Exam 3 - Pediatrics

What happens to CD4 cells in a patient with HIV?

HIV destroys ability to have any CD4 cells to protect you from infections

As a pediatric nurse caring for a child with cancer, you notice the patient has a temperature of 101.7 degrees F what action is critical to save the life of this child? A) antibiotics started within 1 hr B) blood transfusions should be started within 1 hr C) bone marrow transplantation should be started within 24 hours D) stem cell transplantation should be started within 24 hrs

A

The nurse is caring for a child who has a depressed immune system due to chemo treatments. The child is due for scheduled immunizations according to CDC recommendations. The nurse must ensure that the child does not receive which type of immunization? A) live vaccine B) killed vaccine C) inactivated vaccine D) any vaccine

A

The nurse is caring for a child who is scheduled for a bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis? A) The bone scan would show bone age to be two or more deviations below normal. B) The bone scan would show a brain tumor. C) The bone scan would show bone age to be three or more deviations above normal. D) The bone scan would show a tumor on the child's kidney.

A

The school nurse notes that a child diagnosed with diabetes mellitus is experiencing an insulin reaction and is unable to eat or drink. Which action would be the most appropriate for the school nurse to take? A) Request that someone call 911. B) Administer subcutaneous glucagon. C) Anticipate that the child will need intravenous glucose. D) Dissolve a piece of candy in the child's mouth.

B

The nurse is giving medication education to the parent of a child with newly diagnosed growth hormone deficiency. Which statement made by the parent indicates that further education is needed? A) "I will give the subcutaneous medication every morning." B) "I will need to give the medication every day." C) "Treatment will continue until my child's growth is complete." D) "I will ask my child's preference when choosing injection sites."

A

The nurse is preparing a teaching plan for the family and their 6-year-old child who has just been diagnosed with diabetes. What would the nurse identify as the initial goal for the teaching plan? A) developing management and decision-making skills B) evaluating the child's literacy level and readiness to learn C) developing a nutritionally sound, 30-day meal plan D) promoting independence with self-administration of insulin

A

The nurse is providing care to a 5-year-old child brought to the emergency department with a cat bite wound on the arm. While teaching the parents how to care for the wound, the child's mother asks the nurse, "Why isn't the bite being stitched closed?" Which response by the nurse would be appropriate? A) "Bites from cats are likely to become infected, so it is better to leave the wound open and heal from the inside out." B) "It is too early to close the wound with stitches now, but it can be done in a week or two." C) "Your child needs to be seen by a plastic surgeon first before the wound is closed."

A

The nurse is teaching glucose monitoring and insulin administration to a child with type 1 diabetes and the parents. Which comment by a parent demonstrates a need for additional teaching? A) "During exercise we should wait to check blood sugars until after our child completes the activity." B) "If our child is sick we should check blood glucose levels more often." C) "We should check our child's blood glucose levels before meals." D) "Blood glucose level, food intake, and activity need to all be considered when calculating insulin dosage."

A

The parents of a child ask the nurse "why are infants and young children so prone to getting infections?" What is the best response by the nurse? A) the immune system of infants and young children is weaker than that of adults. The system matures as the child ages B) it is really unclear why infants and children get infections more than adults C) infants and young children probably get infections mreo than adults because they aren't aware of how to prevent infeciton D) phagocytosis in teh infant and young child is overactive, allowing infections to occur

A

When assessing a child with Wilms tumor which part of the assessment should the nurse avoid? A) palpation B) inspection C) auscultation D) observation

A

Which of the following is not a manifestation of Wiskott-Aldrich Syndrome? A) jaundice B) eczema C) recurrent infections D) increased bleeding

A

Which of the following are considered an oncological emergency? SATA A) tumor lysis syndrome B) sepsis C) lung metastasis D) mediastinal mass

AB

The nurse is preparing to administer IVIG to a child with wiskott aldrich syndrome. What consideration should the nurse take into account while administering this therapy? SATA A) do not mix with other IV meds or fluids B) have epinephrine available C) prepare for possibility of administering antipyretics and antihistamines D) notify health care provider of muscle weakness E) avoid St. John's Wort

ABC

A nurse on an oncology unit is assessing a child who has a brain tumor. Which of the following findings should the nurse expect? SATA A) headaches B) increased appetite C) vomiting with position changes D) tachycardia

AC

Which adolescents may have delayed puberty? Select all that apply. A) 14-year-old female who has not developed breasts B) 13-year-old female who has no pubic hair C) 15-year-old male who has had no changes to the size of testicles D) 14-year-old male who has no pubic hair E) 13-year-old male who has no changes in the appearance of his scrotum

AC

A 10-year-old child has been diagnosed with precocious puberty. When talking with the child, what statements are appropriate? Select all that apply. A) "How are you doing in school?" B) "Do you like boys yet?" C) "Developing is normal but your development is happening early." D) "Would talking with someone about your feelings help?" E) "Tell me about your feelings about what is happening to your body."

ACDE

A child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? SATA A) administer epi as ordered b) increase fluid intake C) teach child how to use epipen D) administer oxygen E ) initiate IV access

ADE

The nurse is caring for a 5-year-old child recently diagnosed with type 1 diabetes. When discussing the care and management of the disorder with the child's parents, which statement(s) indicates understanding? Select all that apply. A) "Regular exercise will help in the regulation of my child's blood sugar levels." B) "If my child's blood glucose remains stable for a few months, my child can move from injections to pills." C) "When my child is ill and unable to eat, we will need to hold the insulin until the child is able to tolerate fluids." D) "The insulin dosages will be directly associated to my child's carbohydrate ingestion." E) "We need to rotate insulin injection sites to prevent complications."

ADE

A child allergic to insect stings presents to the school nurse stating "A bee stung me on the playground" which action is a priority? A) notify clients caregivers and PCP B) assess the client's airway and breathing rate C) administer epi subcutaneously to the client D) locate the stinger and remove it with tweezers

B

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dl. What would the nurse do next? A) Administer a sliding-scale dose of insulin. B) Give 10 to 15 grams of a simple carbohydrate. C) Offer a complex carbohydrate snack. D) Administer glucagon intramuscularly.

B

A four month old infant is diagnosed with hemophilia A after a prolonged nosebleed. Which clotting factor is this child missing? A) Factor X B) Factor VIII C) Factor vWF D) Factor IX

B

A nurse is admitting a child who has leukemia. Which of the following client should the nurse place in the same room with this child? A) child recovering from ruptured appendix B) child who has nephrotic syndrome C) child who has rheumatic fever D) child who has CF

B

The appearance of which hallmark clinical manifestation occurs in measles? A) conjunctivitis B) koplik spots C) fever D) cough

B

The nurse is administering packed RBCs to a child with sickle cell disease. The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame? A) six hours after transfusion is given B) within first 15-20 minutes of administration of the transfusion C) at the end of the administration of the transfusion D) never; children with SCD do not have reactions

B

The nurse provides med education for a patient T1D. If a child receives regular insulin at 7:30 am which time should the child have a snack? A) 8:30am B) 10:00 am C) 2:00 pm D) 4:30 pm

B

How long does fetal hemoglobin last after birth? A) 12 mo B) 12 days C) 4-6 mo D) 3 mo

C

The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse A) the child should not have info about his health provided his age B) children at his age should have full disclosure of their condition C) when providing health info to a child of this age it should be simplistic and at the child's level of understanding D) once a child is apprised of their health concerns they do not normally experience any after effects

C

The nurse is caring for an 11-year-old child who has type 2 diabetes mellitus. The child has been vomiting for 48 hours and the breath has a fruity odor. The nurse notes that respirations are deep and rapid with a temperature of 102°F (38.9°C). Which intervention would be most appropriate? A) Give the child 8 ounces of clear liquid. B) Test the child's urine to detect the presence of ketones. C) Prepare for IV insertion. D) Give the child 25 g of carbohydrates.

C

Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis A) jogging every other day B) using a treadmill C) swimming D) playing basketball

C

A nurse is reviewing the lab results of four children. Which of the following values should the nurse report to the provider? A) WBC 10,000 cells/mm3 B) Lead 2 mcg/dL C) RBC 4.9 million/mm3 D) Iron 38 mcg/dL

D

Alopecia would most affect the body image of a child from which developmental stage? A) toddler B) preschool C) school age D) adolescent

D

Aplastic anemia is associated with which missing components in the blood? A) RBC B) WBC C) platelets D) all of the above

D

The nurse is talking with a parent of an adolescent who is newly diagnosed with type 2 diabetes and asks, "How could this happen? No one in our family has diabetes." What response would be appropriate? A) "This is caused by the pancreas not making enough insulin." B) "This disorder usually occurs when inadequate calories are ingested on a regular basis." C) "Because this disorder is genetic, someone in the family will eventually develop the illness." D) "This is caused by insulin resistance from previous pancreatic injury or generalized infection."

D

What precautions would the nurse institute for a child with a critically low platelet count? A) neutropenic B) droplet C) isolation D) bleeding

D

Which of the following diseases can be prevented by immunization? A) measles B) mumps C) rubella D) all of the above

D

T/F Children can stop taking oral cephalexin as soon as the warmth and redness from their cellulitis disappears

False

T/F Food allergies can be diagnosed only by challenge testing

False

T/F childhood cancer is less responsive to treatment than adult cancer

False

T/F Desquamation occurs in sunburn but not in frostbite

True