Nurs 380: Helpful Pediatric Questions from Prep U (Final Exam)

The nurse is working with a child who is in sickle cell crisis. Treatment and nursing care for this child include which actions? Select all that apply. A. Administering analgesics B. Administering platelets C. Maintaining fluid intake D. Administering oxygen E. Promoting exercise and activity

A. Administering analgesics C. Maintaining fluid intake D. Administering oxygen

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

B. Cerebral edema

A nurse is reviewing the laboratory test results of a 3-year-old child. Which absolute neutrophil count would the nurse identify as indicating neutropenia? A. 2.0 B. 2.5 C. 1.0 D. 1.5

C. 1.0

The nurse is caring for a school-age child who has been having a continuous seizure for the last 40 minutes. What is the priority action by the nurse? A. Administer carbamazepine as prescribed. B. Observe and document the length of time of the seizure and type of movement observed. C. Administer lorazepam IV as prescribed. D. Perform a glucose finger stick to determine the child's blood sugar level.

C. Administer lorazepam IV as prescribed.

A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting? A. Is curdled and extremely sour smelling B. Continues until stomach is empty C. Only occurs with feeding D. Is projected 1 ft away from infant

C. Only occurs with feeding

Which mechanism is central to cancers in children? A. Environment B. Race C. Genetics D. Cellular growth

D. Cellular growth

A child with sickle cell disease is brought to the emergency department by his parents. He is in excruciating pain. A vaso-occlusive crisis is suspected and analgesia is prescribed. What would the nurse expect as least likely to be ordered? A. Hydromorphone B. Nalbuphine C. Morphine D. Meperidine

D. Meperidine

The nurse is caring for a 6-year-old boy with non-Hodgkin lymphoma who is being treated with monoclonal antibodies. What recommendation would the nurse include in the child's plan of care? A. Assessing the child's hydration status secondary to vomiting. B. Monitoring for complaints of bone pain. C. Assessing for signs of capillary leak syndrome. D. Monitoring for allergic reactions or anaphylaxis.

D. Monitoring for allergic reactions or anaphylaxis.

The nurse is collecting data on an 18-month-old child admitted with a diagnosis of possible seizures. When interviewing the caregivers, which questions would be most important for the nurse to ask? A. "Have you checked your child's temperature?" B. "Is your child up to date on his immunizations?" C. "What type of activities was your child doing today?" D. "Has anyone in your family been sick recently"

A. "Have you checked your child's temperature?"

The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning? A. "I mix ferrous sulfate with milk in a bottle." B. "My child's stools are darker than usual." C. "My child takes ferrous sulfate after meals." D. "I brush my child's teeth once every day."

A. "I mix ferrous sulfate with milk in a bottle."

The nurse recommends rotavirus vaccine for which group of clients? A. infants B. toddlers C. preschoolers D. neonates

A. infants

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

C. Risk for injury related to seizure activity

A 12-year-old child has been prescribed phenytoin (dilantin). What information should be included in discussion about this medication? A. Take medication on an empty stomach. B. Avoid excessive sunlight C. Use a soft tooth brush D. Increase intake of citrus foods to promote absorption.

C. Use a soft tooth brush

Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for: A. early development of septicemia. B. early meningitis. C. leukemic cells. D. platelets.

C. leukemic cells.

The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure? A. "His arms had jerking movements in his legs and face." B. "He kept smacking his lips and rubbing his hands." C. "He usually is very coordinated, but he couldn't even walk without falling." D. "He was just staring into space and was totally unaware."

D. "He was just staring into space and was totally unaware."

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

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

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

B. Improving hydration

The nurse assesses a child and finds that the child's pupils are pinpoint. What does this finding indicate? A. seizure activity B. brain stem dysfunction C. intracranial mass D. brainstem herniation

B. brain stem dysfunction

A child with severe vomiting for 3 days presents with hypopnea and hypokalemia. The nurse reports to the provider that this child is exhibiting signs of which condition? A. respiratory alkalosis B. metabolic acidosis C. respiratory acidosis D. metabolic alkalosis

D. metabolic alkalosis **Vomiting causes metabolic alkalosis because you are vomiting up a lot of acid, therefore you are in an alkalotic state. When someone has diarrhea, you are getting rid of too much bicarbonate, therefore your acid levels will rise and you will be in an acidotic state**

The nurse is reviewing the medical record of a child with a cleft lip and palate. When reviewing the child's history, what would the nurse identify as a risk factor for this condition? A. history of hypoxia at birth B. maternal use of acetaminophen in third trimester C. preterm birth D. mother age 42 with pregnancy

D. mother age 42 with pregnancy

The young child has been diagnosed with bacterial meningitis. Which nursing interventions are appropriate? Select all that apply. A. Administer antibiotics as ordered. B. Initiate seizure precautions. C. Initiate droplet isolation. D. Monitor the child for signs and symptoms associated with decreased intracranial pressure. E. Identify close contacts of the child who will require post-exposure prophylactic medication.

A. Administer antibiotics as ordered. B. Initiate seizure precautions. C. Initiate droplet isolation. E. Identify close contacts of the child who will require post-exposure prophylactic medication.

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude? A. Administering the measles, mumps, rubella (MMR) vaccine B. Assessing dietary intake by addressing "picky eating" and "food jags" C. Teaching the importance of taking water safety measures D. Plotting height and weight on a growth chart

A. Administering the measles, mumps, rubella (MMR) vaccine

A 3-month-old is admitted with severe diarrhea. Yesterday, the infant weighed 11 pounds (5 kg). Today, this infant weighs 9 pounds, 8 ounces (4.3 kg). Based on this information the nurse documents that the infant has: A. severe dehydration. B. risk for fluid volume deficit. C. malabsorption syndrome. D. failure to thrive

A. severe dehydration.

While caring for a child who will be undergoing a lumbar puncture, the nurse explains the procedure to the infant's mother. Which statement by the mother would indicate a need for further education? A. "I need to encourage my child to drink at least 1 glass of water after the procedure." B. "I will cradle her in my arms after the procedure for at least 30 minutes." C. "During the test, the health care provider will most likely take 3 tubes of spinal fluid to test for several things." D. "My child may have a headache after the procedure. If she does, she can have something for the pain."

B. "I will cradle her in my arms after the procedure for at least 30 minutes."

The nurse is assigned an infant with a possible neurological disorder. Which assessment finding would the nurse communicate to the health care provider as a late sign of increased intracranial pressure? A. Dizziness and irritability B. Decorticate posturing and fixed and dilated pupils C. Headache and sunset eyes D. Decreased pupil reaction and decreased respiration.

B. Decorticate posturing and fixed and dilated pupils

Which diagnosis would be most appropriate for an infant with a large retinoblastoma after surgery? A. Pain related to retinal removal B. Disturbed sensory perception related to enucleation C. Fear related to loss of normal vision D. Anticipatory grieving related to change in body image

B. Disturbed sensory perception related to enucleation

The nurse is caring for a 2-year-old child with a gastrointestinal infection resulting in 4 to 5 liquid stools per day over the past 3 days. Based on this information, which important concern(s) will the nurse address in the child's care? Select all that apply. A. undernourishment risk: malnutrition B. fluid deficiency risk: dehydration C. diarrhea and loss of electrolytes D. the risk for skin maceration in the perineum E. availability of parents to care for the child

B. fluid deficiency risk: dehydration C. diarrhea and loss of electrolytes D. the risk for skin maceration in the perineum

The nurse is conducting a physical examination of an infant with suspected pyloric stenosis. Which finding indicates pyloric stenosis? A. sausage-shaped mass in the upper mid abdomen B. hard, moveable "olive-like mass" in the upper right quadrant C. perianal fissures and skin tags D. abdominal pain and irritability

B. hard, moveable "olive-like mass" in the upper right quadrant

A 4-year-old child has developed acute lymphoblastic leukemia (ALL). Nursing care for the child with ALL involves taking axillary, rather than rectal, temperatures because the child: A. is prone to diarrhea. B. has a low platelet count. C. is anemic D. has a low white blood cell count.

B. has a low platelet count.

A 6-year-old child with hydrocephalus had a ventriculoperitoneal (VP) shunt placed 6 weeks ago and now has experienced a seizure, vomiting, and loss of appetite. Which intervention will target the child's priority need? A. Prepare a menu with the child's favorite foods. B. Educate the parents about seizure precautions. C. Administer intravenous antibiotics as prescribed. D. Pad and raise the rails on the child's bed.

C. Administer intravenous antibiotics as prescribed.

During the nursing assessment the nurse notes maximal tenderness upon palpation over the McBurney point. What does this indicate? A. Pancreatitis B. Hernia C. Appendicitis D. intussusception

C. Appendicitis

A 14-year-old adolescent with Hodgkin disease is experiencing difficulty breathing and is sent for a radiograph. Which finding should the nurse expect to see on the x-ray report? A. Tumor in the liver B. Lymphadenopathy C. Retinoblastoma D. Mediastinal mass

D. Mediastinal mass

The nurse is caring for a child diagnosed with hydrocephalus following ventriculoperitoneal shunt placement. The child is currently on a ventilator. Which nursing action is priority? A. Assess the client's respiratory status. B. Measure the client's head circumference. C. Educate the family on the shunt. D. Monitor the client for signs of infection.

A. Assess the client's respiratory status.

Which of these age groups has the highest actual rate of death from drowning? A. toddlers B. school-age children C. infants D. preschool children

A. toddlers

A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer? A. Bladder B. Brain C. Blood D. Kidney

A. Bladder

The nurse is providing care to a child and is to collect a 24-hour urine specimen for catecholamines. The nurse integrates knowledge of this testing as indicative of: A. neuroblastoma. B. Hodgkin disease. C. Leukemia D. Osteosarcroma

A. Neuroblastoma **Remember neuroblastoma originates in the adrenal glands and the adrenal glands secrete catecholamines**

A school-aged child with seizures is prescribed phenytoin sodium, 75 mg four times per day. What instruction would the nurse give the parents regarding this medication? A. The child will have to adhere to good tooth brushing B. Numbness of the fingers is common while taking this drug C. Even small doses may cause noticeable dizziness D. Watching television while taking the drug may cause seizures

A. The child will have to adhere to good tooth brushing

In caring for a child with sickle cell disease, the highest priority goal is: A. The child's fluid intake will improve. B. the child's skin integrity will be maintained. C. the caregiver's anxiety will be reduced. D. the family will verbalize understanding of the disease crisis.

A. The child's fluid intake will improve.

The nurse is providing care for a 13-year-old child diagnosed with iron-deficiency anemia. The client's current hemoglobin level is 11 g/dL (110 g/L). Which intervention will the nurse anticipate including in the client's care? A. giving ferrous sulfate with orange juice between meals B. increasing the daily intake of fresh fruits and vegetables C. packed red blood cell transfusions D. providing a high dose of intravenous immunoglobulin weekly

A. giving ferrous sulfate with orange juice between meals

The nurse is caring for an infant with increased intracranial pressure. The mother is preparing to feed the child. What action by the mother indicates an understanding of the proper care of this infant? A. placing the infant in an infant car seat after feeding the infant B. placing the infant prone in the crib after feeding the infant C. placing the infant supine in the crib after feeding the infant D. placing the infant in a Sims position in the crib after feeding the infant

A. placing the infant in an infant car seat after feeding the infant

An infant with a ventriculoperitoneal (VP) shunt in place is brought to the clinic because of being drowsy and less responsive. Which question in the health history would provide information to the nurse indicating that the VP shunt is perhaps infected? A. "Has your child been crying more than usual?" B. "Has your child been eating well the last few days?" C. "Has your child been sleeping more every day?" D. "Have you noticed any changes in your child's pupils?"

B. "Has your child been eating well the last few days?"

The mother of a newborn with a cleft lip reports she is having a hard time looking her baby. What is the best action by the nurse? A. Tell the mother that while this is difficult it will get easier. B. Encourage the mother to provide care for her infant. C. Encourage the child's mother to hold her infant against her shoulder to provide closeness while not looking at the defect. D. Explain that surgery will make this better in the future.

B. Encourage the mother to provide care for her infant.

A child is hospitalized with dehydration as a result of rotavirus. When reviewing the plan of treatment, what can the nurse anticipate will be included? Select all that apply. A. antidiarrheal agents B. IV fluid administration C. antibiotic therapy D. monitor of intake and output E. daily weight assessment

B. IV fluid administration D. monitor of intake and output E. daily weight assessment

The nurse is caring for a child who has suffered a head injury and has had an ICP monitor placed. Which prescription by the health care provider would the nurse question? A. Administer dexamethasone, dosage determined by the pharmacist. B. Initiate an IV of 0.9% NS to run at 250 ml/hr. C. Administer mannitol IV, dosage determined by the pharmacist. D. Place in an indwelling urinary catheter.

B. Initiate an IV of 0.9% NS to run at 250 ml/hr.

When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority? A. Allow the child to play with a doll and syringe. B. Monitor the site dressing and vital signs. C. Evaluate pain and administer medication. D. Educate the family on proper hand washing.

B. Monitor the site dressing and vital signs.

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

B. Take a stool culture

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. What does this prescription indicate to the nurse? A. The child requires a prophylactic dose of iron. B. The child has mild to moderate iron deficiency. C. The child has severe iron deficiency. D. The child is being prepared for packed red blood cell administration.

B. The child has mild to moderate iron deficiency.

The nurse will select which meal as the best choice for a child with iron-deficiency anemia? A. two slices of pepperoni pizza and a glass of skim milk B. cheeseburger, broccoli, and fresh strawberries C. chicken breast, French fries, and sweetened tea D. peanut butter sandwich, cheese stick, and applesauce

B. cheeseburger, broccoli, and fresh strawberries

The student nurse is caring for a child with the nursing diagnosis "Risk for fluid volume deficit related to inadequate oral intake." Which statement by the student would indicate a need for further education by the nursing instructor? A. "I will monitor her IV line to help maintain her fluid volume." B. "I will teach her mother to give her small drinks frequently." C. "I will make sure there is plenty of orange juice available. It's her favorite juice." D. "I will weigh her every morning at the same time."

C. "I will make sure there is plenty of orange juice available. It's her favorite juice."

The parents of a child with a history of seizures who has been taking phenytoin ask the nurse why it's difficult to maintain therapeutic plasma levels of this medication. Which statement by the nurse would be most accurate? A. "A drop in the plasma drug level will lead to a toxic state." B. "Large increments in dosage lead to a more rapid stabilizing therapeutic effect." C. "Small increments in dosage lead to sharp increases in plasma drug levels." D. "The capacity to metabolize the drug becomes overwhelmed over time."

C. "Small increments in dosage lead to sharp increases in plasma drug levels."

The nurse is collecting data on a 2-year-old child admitted with a diagnosis of gastroenteritis. When interviewing the caregivers, which question is most important for the nurse to ask? A. "How many times a day does your child urinate?" B. "What foods has your child eaten during the last few days?" C. "Tell me about the types of stools your child has been having." D. "How long has your child been toilet trained?"

C. "Tell me about the types of stools your child has been having."

The nurse is providing education to the parents of a 2-year-old boy with hydrocephalus who has just had a ventriculoperitoneal shunt placed. Which information is most important for the parents to be taught? A. "Limit the amount of television he watches." B. "Call the doctor if he gets a headache." C. "Watch for changes in his behavior or eating patterns." D. "Always keep his head raised 30 degrees."

C. "Watch for changes in his behavior or eating patterns."

The child is prescribed liquid ferrous sulfate. The nurse should encourage the child to take which action immediately after each dose to best eliminate possible side effects? A. Drink a glass of milk B. Not eat or drink for one hour C. Brush his or her teeth D. Remain in an upright position for at least 15 minutes

C. Brush his or her teeth **Iron drops could stain teeth**

The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority? A. Writing down phone numbers and appointments B. Keeping a written copy of the treatment plan C. Using acetaminophen if the child needs an analgesic D. Calling the doctor if the child gets a sore throat

D. Calling the doctor if the child gets a sore throat

During the physical assessment of a 2½-month-old infant, the nurse suspects the child may have hydrocephalus. Which sign or symptom was observed? A. Posterior fontanel (fontanelle) is closed B. Pupil of one eye dilated and reactive C. Vertical nystagmus D. Dramatic increase in head circumference

D. Dramatic increase in head circumference

A parent brings a 10-year-old child to the emergency room with reports of abdominal pain. The nurse performing a physical assessment notes the following symptoms: upper right quadrant pain that radiates to the back; fever; nausea; and abdominal distention. Which disease would the nurse suspect? A. Crohn disease B. Ulcerative colitis C. Appendicitis D. Pancreatitis

D. Pancreatitis

A child with acute lymphoblastic leukemia (ALL) is receiving methotrexate for therapy. Which nursing diagnosis would best apply during therapy? A. Risk for self-directed violence related to effect of methotrexate on central nervous system B. Excess fluid volume related to effect of methotrexate on aldosterone secretion C. Risk for impaired mobility related to depressant effects of methotrexate D. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy

D. Risk for impaired skin integrity related to oral ulcerations associated with chemotherapy

A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intracranial pressure? A. reduction in heart rate B. decline in respiratory rate C. increase in heart rate D. changes in LOC

D. changes in LOC

The nurse is caring for an 18-month-old client with suspected iron-deficiency anemia. The nurse will expect to prepare the client for which laboratory tests first? A. iron and thrombocyte levels B. hemoglobin and white blood cell levels C. ferritin and glycosylated hemoglobin levels D. complete blood count and iron level

D. complete blood count and iron level

A nurse is caring for a newborn whose screening test result indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect the test result to be confirmed by which lab tests? A. reticulocyte count B. erythrocyte sedimentation rate C. peripheral blood smear D. hemoglobin electrophoresis

D. hemoglobin electrophoresis