Pediatrics Final
A nurse is caring for a child who has just returned from surgery where he underwent repair for epispadias. The parents are concerned when they see a slight amount of blood in the urinary collection bag. The nurse tells the parents:
"A slight amount of blood in the urine is normal following this surgery"
The nurse instructor asks a nursing student in the class to describe acute lymphoblastic leukemia (ALL). The instructor realizes the nursing student does not need further instruction in the disease when the student states:
"ALL is the overproduction of immature lymphocytes"
The mother of an 8-year-old girl is concerned because her daughter is developing pubic hair and enlarged breast tissue. The nurse's best response would be:
"At what age did you begin puberty?"
The nurse is discussing treatments for a 16-year-old with acne. Which of the following statements is correct about acne treatments?
"Avoid using sunscreen while taking acne medication."
The nurse is attempting to explain humoral immunity to a child's mother who inquired about her child's ability to fight off illness during a well-baby visit to the clinic. The nurse tells the mother the following about humoral immunity so the mother will understand:
"Humoral immunity destroys bacteria, viruses, and allergens"
The parents of a newly diagnosed 2-year-old with autism are having difficulty with the child's diagnosis. The nurse has just finished talking with the parents and answering their questions and realizes additional information is needed when the mother states:
"I realize that with the proper care and medication our child will be cured"
The nurse is providing instructions for the mother of an adolescent girl with scoliosis who has just been fitted for a Milwaukee brace. The nurse realizes additional instruction is needed when the mother states:
"I understand that the brace must be worn for 2 hours on and 2 hours off"
A 12-year-old asks, "Do I really have to wear this Milwaukee brace when I go to school? I look like a freak!" The nurse's best response would be:
"I will ask the doctor if you can wear another type of brace"
A young mother who is HIV positive has followed all of the recommended prenatal precautions and has just delivered a female child by cesarean section. After the infant is examined, the physician states that the infant has no outward symptoms of HIV. The nurse realizes that the mother needs more education about the possibility of HIV transmission to her infant when she states:
"I will be breastfeeding my infant since she does not appear to have HIV"
The nurse has just completed teaching the parents of a child who has started chemotherapy. The mother has been instructed about infection control during therapy. The nurse realizes the mother understands the teaching when she says:
"I will make sure to keep my child away from public places to prevent infections."
The nurse realizes that her client, an overweight teenage male with type II diabetes, needs further instruction when he states:
"If I take these pills, I will never need to take insulin shots"
The nurse is caring for a child with congestive heart failure and has just finished teaching the parents about diuretics and why they are given. The nurse realizes more teaching is needed when the father states:
"If my child throws up the diuretic, I can give him another right away."
The nurse is caring for a pediatric client with sickle cell anemia. The parents ask the nurse about the causes of the disease. Which response by the nurse best describes the cause of this disease?
"It is an inherited disorder caused by abnormal hemoglobin synthesis"
A 6-year-old child is admitted to the pediatric unit with partial and full thickness third-degree burns, From this information, the nurse can plan burn care that affects:
All layers of skin
The parents of an infant with bladder exstrophy ask the nurse about the condition. The nurse explains this condition is caused by:
An extrusion of the bladder through a lower abdominal wall defect
The nurse is reviewing the physician's orders for a child with hemophilia. Indicate the orders that the nurse might expect to see written in the child's chart. SATA
- Avoid carbonated beverages - Avoid salicylates - Avoid unnecessary invasive procedures
Which of the following prevention methods should be followed to decrease the risk of melanoma? SATA
- Avoid late afternoon sun between 4 pm, and 6 pm. - Apply sunscreen of SPF 15 or greater - Wear long-sleeved cotton clothing when outside
A teenager is complaining that between his toes are red, scaly areas with deep fissures that itch and are painful. What should the nurse recommend the teenager do to avoid this skin condition in the future?
Apply Elimite cream on toes for 2 weeks
The nurse is caring for a pediatric client after a kidney transplant. The nurse knows this client has the potential for organ rejection and monitors the following closely:
Urinary function, fluid and electrolyte balance
The nurse is discussing the discharge plans for a newborn with hypospadias. What statement by the parents indicates their understanding of the plan?
"Our child won't be circumcised right away in order to save tissue for repair"
The nurse answers the phone in the Crisis Center. The call is from the mother of a 16-year-old female who has told her mother that she doesn't want to "live any longer." The nurse's most appropriate response to the mother would be:
"Please stay with your daughter and bring her in for a consult with our psychologist"
A 2-week-old infant is recovering from surgery for pyloric stenosis. The mother comments, "Now that the surgery is over, Timmy should not have intestinal obstruction ever again." An appropriate nursing response would be:
"Reoccurrence of obstruction is unlikely, but we will review symptoms you should watch for."
The nurse is providing instructions to parents about a synthetic cast applied to the child for treatment of clubfoot. Which of the following statements is true about synthetic casting?
"Synthetic casts allow for greater mobility"
An infant was born with developmental dysplasia of the hip. His father states, "I am glad we will only have to triple his diaper for a few days. They look so uncomfortable." The nurse should reply:
"Tell me what you understand about the infant's hip problem"
The nurse is providing teaching to the parents of an infant with Hirschsprung's disease. Which of the following statements best describes Hirschsprung's disease?
"The colon has a segment with limited nerve supply that prevents normal movement."
A mother brings her 8-year-old daughter with Cystic Fibrosis to the emergency department. Which of the following signs and symptoms would the nurse expect her to demonstrate on admission? SATA
- Abnormally salty tears, sweat and saliva - Abdominal distention, undernutrition and failure to gain weight - Large, bulky, frothy and foul-smelling stools - Dyspnea, wheezing and respiratory distress with hypoxia
A nurse is preparing to admit an infant to the hospital with a diagnosis of shaken baby syndrome. Choose the correct statements about this syndrome: SATA
- After this injury, infants may have seizures, lethargy, and respiratory difficulties. - Infants are susceptible to this injury because their neck muscles are weak - This type of injury always lead to death within 1 month - Vision impairment or loss of hearing may result from this injury - Jarring motion causes tearing of the nerve fibers in the brain
A nurse is assigned to care for an adolescent with a latex allergy diagnosis. The nurse is taking the client's history and in order to determine the client's risk factors associated with latex allergies, the nurse asks about an allergy to which foods? SATA
- Avocados - Potatoes - Bananas
A nurse is checking off instructions for the parents for the care of a child with a newly applied cast to the right lower leg. Select all instructions that would be included on this list: SATA
- Contact the physician if the child complains of numbness or tingling in the leg - Observe the cast for drainage - Cover cast with plastic bag during bathing
To prevent trauma to the surgical site after a cleft palate repair, the nurse should avoid the use of which of the following? SATA
- Cup - Syringe - Spoon - Oral thermometer
The nurse is reviewing a list of instructions with a parent for an infant with oral candidiasis. Select all instructions that should be included on the list? SATA
- Disinfect all toys - Clean bottle nipples in cool water - Report rash in the diaper area
The nurse is caring for a child admitted to the medical center with a diagnosis of nephrotic syndrome and selects the following data that can be found on assessment: SATA
- Hyperlipidemia - Hypoalbuminemia - Edema - Protein in the urine
The nurse is collecting data on a severely obese 16-year-old female in the physician's office who states she wants bariatric surgery to correct her obesity. Select all criteria required before an adolescent can be considered for this surgery: SATA
- Must have tried weight management techniques for longer than 6 months and failed - Must avoid pregnancy for more than 1 year postoperatively - Must be physiologically mature - Must agree to a psychological evaluation before surgery - Must agree to a psychological evaluation after surgery
A nurse is caring for a 15-year-old child with hyperlipidemia and is implementing a teaching plan for this child. Select all the interventions the nurse would anticipate for this client: SATA
- Regular exercise plan - Consultation with a dietitian - Anticoagulant - Low-fat, low-cholesterol diet - Cholesterol lowering medications
The nurse is discussing iron-deficiency anemia and knows the child with this disorder may crave substances that are not food. Select the following substances that children with this disorder may crave and eat: SATA
- Starch - Dirt - Glue - Chalk
The nurse is caring for a child with Kawasaki's syndrome. The child is in the subacute phase of the disease. Which manifestations would the nurse expect to observe? SATA
- Swollen hands and feet - Sloughing of the skin of the lips, hands, and feet - Conjunctival hyperemia Pain in the joints
You are caring for an adolescent with a known sensitivity to latex. In preparing for his care, you select nursing interventions to care for this client to prevent an allergic response to latex: SATA
- Use only manual blood pressure cuffs - Use medications that are stored in glass - Remove all latex materials from the room - A latex-free cart should be kept in or near the client's room - Use only nonlatex gloves
The nurse selects the following teaching items for the parents of a 2-year old, partially toilet-trained female child with a diagnosis of urinary tract infection: SATA
- Wipe the child from front to back - Clean the perineum after each diaper change - Avoid bubble baths - Avoid putting the child in a commercial hot tub
The nurse caring for a child with head trauma is ordered to monitor the urine specific gravity. The doctor is concerned the child will develop diabetes insipidus. Which of the following urine specific gravity values should be reported immediately?
1,004
An emergency department nurse is collecting data on a child with suspected sexual abuse. What findings are suspicious related to sexual abuse and indicate the need for further investigation?
Vaginal redness, pain and bloody discharge
The nurse is instructing the father of a child with sickle cell anemia about sickle cell crisis and causes. The father verbalizes understanding, but the nurse realizes more instruction is needed when the father identifies which of the following as a major contributor in a sickle cell crisis?
Vomiting
A 6-year-old child is admitted to the pediatric unit with a diagnosis of Rheumatic Fever (RF). The LPN reviews the child's medical history after taking the vital signs. Which of the following data obtained from the child's chart is the probable cause in the development of this condition?
the child was treated by her pediatrician for a sore throat 2 weeks ago
When a child develops diabetic ketoacidosis, the child's condition is:
A life-threatening situation
A child has been diagnosed with Kawasaki's syndrome. The father is asking about the disease, and the nurse explains that Kawasaki's syndrome is:
A systemic, acute inflammatory disease known as mucocutaneous lymph node syndrome
A diabetic adolescent has been admitted following an automobile crash. He is on bed rest and condition is stable. At 11:30 a.m. he develops a flushed face, increased urinary output, and fruity breath. Place the following interventions in priority order:
A) Call the primary care provider B) Administer regular insulin on sliding scale C) Obtain a blood glucose level D) Increase oral intake of water E) Review the intake and output record Correct Order: A, C, D, B, E
The nurse is working at a health care clinic and is scheduled to give immunizations today. The nurse knows that the immunizations provide:
Acquired immunity from diseases
The nurse has assumed care of a child with suspected rheumatic fever. The lab reports have just come back. The nurse reviews them. Which lab report would be helpful in confirmation of this diagnosis?
Antistreptolysin O titer
The nurse is caring for a child with Kawasaki's syndrome and reviews the medication orders, expecting to find orders for:
Aspirin and immune globulin
The nurse realizes the following nursing interventions should be instituted for a child with a suspected diagnosis of HIV:
Avoidance of infection and proper nutrition
The nurse is teaching an adolescent who has recently been diagnosed with type I diabetes mellitus. The nurse bases the teaching on the adolescent's:
Awareness of the severity of the disorder, motivating them to maintain a strict routine
The nurse is caring for a child with symptoms of uremic frost, nausea, vomiting, anorexia, uremic breath odor, anemia, pruritis, and pulmonary edema. The nurse knows these symptoms are most likely caused by:
Bladder exstrophy
A 4-year-old child diagnosed with Leukemia is receiving a blood transfusion. Which of the following signs enumerated below indicate to the nurse that the child might be having a reaction to the infusion?
Blood pressure of 90/50 mm Hg
A nurse participates in a staff conference where discussion was focused on an infant diagnosed with Non-organic Failure to Thrive (NFTT). Which of the following outcomes indicate to the health care team that the teachings and interventions given to the family was successful?
the family demonstrates nurturing behaviors towards the infant
A 12-year-old client has a fever and complains of abdominal pain. The school nurse:
Calls the physician
In a pediatric clinic the mother of a 3-month-old child tells the nurse the child doesn't gain weight, has constant ear infections, fever, mouth infection (oral candidiasis), and diarrhea. On examination, the physician confirms that the child also has hepatosplenomegaly. The nurse suspects the child has a diagnosis of:
Chronic otitis media
A 17-year-old is 3 days post-op below-the-knee amputation for osteosarcoma. Which of the following findings should be reported to the RN?
Client keeps leg under the covers
The nurse is monitoring the intake and output of an infant with congestive heart failure. Which of the following indicators alerts the nurse that the child is accumulating fluid?
Crackles heard on auscultation
A 6 year old child is admitted to the pediatric unit with a diagnosis of Rheumatic Fever (RF). The LPN reviews the Child's medical history after taking the vital signs. Which of the following data obtained from the child's chart is the probable cause in the development of this condition?
DONT KNOW ANSWER
A 4-month-old has gastroesophageal reflux but is thriving without other complications. Which of the following should the nurse suggest to minimize reflux?
Decrease frequency of feedings as much as possible
A 5-year-old child is hospitalized with a suspected diagnosis of idiopathic thrombocytopenic purpura. The laboratory technician has just drawn the child's blood. Because of the suspected diagnosis, the nurse expects to see the following results on the child's lab report:
Decrease platelet count, increased antiplatelet antibodies
Which of the following is most important when assessing a child with poisoning?
Determine what was taken and the treatment provided by parents
The nurse is assigned to care for a 4-year-old autistic child with an upper respiratory infection. The nurses observes the following behavior and knows this is a clinical manifestation of autism:
Displaying repetitive behaviors such as rocking back and forth
The nurse is observing a child with ADD. The child has been taking amphetamine sulfate (Adderall) and is exhibiting irritability and restlessness. Based on these observations, the nurse's initial response would be:
Do nothing as these are common side effects of the drug
The nurse is caring for a child with a right leg cast and is checking the capillary refill of the extremity. The nurse presses the nail bed of the great toe and it returns to the original color in 2 seconds. The nurse's next action is to:
Document the findings
The environmental temperature should be kept cool and ----------- for children with eczema.
Dry
When taking a family history, the nurse discovers that both parents have a history of asthma. Which of the following skin disorders has been associated with asthma?
Eczema
The nurse is assisting the physician during an examination of an infant with a diagnosis of hip dysplasia. The physician is planning on performing an Ortolani-Barlow maneuver. The nurse understands that the physician is assessing the infant's hips for?
Flexion
An adolescent with a new diagnosis of diabetes is learning to give her own insulin injection, but cannot give herself the shot. The nurse should:
Give the shot and allow her to practice more
The nurse is caring for an infant born with fetal alcohol syndrome (FAS). The nurse knows that there are some characteristics displayed in infants with FAS, and they are:
Growth retardation, CNS abnormalities, and craniofacial abnormalities
In a child with a diagnosis of urinary tract infection (UTI), the nurse knows the child may experience the following symptoms?
Hematuria, dysuria, nausea, and vomiting
A school-age child is being discharged home after being treated for respiratory distress from an asthma attack. Which of the following outcomes indicate that the nursing care instructions provided to the family is successful?
the family demonstrates the ability to provide home care
After a thyroidectomy, a teenager is experiencing tingling and spasms of the hands. The nurse identifies this electrolyte imbalance as:
Hypocalcemia
The nurse is reviewing the plan of care for an infant with the diagnosis of bladder exstrophy and targets which of the following priority diagnoses?
Impaired tissue integrity
Children are generally more physically active during the summer months. In caring for the child with type I diabetes mellitus, what changes in the plan of care should be expected?
Increase food intake
A 14-year-old adolescent is admitted with an initial diagnosis of diabetes. The nurse would expect this to be:
Insulin-Dependent Diabetes (IDDM)
A 5-year-old girl named Tara has chickenpox (Varicella). Which of the following interventions would be MOST important in providing nursing care?
Keeping the child's fingernails short to prevent scratching
Which of the following assessment findings in characteristic of port wine stains?
Laser treatments may be needed
A 12-year-old is receiving oral antibiotics because of a deep cut behind his left knee after falling off his bicycle. The child has returned for a follow-up visit. Which of the following assessment findings should be reported immediately to the nursing supervisor?
Limps when walking
The nurse knows that which of the following blood values indicate sickle cell disease?
Low Hgb and high reticulocyte count
The mother of a child with a diagnosis of transposition of the great arteries asks what kind of medication the nurse is giving the child. The nurse tells the mother that the child is receiving prostaglandin E. The mother asks why this medication is necessary. The nurse replies that the medication:
Maintains adequate cardiac output and oxygen saturation
The nursing instructor is conducting a lecture about hematologic disorders in children and leads the discussion about the causes of thalassemia. The nurse tells the students that children who are at greatest risk for this blood disorder are those who are of:
Mediterranean descent
A nurse is reading the health record of her client with Hodgkin's disease. Which of the following symptoms would the nurse expect to see in the record considering the diagnosis?
Nontender, soft tumors in the abdominal area
The nurse is caring for a baby with probable intussusception. The baby has diarrhea before admission but, while waiting for a barium enema, passed a normal brown stool. Which of the following is the most appropriate nursing action?
Notify the physician
A nursing student is caring for a client with anorexia nervosa and developing a care plan. The nursing instructor speaks with the nursing student about which of the following entries as an incorrect nursing intervention for this disorder?
Observe strenuous exercise activities
The nurse is conducting an assessment of a child with a potential Wilms' tumor. In the course of the assessment, the nurse avoids which method of gathering data?
Palpating the abdomen
Which of the following nursing interventions is recommended for a child with impetigo?
Place toys in a plastic bag for 2 weeks
The type of immunity that protects the child against bacteria, viruses, fungi, and tumors and which is also responsible for the process that cause rejection of organs that have been transplanted is called:
Primary immunity
The symptom that the nurse must monitor most closely when pyloric stenosis is suspected is:
Projectile vomiting
A nursing student is asked to identify the characteristics of drug abuse. The nursing instructor steps in to correct the student when the student identifies which incorrect characteristic of drug abuse?
Psoriasis
A nurse is taking care of a child in skeletal traction and avoids which action when caring for this child?
Putting the bed linens on the traction ropes
In planning the care of a child with Neutropenia, the nurse would:
Restrict visitors
A 10-year-old child has been diagnosed with juvenile rheumatoid arthritis (JRA). The nurse realizes this is a chronic autoimmune disorder that causes joint inflammation. What symptom listed below is not associated with this disease?
Rhinitis
A nurse is caring for an infant with a diagnosis of tetralogy of Fallot (TOF). The nurse knows that there are four defects associated with TOF. They are:
Right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and overriding aorta
The nurse reviews the laboratory report of a child with possible glomerulonephritis. The nurse knows which finding is associated with a diagnosis of glomerulonephritis?
Streptococcal infection
The nurse is caring for a child with a diagnosis of coarctation of the aorta. Who has congestive heart failure. Which of the following symptoms is also related to this diagnosis?
Strong, bounding pulse in both arms, thready and weak pulses in the legs
The nurse is caring for a client with osteosarcoma. Which of the following symptoms would the nurse expect?
Swelling in the area of the clavicle
The nurse would consider which of the following as a positive outcome in evaluating an infant with failure to thrive?
The family demonstrates nurturing behaviors toward the infant
A child with lupus has been placed on corticosteroids for an indefinite period of time. Which of the following are cushingoid symptoms associated with corticosteroid administration to children?
Weight gain and delayed puberty
The nurse is caring for an infant with seborrheic dermatitis. Which of the following symptoms would the nurse expect?
Yellow scaly patches on scalp
The nurse in the Pediatric unit receives a call from the admissions office to prepare a bed for a toddler diagnosed with Epiglottitis. Which of the following nursing actions enumerated below would be of highest PRIORITY preparatory to this child's arrival?
have tracheostomy or intubation equipment available at the bedside