exam 3 prepu questions

A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of what information into the discussion? a. The child's risk for cognitive problems is greatly increased. b. Structural damage occurs with febrile seizure. c. The child's risk for epilepsy is now increased. d. Febrile seizures are benign in nature.

d. Febrile seizures are benign in nature.

The nurse is caring for a child with a diagnosis of pyloric stenosis during the preoperative phase of the child's treatment. What is the highest priority at this time? a. Preparing family for home care b. Promoting comfort c. Maintaining skin integrity d. Improving hydration

d. Improving hydration

The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a. A partial or complete intestinal obstruction occurs. b. A thickened, elongated muscle causes an obstruction at the end of the stomach. c. There are recurrent paroxysmal bouts of abdominal pain. d. In this disorder the sphincter that leads into the stomach is relaxed.

d. In this disorder the sphincter that leads into the stomach is relaxed.

The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? a. Sudden, momentary loss of muscle tone, with a brief loss of consciousness b. Muscle tone maintained and child frozen in position c. Brief, sudden contracture of a muscle or muscle group d. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

d. Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention

A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority? a. Hyperextending the child's head while placing him on his side b. Using a tongue blade to pry open the child's jaw c. Loosening the child's clothing to ensure a patent airway d. Protecting the child from harm during the seizure

d. Protecting the child from harm during the seizure

During the trial period to determine the efficacy of an anticonvulsant drug, which caution should be explained to the parents? a. Plasma levels of the drug will be monitored on a daily basis b. Drug dosage will be adjusted depending on the frequency of seizure activity c. The drug must be discontinued immediately if even the slightest problem occurs d. The child shouldn't participate in activities that could be hazardous if a seizure occurs

d. The child shouldn't participate in activities that could be hazardous if a seizure occurs

A client has just been admitted to the unit with a history of recent streptococcal infection, hematuria, and proteinuria. Based on these findings, the nurse suspects which condition? a. acute kidney injury b. urinary tract infection c. prune belly syndrome d. acute glomerulonephritis

d. acute glomerulonephritis

When caring for an infant who is hospitalized with Haemophilus influenzae meningitis, an important nursing intervention for the child would be for the nurse to: a. restrain the child before and during a seizure. b. place the child in a side-lying position and keep the position using pillows. c. monitor intake and output and increase fluid intake every 4 hours. d. check the child's neurologic status every 2 hours.

d. check the child's neurologic status every 2 hours.

The caregiver of a child who has a history of seizures reports that her child was complaining of being dizzy, and the caregiver noted the child seemed drowsy and was clumsy. The nurse recognizes that the description of the child's behavior was most likely which stage of a tonic-clonic seizure? a. aura b. clonic c. postictal d. prodromal

d. prodromal

A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted **first to reduce this condition? a. Barium enema b. Surgery c. Upper endoscopy d. Endoscopic retrograde cholangiopancreatography

a. Barium enema

To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority? a. Cerebral edema b. Renal failure c. Left-sided heart failure d. Cardiogenic shock

a. Cerebral edema

A child presents with intermittent abdominal pain, severe anorexia, and diarrhea. The child's height and weight are significantly behind standards for age. There is skin breakdown in the anal region. The nurse explains that this presentation is consistent with which diagnosis? a. Crohn disease b. ulcerative colitis c. food poisoning d. Hirschsprung disease

a. Crohn disease

The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a. Effortless vomiting just after the child has eaten b. Forceful vomiting followed by the child being eager to eat again c. Severe constipation with occasional ribbon-like stools d. Bouts of diarrhea with failure to gain weight

a. Effortless vomiting just after the child has eaten

A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching? a. Immunosuppression is common after a kidney transplant. b. Induction therapy medication will prevent infection with the transplant. c. As long as the medications are used properly, the transplant will not be rejected. d. The child can stop medication after 3 months of therapy.

a. Immunosuppression is common after a kidney transplant.

A 6-month-old infant is admitted with suspected bacterial meningitis. She is crying, irritable, and lying in the opisthotonic position. Which intervention should the nurse take initially? a. Institute droplet precautions in addition to standard precautions. b. Encourage the mother to hold and comfort the infant. c. Educate the family about preventing bacterial meningitis. d. Palpate the child's fontanels (fontanelles).

a. Institute droplet precautions in addition to standard precautions.

A 9-month-old girl is brought to the emergency room with what appears to be bouts of intense abdominal pain 15 minutes apart in which she draws up her legs and cries, often accompanied by vomiting. In between the bouts, the child recovers and appears to be without symptoms. Blood is found in the stool. What condition should the nurse suspect in this case? a. Intussusception b. Volvulus with malrotation c. Necrotizing enterocolitis d. Short-bowel/short-gut syndrome

a. Intussusception

A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges? a. Positive Kernig sign b. Negative Brudzinski sign c. Positive Chadwick sign d. Negative Kernig sign

a. Positive Kernig sign

In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? a. Prepare the infant for surgery. b. Medicate the infant with analgesics. c. Change the infant's diet to one that is lactose-free. d. Assist in doing a barium enema procedure on the infant.

a. Prepare the infant for surgery.

The parent of 6-month-old girl is concerned about the child getting a urinary tract infection. What should the nurse mention to the parent regarding this concern? a. Report any abnormally colored urine to the child's primary care provider. b. Wipe from back to front when changing the girl's diaper. c. Discontinue prescribed antibiotics once symptoms of UTI have disappeared. d. Bathe the child with bubble bath once a week.

a. Report any abnormally colored urine to the child's primary care provider.

The nurse is caring for a 6-month-old infant who was admitted to the emergency department 24 hours ago with signs of severe diarrhea. The infant's rectal temperature is 104°F (40°C), with weak and rapid pulse and respirations. The skin is pale and cool. The child is on IV rehydration therapy, but the diarrhea is persisting. The infant has not voided since being admitted. Which is the priority nursing intervention? a. Take a stool culture b. Administer antibiotic therapy c. Administer IV potassium d. Feed the child a cracker

a. Take a stool culture

The nurse knows that which statement is a description of peritoneal dialysis when compared to hemodialysis: a. The child can live a more normal lifestyle. b. There are strict diet and fluid restrictions. c. Therapy is only 3 to 4 days per week. d. The child must go into a facility to get peritoneal dialysis.

a. The child can live a more normal lifestyle.

A child with severe diarrhea cannot drink and requires intravenous rehydration. After beginning the therapy, the nurse determines that potassium can be added to the intravenous fluid because which of the following has occurred? a. The child has voided. b. The child's stool is becoming soft. c. The child is now vomiting. d. The child has dry mucous membranes.

a. The child has voided.

What occurs in the gastrointestinal system of the child with Hirschsprung disease? a. There is a partial or complete mechanical obstruction in the intestine. b. There is a severe narrowing of the lumen of the pylorus. c. There is an invagination or telescoping of one portion of the bowel into a distal portion. d. There is a relaxed sphincter in the lower portion of the esophagus.

a. There is a partial or complete mechanical obstruction in the intestine.

The nurse caring for a 3-year-old child with a history of seizures observes the child having a seizure. What information should the nurse document concerning the event? Select all that apply. a. Time the seizure started b. Factors present before seizure started c. Persons in attendance during seizure d. Number of seizures child has had in the last 48 hours e. Eye position and movement f. Incontinence of urine or stool

a. Time the seizure started b. Factors present before seizure started e. Eye position and movement f. Incontinence of urine or stool

The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures? a. Understanding the side effects of medications b. Treating the child as though she did not have epilepsy c. Placing the child on her side on the floor d. Instructing her teacher how to respond to a seizure

a. Understanding the side effects of medications

A child who has been diagnosed with minimal change nephrotic syndrome (MCNS) is being discharged after a 3-week hospitalization. Her edema has been greatly reduced and her appetite is beginning to return. Her caregivers have promised to have a family party to celebrate her return. The child has requested the following foods for the party. Which of these foods would the nurse suggest is appropriate for this child's diet? a. banana splits b. popcorn c. potato chips d. orange soda

a. banana splits

Nurses will need to teach the parents of the infant being treated for Hirschsprung disease (aganglionic megacolon) to: a. care for a temporary colostomy. b. thicken formula feedings. c. avoid use of a pacifier. d. carefully monitor heart rate.

a. care for a temporary colostomy.

An 18-month-old infant is brought to the emergency department with flu-like symptoms. The infant is diagnosed with pneumonia secondary to aspiration of stomach contents. The nurse explains to the parents that pneumonia is a condition that often occurs secondary to: a. gastroesophageal reflux disease. b. cystic fibrosis. c. Hirschsprung disease. d. inflammatory bowel disease.

a. gastroesophageal reflux disease.

The nurse is caring for a 12-month-old infant diagnosed with Haemophilus influenzae meningitis. Which clinical manifestation would likely have been noted in this child? a. high-pitched cry and nuchal rigidity b. shaking the head and pulling the ear c. severe vomiting and confusion d. body stiffening and loss of consciousness

a. high-pitched cry and nuchal rigidity

A parent brings the 10-year-old child in to the clinic. The nurse notes: icteric sclera and skin, headache, anorexia, vomiting, and temperature 101.8°F (38.8°C). The parent states the child has had the symptoms since returning to the US from India a few days ago. The nurse will anticipate preparing the child for which test? a. liver function tests b. abdominal ultrasound c. fecal ova and parasite test d. magnetic resonance imaging (MRI)

a. liver function tests suggestive of HepA

A 7-year-old has experienced severe diarrhea resulting from an intestinal virus. The nurse is concerned that the child will develop an acid-base imbalance. Which analysis of the blood gases indicates that the illness has progressed to metabolic acidosis? a. pH of 7.25, HCO3 of 20 mEq/L (20 mmol/L) b. pH of 7.5, HCO3 of 29 mEq/L (29 mmol/L) c. pH of 7.35, HCO3 of 24 mEq/L (24 mmol/L) d. pH of 7.4, HCO3 of 26 mEq/L (26 mmol/L)

a. pH of 7.25, HCO3 of 20 mEq/L (20 mmol/L)

A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and offers him a bottle. While he drinks, the nurse notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child? a. pyloric stenosis b. peptic ulcer disease c. gastroesophageal reflux d. appendicitis

a. pyloric stenosis

Which congenital condition leads to the infant being hungry, irritable, losing weight, and rapidly becoming dehydrated with the potential of metabolic alkalosis? a. pyloric stenosis b. aganglionic megacolon c. intussusception d. colic

a. pyloric stenosis

A nurse is providing care to an 11-month-old infant diagnosed with intussusception. When assessing the appearance of the child's stool, the nurse expects to note which finding? a. red, currant jelly-like stool b. loose, dark green stool c. hard, formed large brown stool d. clay-colored, watery stools

a. red, currant jelly-like stool

A child is hospitalized with nephrotic syndrome. Which measurement is best for the nurse to determine the child's edema? a. weight, daily b. urine output, every shift c. amount of protein in the urine d. abdominal circumference

a. weight, daily

The nurse is doing teaching with the caregivers of toddler and preschool aged-children. One of the caregivers tells the group that her child had diarrhea and she was told that it was caused by giardiasis. Which statement made by the caregiver indicates the most likely situation in which the child contacted the disorder? a. "My son spent time with a neighbor who was diagnosed with pinworms." b. "He attends a day care center four days a week while I am at work." c. "I won't let his sister take bubble baths but I do let him take one a few times a week." d. "My mother is in a nursing home but I always make the kids wash their hands before we leave her."

b. "He attends a day care center four days a week while I am at work."

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition? a. "My child has recently reported urinary frequency." b. "My child just got over a head cold with laryngitis." c. "My child's urine is pale yellow in color." d. "My child's eyes appear sunken to me."

b. "My child just got over a head cold with laryngitis."

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? a. Klebsiella b. Escherichia coli c. Staphylococcus aureus d. Pseudomonas

b. Escherichia coli

The parents of a 6-week-old boy come to the clinic for evaluation because the infant has been vomiting. The parents report that the vomiting has been increasing in frequency and forcefulness over the last week. The mother says, "Sometimes, it seems like it just bursts out of his mouth." A diagnosis of hypertrophic pyloric stenosis is suspected. When performing the physical examination, what would the nurse most likely find? a. Sausage-shaped mass in the upper mid-abdomen b. Hard, moveable, olive-shaped mass in the right upper quadrant c. Tenderness over the McBurney point in the right lower quadrant d. Abdominal pain in the epigastric or umbilical region

b. Hard, moveable, olive-shaped mass in the right upper quadrant

The nurse is observing an infant who may have acute bacterial meningitis. Which finding might the nurse look for? a. Flat fontanel (fontanelle) b. Irritability, fever, and vomiting c. Jaundice, drowsiness, and refusal to eat d. Negative Kernig sign

b. Irritability, fever, and vomiting

Absence seizures are marked by what clinical manifestation? a. Brief, sudden onset of increased tone of the extensor muscle b. Loss of motor activity accompanied by a blank stare c. Sudden, brief jerks of a muscle group d. Loss of muscle tone and loss of consciousness

b. Loss of motor activity accompanied by a blank stare

The nurse is caring for a child admitted with pyloric stenosis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a. Explosive diarrhea b. Projectile vomiting c. Severe abdominal pain d. Frequent urination

b. Projectile vomiting

In caring for the child with meningitis, the nurse recognizes that which nursing diagnosis would be most important to include in this child's plan of care? a. Delayed growth and development related to physical restrictions b. Risk for injury related to seizure activity c. Risk for acute pain related to surgical procedure d. Ineffective airway clearance related to history of seizures

b. Risk for injury related to seizure activity

The nurse is caring for a child admitted with acute glomerulonephritis. Which clinical manifestation would likely have been noted in the child with this diagnosis? a. Loose, dark stools b. Tea-colored urine c. Strawberry-red tongue d. Jaundiced skin

b. Tea-colored urine

The nurse asks the caregivers of a child diagnosed with cerebral palsy whether the child "seems to be in a state of constant motion." The question is designed to identify what form of cerebral palsy? a. ataxic b. athetoid c. rigidity d. spastic

b. athetoid

Nursing students are reviewing information about the causes of diarrhea in children. They demonstrate understanding of the information when they identify which of the following as a cause of diarrhea from ingestion of unpasteurized milk? a. salmonella b. listeriosis c. shigellosis d. staphylococcal food poisoning

b. listeriosis

Pyloric stenosis has been diagnosed in a 3-week-old male infant who has frequent vomiting after feedings. An important preoperative nursing intervention is: a. reducing vomiting by feeding small amounts of clear liquids or breast milk frequently. b. maintaining NPO status while restoring hydration and electrolyte balance. c. assessing the abdomen hourly for distention and bowel sounds. d. providing adequate pain control.

b. maintaining NPO status while restoring hydration and electrolyte balance.

The nurse is caring for a client newly diagnosed with acute glomerulonephritis? When receiving the pediatric client's history, which is anticipated? a. a sports injury to the kidney two weeks ago b. onset of a streptococcus infection last week c. increased thirst, sweating, and shakiness since yesterday d. fatigue from viral infection onset 3 days ago

b. onset of a streptococcus infection last week

The nurse is preparing to admit a pediatric client living with cerebral palsy, spastic type. In preparation for arrival, which item will the nurse obtain? a. translating board due to slurred speech b. pillows for comfort due to scoliosis c. sign language book due to limited hearing d. mechanical lift due to symmetrical four-limb involvement

b. pillows for comfort due to scoliosis

The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? a. frequent temperature assessment b. use of anticonvulsant medications c. ketogenic diet d. vagus nerve stimulation

b. use of anticonvulsant medications

An otherwise healthy 18-month-old child with a history of febrile seizures is in the well-child clinic. Which statement by the father would indicate to the nurse that additional teaching should be done? a. "I have ibuprofen available in case it's needed." b. "My child will likely outgrow these seizures by age 5." c. "I always keep phenobarbital with me in case of a fever." d. "The most likely time for a seizure is when the fever is rising."

c. "I always keep phenobarbital with me in case of a fever."

The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education? a. "The next time he has a fever, I need to make sure I read the dosage on the acetaminophen bottle carefully." b. "I need to set an alarm to wake up and check his temperature during the night when he is sick." c. "I hate to think that I will need to be worried about my child having seizures for the rest of his life." d. "When he gets his next set of immunizations, I need to make sure I give him some ibuprofen so he doesn't spike a fever."

c. "I hate to think that I will need to be worried about my child having seizures for the rest of his life."

The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching? a. "I will give the medication to him when I first wake him up in the morning." b. "This medication may cause him to have trouble sleeping. He may need something else to help him sleep." c. "I need to watch for any new bruises or bleeding and let my health care provider know about it." d. "I'm glad to know he will only need this medication for a short time to stop his seizures."

c. "I need to watch for any new bruises or bleeding and let my health care provider know about it."

A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? a. Gastroenteritis b. Ulcerative colitis (UC) c. Hirschsprung disease d. Short bowel syndrome (SBS)

c. Hirschsprung disease

Which nursing assessment data should be given the highest priority for a child with clinical findings related to meningitis? a. Onset and character of fever b. Degree and extent of nuchal rigidity c. Signs of increased intracranial pressure (ICP) d. Occurrence of urine and fecal contamination

c. Signs of increased intracranial pressure (ICP)

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication? a. Weight loss b. Hypotension c. Signs of infection d. Hair loss

c. Signs of infection

The nurse is caring for an 8-year-old boy who has chronic epilepsy. What would be most important to address when teaching the child and parents about living with this condition? a. Multiple corrective surgeries to slowly remove diseased parts of his brain b. Physical, occupational, and speech therapy to maximize his potential c. Support for maintaining self-esteem because of his altered lifestyle d. Hyperventilation therapy to counteract the periods of decreased oxygenation

c. Support for maintaining self-esteem because of his altered lifestyle

The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: a. a urinary tract infection. b. lipoid nephrosis (idiopathic nephrotic syndrome). c. acute glomerulonephritis. d. rheumatic fever.

c. acute glomerulonephritis.

Haemophilus influenzae meningitis is usually spread by which method of transmission? a. intravenous b. fecal c. droplet d. contact

c. droplet

The premise behind using plasmapheresis in a client diagnosed with Guillain-Barré syndrome includes which of the following? a. prevention of joint contractures b. prevention of skin breakdown c. prevention of demyelination d. prevention of deep vein thrombosis

c. prevention of demyelination

A child is diagnosed with intussusception. The nurse would prepare the child and family for which of the following? a. upper endoscopy b. abdominal computed tomography c. surgery d. barium swallow

c. surgery

The toddler with sudden, severe abdominal pain and currant jelly stools will be treated with a hydrostatic enema. The nurse explains the therapy in this way. The enema will: a/. push out the stool that is blocking the intestine. b. soothe the irritated and inflamed intestine and treat the pain. c. unfold the intestine that is pushed in on itself to resolve the obstruction. d. seal the bleeding vessels and stop the mucus production in the stool.

c. unfold the intestine that is pushed in on itself to resolve the obstruction.

The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? a. Pulse rate 112 bpm b. Pulse oximetry 93% on room air c. Respirations 24 per minute d. Blood pressure 136/84

d. Blood pressure 136/84

Antibiotic therapy to treat meningitis should be instituted immediately after which event? a. Admission to the nursing unit b. Initiation of IV therapy c. Identification of the causative organism d. Collection of cerebrospinal fluid (CSF) and blood for culture

d. Collection of cerebrospinal fluid (CSF) and blood for culture