Ped Final
A nursing student is reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system? Regulation of water balance Hormonal secretion Cellular metabolism Growth stimulation
Hormonal secretion
The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? Hypernatremia Bradycardia Hypertension Hyperkalemia
Hyperkalemia
What would the nurse include when teaching an adolescent about tinea pedis? "Keep your feet moist and open to the air as much as possible." "Dry the area between your toes really well." "Wear nylon or synthetic socks every day." "Go barefoot when you are in the locker room at school."
"Dry the area between your toes really well."
A mother voices concern to the nurse that her child should not be using alcohol-based hand gels to help prevent the spread of infection. How should the nurse respond? "Alcohol-based hand gels are not as effective as washing the hands with water." "At least your child is using some form of hand hygiene." Correct! "Hand gels are actually very effective in preventing the spread of infection." "As long as your child washes his hands with soap and water a couple of times a day along with the hand gel, it is effective."
"Hand gels are actually very effective in preventing the spread of infection."
The parents ask the nurse how to prevent their child from becoming sick. Which response by the nurse is most appropriate? "A daily multi-vitamin will boost the immune system." "Handwashing is an effective way to prevent infection." "Remind your child to cover the mouth when coughing." "Clean your bathroom and kitchen when they look dirty."
"Handwashing is an effective way to prevent infection."
The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? "We should avoid aspirin and drugs like ibuprofen." Correct! "He can resume participation in football in 2 weeks." "Swimming would be a great activity." "Our son cannot take any antihistamines."
"He can resume participation in football in 2 weeks."
A nurse is working with an adolescent who is slightly overweight and was recently diagnosed with hypertension. They are discussing nutritional management. Which statement by the adolescent demonstrates understanding of the information? "I have to make sure that I don't eat a lot of salty foods." "I can eat any amount at a meal as long as I don't eat between meals." Correct! "I should eat plenty of fresh fruits and vegetables." "If I skip breakfast, I can eat a much bigger lunch."
"I should eat plenty of fresh fruits and vegetables."
After visiting a family with young children ages 2 and 4 year old who live in a house built in 1952. The nurse counsels the family about lead poisoning. The nurse determines the teaching is effective if the parent makes which statement? "I plan to scrape paint off the walls after the children go to bed tonight". " My children eat meals whenever they are hungry". "I wet mop all of my floors and wash all of the window sills weekly". "I am going to leave that patch of dirt uncovered so the children can play in it like a sandbox".
"I wet mop all of my floors and wash all of the window sills weekly".
A teenage girl dry skin tells the nurse that she is so embarrassed by the rough-feeling of her skin that she doesn't want to go to school. What is the best response by the nurse? "Have you been applying your medication and emollients to your skin as directed by your physician?" "It must be really difficult for you. Tell me how you are taking care of your skin on a daily basis." "Sunlight really helps the dry skin areas heal. Maybe going to a tanning bed routinely will help." "You can't miss school because of your skin. Can you wear clothes that will cover the areas?"
"It must be really difficult for you. Tell me how you are taking care of your skin on a daily basis."
The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? "The infant is born with immunity to some diseases, but those immunities decrease over the first year of life." "The antibodies the fetus gets from the mother are in the placenta, so after birth they are no longer available to the infant." "The immunities that the infant is born with are not for the same diseases they will be immunized against." "Infants are unable to develop antibodies to protect them from diseases so they must be immunized."
"The infant is born with immunity to some diseases, but those immunities decrease over the first year of life."
The nurse is caring for a newborn diagnosed with an atrial septal defect (ASD). The parents voice concern and state, "I can't believe this is happening. Will our child be okay?" What is the nurse's best response? "If the defect isn't treated it can cause problems such as pulmonary hypertension, heart failure, atrial arrhythmias, or stroke." "While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the doctor." "Since there are no symptoms being exhibited right now, your child will likely not require surgery until the age of 3 years." "Most children have no symptoms of this defect."
"While each case is different, the majority of these defects correct on their own. Let's see what the tests show, then speak with the doctor."
The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever? 98.2° F (36.8° C) 99.2° F (37.3° C) 100° F (37.8° C) 100.8° F (38.2° C)
100.8° F (38.2° C)
A 7-year-old child with a family history of cardiovascular disease is being screened for hyperlipidemia. When reviewing the child's laboratory test results, which total cholesterol level would be of significant concern? 120 mg/dL 150 mg/dL 180 mg/dL 210 mg/dL
210 mg/dL
The nurse is giving anticipatory guidance to a group of parents. Which of the follow developmental age would the nurse recognizes is the greatest risk for lead poisoning? A child 5 month-old A child 2-year-old A child 5 years-old A child 7-year-old
A child 2-year-old
The nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings will NOT be in the nurse's findings? An Erythema rash A decreased erythrocyte sedimentation rate (ESR) Elevated C-reactive protein Joint pain
A decreased erythrocyte sedimentation rate (ESR)
The nurse is planning care for a child a child who has a urinary tract infection. Which of the following interventions should the nurse NOT include? Monitor for a urine output of at least 0.5 to 2mL/Kg/hour Administer an antidiuretic Encourage frequent voiding Encourage fluids
Administer an antidiuretic
The nurse is caring for a West African 8 year-old child with a hemoglobinopathy in which the RBCs do not carry the normal adult hemoglobin, but instead carry a less effective type. The child appears pale, dehydrated and his joints are swollen. His mother reports a history of join pains and his hands are always cold. What is the priority nursing intervention for this child? Administer fluids Monitor vital signs Monitor blood work Assess for anemia
Administer fluids
A nursing instructor is teaching the students about the standard and transmission-based precautions. What type of precautions require placing a client in isolated room with limited access, wearing gloves during contact with the client and all body fluids or contaminated items, wearing two layers of protective clothing, and wearing a mask? Airborne and Droplet precautions Droplet and Contact precautions Contact and Standard precautions Standard and Droplet precautions
Airborne and Droplet precautions
The nurse is performing a vision screening for a 4-year-old child. Which screening chart would be best for determining the child's visual acuity? Snellen Ishihara Allen figures Color Vision Testing Made Easy (CVTME)
Allen figures
When assessing the 3 old child, the nurse expects which motor skill to be present? Babinski and palmer reflex Moro and Tonic neck Holding a crayon and throwing a ball Planter reflex
Holding a crayon and throwing a ball
The nurse is administering a liquid medication to a 3-year-old using an oral syringe. Which action would be most appropriate? Direct the liquid toward the anterior side of the mouth. Keep the child's hand away from the oral syringe when squirting the medication. Give all of the drug in the syringe at one time with one squirt. Allow the child time to swallow the medication in between amounts
Allow the child time to swallow the medication in between amounts
A preterm newborn is admitted to the neonatal intensive care with the diagnosis of an omphalocele. What nursing action would the nurse least likely perform? Protect the abdominal contents. Minimize Fluid loss of the neonate. Maintain Perfusion to the exposed abdominal contents Assessment of hyperbilirubinemia.
Assessment of hyperbilirubinemia.
The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations? Spastic Athetoid Ataxic Mixed
Athetoid
The nurse is teaching John's parents about delayed speech in a 2 year-old . Which of the following behavior should the parents be concern about? Echolalia Telegraphic speech The ability to communicate desires and feelings Babbling to himself rather than using real words
Babbling to himself rather than using real words
The nurse is educating a mother on the significance of hypovolemia in a child who is post-op tonsillectomy .Regarding bleeding after tonsillectomy, which of the following statements is accurate? The degree of hypovolemia is evident in the clinical presentation. After 24 hours, the risk of significant bleeding becomes negligible. Postoperative nausea and vomiting reduces gastric volume as well as the risk of aspiration. Bleeding after tonsillectomy is a life-threatening situation.
Bleeding after tonsillectomy is a life-threatening situation.
A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis test. When reviewing the child's history, what would the nurse identify as potentially interfering with the accuracy of the results? Use of iron supplementation Blood transfusion 1 month ago Lack of fasting for 12 hours History of recent infection
Blood transfusion 1 month ago
The nurse is assess an infant who has coarctation of the aorta .Which of the following will NOT be a finding in the nurse's assessment? Weak femoral pulse Cool skin of the lower extremities Clubbing of the fingers low blood pressure
Clubbing of the fingers
An 18-month-old child is schedule for tonsillectomy due to recurrent pharyngitis and tonsillar hyperplasia. To evaluate for a history of Obstructive Sleep Apnea, which of the following should the nurse include in the history? Electrocardiogram Irritability Daytime somnolence Hyperactivity
Daytime somnolence
The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan? Developing management and decision-making skills Educating the parents about diabetes mellitus type 1 Developing a nutritionally sound, 30-day meal plan Promoting independence with self-administration of insulin
Developing management and decision-making skills
The nurse is auscultating the bowels sounds of a 3-year-old child and document sever hyperactive bowel sounds. What might this finding indicate? Obstruction Normal findings Diarrhea Infection
Diarrhea
A 4-month-old infant is in the primary care provider's office for routine checkup and immunizations. Which of the following vaccines is routinely recommended at this time? Diphtheria, tetanus, acellular pertussis (DTaP) Oral polio vaccine (OPV) Measles, mumps, rubella (MMR) Varicella
Diphtheria, tetanus, acellular pertussis (DTaP)
The nurse is assessing a 4-year-old with type 1 diabetes she suspects the child is experiencing hypoglycemia. Which of the following is not a finding of the assessment? Tachycardia Dry, flushed skin Diaphoresis Slurred speech
Dry, flushed skin
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A finger stick blood glucose level is 70 mg/dL. What would the nurse do next? Administer a sliding-scale dose of insulin. Give 10 to 15 grams of a simple carbohydrate. Offer a complex carbohydrate snack. Administer glucagon intramuscularly.
Give 10 to 15 grams of a simple carbohydrate.
A 3-year-old child had normal development of motor skills during the first year of life and has normal language development. He now has clumsiness, frequent falls and a waddling gait. Which of the following is consistent with muscular dystrophy? Male gender is clumsiness Hypertrophy of the quadriceps Hyperactivity Gower sign
Gower sign
The nurse is caring for a new born whose screening test results indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect which test result to confirm a sickle cell diagnosis? Reticulocyte count Peripheral blood smear Erythrocyte sedimentation rate Hemoglobin electrophoresis
Hemoglobin electrophoresis
A Toddler is about to receive an immunization injection and begins to cry. Which comment by the nurse is the most appropriate? Do not cry it will be better if you try to behave. I know that you are frighten. It will be over with soon. A big person like you should not cry. You know it isn't going to hurt. Please stop crying there is nothing to be afraid of".
I know that you are frighten. It will be over with soon.
John is a normal full term 2-year-old boy brought to the clinic by his parents for his 2-year-old well visit. His parents state, "We speak Spanish at home to John and are working to make him bilingual." John's mother states that John's favorite word is "No." John's parents asks if this is normal at this age of development. Which of the following would NOT be included in your respond? Frequent repetitive naming helps the toddler learn words for objects in any language. Reading to your child is one of the best way to promote language development. I would not encourage both English and Spanish at this age. At first John will repeat words and phrases and use speech that contains only essential words.
I would not encourage both English and Spanish at this age.
The nurse hears wheezing when auscultating a 4-year-old. Which condition would the nurse most likely rule out based on the assessment findings? Bronchiolitis Asthma Influenza Cystic fibrosis
Influenza
A school-age child with abnormal motor skills and diagnosis of Cerebral Palsy (CP). Which of the following is NOT a nursing intervention for this child? Promoting Mobility Inform the parent that the child will not be able to live at home Promoting Nutrition Providing Support and Education for the Child and Family
Inform the parent that the child will not be able to live at home
The nurse is caring for a child who has been admitted for a sickle cell crisis. What would the nurse do first to provide adequate pain management? Administer a nonsteroidal anti-inflammatory drug (NSAID) as ordered. Use guided imagery and therapeutic touch. Administer meperidine as ordered. Initiate pain assessment with a standardized pain scale.
Initiate pain assessment with a standardized pain scale.
The nurse is assessing a 4-year-old boy whose mother was 40 years old when he was born. Which finding suggests this child has a genetic disorder? Inquiry determines the child had feeding problems. Observation shows nasal congestion and excess mucus. Inspection reveals low-set ears with lobe creases. Auscultation reveals the presence of wheezing
Inspection reveals low-set ears with lobe creases.
The nurse is administering immunizations to children in a neighborhood clinic. What is the most frequent route of administration? Oral Intradermal Intramuscular Topical
Intramuscular
The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? The child has above-normal growth for his age. The child is active and playful. The skin is pink and healthy looking. It is difficult to keep the child awake
It is difficult to keep the child awake
A nursing instructor is preparing a class on chronic lung disease. What information would the instructor include when describing this disorder? It is a result of cystic fibrosis. It is seen most commonly in premature infants. It typically affects females more often than males. It is characterized by bradypnea.
It is seen most commonly in premature infants.
A child admitted to the pediatric unit is to have blood specimens obtained for testing. When preparing to obtain the specimens via venipuncture, which site would the nurse avoid using? Dorsal aspect of the hand Antecubital fossa Jugular vein Heel stick
Jugular vein
The nurse is caring for a child who has high fever for five days that is unresponsive to antibiotics. Abdominal and joint pain, headache, malaise and a strawberry tongue. What might the findings indicate? Kawasaki Polo MMR Coxsackie
Kawasaki
The nurse is caring for a 2 year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the action should the nurse NOT take? Place the child on NPO status prior to the procedure Check for allergies prior to the procedure Limit fluid intake following the procedure Check the procedure site post op
Limit fluid intake following the procedure
The nurse is caring for a child who is post op cleft lip repair. Which of the following action should the nurse take? Maintain the airway by removing the packing from the mouth Maintain airway by placing the child in an in a upright position Offer a pacifier with sucrose Assess the mouth with a tongue blade
Maintain airway by placing the child in an in a upright position
The nurse has developed a plan of care for a 12-month-old hospitalized with dehydration as a result of rotavirus. Which intervention would the nurse include in the plan of care? Encouraging consumption of fruit juice Offering Kool-Aid or popsicles as tolerated Encouraging milk products to boost caloric intake Maintaining the intravenous (IV) fluid rate as ordered
Maintaining the intravenous (IV) fluid rate as ordered
The concern parents of a 4-year-old boy reported that he began walking at 18 months, but he was clumsy and fell frequently; he remains clumsier than his peers, falls during simple tasks, and has developed a "waddling" gait. He now has difficulty arising from a sitting position on the floor, often supporting himself with his hands along the length of his legs. Which of the following is the most likely diagnosis? Cerebral palsy Guillain-Barré syndrome Myasthenia gravis Muscular dystrophy
Muscular dystrophy
The nurse is caring for a 9-year-old newly diagnosed with diabetes. The child has polyuria, polydipsia, and weight loss. Which nursing diagnose will the nurse exclude in the care plan? Imbalanced nutrition: Less than body requirements Deficient fluid volume Deficient knowledge regarding disease process Noncompliance
Noncompliance
During John's physical assessment his Mother stated that John often vomits after a meal .The nurse auscultated the bowel sounds of the 2-year-old and documents hypoactive bowel sounds and mark dullness on percussion. What might this finding indicate? Obstruction Gastroenteritis Diarrhea Infection
Obstruction
A 10-year-old child has a fever of unknown cause and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important? Ensure that the specimen is obtained from the proper area. Collect three specimens on three different days. Use aseptic technique when getting the specimen. Obtain specimen before antibiotics are given.
Obtain specimen before antibiotics are given.
A nursing instructor is teaching students about the chain of infection. What does the instructor tell students is responsible for allowing the pathogen to enter? Reservoir Portal of exit Means of transmission Portal of entry
Portal of entry
The nurse is caring for a child who has Hirschsprung disease. Which of the following actions should the nurse take? Encourage a high fiber, low protein, low calorie diet Prepare the family for surgery Place an NG tube for decompression Initiate bed rest
Prepare the family for surgery
A 5-year-old child is in the pediatrician's office for immunization and physical examination. The mother is concerned that her child is a little "under the weather." Which of the following is a contraindication to vaccinating the child? Acute otitis media with a temperature of 100 °F requiring antibiotic therapy Previous vaccination reaction that consisted of fever and fussiness that lasted for 2 days History of an allergic reaction to penicillin Previous vaccination reaction that consisted of wheezing and hypotension.
Previous vaccination reaction that consisted of wheezing and hypotension.
What would the nurse do first for a 5-year-old girl with profound bradycardia? Provide oxygen at 100% Administer epinephrine as ordered Use warming blankets Perform gastric lavage
Provide oxygen at 100%
The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? Puncturing a vein on the dorsal side of the hand. Administering sucrose prior to beginning. Accessing an indwelling venous access device. Using an automatic lancet device on the heel.
Puncturing a vein on the dorsal side of the hand.
The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? Recommend raising the bed's side rails throughout the day and night. Suggest a caregiver be present continuously to prevent falls from bed. Encourage using a loose restraint when he is in bed. Recommend raising the bed's side rails when a caregiver is not present.
Recommend raising the bed's side rails when a caregiver is not present.
The nurse is examining a 8 year-old with symmetrical swelling of the hands and feet The nurse immediately suspects: Cooley anemia Idiopathic thrombocytopenic purpura (ITP) Sickle Cell disease Hemophilia
Sickle Cell disease
The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which finding would the nurse most likely expect to assess if the child had transposition of the great vessels? Significant cyanosis without presence of a murmur Abrupt cessation of chest output with an increase in heart rate/filling pressure Soft systolic ejection Holosystolic murmur
Significant cyanosis without presence of a murmur
A 17 old boy is in the clinic for a nosebleed. When providing teaching about the management of epistaxis to an adolescent. Which of the following position should the nurse instruct the adolescent to take when experiencing a nosebleed? Sit up and lean forward. Sit up and tilt the head up Lie in a supine position and lean forward Lie in a prone position
Sit up and lean forward.
When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? Skeletal traction Physical therapy Orthotics Occupational therapy
Skeletal traction
The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? Sluggish deep tendon reflexes Full range of motion in extremities Absence of hypotonia Lack of purposeful muscular control
Sluggish deep tendon reflexes
The nurse is caring for a 3-year-old girl with a respiratory disorder. The nurse anticipates the need for providing supplemental oxygen to the child when performing which intervention. Suctioning a tracheostomy tube Administering drugs with a nebulizer Providing tracheostomy care Suctioning with a bulb syringe
Suctioning a tracheostomy tube
Which finding would lead the nurse to suspect that a child is experiencing moderate dehydration? Dusky extremities Tenting of skin Sunken fontanels Hypotension
Sunken fontanels
An 18-month old child is admitted to the hospital. When the parents leave, the child starts to cry loudly. After a while the child is inactive and withdrawn. Which statement about the child's behavior is correct? The child has accepted the separation and has adjusted well. The child has entered the second stage of separation anxiety. The child has entered the third state of separation anxiety The child is behaving very unexpectedly for that age group.
The child has entered the second stage of separation anxiety.
A 4-month old ( 40 weeks gestation) infant is seen in the well-child clinic. The nurse is most concerned about which of the following? The infant's head turns to the side when a sound is made at the level of the ear. The infant's head lags when pulled from a lying to a sitting position The infant does not focus on a toy held close to the face The infant is drooling
The infant does not focus on a toy held close to the face
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with the disorder? The parents report that their child had "a cold or flu" recently. Blood pressure is decreased when checking vital signs. The parents report that their son "can't drink enough water." Auscultation reveals Kussmaul breathing.
The parents report that their son "can't drink enough water."
A 5-year-old girl catches the flu from a friend at day care after the friend sneezed and wiped mucus on a toy that the girl subsequently played with. In this case, what is the portal of exit in the chain of infection? Upper respiratory excretion Toy The friend The 5-year-old girl
Upper respiratory excretion
The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? Deep-breathing exercises Upright positioning Coughing Chest percussion
Upright positioning
The nurse is caring for a child admitted to the hospital for sepsis. Which assessment finding is the most concerning? Oral temperature 102.3°F (39°C) White blood cell count 18,000/mm3 Urine output of 10 ml over 3 hours Apical heart rate 120 beats per minute
Urine output of 10 ml over 3 hours
The nurse is caring for a 10-year-old boy with an unknown immunization documentation and a frequent cough. What would the nurse institute as a precaution? Use of a protective mask Use of a protective gown Negative air pressure ventilation Use of a protective face shield
Use of a protective mask
What finding would lead the nurse to suspect that a child has Turner syndrome? Webbed neck Microcephaly Gynecomastia Cognitive delay
Webbed neck
The nurse talked to a group of adolescents about nutritional needs. Which statement is most accurate? You have a need for fatty foods You need vitamin supplements daily You have an increased need for most nutrients You need to increase your intake of iron
You have an increased need for most nutrients
