertensives and diuretics but not change the dialysate concentration. 4. Decrease the dwell time of the dialysate.

1. Increase the glucose concentration of the dialysate. Increasing concentrate of glucose will pull more fluid into the return

A child had a tonsillectomy 6 days ago and was seen in the emergency room 4 hours ago due to post-operative hemorrhage. The parent noted that her child was "swallowing a lot and finally began vomiting large amounts of blood." The child's vital signs are as follows: T 99.5°F (37.5°C), HR 124, BP 84/48, and RR 26. The nurse knows that this child is at risk for which type of renal failure? 1. CRF due to advanced disease process. 2. Prerenal failure due to dehydration. 3. Primary kidney damage due to a lack of urine flowing through the system. 4. Postrenal failure due to a hypotensive state.

2. Prerenal failure due to dehydration. Prerenal failure = dehydration or hemorrhage

An 18-month-old male is brought to the clinic by his mother. His height is in the 50th percentile, and weight is in the 80th percentile. The child is pale. The physical examination is normal, but his hematocrit level is 20%. Which of the following questions should assist the nurse in making a diagnosis? Select all that apply. 1. "How many bowel movements a day does your child have?" 2. "How much did your baby weigh at birth?" 3. "What does your child eat every day?" 4. "Has the child been given any new medications?" 5. "How much milk does your child drink per day?"

3. "What does your child eat every day?" 5. "How much milk does your child drink per day?"

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony prominences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? 1. An increase in the amount and frequency of Lasix. 2. Addition of a second diuretic, such as mannitol. 3. Administration of intravenous albumin. 4. Elimination of all fluids and sodium from the child's diet.

3. Administration of intravenous albumin. Low albumin INCREASES water retention, adding albumin will help push water back into the bloodstream

A child diagnosed with acute renal failure (ARF) complains of "not feeling well," having "butterflies in the chest," and arms and legs "feeling like Jell-O." The cardiac monitor shows that the QRS complex is wider than before and that an occasional premature ventricular contraction (PVC) is seen. Which would the nurse expect to administer? 1. An isotonic saline solution with 20 mEq KCl/L. 2. Sodium bicarbonate via slow intravenous push. 3. Calcium gluconate via slow intravenous push. 4. Oral potassium supplements.

3. Calcium gluconate via slow intravenous push. Patient displays signs of Hyerkalemia

The nurse should tell the parents of a child with Duchenne muscular dystrophy that some of the progressive complications include: A. dry skin, hirsutism, protruding tongue, and mental retardation. B. anorexia, gingival hyperplasia, and dry skin and hair. C. contractures, obesity, and pulmonary infections. D. trembling, frequent loss of consciousness, and slurred speech.

C. contractures, obesity, and pulmonary infections.

A nurse is caring for a 5-year-old with sickle cell vaso-occlusive crisis. Which of the following orders should the nurse question? Select all that apply. 1. Position the child for comfort. 2. Apply hot packs to painful areas. 3. Give Demerol 25 mg intravenously every 4 hours as needed for pain. 4. Restrict oral fluids. 5. Apply oxygen per nasal cannula to keep oxygen saturations above 94%.

3. Give Demerol 25 mg intravenously every 4 hours as needed for pain. 4. Restrict oral fluids.

The nurse evaluates the parents' understanding of the teaching about an inguinal hernia as successful when they say which of the following? 1. "There are no risks associated with waiting to have the hernia reduced; surgery is done for cosmetic reasons." 2. "It is normal to see the bulge in the baby's groin decrease with a bowel movement." 3. "We will wait for surgery until the baby is older because narcotics for pain control will be required for several days." 4. "It is normal for the bulge in the baby's groin to look smaller when the baby is asleep."

4. "It is normal for the bulge in the baby's groin to look smaller when the baby is asleep."

When planning a rehabilitative approach for a child with osteogenesis imperfecta (OI), the nurse should work to prevent which of the following? Select all that apply. A. Positional contractures and deformities B. Bone infection C. Muscle weakness D. Osteoporosis E. Misalignment of lower extremity joints

A, C, D, & E

A child with cerebral palsy (CP) has been fitted for braces and is beginning physical therapy to assist with ambulation. The parents ask why he needs the braces when he was crawling without any assistive devices. Which is the best response by the nurse? A. "As your child grows, different muscle groups may need more assistance." B. "The CP has progressed and he now needs more assistance to ambulate." C. "Most children with CP need braces to help with ambulation." D. "We have found that when children with CP use braces, they are less likely to fall.

A. "As your child grows, different muscle groups may need more assistance."

Which should be included in the plan of care for a child who has a neuroblastoma with metastasis to the bone marrow and pancytopenia? A. Administer red blood cells. B. Limit school attendance to less than 4 hours daily. C. Administer Coumadin. D. Encourage a diet high in fresh fruits and vegetables.

A. Administer red blood cells.

The nurse is caring for a child who is experiencing hives and respiratory difficulty following exposure to latex. Which drug should the nurse initially plan to administer to this child if indicated? A. Give epinephrine through an EpiPen B. Administer prednisone immediately C. Place the child on oxygen D. Give diphenhydramine (Benadryl)

A. Give epinephrine through an EpiPen

Sepsis has a systemic effect on the body and is most likely to impair which organs? A. Lungs, liver, and kidneys B. Bowels, kidneys, and lungs C. Gallbladder and appendix D. Heart and spleen

A. Lungs, liver, and kidneys

The nurse is planning care for a child with acute bacterial meningitis. Based on the mode of transmission of this infection, which precautionary intervention should take priority? A. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics. B. Maintain enteric precautions. C. No precautions are needed as long as antibiotics have been started. D. Maintain neutropenic precautions.

A. Maintain respiratory isolation precautions for at least 24 hours after the initiation of antibiotics.

Which will help the school-aged child with muscular dystrophy stay active longer? A. Normal activities, such as swimming B. Using a treadmill every day C. Several periods of rest every day D. Using a wheelchair upon getting tired

A. Normal activities, such as swimming

A child recently diagnosed with epilepsy is being evaluated for anticonvulsant medication therapy. The child will likely be placed on which type of regimen? A. One oral anticonvulsant medication to observe for effectiveness and minimize side effects. B. Two or three oral anticonvulsant medications so dosing can be low and side effects minimized. C. One rectal anticonvulsant medication to be administered in the event of a seizure. D. A combination of oral and intravenous anticonvulsant medications to ensure compliance.

A. One oral anticonvulsant medication to observe for effectiveness and minimize side effects.

The nurse notes documentation that a child with meningitis is exhibiting a positive Kernig's sign. Which observation is characteristic of this sign? A. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip. B. The child complains of muscle and joint pain. C. Petechial and purpuric rashes are noted on the child's trunk. D. Neck flexion causes adduction and flexion movements of the lower extremities.

A. The child is not able to extend the leg when the thigh is flexed anteriorly at the hip.

The nurse is assisting the health care provider (HCP) examining an infant with developmental dysplasia of the hip perform an Ortolani maneuver. The nurse knows that this maneuver is performed for which purpose? A. To assess for hip instability B. To assess for movement of the hips C. To push the femoral head into the acetabulum D. To ensure full range of motion exists

A. To assess for hip instability

Which is the nurse's best explanation to the parent of a toddler who asks what a greenstick fracture is? A. "It is a fracture in the growth plate of the bone." B. "It is a fracture that does not go all the way through the bone." C. "Because children's bones are not fully developed, any fracture in a young child is called a greenstick fracture." D. "It is a fracture in which a complete break occurs in the bone and small pieces of bone are broken off."

B. "It is a fracture that does not go all the way through the bone."

A child with a ventriculoperitoneal (VP) shunt complains of headache and blurry vision and is now experiencing irritability and sleeping more than usual. The parents ask the nurse what they should do. Select the nurse's best response. A. "Give her some acetaminophen and see if her symptoms improve. If they do not improve, bring her to the pediatrician's office." B. "You should immediately take her to the emergency room as these may be symptoms of a shunt malfunction." C. "It is common for girls to have these symptoms, especially prior to beginning their menstrual period. Give her a few days and see if she improves." D. "You are likely worried that she is having problems with her shunt. This is very unlikely as it has been working well for 9 years."

B. "You should immediately take her to the emergency room as these may be symptoms of a shunt malfunction."

Which child is at increased risk for CP? A. Infant born at 34 weeks with an Apgar score of 6 at 5 minutes B. 17-day-old infant with group B streptococcus meningitis. C. 24-month-old child who has experienced a febrile seizure. D. 5-year-old with a closed head injury after falling off a bike.

B. 17-day-old infant with group B streptococcus meningitis.

Which test provides a definitive diagnosis of aplastic anemia? A. Complete blood count with differential B. Bone marrow aspiration C. Serum IgG levels D. Basic metabolic panel

B. Bone marrow aspiration CBC is done first BUT bone marrow studies is confirmatory test Aplastic = ALL elements are depressed Hypoplastic = hypo, LOW RBC only

A child with Thalassemia is receiving long-term blood transfusion therapy for treatment of the disorder. Which medication should the nurse expect to administer for chelation therapy? A. Fragamin B. Deferoxamine (Desferal) C. Metroprolol (Toprol - XL) D. Meropenem (Merrem)

B. Deferoxamine (Desferal)

Which of the following should the nurse expect to administer to a child with ITP and a platelet count of 5000/mm3? A. Platelets B. Intravenous immunoglobulin C. Packed red blood cells D. White blood cells

B. Intravenous immunoglobulin Tx: (I T P) IvIg, anTibodies, Prednisone

A child in PICU with a head injury is comatose and unresponsive. The parent asks if the child needs pain medication. Which is the best response by the nurse? A. "Pain medication is not necessary as he is unresponsive and cannot feel pain." B. "Pain medication may interfere with his ability to respond and may mask any signs of improvement." C. "Pain medication is necessary to make him comfortable." D. "Pain medication is necessary for comfort, but we use it cautiously as it increases the demand for oxygen."

C. "Pain medication is necessary to make him comfortable."

A 6-month-old infant was just diagnosed with craniosynostosis. The infant's father asks the nurse for more information about reconstructive surgery. Which is the best response by the nurse? A. "The surgery is done for cosmetic reasons and is without many complications." B. "The surgery is mainly done for cosmetic reasons, and most surgeon wait until the child is 3 years old as the head has finished growing at that time." C. "The surgery is important to allow the brain to grow properly. Although most children do well, serious complications can occur, so your child will be closely monitored in an intensive care unit." D. "The surgery is important to allow the brain to grow properly. Most surgeons wait until the child is 3 years old to minimize potential complications."

C. "The surgery is important to allow the brain to grow properly. Although most children do well, serious complications can occur, so your child will be closely monitored in an intensive care unit."

The nurse is instructing the parent of a child with HIV about immunizations. Which of the following should the nurse tell the parent? A. Hepatitis B vaccine will not be given to this child. B. Members of the family should be cautioned not to receive the varicella vaccine. C. Inactivated pneumococcal and influenza vaccines are recommended. D. The child will need to have a Western blot done prior to all immunizations

C. Inactivated pneumococcal and influenza vaccines are recommended.

A nurse is caring for a 5-year-old with a fracture of the tibia involving the growth plate. When providing information to the parents, the nurse should indicate that: A. The child will never be able to play contact sports. B. The fracture usually heals within 6 weeks without further complications. C. This is a serious injury that could cause long-term growth issues. D. Fractures involving the growth plate require pain medication

C. This is a serious injury that could cause long-term growth issues.

The nurse is caring for a child with sickle cell disease who is scheduled to have a splenectomy. What information should the nurse explain to the parents regarding the reason for the splenectomy? A. To decrease potential for infection. B. To prevent sickling of the red blood cells C. To prevent splenic sequestration D. To prevent sickle cell crisis

C. To prevent splenic sequestration

The nurse teaching the parents of a child newly diagnosed with juvenile idiopathic arthritis (JIA). The nurse would evaluate the teaching as successful when the parent is states that, "The disorder is caused by...: A. ...the breakdown of osteoclasts in the joint space causing bone loss." B. ...loss of cartilage in the joints." C. ...a build-up of calcium crystals in joint spaces." D. ...an immune-stimulated inflammatory response.

D. ...an immune-stimulated inflammatory response.

The nurse is caring for a school-aged child with Duchenne muscular dystrophy. Which would be the most appropriate nursing diagnosis? A. Anticipatory grieving B. Anxiety reduction C. Increased pain D. Activity intolerance

D. Activity intolerance

Which medication should the nurse anticipate administering first to a child is status epilepticus? A. Establish an intravenous line and administer IV lorazepam. B. Administer an oral glucose gel to the side of the child's mouth. C. Administer oral diazepam. D. Administer IM Ativan.

D. Administer IM Ativan. It would take too long to establish an IV line.

Laboratory tests are done for a child suspected to have iron deficiency anemia. The nurse reviews the laboratory results, knowing that which result indicates this type of anemia? A. Elevated hemoglobin level B. Decreased reticulocyte count C. Elevated red blood cell count D. Microcytic and hypochromic red blood cells

D. Microcytic and hypochromic red blood cells ^this describes microcytic anemia (iron deficiency causes microcytic anemia) Body lacks enough iron to supply oxygen to hemoglobin for RBC production

A child with a right femur fracture is placed in skin traction until surgery can be performed. During assessment of the child, the nurse notes that the dorsalis pedis is absent on the right foot. Which action should the nurse take? A. Administer an analgesic B. Release the skin traction C. Apply ice to the extremity D. Notify the health care provider (HCP)

D. Notify the health care provider (HCP)

Which of the following laboratory tests will be ordered to determine the presence of the human immunodeficiency virus antigen in an infant whose parent is HIV+ ? A. CD4 cell count B. Western blot C. IgG levels D. P24 antigen assay

D. P24 antigen assay

The nurse analyzes the laboratory results of a child with hemophilia. The nurse recognizes that which result would most likely be abnormal in this child? A. Platelet count B. Hematocrit level C. Hemoglobin level D. Partial thromboplastin time

D. Partial thromboplastin time This is a clotting factor issue NOT platelets. PTT would be prolonged (longer to clot)