Pedi EX 3 immunological, infectious, integumentary, etc.
A 12-year-old experiences absence seizures. Which of the following is a typical manifestation of this type of seizure? a. Rapid blinking for 10 seconds b. Spastic stiffening of all muscles c. "Marching" spasms of the left or right arm d. Stupor from which it is difficult to be roused
a
A child sustains a fractured femur in a bicycle accident. The admission x-rays films reveal evidence of fractures of other long bones in various stages of healing. What does the nurse suspect is the cause of the fracture? a. Child abuse b. Vitamin D deficiency c. Osteogenesis imperfecta d. Inadequate calcium intake
a
A nurse in the pedi clinic is assessing a child with strabismus. What is one of the major goals for the surgical correction of this child's disorder? a. Improve appearance b. Avoid need for glasses c. Prevent legal blindness d. Restore peripheral vision
a
A nurse is caring for a 9-month old infant who was admitted to the unit with a tentative diagnosis of meningitis. A lumbar puncture is performed. The nurse explains to the parents that the primary reason this procedure is performed is to: a. Determine the causative agent b. Identify the presence of blood c. Reduce the intracranial pressure d. Measure the spinal fluid glucose level
a
A nurse is cleansing the skin of a hospitalized child with impetigo. Which action is most important for the nurse to take? a. Apply clean gloves to prevent the spread of the infection to others. b. Use sterile technique to prevent any further infection of the lesions. c. Ensure the water is cold to help reduce pain during cleansing. d. Keep the child in contact precautions until the child is discharged.
a
A nurse is obtaining the health history of a 7-month old boy who has had repeated episodes of otitis media. What question should be included in the interview with the mother? a. "Please describe your son's feeding patterns." b. "Tell me how often your son has had otitis media." c. "What medicine do you give your son for the otitis media?" d. "Do any of your children other than your son have this problem?"
a
A nurse is teaching a high school student about scoliosis treatment options. What should be the nurse's focus? a. Effect on body image b. Lease invasive treatment c. Continuation with schooling d. Maintenance of contact with peers
a
A nurse places a child with bacterial meningitis in isolation with droplet precautions. What is the purpose of these precautions? a. They separate the child from noninfected people b. The infectious process is interrupted as quickly as possible c. The child is protected from developing a secondary infection d. They prevent the development of a hosptial-acquired infection
a
A school-aged child with external otitis media wonders how she got the illness. What information would the nurse discuss with her as a common cause? a. Swimming b. Use of ear plugs c. Wearing sunglasses that are too tight d. Excessive use of cotton swabs
a
An adolescent has migraine headaches. A drug you would expect to see prescribed for him is a. Ergotamine tartrate (Cafergot). b. Parathyroid hormone. c. Methotrexate. d. Clindamycin (Cleocin).
a
Mebendazole (Vermox) is prescribed for a 3 year old with pinworms. What information should the nurse include when teaching the parents about this medication? a. It may precipitate transient diarrhea b. One dose will eliminate the infection c. Rectal itching will be relieved the next day d. Other family members will not need to take it
a
Scarlet fever is a childhood exanthema. The causative agent is a. streptococci. b. staphylococci. c. an equinovarus. d. a syncytial virus.
a
The 3-year-old who has just been admitted to the hospital with bacterial meningitis may be most afraid due to a. the masks worn by the staff. b. the headache. c. the intravenous line in his hand. d. A.keeping the room lights dim.
a
The best way to approach a child who is blind would be to a. call his name and then identify yourself. b. call his name and then touch him. c. touch him and then identify yourself. d. touch him and then say his name.
a
The physician of a child with extensive burns tells you an hour after the injury to "monitor him carefully." Which of the following would be the most important factor to monitor closely? a. Urinary output b. Pupillary reaction c. Intracranial pressure d. Sugar and acetone of urine
a
While visiting a friend, you see an 18-month-old toddler pull a scalding cup of coffee off a table onto himself. Your first action should be to a. pour cool water over the skin area where the coffee spilled. b. remove his shirt and apply burn ointment. c. wrap him in a blanket and rush him to the nearest hospital. d. apply butter to soothe the injured skin.
a
What are the hallmark signs of a fracture? select all that apply. a. deformity b. edema c. pain d. break in skin e. cyanosis to skin
a, b, c
A 4-year old child is admitted to the pedi unit with a seizure disorder. Shortly after admission, while in bed, the child has a generalized seizure. What nursing actions are most appropriate? Select all that apply. a. Assess the seizure. b. Take the child's vital signs. c. Turn the child onto the side. d. Pull the padded side rails up. e. Initiate oxygen administration.
a, c, d
The nurse is developing a plan of care for a child who is at risk for seizures. Which interventions apply if the child has a seizure? Select all that apply. a. Time the seizure b. Restrain the child c. Stay with the child d. Place the child in a prone position e. Move furniture away from the child f. Insert a padded tongue blade in the child's mouth
a, c, e
A 10 year old boy arrives with his mother at the ER after being bitten by a stray dog. There is a bleeding soft tissue injury on the inner aspect of the left forearm. What is the priority nursing action? a. Ask the mother if her son is allergic to horse serum b. Assess the injury, vital signs, and past health history c. Inoculate the child with human rabies immunoglobulin d. Notify the police department to capture and test the dog
b
A nurse is assessing a 3 year old child with a tentative diagnosis of lead poisoning. What clinical finding supports this diagnosis? a. Epistaxis b. Clumsiness c. Excessive salivation d. Decreased pulse rate
b
A nurse is caring for a child with severe burns who has extensive eschar formation on the arms. What is the priority nursing intervention? a. Removing blisters b. Checking radial pulses c. Maintaining respiratory isolation d. Performing range-of-motion exercises
b
A nurse is explaining a myringotomy procedure to a child's parents. The nurse includes that the incision: a. Takes several days to heal, leaving some scar tissue b. Provides immediate relief of pressure in the middle ear c. Widens the perforation in the eardrum, allowing for drainage d. May result in permanent perforation of the tympanic membrane
b
After treatment for Lyme disease, a child expresses fear of going camping again because of the ticks. What is the nurse's best response? a. "Tell me more about your fears about camping." b. "Frequent checks for ticks will help prevent an infection." c. "Just think of all the fun you'll be missing if you don't go to camp." d. "It's hard to believe you're afraid to go camping just because of a tick."
b
Sulfadiazine (Silvadene) cream is often used to treat burns. Before applying this to a child, you would explain that the drug a. will cause some discomfort when applied. b. helps to keep the burn eschar soft. c. sometimes causes mild but annoying itching. d. may stain the bed linen brown.
b
The nurse is monitoring a child with burns during treatment for burn shock. The nurse understands that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? a. Skin turgor b. Neurological assessment c. Level of edema at burn site d. Quality of peripheral pulses
b
What statement by the mother of a 6-week old girl leads the nurse to assess the infant for the presence of a skeletal abnormality? a. "She seems to want to sleep curled up." b. "It's hard to put the diaper between her legs." c. "Her feet look flat when I put booties on her." d. "When I try to stand her up her legs won't straighten."
b
What are some interventions to carry out when a child is experiencing a seizure? a. Place a tongue blade in the mouth b. Document and record the seizure activity observed c. Protect the child from harm d. Suction the child e. Move furniture away from the child
b, c, e
A nurse is caring for a child with juvenile idiopathic arthritis (JIA). What is most important for the nurse to attempt to prevent? a. Infection b. Hemarthrosis c. Contracture deformities d. Delayed intellectual development
c
A nurse is teaching the parents of an infant with cerebral palsy how to provide optimum care. What should the nurse include in the teaching? a. Focus on cognitive rather than motor skills b. Maintain immobility of the limbs with splints c. Preserve muscle tone to prevent joint contractures d. Continue offering a special formula to limit gagging
c
The nurse prepares a teaching plan for the mother of a child diagnosed with bacterial conjunctivitis. Which, if stated by the mother, indicates a need for further teaching? a. "I need to wash my hands frequently." b. "I need to clean the eye as prescribed." c. "It is okay to share towels and washcloths." d. "I need to give the eye drops as prescribed."
c
The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent, indicates a need for further instruction? a. "It is extremely contagious." b. "It is most common in humid weather." c. "Lesions are most often located on the arms and chest." d. "It might show up in an area of broken skin, such as an insect bite."
c
The symptoms of AIDS in children most commonly begin as which of the following? a. Kaposi's sarcoma b. Bone tumors c. Frequent respiratory infections d. Nashua pneumonia
c
Which statement by a parent would best indicate that she understands the precautions required for her son after the insertion of myringotomy tubes? a. "I will keep him away from all children to prevent infections." b. "I will be certain he takes showers, not tub baths." c. "I will be certain he does not swim with the tubes in place." d. "I will not shampoo his hair until the tubes come out."
c
While in the playroom a 7-year old child has a twitching of the right arm an leg that progresses to a generalized tonic-clonic seizure. What is the nurse's initial action? a. Take other children to their rooms b. Insert an airway into the child's mouth c. Move toys and furniture away from the child d. Position the child on the back and place a pillow under the head
c
A child is admitted to the burn unit with partial-thickness burns of both arms and chest. What information about burns should guide the nurse's plan of care? a. Burns are extremely painful and disfiguring b. Some grafting of the burned area is necessary c. Pressure dressings and prolonged hydrotherapy are required d. Spontaneous epithelial regeneration occurs within several weeks
d
A child is diagnosed with Reye's syndrome. The nurse develops a nursing care plan for the child and should include which intervention in the plan? a. Assessing hearing loss b. Monitoring urine output c. Changing body position every 2 hours d. Providing a quiet atmosphere with dimmed lighting
d
A mother arrives at an emergency department with her 5-year-old child and states that the child fell of a bunk bed. A head injury is suspected, and the nurse checks the child's airway status and assesses the child for early and late signs of increased ICP. Which is a late sign of increased ICP? a. Nausea b. Irritability c. Headache d. Bradycardia
d
A new nurse asks an experienced nurse why the first dose of the measles, mumps, and rubella (MMR) vaccine is given only between 12 to 15 months of age and not earlier. Which explanation by the experienced nurse is correct? a. "The second dose of the vaccine is given before a child reaches puberty, and giving the first dose of the vaccine at 12 to 15 months of age allows the correct interval between vaccinations." b. "Because a live virus is administered, the chance of developing measles, mumps, or rubella is much higher if given at an earlier age." c. "A first dose at this age provides passibe immunity and decreases the incidence of a child developing any of the diseases." d. "If administered earlier, the vaccine will neutralize the passive immunity to measles from the child's mother and no immunity will result."
d
A nurse suspects that a 7-month old infant who is brought to the well-baby clinic for the first time may have a hearing deficit. What behavior leads the nurse to come to this conclusion? a. Mother says the infant is unable to learn the word Mama b. Infant does not always turn head when called by name c. Infant fails to demonstrate a Moro reflex in response to hand clapping d. Mother says the infant stopped making verbal sounds about a month ago
d
A school-aged child has a deficiency in humoral immunity. You expect that the child would have a reduced level of a. lymphokines. b. haptens. c. allergens. d. antibodies.
d
An infant with a diagnosis of AIDS has a nursing diagnosis of altered growth and development on the nursing care plan. Which nursing measure would enhance growth and development in the infant? a. Provide opportunities for the family to participate in the infant's care. b. Stimulate the infant with a mobile in the crib. c. Weigh the infant daily and count diapers for estimation of fluid loss. d. Provide nutritional supplements throughout the day.
d
The home health nurse visits a child with infectious mononucleosis and provides home care instructions to the parents about the care of the child. Which instruction should the nurse give to the parents? a. Maintain the child on bedrest for 2 weeks b. Maintain respiratory precautions for 1 week c. Notify the health care provider if the child develops a fever d. Notify the HCP if the child develops abdominal pain or left shoulder pain
d
The mother of a child with muscular dystrophy asks you what type of diet her son will need to follow. You would advise her that a. there is no special diet necessary for her son. b. a high-protein, high-carbohydrate diet may be helpful. c. extra creatinine should be added to his diet daily. d. a moderate calorie diet will help him remain ambulatory longer.
d
The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? a. "We need to encourage our child to drink fluids." b. "Coughing spells may be triggered by dust or smoke." c. "Vomiting may occur when our child has coughing episodes." d. "We need to maintain droplet precautions and a quiet environment for at least 2 weeks."
d
When asking health history questions about the child admitted with Reye's syndrome, which would be considered a common finding? a. Parental administration of acetaminophen for fever b. Recent streptococcal infection c. Recent sickle cell crisis d. Recent influenza illness
d
T/F: A fracture to the epiphyseal plate should be treated like any other fracture.
false; it's more serious
T/F: A fixed and dilated pupil is a normal finding.
false; medical emergency
What is autoimmunity?
results from an inability to distinguish self from non-self, causing the immune system to carry out immune responses against normal cells and tissue
What type of muscle is found in the skeletal muscular system?
striated
