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polydipsia, polyuria, polyphagia

3 main signs of type 1 DM

Rapid pulse, dyspnea, irritability, weight loss, sweating

5 signs of hyperthyroidism

ANS: B The presence of two major Jones criteria would indicate a high probability of rheumatic fever.

A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever? a. Subcutaneous nodules and fever b. Painful, tender joints, and carditis c. Erythema marginatum and arthralgia d. Chorea and elevated sedimentation rate

A child is being treated for frostbite of the right hand. How will the nurse know that this condition is improving? Hand appears pale and is pain free. Hand is deep purple associated with severe pain. Radial pulse is palpable. Hand blanches with pressure applied.

ANS: B, C, D, E ADHD is characterized by inattention, hyperactivity, impulsivity, and distractibility.

A child is diagnosed with attention-deficit hyperactivity disorder (ADHD). Which characteristics would the nurse assess in this child? (Select all that apply.) a. Social anxiety b. Impulsivity c. Hyperactivity d. Distractibility e. Inattention

ANS: B Untreated iron deficiency anemias progress slowly, and in severe cases the heart muscle becomes too weak to function. If this happens, heart failure follows.

A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated? a. Hemorrhage b. Heart failure c. Infection d. Pulmonary embolism

ANS: B In nonparalytic strabismus, the refractory error is usually corrected with eyeglasses.

A child is diagnosed with nonparalytic strabismus. How will this disorder most likely be corrected? a. Patching the unaffected eye b. Corrective lenses c. Laser treatment d. Surgery

ANS: D In fifth disease, the child has a generalized rash and the cheeks have a slapped-cheek appearance.

A child was sent to the school nurse because of a rash. The nurse noted the rash was present on the trunk, extremities, and face. The child's cheeks were bright red. With what is the nurse aware this type of rash is consistent? a. Measles b. Roseola c. Varicella d. Fifth disease

ventricular septal defect (VSD)

A hole in the septum between the right and left ventricle that results in increased pulmonary blood flow

Neuroblastoma

A malignancy that occurs in the adrenal gland, sympathetic chain of the retroperitoneal area, head, neck, pelvis or chest

Wilms tumor

A malignancy that occurs in the kidneys or abdomen

Leukemia

A malignant disease of the blood forming organs that results in an uncontrolled growth of immature WBCs

ANS: D Miliaria, or prickly heat rash, is caused by excess body heat and moisture.

A mother is concerned about what might have caused a heat rash on her infant. The nurse observes tiny pinhead-sized reddened papules on the infant's neck and axilla. What does the nurse explain as the most likely cause of this rash? a. Sun exposure b. Allergic reaction c. Infection d. Heat and moisture

ANS: D Early recognition of and intervention for children of alcoholics are paramount. This adolescent is using the coping pattern of acting-out behaviors to deal with the family situation.

A mother is concerned because her adolescent son is always in trouble for fighting at school and always seems to be angry. She mentions that her husband drinks a bit. Which understanding will guide the nurse's response? a. The boy is displaying antisocial behavior and should be evaluated for mental illness. b. The boy is displaying one of the typical defense patterns of children of alcoholics and should receive immediate treatment. c. The mother is displaying her own anger with her husband's drinking, and she needs immediate intervention. d. The boy is only one member of the family affected by alcoholism, and all members should receive immediate intervention.

A newborn does not pass meconium within the first 48 hours after birth. Which diagnosis does the nurse suspect? An abdominal wall defect Intussusception Hirschsprung's disease Celiac disease

A, E

A nurse is collecting data from a child who has rheumatic fever. Which of the following findings should the nurse expect? (Select all that apply.) A. Erythema marginatum (rash) B. Continuous joint pain of the digits C. Tender, subcutaneous nodules D. Decreased erythrocyte sedimentation rate E. Elevated C-reactive protein

ANS: D An infant's Eustachian tubes are short, wide, and straight, allowing microorganisms easy access to the middle ear.

A parent comments that her infant has had several ear infections in the past few months. Why are infants more susceptible to otitis media? a. Infants are in a supine or prone position most of the time. b. Sucking on a nipple creates middle ear pressure. c. They have increased susceptibility to upper respiratory tract infections. d. The Eustachian tube is short, straight, and wide.

CHF

ASO and BNP test shows

intussusception

Acute pain, currant jelly stools, sausage shaped mass on palpating, high temp up to 106

Hypertension and vasoconstriction

After load is increased in?

acute glomerulonephritis

Allergic reaction to group A beta hemolytic streptococcal infection

Congenital heart disease

Anatomic defects of the heart prevents normal blood flow to the pulmonary or systemic system

Allergies, eczema, and asthma

Atopic triad of juvenile idiopathic arthritis

Between which two ages does the highest incidence of iron-deficiency anemia occur? Birth and 4 weeks 9 and 24 months 3 and 5 years 12 and 16 years

atrial septal defect (ASD)

CHF, easy tiring, poor growth

Tricuspid Atresia

Complete closure of the tricuspid valve that results in mixed blood flow

Heart failure

Decrease in cardiac output necessary to meet the metabolic needs of the body

ANS: C Notify the charge nurse of this occurrence of paraphimosis. The tight foreskin can impede blood flow to the penis; this should be remedied immediately.

During a physical assessment of a hospitalized 5-year-old child, the nurse notes that the foreskin has been retracted and is very tight on the shaft of the penis; the nurse is unable to return it over the head of the penis. What action should the nurse implement? a. Forcibly push the foreskin down over the head of the penis. b. Place a warm compress on the penis. c. Notify the charge nurse. d. Wait a few hours and try again.

Rheumatic fever

Erythema marginatum, subcutaneous nodules, rheumatism, carditis, and Sydenham's chorea are manifestations of

Rotavirus

Fever, foul smelling watery stools, diarrhea, vomiting

Umbilical cord clamping

Foramen ovale and ductus arterosus close following?

Pyloric stenosis

Fowlers position should be implemented with

Type 1 DM

Glucose can be found in urine with

Duchenne's muscular dystrophy

Gowers sign is seen with

Duchenne muscular dystrophy

Group of disorders in which progressive muscle degeneration occurs

Less than 70

Hypoglycemia levels

Celiac disease

Implement strict gluten free diet with

pyloric stenosis

Inability to move food from stomach to duodenum, infant always hungry, emesis is mucus and undigested formula

Acute Rheumatic Fever

Inflammatory connective tissue disorder, results from autoimmune response to a pharyngeal infection

viral meningitis

Irritable, lethargic, fever, headache, photophobia, upper respiratory symptoms, positive kernig and brudzinski signs, seizures are rare

Adolescent Idiopathic Scoliosis

Lateral S or C shaped curvature of the spine

Kawasaki disease

Leading cause of acquired heart disease in children. It's an acute febrile, systemic vascular inflammatory disorder

cryptorchidism

Often accompanied by inguinal hernia

intussusception

One portion of the intestine prolapses and then telescopes into itself

rheumatic fever

Only condition in where it's okay to use aspirin to treat _ _ in children

ANS: C If the vitelline duct fails to disappear completely after birth, a blind pouch may form.

Parents ask the nurse how their infant developed a Meckel's diverticulum. What condition, will the nurse explain, is present causing this diagnosis? a. The yolk sac remains connected to the intestine. b. There is inflammation of the ileocecal valve. c. A pouch forms when the vitelline duct fails to disappear. d. There is a weakness in the abdominal wall.

Hypoplastic Left Heart Syndrome

Poor peripheral perfusion, pulmonary edema, shock, acidosis, death without intervention

Bone tumors

Prognosis is poor if Mets are present with which cancer?

liver dysfunction

Pruritus in the absence of allergy may indicate

glomerulonephritis

Rapid onset, more serious than nephrotic syndrome

Epilepsy

Seizures that occur more than once without such a specific cause

Febrile seizures

Seizures that result from sudden high fevers, particularly in children. Fever above 102

Leukemia

Severe anemia despite transfusions

rhabdomyosarcoma

Soft tissue tumor, usually found in muscles around eyes, in neck, and less commonly in abdomen, genitourinary tract, and extremities

The nurse is caring for a 5-year-old child with leukemia admitted to the hospital with the primary diagnosis of pneumonia. What does the nurse suspect as most likely cause of this child's pneumonia? Eosinophilia Neutropenia Thrombocytopenia Anemia

ANS: C The preschooler views death as reversible and temporary.

The nurse is dealing with a preschool child with a life-threatening illness. What should the nurse remember the child's concept of death is at this age? a. That it is final b. Only a fear of separation from her parents c. That a person becomes alive again soon after death d. An understanding based on simple logic

ANS: B Ewing's sarcoma is sensitive to radiation therapy and chemotherapy. Amputation of the affected extremity is not recommended. This cancer occurs in school-age children and does metastasize.

The nurse is reviewing the characteristics of Ewing's sarcoma. Which statement if made by the nurse indicates correct understanding of this disease? a. ―Amputation is the accepted treatment.‖ b. ―The disease is sensitive to radiation and chemotherapy.‖ c. ―Metastasis is rare.‖ d. ―The disease is more prevalent among toddlers and preschoolers.‖

ANS: C An oral rehydrating solution is recommended to replace fluids and electrolytes lost from frequent bowel movements.

The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise? a. Soft foods with rice, bananas, toast, and applesauce b. Small amounts of clear fluids such as gelatin c. An oral rehydrating solution, such as Pedialyte d. Chicken soup because it is high in sodium

ANS: C Curling's ulcer is a complication of burn victims resulting from the stress of their trauma.

The nurse observes a tarry stool from a 16-year-old burn victim who has been in the ICU for 2 weeks. Which complication does the nurse anticipate? a. Diverticulitis b. Stress diarrhea c. Curling's ulcer d. Perforated bowel

ANS: C Spasticity is characterized by tension in certain muscle groups, which makes voluntary movements of muscles jerky and uncoordinated.

The nurse observes that the legs of a child with cerebral palsy cross involuntarily, and the child exhibits jerky movements with his arms as he tries to eat. The nurse recognizes that he has which type of cerebral palsy? a. Athetoid b. Ataxic c. Spastic d. Mixed

ANS: A, B, C, E The traditional members of the child guidance team are the psychiatrist, pediatrician, psychologist, and social worker. The dietitian is not usually on the treatment team.

The nurse states that the members of a mental health team for child guidance include which member(s)? (Select all that apply.) a. Psychiatrist b. Pediatrician c. Psychologist d. Dietitian e. Social worker

ANS: C H. influenzae type B and conjugated pneumococcal vaccines have decreased the incidence of bacterial meningitis

The nurse urges the mother of a 6-month-old child to get her child inoculated with Haemophilus influenzae type B. What does this immunization protect against? a. Encephalitis b. Influenza c. Bacterial meningitis d. Otitis media

ANS: A, B, E Children from dysfunctional families exhibit lack of trust, act out, and show signs of depression.

The nurse working with children from dysfunctional families must be prepared to address what associated problem(s)? (Select all that apply.) a. Lack of trust b. Acting out c. Exaggerated self-confidence d. Blaming others for problems e. Depression

ANS: A Peripheral neuropathy may be signaled by severe constipation resulting from decreased nerve sensations in the bowel.

The nurse, caring for a child receiving chemotherapy, notes that the child's abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest? a. Peripheral neuropathy b. Stomatitis c. Myelosuppression d. Hemorrhage

Concussion

There is some death of brain cells with

Enema of air, barium enema, bowel resection

Treatment of choice with intussusception

Stroke

Untreated adults with ASD are at risk for

Heart failure

VSD, ASD, and PDA can be seen with

ANS: A, B, C, D All of the options are classic signs of thalassemia major except renal failure.

What are the classic symptoms of thalassemia major (Cooley's anemia)? (Select all that apply.) a. Hepatomegaly b. Jaundice c. Protruding teeth d. Pathological fractures e. Renal failure

A, B, D, E, F

What are the stages of dying as detailed by Kubler-Ross (1975)? (Select all that apply.) Bargaining Denial Remorse Anger Acceptance Depression

Tetralogy of Fallot, tricuspid atresia

What causes decreased pulmonary blood flow

What is considered a manifestation of retinoblastoma? Yellowish-white reflex seen in the pupil Red-eye reflex seen behind the retina Cloudy appearing cornea Increase in tear production

What resource defines mental disorders and is used by health professionals to aid in diagnoses of specific mental health conditions? Physicians' Desk Reference American Journal of Psychiatry Diagnostic and Statistical Manual of Mental Disorders Manual of Psychiatric Disorders

ANS: B Toe walking after 3 years of age may indicate a muscle problem.

What would the nurse consider an abnormal finding on a musculoskeletal assessment of a 4-year-old child? a. Has inward-turned knees while standing. b. Walks on the toes. c. Appears to have flat feet. d. Swings his arms when walking.

ANS: A Irregular respirations in conjunction with slowing heart rate and increasing blood pressure are reported immediately, because they could indicate increased intracranial pressure.

Which assessment finding in a child with meningitis should be reported immediately? a. Irregular respirations b. Tachycardia c. Slight drop in blood pressure d. Elevated temperature

ANS: A, B, D, E All options are potential benefits to including the sibling in the care of a dying child except increased helplessness. She would feel less helpless.

Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.) a. She will feel less neglected by the parents. b. She can make amends for past hostilities to her brother. c. She will feel increased helplessness. d. She can express her feelings through care. e. She can experience being supportive of her parents and brother.

Left sternal border

With VSD, a loud harsh murmur can be heard where

Bulimia

_________________, or compulsive eating, is characterized by recurrent episodes of uncontrolled binge eating followed by self-induced vomiting and the misuse of laxatives and/or diuretics.

patent ductus arteriosus (PDA)

a condition in which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to close and results in increased pulmonary blood flow (left-to-right shunt)

coarctation of the aorta

a narrowing of the lumen of the aorta, usually at or near the ductus arteriosus, that results in obstruction of blood flow from the ventricle

Oxygen rich blood

enters the heart from the lungs and goes out to the body

Shunt

flow of blood through an abnormal opening between two vessels of the heart

atrial septal defect (ASD)

hole in the septum between the right and left atria that results in increased pulmonary blood flow

Kawasaki disease

strawberry tongue is seen with

Pinworms

the scotch tape test is used to diagnose what condition

A 1-year-old child has been treated for 2 weeks for an electrical burn of the mouth sustained from biting into an electrical cord. The child's mother calls the nurse reporting concern because her child's burn continues to bleed at times throughout the day. What education should the nurse provide to the patient's mother? Take the child to the emergency department immediately. Medicate with acetaminophen every 4 hours. Electrical burns of the mouth may bleed for several weeks. Have the child rinse and spit with salt water.

ANS: D Hepatitis A results from ingestion of contaminated water or shellfish.

A 10-year-old child is diagnosed with hepatitis A. What is the most likely way the child contracted this disease? a. Came in contact with infected blood. b. Came in contact with droplets in the air. c. Was bitten by a mosquito or a tick. d. Ate shrimp while in Mexico.

ANS: B Functional scoliosis usually is caused by poor posture, and it is not a spinal disease.

A 13-year-old girl is diagnosed with functional scoliosis. What does the nurse explain as the cause of this spinal curvature defect? a. Juvenile rheumatoid arthritis b. Poor posture c. Heredity d. Myelomeningocele

A 14-year-old girl has been diagnosed with scoliosis with a curve of 30 degrees. What medical intervention will treatment include for this patient? Transcutaneous electrical muscle stimulation (TENS) Only exercise to increase muscle tone and posture Surgery with insertion of a Harrington rod Use of a Milwaukee brace

ANS: B OCD is related to depression and other psychiatric disorders. Suicidal behavior is a high risk for adolescents with OCD.

A 14-year-old girl with obsessive-compulsive disorder (OCD) tells the nurse other adolescents tease her because she washes her hands many times during the school day. For what does this disorder put the adolescent at greater risk? a. Anorexia nervosa b. Depression c. ADHD d. A learning disability

ANS: C A major depression is characterized by a prolonged behavioral change from baseline that interferes with school, family life, and age-specific activities, frequently signaled by giving prized possessions away.

A 15-year-old boy was previously active in a band and saved money to buy a special guitar. What would a nurse assess as an early sign of depression in this boy? a. He gives up the band to spend time with his girlfriend. b. He spends all of his time at the library studying to qualify for the honor society. c. He gives his guitar away and spends his time listening to music in his room. d. He withdraws all of his money out of the bank to buy an expensive leather jacket.

A 16-year-old boy enters the emergency department reporting acute scrotal pain. He is diagnosed with testicular torsion. What treatment for this condition will the nurse expect? Application of cool compresses Immediate surgery Ultrasound-guided external manipulation Rest and elevation

A 16-year-old boy is being examined in the emergency department. While completing the initial assessment, the nurse notes constricted pupils bilaterally, decreased respirations, and needle marks. The patient states he regularly uses "smack." What illegal drug does this street name refer to? LSD Cocaine Marijuana Heroin

ANS: A A staphylococcal infection can spread readily from one infant to another. Small pustules on the newborn must be reported immediately.

A 2-day-old infant is noted to have small pustules on her skin. What is the best nursing action? a. Report it immediately because it may be a staphylococcus infection. b. Keep the affected area dry and clean. c. Teach the parents how to care for seborrheic dermatitis. d. Chart the finding because it may be the beginning of a strawberry nevus.

ANS: A When bleeding occurs, the traditional approach is to follow RICE—rest, ice, compression, and elevation.

A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care? a. If bleeding occurs, apply pressure, ice, elevate, and rest the extremity. b. Children's aspirin in lowered doses may be given for joint discomfort. c. A firm, dry toothbrush should be used to clean teeth at least twice a day. d. Do not permit interactive play with other children.

ANS: C Vaso-occlusive crisis, or painful crisis, is caused by obstruction of blood flow by sickle cells, infarctions, and some degrees of vasospasm.

A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing? a. Aplastic b. Hyperhemolytic c. Vaso-occlusive d. Splenic sequestration

ANS: D Acute glomerulonephritis develops from 1 to 3 weeks after a streptococcal infection, which causes an allergic-type response that alters the effectiveness of the glomeruli.

A 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child's history, what does the nurse recognize as the probable cause? a. Recovery from German measles 2 months ago b. Dysuria since the previous night c. A history of allergy d. A sore throat 2 weeks ago

ANS: A Urinary frequency and pain during micturition are symptoms of acute urinary tract infection.

A 6-year-old child with daytime enuresis complains of dysuria and urgency. What does the nurse recognize these signs and symptoms indicate? a. Urinary tract infection b. Nephrotic syndrome c. Acute glomerulonephritis d. Vesicoureteral reflux

ANS: A This response gives the child an opportunity to verbalize his or her feelings and concerns, whereas closed responses shut off communication. The asking of a ―why‖ question is not therapeutic as it calls for justification.

A 6-year-old child with leukemia asks, ―Who will take care of me in heaven?‖ What is the best response by the nurse? a. ―Who do you think will take care of you?‖ b. ―Your grandparents and God will take care of you.‖ c. ―Your mom will know more about that than I do.‖ d. ―Why are you asking me that?

ANS: A Although all of these nursing diagnoses are relevant to the child in traction, pain resulting from muscle spasm and tissue trauma is the highest priority.

A 6-year-old sustained a fractured femur and was put in Russell traction 2 days ago. She screams in pain when she raises herself onto the bedpan. Which nursing diagnosis takes highest priority for this child? a. Pain resulting from tissue trauma b. High risk for impaired skin integrity resulting from immobility c. Altered growth and development related to separation from family d. Altered urinary elimination related to immobility and traction

ANS: A The priority goal of care in gastroenteritis is preventing fluid and electrolyte imbalance.

A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nurse's priority goal of the infant's care? a. Prevent fluid and electrolyte imbalance. b. Prevent nutritional deficiency. c. Prevent skin breakdown. d. Prevent malabsorption.

ANS: A Although children may feel well, activity is limited until hematuria resolves.

A 7-year-old child with acute glomerulonephritis has gross hematuria and has been confined to bed. What is the most appropriate nursing intervention for this child? a. Providing activities for the child on restricted activity b. Feeding the child a protein-restricted diet c. Carefully handling edematous extremities d. Observing the child for evidence of hypotension

ANS: A Inhaling hydrocarbons depresses the central nervous system, including respiratory rate and general sensorium.

A 9-year-old child has been admitted to the hospital after ―huffing‖ lighter fluid and is in a high euphoric state. For what should the nurse assess? a. Depressed respirations b. Severe vomiting c. Frightening hallucinations d. Elevation of temperature

ANS: B Protective isolation is used for patients who are not communicable but have a lowered resistance and are highly susceptible to infection.

A 9-year-old child hospitalized for neutropenia is placed in protective isolation. What is the most appropriate response for the nurse to make when the child asks, ―Why do you have to wear a gown and mask when you are in my room?‖ a. ―Nurses and doctors wear gowns and masks because you have a condition that could be spread to others.‖ b. ―The gown and mask are to protect you because you could get an infection very easily.‖ c. ―I'm wearing this because there are a lot of bacteria in the hospital.‖ d. ―I might look scary but you won't need this after you have had medication for 24 hours.‖

ANS: B The tissues that cover the heart and heart valves are affected. The heart muscle may be involved and the mitral valve is frequently involved.

A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis? a. Coronary arteries b. Heart muscle and the mitral valve c. Aortic and pulmonic valves d. Contractility of the ventricles

ANS: B Following a generalized tonic-clonic seizure, the child may have some confusion and may sleep for a time (postictal lethargy) and then return to full consciousness.

A child diagnosed with epilepsy had a generalized tonic-clonic seizure that lasted 90 seconds. What would the nurse expect to assess after a generalized tonic-clonic seizure? a. Restlessness b. Sleepiness c. Nausea d. Anxiety

ANS: B A second-degree superficial burn appears blistered, moist, and pink or red. The pain associated with this burn indicates tissue viability.

A child had a burn, evidenced by pink skin and blistering. The child complains of pain and is crying. How does the nurse classify this burn when documenting? a. First-degree b. Second-degree superficial c. Second-degree deep dermal d. Third-degree

ANS: B The child can ingest roundworm eggs from contaminated soil.

A child has been diagnosed with ascariasis (roundworm). Which statement made by her mother that may suggest a cause for her condition? a. ―I've been airing out the house on these nice breezy days.‖ b. ―My child often goes out to the garden and pulls up a carrot to eat.‖ c. ―She runs barefoot so much I have to wash her feet at least twice a day.‖ d. ―We just remodeled our bathroom at home.‖

ANS: D An overproduction of immature white blood cells increases the child's susceptibility to infection.

A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow? a. Decreased T-cell production b. Decreased hemoglobin c. Increased blood clotting d. Increased susceptibility to infection

ANS: A First aid treatment of a second-degree deep thermal burn is immersion of the burned area in water to halt the burning process.

A child has sustained a second-degree deep thermal burn to the hand. What is the best first action to take? a. Immerse the burned area in cold water. b. Apply ice to the burned area. c. Break any blisters that are present. d. Apply petroleum jelly to the burned skin.

ANS: B Because osteomyelitis is an infection in the bone, antibiotics are given intravenously for 4 to 6 weeks.

A child hospitalized for treatment of osteomyelitis complains that he is tired of being sick and wants to know when the antibiotic protocol will end. How long will the nurse indicate that antibiotic therapy will probably last? a. 2 weeks b. 6 weeks c. 2 months d. 3 months

A child is admitted to the emergency department with suspected intussusception. What significant assessment supports this diagnosis? A gradual onset of pain Currant jelly stools Frothy, bulky stools Vague abdominal pain

ANS: C The signs and symptoms of a brain tumor are related to its size and location. Most tumors create increased intracranial pressure (ICP) with the hallmark symptoms of headache, vomiting, drowsiness, and seizures.

A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches, with vomiting, that are worse in the morning. What does the nurse suspect? a. Meningitis b. Reye's syndrome c. Brain tumor d. Encephalitis

A child is admitted to the hospital with dehydration. The physician orders potassium to be added to the child's IV. What is the nurse's priority assessment? Skin integrity Mucous membranes Bowel status Genitourinary status

ANS: B The chain of infection refers to the way in which organisms spread and infect the individual. A portal of entry is a route by which the organisms enter the body (e.g., a cut in the skin). A portal of exit is the route by which the organisms exit the body (e.g., feces or urine). A reservoir for infection is a place that supports the growth of organisms (e.g., standing, stagnant water). A vector is an insect or animal that carries and spreads a disease.

A child is admitted to the pediatric unit with a diagnosis of cellulitis on the right upper thigh. Patient history reveals the child had a 2-cm laceration on the right thigh prior to infection. When explaining the chain of infection, how does the nurse identify this laceration? a. Reservoir b. Portal of entry c. Portal of exit d. Vector

A child is being treated for mental illness at a modern child guidance clinic and is reading stories about other children in a similar situation. What type of therapy is this considered? Bibliotherapy Play therapy Behavior modification Milieu therapy

ANS: C A concussion is a temporary disturbance of the brain that is immediately followed by a period of unconsciousness. It is accompanied often by a loss of memory of the events that occurred immediately before, during, or after the injury.

A child is brought to the emergency department after he fell and hit his head on the ground. Which nursing assessment suggests the child has a concussion? a. Sleepy but easily arousable b. Complaining of a stiff neck c. Cannot remember what happened to him d. Pupils react sluggishly to light

ANS: B Gastric lavage is followed by N-acetylcysteine (Mucomyst), the antidote for acetaminophen.

A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage? a. Activated charcoal b. N-Acetylcysteine c. Vitamin K d. Syrup of ipecac

ANS: A Airway assessment and establishing an airway are the initial priorities.

A child is brought to the emergency department with burns on the face and chest. What is the nurse's first priority? a. Assess respiratory status. b. Administer pain medication. c. Remove clothing. d. Insert a Foley catheter.

ANS: D In extreme cases of exposure to freezing temperatures, the head and torso should be warmed before the extremities.

A child is brought to the emergency department with severe frostbite. Which body parts should be warmed first? a. Hands and arms b. Feet and legs c. Fingers and toes d. Head and torso

ANS: D Hydrochloric acid and sodium chloride from the stomach are lost from persistent vomiting. This results in alkalosis.

A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting? a. Hyperkalemia b. Hypernatremia c. Acidosis d. Alkalosis

ANS: C Physical neglect is the failure to provide for the basic physical needs of the child, including food, clothing, shelter, and basic cleanliness.

A child is sent to the school nurse for assessment because she comes to school every day disheveled, unbathed, and hungry. The assessment does not indicate any bruises or marks on the body. What do these finding indicate? a. Sexual abuse b. Physical abuse c. Physical neglect d. Emotional abuse

A child receives a combination of regular and NPH insulin at 8:00 AM. At 8:45 AM the breakfast trays have not yet arrived from the kitchen. What is the best action by the nurse? a. Notify the charge nurse. b. Give the patient a snack of graham crackers and milk. c. Ambulate the patient in the hall for a short time. d. Give the patient more insulin according to the sliding scale.

ANS: C In ketoacidosis, the child's skin is dry, and the face is flushed. Patients appear dehydrated. They may perspire and be restless. The breath has a fruity odor, and there is no rest period between inspiration and expiration.

A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing? a. Somogyi phenomenon b. Dawn syndrome c. Ketoacidosis d. Water intoxication

ANS: C As the effects of rheumatic fever affect the central nervous system, the child may develop Sydenham's chorea, manifested by involuntary, purposeless movements of the limbs.

A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates? a. Seizure activity b. Hypoxia c. Sydenham's chorea d. Decreasing level of consciousness

ANS: D As a result of repeated blood transfusions, excessive deposits of iron (hemosiderosis) are stored in tissues.

A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions? a. Hemarthrosis b. Hematuria c. Hemoptysis d. Hemosiderosis

A circular reddened area on the skin that is elevated and contains fluids is called a(n): wart cyst plaque vesicle

ANS: A The squatting position allows the child to breathe more easily because systemic venous return is increased.

A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurse's best response? a. Squatting increases the return of venous blood back to the heart. b. Squatting decreases arterial blood flow away from the heart. c. Squatting is a common resting position when a child is tachycardic. d. Squatting increases the workload of the heart.

ANS: B Inducing vomiting is no longer recommended because it may pose additional problems. The child should be taken immediately to the nearest emergency department along with the packaging of the ingested substance.

A frightened mother calls the pediatrician's office because her child swallowed dishwashing detergent. What is the most appropriate action? a. Induce vomiting by giving the child syrup of ipecac. b. Take the child to the local emergency department. c. Give the child activated charcoal mixed with juice. d. Give the child milk to soothe affected mucous membranes.

ANS: C Consumption of alcohol while taking griseofulvin will cause severe tachycardia.

A group of football players is taking oral griseofulvin for tinea pedis. What should the school nurse caution them to avoid? a. Citrus fruit and juice b. Eating shellfish c. Alcohol consumption d. Taking corticosteroids

ANS: C Dietary modifications for constipation include eating more high-roughage foods such as whole-grain breads and cereals.

A mother reports that her 2-year-old child experiences constipation frequently. Which food would the nurse recommend to include in the child's diet? a. Cooked vegetables b. Pretzels c. Whole-grain cereal d. Yogurt

ANS: A The infant with hypothyroidism will appear sluggish, and the tongue will be enlarged, causing noisy respiration.

A mother reports that her 4-month-old infant is lethargic, sleeps 18 hours a day, and snores. The nurse recognizes these signs are characteristic of what? a. Hypothyroidism b. Hyperthyroidism c. Type 1 diabetes mellitus d. Tay-Sachs disease

ANS: C The sickle cell gene is inherited from both parents; therefore, each offspring has a one in four chance of inheriting the disease.

A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the children's risk of inheriting this disease? a. Every fourth child will have the disease; two others will be carriers. b. All of their children will be carriers, just as they are. c. Each child has a one in four chance of having the disease and a two in four chance of being a carrier. d. The risk levels of their children cannot be determined by this information.

C, D, E

A nurse is assisting with the care for a child who has oral mucositis. Which of the following actions should the nurse take? (Select all that apply.) A. Swab the mucosa with lemon glycerin swabs. B. Apply viscous lidocaine. C. Offer soft foods. D. Use a soft, disposable toothbrush for oral care. E. Encourage gargling with a warm saline mouthwash.

A, D

A nurse is assisting with the care for a child who has thrombocytopenia following chemotherapy. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor for manifestations of bleeding. B. Administer routine immunizations. C. Obtain rectal temperatures. D. Avoid peripheral venipunctures. E. Limit visitors.

A nurse is assisting with the care for a toddler who has a Wilms' tumor. Which of the following actions should the nurse take? A. Palpate the child's abdomen to identify the size of the tumor. B. Assist with preparing the child for surgery. C. Reinforce teaching with the guardians about dialysis. D. Obtain a 24-hr urine specimen from the child.

A nurse is assisting with the care of a 2-vear-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A. Place on NPO status for 12 hr prior to the procedure. B. Check for iodine or shellfish allergies prior to the procedure. C. Elevate the affected extremity following the procedure. D. Limit fluid intake following the procedure

B, C, D

A nurse is caring for a child who has a depressive disorder. Which of the following findings should the nurse expect? (Select all that apply.) A. Prefers being with peers B. Weight loss or gain C. Reports low self-esteem D. Sleeps more than usual E. Hyperactivity

B, C, E

A nurse is collecting data from a child who has leukemia. Which of the following are early manifestations of leukemia? (Select all that apply.) A. Hematuria B. Anorexia C. Petechiae D. Ulcerations in the mouth E. Unsteady gait

A, B, D

A nurse is collecting data from a child who has rhabdomyosarcoma of the nasopharynx. Which of the following are manifestations of rhabdomyosarcoma? (Select all that apply.) A. Enlarged neck lymph nodes B. Pain C. Vomiting D. Epistaxis E. Diplopia

A, B, E

A nurse is collecting data from an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Low blood pressure

B, C, E

A nurse is collecting data from an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring

A nurse is educating a client's mother about the child receiving the Varicella vaccination. What would be included in the teaching? "Please refrain from obtaining any tuberculin test for at least 2 weeks." "This vaccination allows the child to produce their own immunity through an active process." "This vaccination has no special instructions after today." "This vaccination will prevent Varicella for a few years."

ANS: A, B, C, D Oppositional defiant disorder is described as an ongoing pattern of anger-guided disobedience, a hostile or defiant response to authority and is not considered a form of OCD.

A nurse is hired to work in a psychiatric facility on a unit specializing in obsessive-compulsive disorders (OCD). Which diagnoses might the nurse expect to encounter? (Select all that apply.) a. Trichotillomania b. Hoarding disorder c. Excoriation disorder d. Body dysmorphic disorder e. Oppositional defiant disorder

ANS: A Failure to use eye contact and look at others, poor attention span, and poor orienting to one's name are significant signs of dysfunction by 1 year of age.

A nurse is planning to speak with a parent support group about childhood autism. What will the nurse include? a. Significant signs of the disorder manifest by 1 year of age. b. The earliest signs of autism are impulsivity and overactivity. c. Autism is usually diagnosed when the child goes to elementary school. d. Medications can cure childhood autism.

ANS: A The pattern of inheritance is generally autosomal recessive.

A nurse is planning to teach a family about Tay-Sachs disease. What will the nurse relay about the pattern of inheritance for inborn errors of metabolism? a. They are usually autosomal recessive. b. They are usually autosomal dominant. c. They are usually X-linked recessive. d. They are usually multifactorial.

A nurse is reinforcing teaching with a group of guardians about characteristics of infants who have failure to thrive. Which of the following characteristics should the nurse include? A. Intense fear of strangers B. Increased risk for childhood obesity C. Inability to form close relationships with siblings D. Developmental delays

A, B, D

A nurse is reinforcing teaching with a guardian about posttraumatic stress disorder (PTSD). Which of the following information should the nurse include? (Select all that apply.) A. Children who have PTSD can benefit from psychotherapy. B. A manifestation of PTSD is phobias. C. Personality disorders are a complication of PTSD. D. PTSD develops following a traumatic event. E. There are six stages of PTSD.

A nurse is reinforcing teaching with the caregiver of an infant who has a prescription for digoxin. Which of the following statements should the nurse make? A. "Do not offer your baby fluids after giving the medication." B. "Digoxin increases your baby's heart rate. C. "Give the correct dose of medication at regularly scheduled times." D. "If your baby vomits a dose, you should repeat the dose to ensure that the correct amount is received."

A nurse is reinforcing teaching with the guardian of a child about risk factors for attention-deficit/ hyperactivity disorder (ADHD). Which of the following risk factors should the nurse include? A. Formula-feeding as an infant B. History of head trauma C. History of postterm birth D. Child of a single guardian

B, C, D

A nurse is reinforcing teaching with the teacher of a child who has attention-deficit/hyperactivity disorder (ADHD). Which of the following classroom strategies should the nurse include? (Select all that apply.) A. Eliminate testing. B. Allow for regular breaks. C. Combine verbal instruction with visual cues. D. Establish consistent classroom rules. E. Increase stimuli in the environment.

ANS: A Learning disability is an educational term. Children with learning disabilities may have average to above-average intelligence, but they may experience difficulties in perception, language, comprehension, and conceptualization.

A parent asks the nurse to describe what is meant by a ―learning disability.‖ Which is the nurse's most helpful response? a. ―A child may have difficulty with perception, language, comprehension, or memory.‖ b. ―It is characterized by inattention, impulsiveness, and hyperactivity.‖ c. ―The child's intellectual ability limits his learning.‖ d. ―The child has difficulty learning because of brain damage.‖

ANS: A Absence seizures are characterized by transient loss of consciousness where the child appears to stare blankly, and may last only a few seconds.

A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? a. Absence b. Akinetic c. Myoclonic d. Complex partial

ANS: C An x-ray examination of the bladder and urethra before and during micturition is called a voiding cystourethrogram.

A parent tells the nurse that her child is scheduled for an x-ray of the bladder and urethra that is done while the child is urinating. What is this test known as? a. Cystometrogram b. Cystoscopy c. Voiding cystourethrogram d. Intravenous pyelogram

ANS: C A spiral fracture of the femur is caused by a forceful twisting motion. When the history of an injury does not correlate with x-ray findings, child abuse should be suspected because spiral fractures can be the result of manual twisting of the extremity.

A pediatric nurse is assisting with the care of a child diagnosed with a fractured femur. What type of fracture would be the most likely to alert the nurse to the possibility of physical abuse? a. Stress fracture b. Compound fracture c. Spiral fracture d. Greenstick fracture

ANS: D Echocardiography is a noninvasive procedure that localizes murmurs and determines if the heart is structurally normal.

A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate? a. Barium swallow b. Chest x-ray c. Electrocardiogram d. Echocardiogram

Congenital heart defects

A structural defect of the heart or blood vessels near the heart

Concussion

A temporary disturbance of the brain that is usually followed by a period of unconsciousness

Retinoblastoma

A white pupil is a manifestation of

ANS: B Play therapy allows a young child to act out with dolls or figures concerns that the child may be unable to adequately express verbally.

A young child on the pediatric unit cannot express himself well. What therapeutic intervention might the nurse implement that allows children to act out their feelings? a. Art therapy b. Play therapy c. Music therapy d. Bibliotherapy

ANS: A Diabetes insipidus can be acquired as the result of a head injury or tumor, and suppression of the posterior pituitary causes copious urine output with an attendant drop in BP. The child can become dehydrated very quickly if some remedy is not applied.

After a closed head injury, the unconscious 10-year-old child begins to excrete copious amounts of pale urine with an attendant drop in blood pressure (BP). Based on these symptoms, what does the nurse suspect has developed? a. Diabetes insipidus b. Diabetes mellitus c. Hypothyroidism d. Hyperthyroidism

ANS: C The immediate remedy is to give orange juice to raise the blood glucose. Giving more sugar will increase the blood glucose in a hyperglycemic child. Walking exercise will use up even more glucose. The treatment for hyperglycemia is to give the patient more insulin.

Although the child with type 1 diabetes had her prescribed insulin at 7:30 AM, the child is complaining of hunger and thirst and is drowsy at 10:30 AM. What should the nurse do first? a. Walk the patient in the hall for 10 minutes. b. Allow the patient a short nap. c. Give her a cup of orange juice. d. Test her blood with a glucometer and give insulin according to the sliding scale.

B, C, E, F

An 8-year-old boy diagnosed with hemophilia presents at the emergency department with hemarthrosis from a fall on the school playground. What would be included when following a traditional approach to care? (Select all that apply.) Warm compresses Compression Ice Continuous pulse oximetry Rest Elevation

ANS: B Vaccines contain live weakened or dead organisms not strong enough to cause disease but they stimulate the body to develop an immune reaction and antibodies. This is active acquired immunity.

An 8-year-old child asks the nurse how she got the antibodies that kept her from getting whooping cough. What is the nurse's best explanation? a. ―You received borrowed antibodies from another person who had whooping cough.‖ b. ―You were given a tiny case of whooping cough and then you made your own antibodies.‖ c. ―An immunization strengthened antibodies you were born with.‖ d. ―You received only temporary borrowed antibodies and you need to have another shot every 5 years.‖

ANS: D Antibiotic therapy can cause a monilial vaginitis.

An adolescent girl with acne is being treated with an antibiotic in addition to topical applications. What side effect does the nurse caution the girl to expect? a. Lessened effectiveness of oral contraceptives b. Urinary burning and frequency c. Breast engorgement d. Vaginitis

ANS: A If there are multiple seizures or if seizures last more than 5 minutes, call 911 because these are indicators of possible status epilepticus, a medical emergency.

An adolescent has just had a generalized seizure and collapsed in the school nurse's office. When should the nurse should call 911? a. The seizure lasts more than 5 minutes. b. The child is sleepy and lethargic after the seizure. c. The child vomited at the onset of the seizure. d. The child is confused and has slurred speech after the seizure.

ANS: A Intense itching, especially at night, is characteristic of scabies.

An adolescent is at the pediatrician's office because he has been experiencing intense itching, particularly in the axilla and between the fingers. The itching is worse during the night and he has not been sleeping well. With what is this symptom associated? a. Scabies b. Pediculosis capitis c. Tinea corporis d. Eczema

ANS: A Behavioral signs of alcohol ingestion include slurred speech, short attention span, drowsiness, combativeness, and violence.

An adolescent is brought to the emergency department after an automobile accident. When the nurse approaches the adolescent, he becomes combative. The nurse notes his speech is slurred and his gait is ataxic. What does the nurse suspect the adolescent has used? a. Alcohol b. Cocaine c. Amphetamines d. PCP

ANS: C Lymph node regions on both sides of the diaphragm are consistent with a diagnosis of stage-III Hodgkin's disease.

An adolescent is diagnosed with Hodgkin's disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this? a. I b. II c. III d. IV

ANS: A The nurse would teach the adolescent to take all of the prescribed medication to avoid making the microorganism resistant to tetracyclines.

An adolescent is taking tetracycline for a sexually transmitted disease. What would the nurse stress when providing instruction about this medication? a. Finish all of the medication. b. Get plenty of fresh air and sunlight. c. Take the medication with food. d. Take an antacid if the medication causes an upset stomach.

ANS: A A pH lower than 7.35 indicates acidosis. If the child's pH falls in the same line as the HCO3-, the problem is metabolic

An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO2 40, HCO3- 21. How does the nurse interpret these values? a. Metabolic acidosis b. Metabolic alkalosis c. Respiratory acidosis d. Respiratory alkalosis

An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs? a. Blood is circulated through the lungs again, causing pulmonary circulatory congestion. b. Blood is shunted past the pulmonary circulation, causing pulmonary hypoxia. c. Blood is shunted past cardiac arteries, causing myocardial hypoxia. d. Blood is circulated through the ductus from the pulmonary artery to the aorta, bypassing the left side of the heart.

ANS: C Contact precautions are used when the condition transmits organisms via skin-to-skin contact or indirect touch of a contaminated fomite.

An infant is hospitalized for RSV bronchiolitis. Which type of precautions would the nurse use when caring for the infant? a. Large-droplet infection precautions b. Airborne-infection precautions c. Contact precautions d. Protective precautions

ANS: D Symptoms of digoxin toxicity include nausea, vomiting, anorexia, irregularity in pulse rate and rhythm, and a sudden change in pulse.

An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity? a. Restlessness b. Decreased respiratory rate c. Increased urinary output d. Vomiting

ANS: C Bruises heal in various stages that are indicated according to color; after 5 to 7 days bruise are green.

Approximately how old does the nurse assess a large green bruise on the thigh of a 4-year-old to be? a. 2 days b. 4 days c. 6 days d. 8 days

ANS: B The strawberry nevus is a common hemangioma consisting of dilated capillaries in the dermal space, which may not become apparent for a few weeks after birth.

At a 2-month well-child visit, parents ask the nurse about the red area on the infant's neck. They tell the nurse that the mark appeared a few weeks after birth. What does the nurse recognize this skin lesion as? a. A port wine nevus b. A strawberry nevus c. Exanthem d. Intertrigo

asymptomatic

Atrial septal defects can be

Wilms tumor

Avoid palpating abdomen to prevent tumor encapsulation from breaking open with?

25-30

Bracing is needed when curvature is

ventricular septal defect (VSD)

CHF, poor growth, decreased exercise tolerance, pulmonary hypertension are manifestations of

Bacterial Meningitis

CSF is cloudy, thick and discolored with

patent ductus arteriosus (PDA)

Can have rales, bounding pulses and wide pulse pressure

Can patent ductus arteriosus be found on fetal ultrasound

Fractures

Children have softer bones which lead to

hypospadias

Congenital defect in which the urinary meatus is located on the lower portion of the shaft

Spina bifida

Congenital defect where spinal cord contents protrude In one or more vertebrae

beau lines on nails, lingering signs of inflammation

Convalescent phase of Kawasaki disease

Kawasaki disease

Crash and burn is seen with

Tetralogy of Fallot

Cyanosis at birth (progresses over one year), systolic murmur, and episodes of acute cyanosis and hypoxia

Pulmonary stenosis

Cyanosis can be seen with _, becomes worse with severe narrowing

muscular dystrophy

Death usually occurs by 30s due to respiratory issue or cardiomyopathy

Echo

Diagnosis of CHD

CHD

Diaphoretic, especially during feedings, often over forehead

ANS: D A potent antisuppressant such as Cytoxan can bring about diuresis when corticosteroids have proven ineffective.

Diuresis has not occurred on a child with nephrotic syndrome after a month on corticosteroids. What protocol can the nurse encourage to bring about diuresis? a. Ibuprofen, an anti-inflammatory agent b. Furosemide (Lasix), a diuretic c. Ciprofloxacin (Cipro), an antibiotic d. Cyclophosphamide (Cytoxan), an antisuppressant

Bacterial Meningitis

Fever, changes in feeding pattern, vomiting, diarrhea, anterior fontanel bulging or flat, alert, restless, lethargic, irritable, difficult to console

Nephrotic syndrome

Foamy, frothy, urine that may contain blood

ANS: D Small oral feedings of glucose water are given after recovery from anesthesia. Feedings are gradually increased to larger amounts of regular formula or breastmilk.

Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action? a. Delay feeding the child for 6 hours. b. Offer regular formula thinned with water. c. Give small amounts of regular formula thickened with cereal. d. Allow 1 ounce of glucose water at frequent intervals.

Prostaglandin E1, intubation and ventilation, surgery or heart transplant, Norwood surgery

Four treatments for HLHS

Breast milk

HIV can be spread through?

Kaposis syndrome

HIV can cause?

Kawasaki disease

Has increased platelet count, WBC may be increased

ANS: D Russell traction is skin traction, similar to Buck, with a sling positioned under the knee, which prevents subluxation of the tibia. Although the traction interferes with full ROM, the patient can change position without disrupting the continuous pull in two directions.

How does Russell traction provide adequate skin traction? a. Subluxates the tibia. b. Does not interfere with range of motion. c. Prevents the knee from flexing. d. Supplies continuous pull in two directions.

ANS: B Bulimia is characterized by alternating binge eating and purge behavior.

How does the nurse describe a person who is bulimic? a. Severely underweight b. Alternates binge eating with purging c. Introverted perfectionist d. Has extremely close family relationships

ANS: D A gateway drug is a substance that creates a high that can lead to the use of stronger drugs.

How is a gateway substance defined? a. Recreational drug used occasionally b. Nonaddictive drug used daily c. Drug used to wean from stronger drugs d. Substance that can lead to use of stronger drugs

ANS: C Children who recover from rheumatic fever should have a chemoprophylaxis protocol of penicillin G injections (about 200,000 units per dose) for a minimum of 5 years or up to the age of 18 years to prevent further bouts of rheumatic fever.

How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G? a. 1 year b. 2 years c. 5 years d. 10 years

ANS: A, B, C, E Infants with CHF fatigue easily. Feeding can be given more frequently in smaller amounts through a soft, large-holed nipple. Formulas with a denser caloric content can be offered. The child may be encouraged to nurse if he or she is held.

How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child's weakness and fatigue? (Select all that apply.) a. Feeding more frequently with smaller feedings b. Using a soft nipple with enlarged holes c. Holding and cuddling the child during feeding d. Substituting glucose water for formula e. Offering high-caloric formula

ANS: A The psychiatrist is a medical doctor; the psychoanalyst may be a medical doctor or a psychologist. The psychologist is not a medical doctor, and neither is the counselor.

How would the nurse identify a member of the child guidance team who is a medical doctor with special training in psychoanalytic theory? a. Psychiatrist b. Psychoanalyst c. Psychologist d. Counselor

underdeveloped

Hypoplastic means?

Tricuspid atresia

Hypoxemia and clubbing of fingers

Juvenile Idiopathic Arthritis

Intermittent spiking fever persistent more than 10 days, nonpruritic rash, abdominal pain, hands and feet become swollen warm and tender, larger joints, redness, pain, photophobia

Aortic stenosis

Intolerance to exercise, dizziness, chest pain, possible ejection murmur

rheumatic fever

JONES pneumonic is seen with

Hyperglycemia manifestations

Lethargy, confusion, thirst, N/V, warm dry skin, abdominal pain, rapid deep respirations

Puberty occurs

Ligaments and tendons are stronger than bones until _

Pin worm

Looks like a white thread, lives in lower intestine but lays eggs outside anus

atrial septal defect (ASD)

Loud harsh murmur with a fixed split second heart sound

coarctation of the aorta

Low cardiac output, CHF, pulmonary edema, cooler feet than hands, stronger pulses and blood pressures in arms than in legs, necrotizing enterocolitis, pallor, failure to thrive

spontaneously in early life

Many VSDs close when

Latex

Many infants with spina bifida are allergic to

acquired heart disease

May be a complication of a congenital heart disease or a response to a respiratory infection, sepsis, hypertension or severe anemia

atrial septal defect (ASD)

May have spontaneous closure by age 4 with

IV ibuprofen or indomethacin

Medication treatment for patent ductus arteriosus

spontaneously within 6 months

Most VSDs close when

Enterovirus

Most common cause of acute meningitis

Heart and lungs

Muscular dystrophy will eventually affect ?

Mixed congenital heart defects

Must have surgery to live with

EEG

No caffeine before

Kawasaki disease

No live vaccines for one year with

Nephrotic syndrome

No vaccinations or immunizations should be administered while what disease is present

Normal HbA1c

congestive heart failure

Occurs when heart function is impaired and cardiac output is inadequate to support the body's circulatory and metabolic needs

Pyloric stenosis

Olive shaped mass can be palpated over abdomen with

ANS: A When platelets are low, the greatest danger is spontaneous intracranial bleeding. Neurological assessments are therefore a priority of care.

On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention? a. Assessing neurological status b. Inserting an intravenous line c. Monitoring vital signs during platelet transfusions d. Providing family education about how to prevent bleeding

ANS: A Buck traction is dependent on the child as a counterweight. The heels should be elevated above the level of the foot of the bed.

On entering the room of a child in Buck traction, the nurse makes all of the following observations. Which observation requires a nursing intervention? a. Child's heels are placed firmly against the foot of the bed. b. Head of bed is elevated 20 degrees. c. Weights are hanging freely. d. Ropes are on pulleys.

ANS: B With the fluid shift associated with severe burns, the nurse must be observant for the reduction of urine, an indication of altered renal function.

On the first day following a severe burn, the body's fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. What should the nurse monitor for very closely in the burn victim? a. Increasing intracranial pressure b. Reduced urine output c. Eschar formation d. Fluid overload

ANS: A Weight loss is the most significant indicator of dehydration because an infant's weight comprises 77% water.

On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment? a. Weight loss of 4 ounces b. Dry mucous membranes c. Decreased skin turgor d. Depressed fontanelle

ANS: A Type 1 insulin-dependent diabetes mellitus is characterized by an absolute or complete deficiency of insulin.

On what understanding does the nurse plan the care of a child with a new diagnosis of type 1 diabetes mellitus? a. There is an absolute deficiency of insulin. b. Insufficient quantities of insulin are produced by the pancreas. c. Oral hypoglycemic agents can control it. d. Insulin deficiency is caused by another disease affecting the pancreas.

ANS: A Although orchiopexy improves the condition, the fertility rate among patients may be reduced even when only one testis is undescended.

Parents are speaking with the urologist about their son's undescended testicle. Which statement by the child's father causes the nurse to determine he understands the information presented? a. ―An undescended testicle can reduce fertility.‖ b. ―The testicle usually descends spontaneously during the first month of life.‖ c. ―Surgical correction reduces the risk for testicular tumors.‖ d. ―The optimal time to surgically correct the condition is at diagnosis.‖

ANS: A The mentally handicapped child needs to develop a sense of accomplishment. Caregivers should not ―take over‖ projects because of their own need to assist or speed up the process.

Parents of a 10-year-old child diagnosed with an intellectual deficit are sharing multiple approaches they implement in dealing with various challenges. Which statement by the parents alerts the nurse they need further instruction? a. ―We dress our son every morning for school.‖ b. ―Our son participates in the Special Olympics every year.‖ c. ―Our son attends play therapy at a center close to home.‖ d. ―We attend a support group once a week.‖

Tetralogy of Fallot

Polycythemia, hypercyanotic spells, metabolic acidosis, poor growth, clubbing, exercise intolerance, systolic murmur, palpable thrill

Droplet

Precautions for bacterial meningitis

intussusception

Sausage shaped mass on palpatation

nephrotic syndrome

Several different types of kidney conditions distinguished by the presence of marked amounts of protein in the urine, edema, and hypoalbuminemia

Hydrocephalus

Shunts are used for

neural tube defects

Spina bifida is classified as

45 degrees

Surgery is needed for scoliosis when curvature is more than

orchiopexy

Surgical correction for cryptorchidism

Juvenile Idiopathic Arthritis

Systemic inflammatory disease involving joints, connective tissues and viscera

Brain Natriuretic Peptide (BNP)

Tells how effectively heart is pumping

Antistreptolysin O (ASO) titer

Tells if you have had a strep infection recently

ANS: C Encourage the patient to talk about what he knows and what feelings he has about the surgery. School-age children have a fear of bodily harm.

The 6-year-old child scheduled for an orchiopexy shyly asks the nurse, ―What are they going to do to me ̳down there'?‖ What is the nurse's best response? a. ―They are going to fix you up ̳down there'.‖ b. ―They will move your testicle from your abdomen to your scrotum.‖ c. ―What do you think your doctor is going to do?‖ d. ―You shouldn't worry. Your doctor knows exactly what to do.‖

ANS: D If a blood transfusion reaction occurs, the first action is to stop the blood infusion, keep the line open with normal saline, and notify the charge nurse.

The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse? a. Notify the charge nurse. b. Disconnect intravenous lines immediately. c. Give diphenhydramine (Benadryl). d. Clamp off blood and keep line open with normal saline.

ANS: C Combing a vinegar-water solution through the hair with a fine-tooth comb and then shampooing is an initial step toward eradication.

The home health nurse discovers a family infected with pediculosis. What information can the nurse provide to the mother to start eradication of the lice? a. Cover the hair with Vaseline. b. Apply a soda-vinegar solution to the hair. c. Comb through the hair with a vinegar-water solution. d. Shampoo the hair with dish detergent.

ANS: A The child with neutropenia is at risk for infection.

The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child? a. Risk for infection b. Risk for hemorrhage c. Altered skin integrity d. Disturbance in body image

The mother of a 3-year-old tells the nurse she is concerned about her child's bow-legged appearance. What is the best response from the nurse? "A referral to a pediatric orthopedic physician is indicated immediately." "Is your child having any pain or difficulty walking?" "Do not worry about it; this is normal." "I would be concerned if I were you."

ANS: D No vaccinations or immunizations should be administered while the disease is active and during immunosuppressive therapy.

The mother of a 5-year-old child taking prednisone for nephrotic syndrome tells the nurse he needs to get immunizations to enter kindergarten. What does the nurse clarify about receiving immunizations while on prednisone? a. Can interfere with the treatment for nephrosis. b. Require that the child have antibiotic coverage. c. Can be given in smaller, divided doses. d. Should be delayed.

ANS: A The American Academy of Pediatrics recommends that Comvax, the only thimerosal-free hepatitis B vaccine, should be used for infants born to HBsAg-positive mothers within 12 hours of birth.

The mother of a newborn asked the nurse, ―When will my baby get the hepatitis B vaccine?‖ When will the nurse explain the first dose of Comvax should be given to infants born to a hepatitis B-positive mother? a. Within 12 hours after birth b. Within 2 weeks after birth c. Within 1 month after birth d. Within 2 months after birth

ANS: D Discrediting parents threatens the child's security and creates anxiety.

The nurse asks, ―Do your parents drink every day?‖ The adolescent suddenly shouts, ―I'm not going to talk about that! It's none of your business, anyway! Leave me alone!‖ How does the nurse interpret the adolescent's behavior? a. The adolescent is acting out and needs to be brought under control so the conference can continue. b. The adolescent is trying to shift the focus of the conference away from himself, and the nurse needs to refocus. c. The adolescent is demonstrating that this problem requires the assistance of a psychiatrist. d. The adolescent is responding to the discrediting of his parents, which causes anxiety.

ANS: C The systemic form of juvenile rheumatoid arthritis is associated with an elevated temperature, erythrocyte sedimentation rate (ESR), and C-reactive protein; abdominal pain; and a macular rash.

The nurse assessing a child with juvenile rheumatoid arthritis notes the child's right knee and ankle are swollen, warm, and tender. The child has a temperature of 38.8C (102F) and abdominal pain. What type of juvenile rheumatoid arthritis do these findings suggest? a. Psoriatic b. Enthesitis c. Systemic d. Acute febrile

ANS: D A purple flush indicates the return of sensation and causes extreme pain.

The nurse caring for a patient with severe frostbite observes a purple flush on the hands and feet. What is the most appropriate nursing action? a. Report this sign immediately. b. Place a warm towel over the extremities. c. Gently sponge with cool water. d. Medicate for pain.

ANS: C, D, E Stuttering, aggressive behavior, and finger or thumb sucking that appear suddenly with no previous history are a clue to increased nervous tension in the young school-age child. Masturbation and food fads are normal behavioral phenomena for the early school-age child.

The nurse counsels parents that the early school years create nervous tension in the child manifested by which abnormal behavior(s)? (Select all that apply.) a. Masturbation b. Food fads c. Stuttering d. Aggressive behavior e. Nonnutritive sucking

ANS: C Oils in bubble bath and similar products are known to irritate the urethra.

The nurse discussed strategies with a parent to prevent a recurrence of urinary tract infection in the child. Which statement made by the parent indicates a need for further teaching? a. ―My daughter should wash and wipe the perineal area from front to back.‖ b. ―I am only going to have my daughter wear cotton underwear.‖ c. ―It is acceptable to take frequent bubble baths.‖ d. ―She needs to drink lots of fluids and void frequently.‖

ANS: A The immediate treatment of hypoglycemia consists of administering sugar in some form such as orange juice, hard candy, or a commercial product. Cheese will eventually raise the blood glucose, but not as quickly as candy.

The nurse discussed treatment of hypoglycemia with an adolescent. Which statement by the adolescent leads the nurse to determine the patient understood the instructions? a. ―When my blood glucose is low or if I begin to feel hungry and weak, I will eat six LifeSavers.‖ b. ―When my blood glucose is low or if I begin to feel hungry and weak, I will give myself Lispro insulin.‖ c. ―When my blood glucose is low or if I begin to feel hungry and weak, I will have a slice of cheese.‖ d. ―When my blood glucose is low or if I begin to feel hungry and weak, I will drink a diet soda.‖

ANS: A In the event of a paroxysmal hypercyanotic or ―tet‖ spell, the infant should be placed in a knee-chest position.

The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions? a. ―If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest.‖ b. ―If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body.‖ c. ―If the baby turns blue, I will immediately put the baby upright in an infant seat.‖ d. ―If the baby turns blue, I will put the baby in supine position with his head elevated.‖

ANS: B Stimulants that decrease the hyperactivity in the autistic child also impair cognition and may increase the potential of self-injuring behavior.

The nurse explains that use of stimulants will decrease hyperactivity in the autistic child. What is a negative aspect of stimulants? a. Sedating the child b. Impairing cognition c. Causing hypotension d. Creating fluid retention

ANS: B The prodromal stage is the initial stage of the communicable disease in which the child is infected and contagious but does not yet have outward signs of the disease.

The nurse explains to the parents that their child is in the prodromal stage of varicella. What does this mean? a. The child is now immune to varicella. b. The child has varicella but has not yet broken out. c. The child is infected with varicella but is not contagious. d. The child does not have varicella but has been exposed to it.

The nurse finds an adolescent with Hodgkin's disease crying. The adolescent says, ―I am so scared.‖ What is the most appropriate nursing response to this comment? a. ―I understand how you must feel.‖ b. ―You shouldn't feel that way.‖ c. ―Is this the strongest feeling you've had today?‖ d. ―Tell me what's got you scared.‖

ANS: D Rice is a gluten-free grain that can be eaten by children afflicted with celiac disease. These children will have a lifelong restriction of wheat, oats, barley, and rye.

The nurse has reviewed dietary restrictions for celiac disease with concerned parents. Which grain will the nurse explain can be eaten with celiac disease? a. Wheat b. Oats c. Barley d. Rice

ANS: B The risk of death increases when there is a definite plan of action, the means are readily available, and the person has few resources for help and support.

The nurse is answering phone calls at a local suicide prevention hotline. Which statement would be recognized as the greatest risk of suicide? a. ―I just needed to talk to someone to keep myself from thinking silly thoughts about killing myself.‖ b. ―My parents aren't home and won't be back for 4 hours. That should be enough time for the pills to work. I've got a hundred of them.‖ c. ―My dad will be home first, so he'll find me. So I think I'll use his gun. I hope he didn't lock the cabinet.‖ d. ―My girlfriend is here with me. She told me to call because I was talking crazy about killing myself.‖

ANS: A, B, E The primary symptom of anorexia nervosa is severe weight loss. Adolescents who wish to be fashion models or actresses or who participate in sports, dance, or gymnastics activities may be at risk for developing an eating disorder. On physical examination, some of the following conditions may be evident: dry skin, amenorrhea, lanugo hair over the back and extremities, cold intolerance, low blood pressure, abdominal pain, and constipation.

The nurse is assessing a 16-year-old female for characteristics of anorexia nervosa. Which assessment finding(s) would lead the nurse to suspect the possibility of this diagnosis? (Select all that apply.) a. Amenorrhea b. Severe weight loss c. Oily skin d. Hypertension e. Lanugo on back

ANS: D The child's skin has a dramatically greater ability to absorb than does that of the adult.

The nurse is careful to apply only the prescribed amount of ointment to the skin of a 2-month-old infant. How is infant skin different from adult skin? a. Less perfusion b. Greater moisture c. More perspiration d. Greater absorption

The nurse is caring for a 15-year-old boy after left lower extremity amputation surgery after a diagnosis of osteosarcoma. The patient reports that his "left foot is in severe pain." What should the nurse do first? Remind him that he no longer has a left foot. Provide emotional support. Medicate for pain as ordered. Reposition for comfort.

ANS: B Increasing blood pressure, accompanied by decreasing pulse, and accompanied by unequal pupils are indicators of ICP.

The nurse is caring for a 3-year-old child with a head injury. Which assessment would lead the nurse to report the probability of increasing intracranial pressure (ICP)? a. Temperature increase from 37.2C (99F) to 37.7C (100F) c. Increase in respirations b. Increase in blood pressure with an attendant decrease in pulse d. Equilateral pupils

ANS: D The minimum acceptable hourly urine output for children over the age of 2 years is 20 to 30 mL/hr.

The nurse is caring for a 3-year-old child with severe burns. What is the nurse aware is the minimum adequate hourly urine output? a. 5 mL/hr b. 10 mL/hr c. 15 mL/hr d. 20 mL/hr

The nurse is caring for a child receiving digoxin (Lanoxin) for the diagnosis of heart failure. Which manifestation does the nurse recognize as a cardinal sign of digoxin toxicity? Respiratory distress Sudden change in pulse Constipation Headache

ANS: A Inflammation of vessels weakens the walls of the vessels and often results in aneurysm.

The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, ―How does Kawasaki disease affect my child's heart and blood vessels?‖ On what understanding is the nurse's response based? a. Inflammation weakens blood vessels, leading to aneurysm. b. Increased lipid levels lead to the development of atherosclerosis. c. Untreated disease causes mitral valve stenosis. d. Altered blood flow increases cardiac workload with resulting heart failure.

ANS: A, B, C, D The reduction or destruction of platelets in the body interferes with the clotting mechanism. Skin lesions that are common to these disorders include petechiae, a bluish, nonblanching, pinpoint-sized lesion; purpura, groups of adjoining petechiae; ecchymosis, an isolated bluish lesion larger than a petechia; and hematoma, a raised ecchymosis. Lymphadenopathy is an enlargement of lymph nodes that is indicative of infection or disease.

The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply.) a. Petechiae b. Purpura c. Ecchymosis d. Hematoma e. Lymphadenopathy

ANS: D The formula for oral fluid replacement is 10 mL/kg. 18 pounds = 8.1 kg 10 = 81 mL.

The nurse is caring for an 18-pound child who has had one stool of diarrhea. The nurse knows that the child needs to consume how many milliliters of oral fluid to make up for the fluid loss? a. 18 b. 36 c. 64 d. 81

ANS: A Capillary refill in 3 seconds or less is determined to be indicative of adequate perfusion.

The nurse is checking for capillary refill on a child in Bryant's traction. How long does it take for the toe to regain color if adequate perfusion is assessed? a. 3 seconds b. 4 seconds c. 5 seconds d. 6 seconds

ANS: D A vesicle is an elevated, fluid-filled blister (cold sore, chicken pox).

The nurse is documenting a description of a skin assessment. What term can be used for an elevated, fluid-filled blister? a. Pustule b. Papule c. Wheal d. Vesicle

ANS: C Juices such as apple or cranberry help maintain acidity of urine.

The nurse is explaining to a 17-year-old female the actions to prevent urinary tract infection. Which is the best beverage for the nurse to recommend to keep urine acidic? a. Milk b. Grape juice c. Apple juice d. Orange juice

ANS: D An appropriate way to administer nystatin is to moisten a sterile applicator with the medication and then swab it on the inside of the mouth.

The nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include? a. Pour the prescribed amount into a nipple and have the infant suck the medication. b. Squirt the prescribed dose into the back of the mouth and have the infant swallow. c. Give the medication mixed with a small amount of juice in a bottle. d. Use a sterile applicator to swab the medication on the oral mucosa.

ANS: B Vomiting is the outstanding symptom of pyloric stenosis. Food is ejected with considerable force, which is described as projectile vomiting.

The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report? a. Diarrhea b. Projectile vomiting c. Poor appetite d. Constipation

ANS: C The main focus of a hypertension-prevention program is patient education.

The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information? a. Pharmacological treatment b. Surgical interventions available c. Patient education d. Reduction of aerobic exercise

ANS: C The primary source of lead is paint from old, deteriorating buildings.

The nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community? a. Increased lead content of air b. Use of aluminum cookware c. Deteriorating paint in older buildings d. Inhaling smog

ANS: A, B, D, E All options except pervasive high self-esteem are considered to be a cause of anorexia nervosa. Pervasive low self-esteem also is considered a cause of anorexia nervosa.

The nurse is planning the care of an adolescent with anorexia nervosa. What characteristic(s) cause this disorder? (Select all that apply.) a. Discomfort relative to emerging sexuality b. Fear of intimacy c. Pervasive high self-esteem d. Egocentricity e. Inability to meet developmental needs

ANS: A The influenza vaccine should not be given to children who are allergic to eggs.

The nurse is planning to administer immunizations at a well-child visit when a parent reports the 18-month-old child is allergic to eggs. Which vaccine would be contraindicated? a. Influenza b. Inactivated polio vaccine c. Diphtheria, tetanus, acellular pertussis d. Hepatitis B

ANS: C Prevention of Reye's syndrome includes educating parents not to give aspirin-containing medication to children with viral symptoms.

The nurse is planning to teach parents about prevention of Reye's syndrome. What information would the nurse include in this teaching? a. Use aspirin instead of acetaminophen for children with viral illness. b. Advise parents to have their children immunized against Reye's syndrome. c. Avoid giving salicylate-containing medications to a child who has viral symptoms. d. Get the child tested for Reye's syndrome if the child exhibits fever, vomiting, and lethargy.

ANS: C Insulin glargine is a long-acting insulin. Regular is short acting. Lispro and Aspart are rapid acting.

The nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting? a. Lispro b. Aspart c. Glargine d. Regular

ANS: B Hib vaccine must be given in a separate syringe from other vaccines administered at the same time.

The nurse is preparing to administer immunizations at a well-child clinic. Which method of administration will the nurse implement? a. DTaP subcutaneously b. Hib vaccine prepared in a separate syringe c. Varicella intramuscularly d. Varicella 1 week after the MMR vaccine

ANS: B Hemophilia A affects mostly males who received the sex-linked recessive trait from a symptom-free female. The defective gene is on the X chromosome.

The nurse is presenting information on the congenital disorder of hemophilia A. What fact will the nurse include? a. It is seen in males and females equally. b. It is transmitted by symptom-free females. c. It is a sex-linked dominant trait. d. It is a defective gene located on the Y chromosome.

ANS: D When one or both testes fail to lower into the scrotum, the condition is termed cryptorchidism. The unilateral form is more common. Because the testes are warmer in the abdomen than in the scrotum, the sperm cells begin to deteriorate. If both testes are affected, sterility results. Inguinal hernia often accompanies this condition. Occasionally, a testis or the testes spontaneously descend during the first year of life. An operation called an orchiopexy may be performed.

The nurse is providing information to parents of a child born with bilateral cryptorchidism. What information is accurate to include? a. This is the most common form. b. Fertility will be unaffected. c. Surgical intervention is not recommended. d. An inguinal hernia may be present.

ANS: A Heat is not a treatment for soft tissue injuries. The principles of managing soft tissue injuries are rest, ice, compression, and elevation.

The nurse is providing instructions about how to treat a sprained ankle. What statement by the mother does the nurse recognize as indicative of a need for additional teaching? a. ―Apply warm compresses to the ankle for the first 24 hours.‖ b. ―Put an ice pack on the ankle, alternating 30 minutes on with 30 minutes off.‖ c. ―Wrap the ankle in an Ace bandage for support.‖ d. ―Keep the leg elevated when sitting.‖

ANS: C The nurse should advise parents that pyrvinium stains clothing and turns stools red.

The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects? a. Diarrhea b. Skin rash c. Red stool d. Metallic taste

ANS: D Signs of water intoxication include edema, lethargy, nausea, and central nervous system signs.

The nurse is teaching the parents of a child with diabetes insipidus about water intoxication. The nurse would tell the parents to be alert for what symptom? a. Polyuria b. Cough c. Weight loss d. Lethargy

ANS: B Good nutritional sources of iron include boiled egg yolk, liver, green leafy vegetables, Cream of Wheat, dried fruits, beans, nuts, and whole-grain breads.

The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron? a. An egg white b. Cream of Wheat c. A banana d. A carrot

ANS: A The normal platelet count is 150,000 to 400,000/mm3. This finding is very low, indicating an increased bleeding potential.

The nurse notes that a 4-year-old child's gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms? a. Platelet count of 25,000/mm3 b. Hemoglobin level of 8 g/dL c. Hematocrit level of 36% d. Leukocyte count of 14,000/mm3

ANS: C In decerebrate posturing, arms are extended along the side of the body and hands are pronated. This posture indicates brainstem function only.

The nurse observes a child's position is supine with his arms and legs rigidly extended and the hands pronated. How does the nurse identify this posture? a. Correct anatomical position b. Decorticate c. Decerebrate d. Opisthotonos

ANS: D Clubbing of the fingers develops in response to chronic hypoxia.

The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, ―Why do my child's fingertips look like that?‖ On what understanding does the nurse base a response? a. Clubbing occurs as a result of untreated congestive heart failure. b. Clubbing occurs as a result of a left-to-right shunting of blood. c. Clubbing occurs as a result of decreased cardiac output. d. Clubbing occurs as a result of chronic hypoxia

ANS: B Osteomyelitis is an infection of the bone. Inflammation produces an exudate that collects under the marrow and cortex of the bone. The vessels are compressed and thrombosis occurs, producing ischemia and pain.

The parent of a child with osteomyelitis asks why his child is in so much pain. What will the nurse respond causes the pain experienced with osteomyelitis? a. ―Pressure of inelastic bone‖ b. ―Purulent drainage in the bone marrow‖ c. ―The cast applied on the extremity‖ d. ―Circulatory congestion of the skin‖

ANS: B Type 2, non-insulin-dependent diabetes mellitus is caused by insulin resistance or failure of the body to use the insulin.

The parents of a child newly diagnosed with diabetes mellitus tell the nurse, ―Our son's body is resistant to insulin.‖ With what does the nurse recognize this description is consistent? a. Type 1, insulin-dependent diabetes mellitus b. Type 2, non-insulin-dependent diabetes mellitus c. Maturity-onset diabetes of youth d. Drug-induced diabetes

ANS: C These signs are indicative of a hydrocele, a collection of fluid in the scrotum that usually corrects itself in a year.

The parents of a newborn are concerned that their son's scrotum is enlarged and swollen on one side. What is the nurse's best response? a. ―It is very common in the newborn that one gonad is larger than the other.‖ b. ―Birth trauma caused bruising to the scrotum. It will reduce in size in a few days.‖ c. ―It is a collection of fluid that will most likely correct itself in a year.‖ d. ―The doctor will drain this collection of blood before your baby is discharged.‖

The pediatric nurse is admitting a child diagnosed with tuberculosis. What personal protective equipment (PPE) will the nurse prepare? Contact precautions Airborne infection isolation Droplet isolation Enteric precautions

The pediatric nurse is providing discharge instructions to parents whose infant is prescribed Synthroid for the medical diagnosis of hypothyroidism. Which statement made by the mother indicates a knowledge deficit? "My child's medication is taken at the same time each day." "I am looking forward to my child being able to stop this medication." "It may take 1 to 3 weeks for the medication to reach the full therapeutic effect." "Side effects include hair loss, insomnia, and aggressiveness."

ANS: B Dyslexics often transpose a word as they read; for example, the word is dog, but it appears to the dyslexic child as the word God.

The pediatric nurse listens to a 9-year-old child read to his 6-year-old roommate. What action by 9-year-old child leads the nurse to question possible dyslexia? a. Becomes hyperactive and ceases to read. b. Reads the word dog as God. c. Makes up a story rather than reading the text. d. Stutters as he reads.

The presence of blood in the anterior chamber of the eye is called varicella. encephalitis. orbital cellulitis. hyphema.

ANS: A, C, E Although there are many products that could be inhaled, the most frequently used products are glue, cleaning fluid, aerosol sprays, Freon, shoe polish, and gasoline products.

The school nurse cautions a group of parents about the prevalence of children who get high by inhaling hydrocarbons and fluorocarbons. Which products contain these substances? (Select all that apply.) a. Glue b. Chlorine c. Cleaning fluid d. Copy machine toner e. Aerosol sprays

congenital hypothyroidism

Thick protruding tongue, pale skin, constipation, coarse facial features, prolonged jaundice, poor muscle tone, swollen protruding belly button

VSD, ASD, PDA

Three conditions that cause diaphoresis when feeding

ANS: D Because the right side of the heart must take over pumping blood to both the lungs and systemic circulation, the ductus arteriosus must remain open to shunt the oxygenated blood from the lungs.

Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood? a. The patent ductus arteriosus b. A ventricular septal defect c. The closure of the foramen ovale d. An atrial septal defect

Knee to chest

To help a child with fallot of tetralogy, have them get in what position

Surgical resection

Treatment for coarction of the aorta

Pavlik harness, allows movement, keeps hips flexed and abducted, prevents extension and adduction

Treatment for developmental dysplasia of the hip for infants <3 months

Surgery with open reduction and spina cast

Treatment for developmental dysplasia of the hip in infants >6 months

Corrective surgery

Treatment for tetralogy of fallot

Pinworms

Weight loss, poor appetite, rectal area itchy

A, b, d

What are appropriate interventions when caring for a child in traction? (Select all that apply.) Use of trapeze for positioning Neurovascular checks performed regularly Upright for 30 minutes a day Skin integrity monitored regularly Other extremities must be immobilized Liquid diet to prevent constipation

ANS: A, B, D, E The four anomalies that comprise tetralogy of Fallot are hypertrophied right ventricle, patent ductus arteriosus, stenosis of pulmonary artery, and dextroposition of the aorta

What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select all that apply.) a. Hypertrophied right ventricle b. Patent ductus arteriosus c. Ventral septal defect d. Narrowing of pulmonary artery e. Dextroposition of aorta

What are the initial signs of diabetes insipidus? Polyuria and dysphagia Diaphoresis and polydipsia Weight loss and lethargy Polydipsia and polyuria

What are the priority nursing actions when administering Diuril (chlorothiazide) to a child diagnosed with congestive heart failure (CHF)? Intake and output and periods of rest Measure pulse for 1 minute and review ECG Monitor serum electrolytes and daily weight Hold dose if patient vomits and until doctors write order to repeat dose

ANS: C A dark red spot in front of the iris is blood that has drained into the anterior chamber as the result of an injury.

What assessment does the school nurse recognize as the cardinal sign of a hyphema? a. Opacity of the lens b. A yellow-white reflex on the pupil c. A dark-red spot in front of the iris d. Inflamed mucous membranes of the eyelids

ANS: B Indicators of strabismus include covering one eye to see, tilting the head to see, and missing objects in attempts to pick them up. Although headaches may be associated with amblyopia, this symptom is too vague to point suspicion to any disorder.

What assessment made by the school nurse would lead to the suspicion of strabismus? a. Reddened sclera in one eye b. Child covers one eye to read the chalkboard c. Child complains of a headache d. Copious tears while watching TV

ANS: A, B, C, E Indicators of a paroxysmal hypercyanotic episode or a ―tet‖ episode are spontaneous cyanosis, dyspnea, weakness, and syncope.

What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.) a. Spontaneous cyanosis b. Dyspnea c. Weakness d. Dry cough e. Syncope

ASD, VSD, PDA

What causes increased pulmonary blood flow

Transposition of the great arteries, truncus arteriousus, hypoplastic left heart syndrome

What causes mixed blood flow

coarctation of the aorta, pulmonary stenosis, aortic stenosis

What causes obstruction to blood flow

ANS: C Frequent falling and clumsiness are clinical manifestations of Duchenne's muscular dystrophy

What characteristic manifestation does the nurse caring for a child with Duchenne's muscular dystrophy document? a. Ambulates by holding onto furniture. b. Exhibits atrophy of the calf muscles. c. Falls frequently and is clumsy. d. Has delayed fine-motor development.

What clinical manifestation is most suggestive of pyloric stenosis? Regurgitation Projectile vomiting Bloody stool Steatorrhea

ANS: B The Somogyi phenomenon (rebound hyperglycemia) occurs when the blood glucose level is lowered to the point at which the body's counter-regulatory hormones are released, producing the symptoms described.

What condition does the nurse suspect when a child with type 1 diabetes mellitus has hyperglycemia, diaphoresis, and headaches in the morning? a. Dawn phenomenon b. Somogyi phenomenon c. Honeymoon effect d. Ketoacidosis

What description of a child's stool characteristic leads the nurse to suspect intussusception? a. Currant jelly b. Black and tarry c. Green liquid d. Greasy and foul-smelling

C- Conjunctivitis, R- rash, A- Adenopathy, S- strawberry tongue, H- hand and foot changes Burn- high fevers with sudden onset

What does CRASH and burn stand for with Kawasaki disease

J-joints, O looks like a heart-myocarditis, N- nodules, E- erythema marginatum, S- Sydenham Chorea

What does JONES stand for

ANS: C Celiac disease causes malabsorption. Stools that are large, bulky, and frothy may indicate malabsorption

What does the nurse expect the appearance of the stools of a child with celiac disease to be? a. Ribbon like b. Hard, constipated c. Bulky, frothy d. Loose, foul-smelling

ANS: A Pulmonary blood flow is increased when a ventricular septal defect exists. The blood shifts from left to right because of the higher pressure in the left ventricle. This particular shift does not cause cyanosis.

What does the nurse explain that a ventricular septal defect will allow? a. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis b. Blood to shunt right to left, causing decreased pulmonary flow and cyanosis c. No shunting because of high pressure in the left ventricle d. Increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume

ANS: D Febrile seizures occur in response to a rapid rise in temperature, often above 38.8C (102F).

What does the nurse explain to parents of a child with febrile seizures? They occur when the body temperature exceeds 38.3C (101F). a. They usually lead to the development of epilepsy. b. They can be prevented by anticonvulsant medication. d. They occur when the temperature rises quickly.

ANS: C Children often find it easier to learn to inject the needle at a 90-degree angle.

What does the nurse instruct a 12-year-old to do when teaching how to administer insulin? a. Make sure injection sites are 6 inches apart. b. Select an injection site that was recently exercised. c. Inject the needle at a 90-degree angle. d. Give the injection deep into the muscle.

ANS: D Cyanosis or pallor noted in an extremity is an indication of circulatory impairment.

What finding would the nurse assessing the neurovascular status of a child in Russell traction report immediately? a. Skin that's warm to the touch b. Capillary refill less than 3 seconds c. Ability to wiggle toes d. Bluish coloration of skin

ANS: D The characteristic symptoms of coarctation of the aorta are a marked difference in blood pressure and pulses between the upper and lower extremities. Pressure is increased proximal to the defect and decreased distal to the coarctation.

What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta? a. Blood pressure higher on the right side b. Blood pressure higher on the left side c. Blood pressure lower in the arms than in the legs d. Blood pressure lower in the legs than in the arms

ANS: D Bananas are very high in potassium and should be avoided.

What foods does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia? a. Dairy products b. Whole-grain cereals c. Organ meats d. Bananas

ANS: C Hearing is intact even when there is a loss of consciousness.

What important focus of nursing care for the dying child and the family should the nurse implement? a. Nursing care should be organized to minimize contact with the child. b. Adequate oral intake is crucial to the dying child. c. Families should be made aware that hearing is the last sense to stop functioning before death. d. It is best for the family if the nursing staff provides all of the child's care.

ANS: A One intervention to prevent the further spread of pinworms is to keep the child's fingernails short. Pinworms are not spread from person to person.

What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms? a. Keep children's nails short. b. Dress child in loose-fitting underwear. c. Clean the bathroom with bleach solution. d. Wash bed linens in cold water.

ANS: C A Milwaukee brace is worn approximately 23 hours a day over a T-shirt, which protects the skin.

What instruction would the nurse provide to an adolescent who has been fitted with a Milwaukee brace? a. Wear the brace directly against the skin. b. Wear the brace over regular clothing. c. Wear the brace over a T-shirt 23 hours a day. d. Remove the brace before sleeping.

What intervention is appropriate for a nurse assessing a preadolescent child for scoliosis? a. Ask the child to bend forward at the waist and observe the child's back for asymmetry. b. Observe the gait while the child is walking forward heel to toe. c. Have the child flex the knees and look for uneven knee height. d. Look at the child's shoulders and hips while fully clothed.

ANS: B Buck traction is a type of skin traction that relies on the child's weight as counterbalance. The child must be kept with head elevated no more than 20 degrees and pulled up in bed, and the feet should not touch the bed surface or the foot of the bed.

What intervention will the nurse caring for a child in Buck skin traction implement? a. Position in high Fowler's position. b. Assist the child to be pulled up in bed. c. Keep child's heel on the bed surface. d. Maintain child's feet against the foot of the bed.

ANS: C HDLs have low amounts of triglycerides, large amounts of proteins, and low amount of cholesterol, and are excreted via the liver. They have no role in the production of steroids.

What is accurate about the characteristics of high-density lipoproteins (HDLs)? a. They have high amounts of triglycerides. b. They have only small amounts of protein. c. They have little cholesterol. d. They aid in steroid production.

ANS: B The child should be turned frequently to prevent respiratory tract infection and to prevent pressure on delicate skin.

What is an appropriate intervention for the edematous child with reduced mobility related to nephrotic syndrome? a. Reach the child to minimize body movements. b. Change the child's position frequently. c. Keep the head of the child's bed flat. d. Keep edematous areas moist and covered

ANS: B During a generalized tonic-clonic seizure, the immediate area is cleared to protect the child from injury.

What is an appropriate nursing action when a child is experiencing a generalized tonic-clonic seizure? a. Assist the child to bed and then go for help. b. Move objects out of the child's immediate area. c. Stick a padded tongue blade between the child's teeth. d. Manually restrain the child.

ANS: D During hospitalization, the nurse should provide a highly structured environment with few distractions for a child who is autistic.

What is an appropriate nursing intervention for a hospitalized child who is autistic? a. Place the child in a location where she can watch all of the activity on the unit. b. Use the child's chronological age as a guide for communication. c. Keep the child's room free of toys or objects that she might want to take home with her. d. Organize care to provide as few disruptions to the routine as possible.

ANS: C The child with diabetes insipidus needs liberal access to bathrooms and water fountains. Arrangements may have to be made with the school to allow access.

What is an important consideration for the school-age child taking DDAVP for diabetes insipidus? a. Observe for signs of water deprivation. b. Restrict his physical education program. c. Arrange for the child to use the bathroom when needed. d. Limit fluid intake other than during the lunch period.

ANS: B The edema of nephrotic syndrome is generalized and not readily noticed, even by the parents, but an early sign that can be assessed is periorbital edema.

What is an initial sign of nephrosis that the nurse might note in a child? a. Raspberry-like rash b. Periorbital edema c. Temperature elevation d. Abdominal pain

B, c, d

What is included in preventive teaching for urinary tract infections (UTIs) in girls? (Select all that apply.) Wearing nylon underwear Encouraging fluids Wiping front to back Avoiding bubble baths Encouraging use of talcum powder

ANS: A Prednisone depresses the immune response and increases susceptibility to infection. Because steroids mask signs of infection, the child must be assessed for more subtle symptoms of illness.

What is it important to assess in a child receiving prednisone to treat nephrotic syndrome? a. Infection b. Urinary retention c. Easy bruising d. Hypoglycemia

Coronary artery aneurysm

What is most common in the subacute phase of Kawasaki disease

ANS: B The prescribed amount of ointment is usually applied to the skin by a gloved hand in long, smooth strokes. Lanolin-based preparations should be avoided because of a possible allergy to wool.

What is the appropriate technique for the application of a topical treatment for a child with eczema? a. Apply skin lotions in a circular motion. b. Apply prescribed ointments with a gloved hand. c. Apply as much and as frequently as relieves the symptoms. d. Choose lanolin-based ointments.

What is the approximate bladder capacity of a 4-year-old child? 2 ounces 4 ounces 6 ounces 8 ounces

ANS: C The nurse who faces the child and speaks clearly will help the hearing-impaired child in the hospital to develop a healthy personality.

What is the best way for the nurse to communicate with a 10-year-old child who has a hearing impairment? a. Use gestures and signs as much as possible. b. Let the child's parents communicate for her. c. Face the child and speak clearly in short sentences. d. Recognize that the child's ability to communicate will be on a 6-year-old child's level.

What is the classic symptom of idiopathic (immunological) thrombocytopenia purpura (ITP)? Bruising Fever Nosebleed Irregular pulse

ANS: A Scales may be softened by applying baby oil to the head the evening before, and shampooing the hair in the morning.

What is the correct nursing response to a mother who asks, ―How can I get rid of the baby's cradle cap?‖ a. ―Rub baby oil on the infant's head at night and shampoo the hair the next morning.‖ b. ―Use a brush with firm bristles to loosen the scales on the baby's head several times a day.‖ c. ―Wash the baby's head every night with a dandruff-control shampoo.‖ d. ―Lubricate the baby's head every morning with a small amount of olive oil.‖

ANS: B The insulin pump that is attached to a subcutaneous tube releases a continuous infusion of insulin.

What is the function of an insulin pump? a. Releases insulin as blood glucose rises. b. Provides continuous infusion of insulin. c. Decreases need for painful glucose monitoring. d. Delivers a prescribed amount of insulin twice a day.

What is the most accurate diagnostic tool in diagnosing suspected osteomyelitis in the pediatric patient? Bone scan RBC count X-ray Serum albumin level

ANS: C The child with ADHD needs breaks between periods of work and study

What is the most appropriate classroom intervention for a child with attention-deficit hyperactivity disorder (ADHD) for the school nurse to suggest? a. Seat the child in the back of the room to prevent distractions for other children. b. Pair the child with a student buddy to offer reminders to pay attention. c. Divide work assignments into shorter periods with breaks in between. d. Separate the child from others to increase his focus on schoolwork.

What is the most common form of childhood cancer? Lymphoma A brain tumor Leukemia Osteosarcoma

What is the most important nursing intervention to identify and minimize compartment syndrome? Apply BP cuff above the cast. Treat pain with minimum amount needed to control it. Elevate arm at least 30 minute/hr. Perform frequent neurovascular checks.

What is the name of the condition in which the urinary meatus is located on the underside of the penis? Hypospadias Epispadias Phimosis Chordee

What is the nurse's priority action if a child's mother is complaining of a foul odor and colored discharge in the child's underwear? Collect underwear for cultures. Gather additional data about child's activities. Ask the mother if the child has had any changes of diet. Make a note to ask the health care provider for a culture and sensitivity.

ANS: D The infant who is HIV positive has impaired immunologic functioning and is at high risk for infection.

What is the priority nursing diagnosis for a hospitalized infant who is HIV positive? a. Risk for injury b. Altered nutrition c. Impaired skin integrity d. Risk for infection

ANS: D Christmas disease, or hemophilia B, is caused by the deficiency of factor IX.

What is the result of a deficiency of factor IX? a. Thalassemia b. Idiopathic thrombocytopenic purpura c. Hemophilia A d. Christmas diseased

ANS: A A barium enema is the treatment of choice for intussusception because the passage of the barium frequently ―un-telescopes‖ the bowel. Surgery is scheduled only if reduction is not achieved.

What is the treatment of choice for a child with intussusception? a. A barium enema b. Immediate surgery c. IV fluids until the spasms subside d. Gastric lavage

What may be included in the treatment of salicylate poisoning? Vitamin K Mucomyst Acetaminophen Chelating agents Syrup of ipecac

What medication should be readily available when immunizations are administered? Epinephrine Amoxicillin Mucomyst Ativan

ANS: A Early detection and treatment are essential for the child with amblyopia. Treatment includes patching the good eye and using glasses to correct refractive errors.

What might the nurse explain as a common treatment for amblyopia? a. Patching the good eye to force the brain to use the affected eye b. Patching the affected eye to allow the refractory muscles to rest c. Using glasses that will slightly blur the image for the good eye d. Using corticosteroids to treat inflammation of the optic nerve

ANS: A The nurse caring for a child in traction must be alert for Volkmann's ischemia, which occurs when circulation is obstructed.

What nursing action will significantly decrease the risk of serious complications for a child in Bryant's traction? a. Neurovascular checks are done frequently. b. Bandages are wrapped tightly. c. The child is restrained from rolling over. d. The child's buttocks are resting on the bed.

ANS: B When insulin is deficient, the body cannot metabolize carbohydrates for energy. The body is also unable to store and use fat properly. Incomplete fat metabolism produces ketone bodies that accumulate in the blood.

What occurs as a result of an inadequate secretion of insulin? a. Protein synthesis is increased. b. Increased fat breakdown leads to ketonemia. c. Serum glucose levels are markedly decreased. d. More rapid conversion and storage of carbohydrates to glucose occurs

ANS: D Some children with eczema also develop asthma and hay fever-type allergies.

What risk is increased with children who have been diagnosed with infantile eczema? a. Pneumonia b. Acne c. Sun sensitivity d. Asthma

ANS: B Of the four roles for the child of the alcoholic, the super coper is one who tries to do everything perfectly and feels overly responsible. The perfect child is the child who tries to earn love by never causing any trouble.

What role has the child of an alcoholic assumed if he tries to do everything perfectly? a. Perfect child b. Super coper c. Flight d. Helper

ANS: A, B, C, D Sun block should be applied to skin after radiation to prevent burning. Low energy levels produce anorexia and anger in many young patients. Radiation delays the development of secondary sex characteristics and menses.

What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkin's disease? (Select all that apply.) a. Application of sunblock b. Appetite stimulation c. Conservation of energy d. Provision for expressions of anger e. Preparation for premature sexual development

ANS: A The child receiving a blood transfusion is observed for signs of a transfusion reaction including chills, itching, fever, rash, headache, and back pain.

What should the nurse closely assess in a child receiving a transfusion? a. Fever b. Lethargy c. Jaundice d. Bradycardia

What should the nurse include when educating parents regarding care of their child following a lymphangiogram? The child may be lethargic. Slight hair loss may occur. Diarrhea is common. The skin and urine may take on a bluish color.

ANS: C A burn injury is taxing to the child and parents. It requires long periods of hospitalization and frequent readmissions. The accident itself is terrifying for the child but is made even worse if caused by disobedience. Nurses encourage children to express their feelings. Analgesics are administered before painful procedures. The long-term patient requires diversions of various types. School tutors are requested, and contact is maintained with peers through cards or e-mail.

What should the nurse keep in mind when providing care to the school-age child hospitalized with a burn injury? a. Hospitalization will be brief. b. Analgesics should be given immediately after dressing changes. c. Contact with peers should be maintained. d. Parents usually handle injury worse than the child.

ANS: D Small cuts and bites should be treated promptly to prevent the invasions of the bacteria that cause impetigo. The crusts from the lesions should be gently removed. The disease is contagious.

What should the nurse stress to the mother of a child with impetigo? a. The condition is caused by the herpes simplex virus type I. b. The crusts on the lesions should be left in place. c. The lesions may spread, but the disease is not contagious. d. Small cuts and bites should be treated promptly.

ANS: A Oral contraceptives are often prescribed for adolescents with acne. Accutane can cause birth defects, so pregnancy should be prevented.

What should the nurse suggest before a 17-year-old girl starts a protocol of isotretinoin (Accutane) for her acne? a. Get a prescription for oral contraceptives. b. Increase the dose of the present medication. c. Limit intake of chocolate, cola, and peanuts. d. Increase exposure to sunlight.

A,b,d,e

What signs and symptoms would alert the nurse to the possibility of intussusception? (Select all that apply.) Onset is sudden Kicking and drawing of legs Failure to thrive Bile stained vomit Currant jelly stools

ANS: D Synthroid should be given at the same time each day, preferably in the morning.

What statement by a parent leads the nurse to determine a parent is administering levothyroxine (Synthroid) correctly? a. ―I stopped giving the medication because my daughter was losing her hair b. ―I am using a different brand now because it costs less money.‖ c. ―I don't give the medication on the weekends.‖ d. ―I give the medication at 8:00 AM every day.‖

ANS: D Antibiotic therapy for otitis media is continued until the prescribed amount has been completed, even if symptoms are alleviated.

What statement by a patient's mother leads the nurse to determine she understands instructions about administering an oral antibiotic for otitis media? a. ―I will continue using the medication until symptoms are relieved.‖ b. ―I will share the medicine with siblings if their symptoms are the same.‖ c. ―I will give the medication with a glass of milk.‖ d. ―I will administer prescribed doses until all the medication is used.‖

What statement by the mother of a 1-year-old with intertrigo suggests that she needs more education about treatment for this diagnosis? "I should let him run around without a diaper to help him get better." "I should make sure his diaper is changed frequently." "I should wash my hands before and after changing his diaper." "I should keep him away from other kids until this is healed."

ANS: D People should keep skin covered by wearing protective clothing in wooded areas to prevent tick bites.

What statement leads the nurse to determine that a child's parent understands information related to tick bites? a. ―I'll have my son wear dark clothing on his hike.‖ b. ―We should all get the Lyme disease vaccine before our trip.‖ c. ―I'll get a prescription for amoxicillin to take with us.‖ d. ―We will wear long pants and long-sleeved shirts in the woods.‖

ANS: C A child with a viral infection is at risk for Reye's syndrome, the onset of which is effortless vomiting, lethargy, and a change in level of consciousness. A 5-month-old child who sleeps after eating is normal.

What symptom leads the nurse caring for a 5-month-old child with viral influenza to suspect the development of Reye's syndrome? a. Respirations drop from 18 to 14 breaths/minute b. Falling asleep after feeding c. Sudden vomiting without effort d. Development of a macular rash

What terminology applies when there is an intentional omission of verbal or behavioral actions that are necessary for development of a healthy self-esteem, including social or emotional isolation of a child? Physical neglect Emotional abuse Physical abuse Emotional neglect

ANS: C Airborne-infection precautions are used for patients with conditions such as tuberculosis, varicella, and rubella. Small airborne particles caught on floating dust in the room can be inhaled from anywhere in the room.

What type of precautions are necessary when caring for a toddler with varicella? a. Contact b. Protective c. Airborne d. Droplet

ANS: B Vitamin C aids in the absorption of iron, whereas food and milk interfere with the absorption of iron.

What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit? a. With milk b. With orange juice c. With water d. On a full stomach

ANS: C The skin exposed to frequent friction may break down.

What will the nurse include when caring for a child in Buck's extension? a. Positioning the child with hips flexed 90 degrees at all times b. Keeping the weights in contact with the floor c. Checking for skin irritation from traction equipment d. Releasing the weights on a schedule

B, c, d, e

What will the nurse include when performing cranial or neurological assessments? (Select all that apply.) Lung sounds Pupil assessment Vital signs Motor activity Level of consciousness

ANS: D General hygienic measures of cleanliness, rest, and avoidance of emotional stress may help prevent exacerbations.

What will the nurse include when teaching about general skin care measures that could help prevent acne? a. Eliminating chocolate, peanuts, and cola from the diet b. Washing the face with a cleansing product frequently c. Planning indoor activities to avoid sun exposure d. Eating a balanced diet and getting sufficient rest

ANS: C Eye secretions are always cleared from the inner canthus downward and away from the opposite eye (inner to outer direction).

What will the nurse teach parents when giving instructions for acute conjunctivitis? a. Apply cool compresses to the affected eye several times a day. b. Instill topical steroid eyedrops for 1 week. c. Clear drainage from the inner to the outer aspect of the eye. d. Keep the eye patched until the inflammation resolves.

ANS: B Aspirin interferes with platelet function and should be avoided to prevent the risk of prolonged bleeding.

What will the nurse teach the parents of a child with a low platelet count to avoid? a. Benadryl b. Aspirin c. Caffeine d. Prednisone

ANS: D The nurse establishes a rapport with the adolescent by acknowledging his or her feelings and giving the adolescent full attention

What would be the appropriate response to an adolescent who states, ―This has been the worst day of my life?‖ a. ―You should focus your mind on positive thoughts.‖ b. ―Everybody has a bad day now and then.‖ c. ―You're young. What could be so terrible?‖ d. ―Tell me about the worst day of your life.‖

ANS: B Carriers can be identified by screening tests. Tay-Sachs disease has an autosomal recessive pattern of transmission.

What would be the most appropriate nursing response to a woman who says, ―My sister had a child with Tay-Sachs disease, and I want to know if I could have a child with this condition‖? a. ―The disease is rare. It is unlikely that you would have a child with Tay-Sachs disease.‖ b. ―A screening test can be done to determine if you are a carrier of the gene.‖ c. ―The gene for Tay-Sachs disease is transmitted by the father.‖ d. ―The cause of Tay-Sachs disease is thought to be an autoimmune response to a virus.‖

ANS: B Frequent meals and snacks high in calories, protein, and iron are needed to meet the increased metabolic needs of the child with burns.

What would help the child with a serious burn meet nutritional needs during the subacute phase of recovery? a. Decrease calories because the child will be on bed rest and will not need as many. b. Increase calories and protein to compensate for the healing process. c. Increase fat to replace the layer of fat next to the burned skin. d. Decrease carbohydrates and starches because the pancreas is strained by the healing process.

ANS: B Some children with failure to thrive have rag-doll limpness (hypotonia) and appear wary of their caregivers.

What would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive? a. Cry to be picked up b. Be limp like a rag doll c. Be responsive to cuddling d. Weigh in the 10th percentile for age

ANS: B A soft toothbrush reduces capillary damage and mucous membrane breakdown and prevents bleeding and infection. Commercial mouthwashes may kill oral flora that combat infection. Water-Pik is useful for toughening gums.

What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy? a. Use commercial mouthwash. b. Clean teeth with a soft toothbrush. c. Avoid use of a Water-Pik. d. Inspect the mouth weekly for ulcerations.

ANS: C Marked distortion of the head of the femur may lead to an imperfect joint or to degenerative arthritis of the hip later in life.

What would the nurse include in planning teaching to parents of a child with Legg-Calvé-Perthes disease about the long-term effects of this disease? a. There are no long-term effects. b. The disease is self-limited and requires no long-term treatment. c. Degenerative arthritis may develop later in life. d. There is risk of osteogenic sarcoma in adulthood.

ANS: C Encouraging an infant to swallow reduces the pressure in the ears during descent.

What would the nurse include in teaching when preparing to teach parents about air travel instructions to prevent barotrauma in infants? a. Using ear plugs during takeoff b. Omitting the meal just before takeoff c. Letting the infant nurse during descent d. Applying ear drops before takeoff

ANS: C Dilantin can cause gum overgrowth, which can be minimized by regular massaging. Dilantin frequently causes drowsiness and should be given with meals at the same time each day.

What would the nurse include when creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)? a. The medication should be given on an empty stomach. b. Insomnia can be a significant side effect. c. Gums should be massaged regularly to prevent hyperplasia. d. Blood pressure should be closely monitored.

ANS: C After a tympanostomy, care should be taken to avoid getting water in the ears.

What would the nurse include when planning postoperative teaching for a child who has had a tympanostomy with insertion of tubes? a. Keeping the infant flat after feeding b. Giving over-the-counter decongestants c. Avoiding getting water in the ears d. Cleaning the ear canal with cotton-tipped applicators

ANS: B Treatment of hypospadias consists of surgical repair and is usually performed before 18 months of age.

When asked about correcting the hypospadias of a newborn, what does the nurse explain about this condition? a. No intervention is necessary as the defect will correct itself over time. b. Surgical repair of the hypospadias is done before 18 months of age. c. Corrective surgery is usually delayed until the preschool age. d. Repairing the defect will increase the risk of testicular cancer.

ANS: C ―Speed‖ is the street name for methamphetamine.

When the nurse is collecting a nursing history, an adolescent states that she has tried speed. For what does the nurse recognize this as the street name? a. Barbiturates b. Cocaine c. Methamphetamine d. Marijuana

Polycythemia

When you overproduce RBC

ANS: D The use of Silvadene cream on burns is contraindicated if the patient has a sulfa allergy.

Which allergy would contraindicate the use of silver sulfadiazine (Silvadene) as a topical agent for burns? a. Penicillin b. Iodine c. Tetanus immunizations d. Sulfa

A, b, c, f

Which are characteristics of sickle cell anemia? (Select all that apply.) Clinical symptoms present around 1 year of life Chronic anemia Pale and tires easily Can be caused by severe hemorrhage Prevented by adequate intake of iron by mother during pregnancy Potentially fatal crises can occur

ANS: D Neurovascular checks include assessment of pain, pulse, sensation, color, capillary refill, and movement. Pupils are assessed with a neurological check.

Which assessment performed by a nursing student performing a neurovascular check alerts the instructor that further education is necessary? a. Pulses b. Capillary refill c. Movement d. Pupils

ANS: A A loud, harsh murmur combined with a systolic thrill is characteristic of a ventricular septal defect.

Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect? a. A loud, harsh murmur with a systolic thrill b. Cyanosis when crying c. Blood pressure higher in the arms than in the legs d. A machinery-like murmur

ANS: D Steroids are immunosuppressive drugs that make the child very susceptible to opportunistic infections.

Which classification of medication would make a child most susceptible to an opportunistic infection? a. Anticonvulsant b. Beta-adrenergic agent c. Antibiotic d. Corticosteroid

ANS: B Fatigue during feeding or activity is common to most infants with congenital cardiac problems.

Which comment made by a parent of a 1-month-old infant would alert the nurse about the presence of a congenital heart defect? a. ―He is always hungry.‖ b. ―He tires out during feedings.‖ c. ―He is fussy for several hours every day.‖ d. ―He sleeps all the time.‖

ANS: C Blood glucose is high after meals. The child with type 1 diabetes mellitus who skips a meal before exercise is at risk for hypoglycemia.

Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise? a. ―I carry a piece of hard candy with me in case I start to feel shaky.‖ b. ―I make sure I have emergency money when I have soccer practice or a game.‖ c. ―Sometimes I skip my breakfast when I have a game in the morning.‖ d. ―I play in soccer games that are scheduled after dinner.‖

patent ductus arteriosus (PDA)

Which condition has a systolic murmur

ANS: A, D, E The congenital heart defects that cause increased pulmonary blood flow are ASDs, VSDs, and patent ductus arteriosus.

Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.) a. Atrial septal defects (ASDs) b. Tetralogy of Fallot c. Dextroposition of aorta d. Patent ductus arteriosus e. Ventricular septal defects (VSDs)

B, C, E, F

Which coping patterns do children of alcoholics often display? (Select all that apply.) Determination Flight Perfect child Procrastinator Fight Super coper

B, C, D, E

Which defects are associated with tetralogy of Fallot? (Select all that apply.) Atrial septal defect Ventricular septal defect Dextroposition of the aorta Pulmonary artery stenosis Hypertrophy of the right ventricle Patent ductus arteriosus

Which deficiency causes Tay-Sachs disease? Phenylketonuria (PKU) Galactose Leucine Hexosaminidase

Which diagnosis is related to the development of Reye's syndrome in conjunction with aspirin administration in the pediatric patient? Varicella Meningitis Encephalitis Strep throat

Which diagnosis often accompanies cryptorchidism? Wilms' tumor Pyloric stenosis Paraphimosis Inguinal hernia

Which diagnostic test is a standardized diagnostic test for rheumatic fever? Sedimentation rate WBC count Antistreptolysin O titer Rubella titer

Which disorder causes unoxygenated blood to enter the systemic arterial circulation? Patent ductus arteriosus Tetralogy of Fallot Coarctation of the aorta Atrial stenosis

ANS: B After birth, a newborn with tracheoesophageal fistula will vomit and choke when the first feeding is introduced.

Which finding in a newborn is suggestive of tracheoesophageal fistula? a. Failure to pass meconium in 24 hours b. Choking on the first feeding c. Palpable mass in the sternal area d. Visible peristalsis across abdomen

ANS: B A contraindication to giving the DTaP vaccine is a 40.5C (105F) temperature following the previous vaccination.

Which finding would lead the nurse to delay the administration of DTaP for an infant? a. Diarrhea b. Temperature of 40.5C (105F) from the previous inoculation c. Teething d. Traveling to Europe in a week

ANS: B The nutritional needs of a child with diabetes mellitus are essentially the same as those of the nondiabetic child, with the exception of the elimination of concentrated carbohydrates such as sugar. Fiber has been shown to reduce blood glucose levels.

Which general dietary measure should the nurse include in a teaching plan for the child with type 1 diabetes mellitus? a. Control intake of carbohydrates and consume fewer calories. b. Focus on complex carbohydrates and eat foods high in fiber. c. Obtain most calories from proteins and fats. d. Eat a diet low in fat and low in complex carbohydrates.

ANS: B Application of moist heat, with a compress or by tub bath upon awakening in the morning, will help to lessen stiffness.

Which intervention would be helpful in relieving morning discomfort associated with juvenile rheumatoid arthritis? a. Wearing splints at night to prevent extension contractures b. Applying moist heat packs upon awakening c. Taking a warm tub bath the evening before d. Sleeping with two pillows under the head

A, b, c, d

Which interventions can be used to prevent diaper dermatitis? (Select all that apply.) Expose diaper area to air and light. Use non-alcohol baby wipes for cleansing. Apply ointments with vitamins A and D and lanolin. Cleanse with mild soap and water. Apply corticosteroid ointment.

Which is a characteristic of tinea capitis? Lesions located between the toes An oval, scaly inflamed ring with a clear center A raised, scaly rash in the groin area Patches of alopecia

ANS: B Pneumocystis jiroveci is the most common of opportunistic diseases.

Which is an example of an opportunistic infection? a. Measles b. Pneumocystis jiroveci c. Clostridium difficile d. Smallpox

Which is characterized by recurrent episodes of uncontrolled binge eating followed by self-induced vomiting and the misuse of laxatives and/or diuretics. bulimia anorexia nervosa depression oppositional defiant disorder

Which is the earliest sign of esophageal atresia? Mother develops gestational diabetes. Mother develops unexplained polyhydramnios. Infant does not pass meconium within 48 hours. Infant appears to drool during feedings.

ANS: A After feedings, the infant is placed in a prone position to avoid increased intraabdominal pressure.

Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux? a. Position the infant in the crib on his or her abdomen, with the head elevated. b. Administer medication as ordered to stimulate the pyloric sphincter. c. Give thin rice cereal with formula before feeding solid foods. d. Place the infant in an infant seat after feedings.

ANS: B As a rule, if the pulse rate of an infant is less than 100 beats/minute, the medication is withheld and the physician is notified.

Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant? a. Counting the apical rate for 30 seconds before administering the medication b. Withholding a dose if the apical heart rate is less than 100 beats/minute c. Repeating a dose if the child vomits within 30 minutes of the previous dose d. Checking respiratory rate and blood pressure before each dose

Which is the most useful diagnostic procedure in diagnosing a seizure disorder? Electroencephalography Lumbar puncture Brain scan Skull radiography

A, b, c, e

Which lab tests and results can be used to identify diabetes mellitus type I? (Select all that apply.) Fasting blood glucose (FBG) >126 mg/dL Glucose tolerance test (GTT) concentration >200 mg/dL Glycosylated hemoglobin test (HgbA1C) >9% Aspartate aminotransferase (AST/SGOT) test >45 U/L Urine ketone testing-positive Complete blood count (CBC): Bands >12%

ANS: D The nurse can increase parent's knowledge of growth and development by providing anticipatory guidance about normal developmental milestones.

Which nursing interventions will be implemented for the mother of a 10-month-old infant with nonorganic failure to thrive? a. Pointing out errors that the nurse observes when the mother is caring for the infant b. Discussing negative characteristics of the infant with the mother c. Having the nurse provide as much of the infant's care as possible d. Teaching the mother about the developmental milestones to expect in the next few months

Which observation indicates that an infant with congestive heart failure (CHF) is carefully following the prescribed medical regimen? The child takes antibiotics daily. The child exhibits normal weight for age. The child has an elevated RBC. The child's pulse rate is less than 50 beats/minute.

ANS: A As bruises heal, they change color in stages. Different colors of bruises indicate that injuries have not all occurred at the same time. The nurse must consider whether the bruises match the caretaker's explanation of what happened.

Which observation is most likely to cause the nurse to consider the possibility of child abuse when a mother says that her young child fell down the basement stairs? a. Red, green, and yellow bruises on his body. b. Bruises are dispersed on his head, arms, and legs. c. A broken arm last year, and the child being described as accident-prone. d. The mother is very anxious for her son to get medical attention.

Which organism is the most common cause of urinary tract infections in children? Escherichia coli Staphylococcus Klebsiella Pseudomonas

ANS: B Palpation of the abdomen could disturb the tumor and cause the malignancy to spread.

Which physical assessment technique will the nurse omit when caring for a 2-year-old child diagnosed with Wilms' tumor? a. Performing range-of-motion exercises on lower extremities b. Palpating the abdomen c. Assessing for bowel sounds d. Percussing ankle and knee reflexes

A, b, c

Which risk factors are potential causes of diabetes insipidus? (Select all that apply.) Head injury Heredity Brain tumor Viral syndrome Diabetes mellitus

B, D, E, F

Which signs indicate congenital cardiac problems? (Select all that apply.) Greater than normal weight gain Clubbing of fingers Bradycardia Tachypnea Pulsations in neck veins Dyspnea

A, b, c

Which signs/symptoms are characteristics of brain tumors in children? (Select all that apply.) Headache upon awakening Projectile vomiting Seizure activity Decreased blood pressure

ANS: D The child who is not making verbal attempts by 24 months should undergo a complete physical examination.

Which situation would cause the nurse to suspect a hearing impairment? a. 3-month-old infant with a positive Moro (startle reaction) reflex b. 15-month-old toddler who is babbling c. 18-month-old toddler who is speaking one-syllable words d. 24-month-old toddler who communicates by pointing

ANS: A The child with varicella is contagious for 6 days after the appearance of the rash.

Which statement assures the nurse that parents understand how long a child who has varicella is contagious? a. ―My child should stay home from school for 6 days after the pox appear.‖ b. ―My child can return to school when the rash fades.‖ c. ―My child must stay away from other children until all of the lesions have healed.‖ d. ―My child is contagious as long as he has a fever.‖

ANS: A Because cow's milk contains very little iron, infants should drink iron-fortified formula for the first year of life.

Which statement by a mother may indicate a cause for her 9-month-old's iron deficiency anemia? a. ―Formula is so expensive. We switched to regular milk right away.‖ b. ―She almost never drinks water.‖ c. ―She doesn't really like peaches or pears, so we stick to bananas for fruit.‖ d. ―I give her a piece of bread now and then. She likes to chew on it.‖

ANS: A Vitamin C is destroyed by heat.

Which statement by a mother may indicate a cause of her son's vitamin C deficiency? a. ―We get our fruits from homemade preserves.‖ b. ―We use milk from our own goats.‖ c. ―We grow all our own vegetables.‖ d. ―We're not big meat eaters.‖

ANS: A The child with type 1 diabetes mellitus has an insulin deficiency and will require lifelong management of this disease. Insulin does not cure the pancreas.

Which statement made by a 7-year-old child with type 1 diabetes mellitus indicates a need for more teaching? a. ―My pancreas is sick and needs insulin until it is well.‖ b. ―I will need to take my insulin every day.‖ c. ―I need to keep a piece of candy in my pocket in case I start to feel shaky.‖ d. ―My mom has to give me insulin shots twice a day.‖

ANS: C Traditionally, syrup of ipecac was the treatment of choice to remove some types of poisons from a child's system and parents were advised to keep a supply on hand in the home. However, the American Academy of Pediatrics (AAP) revised this policy in 2003. Parents are now advised to call the poison control center and bring the container of the substance ingested to the hospital emergency department as quickly as possible because stomach lavage is rarely effective 1 hour or more after ingestion. Ipecac syrup should not be kept in the home. Uncontrolled vomiting can cause serious complications.

Which statement made by a parent alerts the nurse to the need for additional education about poison prevention? a. ―I keep the poison control center phone number easily accessible.‖ b. ―All medication is kept out of reach in a locked cabinet.‖ c. ―I keep a bottle of syrup of ipecac handy.‖ d. ―Our garden is free from marigolds.‖

ANS: B Prevention of dehydration, which can trigger the sickling process, is a priority goal in the care of a child with sickle cell disease.

Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease? a. ―I should give my child a daily iron supplement.‖ b. ―It is important for my child to drink plenty of fluids.‖ c. ―He needs to wear protective equipment if he plays contact sports.‖ d. ―He shouldn't receive any immunizations until he is older.‖

ANS: A Absorption of topical medications is best when preparations are applied after a warm bath.

Which statement made by a parent indicates an understanding of the topical application of medications for a skin condition? a. ―I apply the medication after I give my child a bath.‖ b. ―I rub the ointment in a circular motion over the rash.‖ c. ―I increased the amount of cream because the rash was not improving.‖ d. ―I use powder and cornstarch to keep the skin dry.‖

Which statement made by a parent indicates the need for further teaching about strategies to control itching for the infant with eczema? a. ―Wool is the best fabric for the infant's clothing.‖ b. ―I should avoid laundry detergents with fragrances.‖ c. ―I put cotton gloves on the infant's hands.‖ d. ―The infant's fingernails are kept short.‖

ANS: C The parents should be instructed to keep a daily record of the child's urinary proteins.

Which statement made by a parent of a child with nephrotic syndrome indicates an understanding of discharge teaching? a. ―I will make sure he gets his measles vaccine as soon as he gets home.‖ b. ―He can stop taking his medication next week.‖ c. ―I should check his urine for protein when he goes to the bathroom.‖ d. ―He should eat a low-protein diet for the next few weeks.

ANS: D Individuals with anorexia nervosa have a disturbed body image, which this parent correctly recognizes.

Which statement made by a parent of an adolescent with anorexia nervosa indicates an understanding of this condition? a. ―There really isn't anything to worry about. Don't they say you can never be too thin?‖ b. ―My daughter just doesn't have much of an appetite.‖ c. ―She is just trying to punish me for divorcing her father.‖ d. ―She seems to see herself as fat, even though her weight is below normal.‖

ANS: C The use of condoms to prevent STDs is not considered 100% effective but is recommended for sexual intercourse.

Which statement made by a sexually active adolescent girl indicates an understanding of the prevention of sexually transmitted diseases? a. ―I always douche after intercourse.‖ b. ―I think you can get a vaccination for STDs now.‖ c. ―I insist that my partner wear a condom.‖ d. ―I am protected because I take the pill.‖

ANS: B The use of opiates coupled with sharing needles put the user at risk for HIV and hepatitis B.

Which substance puts a person at the greatest risk for HIV and hepatitis B? a. Alcohol b. Opiates c. Cocaine d. Marijuana

A, B, D

Which symptoms are indicative of rheumatic fever (RF)? (Select all that apply.) Abdominal pain Migratory polyarthritis Peeling skin Chorea Vomiting

A, c, e

Which symptoms are manifestations of hypothyroidism in an infant? (Select all that apply.) Noisy respiration Excess perspiration Enlarged tongue Diarrhea Lethargy

Which term is a narrowing of the preputial opening of the foreskin, which prevents the foreskin from being retracted over the penis. Phimosis Hypospadias Epispadias Chordee

Which test reflects glucose control over a period of time. glycosylated hemoglobin (HbA1C) Complete blood count Glucose tolerance test (GTT) Aspartate aminotransferase

B, c

Which types of skin grafts are considered permanent? (Select all that apply.) Homografts Autografts Isografts Xenografts Heterografts

ANS: B The ileal conduit diverts urine to the colon, and the urine is excreted with the feces. There is no external appliance, as is needed with the other diversion methods.

Which urinary diversion procedure is the least damaging to the body image of the adolescent? a. Urostomy b. Ileal conduit c. Nephrostomy d. Suprapubic placement

ANS: C A greater percentage of body water is contained in the extracellular compartment of children under 2 years of age.

Why are infants more vulnerable to fluid and electrolyte imbalances than adults? a. They have a smaller surface area than adults in proportion to body weight. b. Water needs and losses per kilogram are lower than those for adults. c. A greater percentage of body water in infants is extracellular. d. Infants have a lower metabolic turnover of water.

ANS: C Rapid respirations cause increased insensible fluid loss.

Why are rapid respirations a possible cause of dehydration? a. They prevent the child from drinking. b. They increase circulation, thus increasing urine production. c. They cause evaporation of fluid on the mucous membranes. d. They often lead to vomiting.

ANS: D Callus forms more rapidly in the child than the adult.

Why does a child's fracture heal more rapidly than the adult's? a. A child's bones are less porous than adult bone. b. A child's bones are covered by a thicker periosteum. c. A child's bones are not affected by bone overgrowth. d. A child's bones have faster callus formation.

ANS: D The sides of the finger have fewer nerve endings and more capillaries but are not easier to puncture than the fingertip. The risk for infection is remote for either site.

Why does the nurse instruct an 11-year-old diabetic child to use the side of the finger for blood testing? a. It has fewer capillaries. b. It is easier to puncture. c. It is less likely to become infected. d. It has fewer nerve endings.

Pulmonary stenosis

a narrowing of the pulmonary valve or pulmonary artery that results in obstruction of blood flow from the ventricles

epispadias

congenital defect in which the urinary meatus is located on the upper surface of the penis

Tetralogy of Fallot

congenital malformation involving four distinct heart defects. Pulmonary outflow tract or valve stenosis, right ventricular hypertrophy, vsd, overriding aorta

oxygen poor blood

enters the heart from the body and goes out to the lungs

Tetralogy of Fallot

four defects that result in mixed blood flow: pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

Last Peds test

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