Pediatrics~ Final

Which is the most common cause of acute renal failure in children?

Inadequate perfusion

The nurse closely monitors the temperature of a child with minimal change nephrotic syndrome. The purpose of this assessment is to detect an early sign of which possible complication?

Infection

Which is the initial clinical manifestation of generalized seizures?

Losing consciousness

A child will start treatment for precocious puberty. The nurse recognizes that this will involve the injection of which synthetic medication?

Luteinizing hormone-releasing hormone

When caring for the child with Reye syndrome, what is the priority nursing intervention?

Monitor intake and output

Which best describes acute glomerulonephritis?

Occurs after a streptococcal infection

The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death?

Periodic and irregular breathing

A nurse is caring for a child who is suspected of having Legg-Calve-Perthes disease. The nurse should prepare the child for which of the following diagnostic procedures?

Radiographs

Which is included in the diet of a child with minimal change nephrotic syndrome?

Salt restriction

Which is a major complication in a child with chronic renal failure?

Water and sodium retention

Which should the nurse recommend to prevent urinary tract infections in young girls?

Wear cotton underpants.

A nurse is providing teaching to the guardians of a child who is to have an electroencephalogram EEG. Which of the following statements, by a guardian indicates teaching was effective?

"My child should remain quiet and still during this procedure."

A nurse is assessing a child who has a concussion. Which of the following findings should the nurse expect? Select all that apply

1. Amnesia 2. Confusion

A nurse is caring for a child who is in skeletal traction. Which of the following actions should the nurse take? Select all that apply

1. Assess the child's position frequently 2. Assess pin sites q4hrs 3. Ensure the weights are hanging freely

A nurse is caring for a male infant who has an epispadias. Which of the following findings should the nurse expect? Select all that apply

1. Bladder exstrophy 2. Widened pubic symphysis 3.Urethral opening on the dorsal side of penis

A nurse is caring for a child who has short status. Which of the following diagnostic tests should be completed to confirm GH deficiency? Select all that apply

1. CT scan of the head 2. Skeletal xrays 3. GH stimulation test 4. Blood IGF-1

The nurse is monitoring an infant for signs of increased intracranial pressure (ICP). Which are late signs of increased intracranial pressure (ICP) in an infant? (Select all that apply.)

1. Cheyne-Stokes respirations 2. Extension or flexion posturing 3. Alteration in pupil size and reactivity

A nurse is caring for a child who has a fracture. Which of the following are manifestations of a fracture? Select all that apply

1. Crepitus 2. Edema 3. Pain 4. Ecchymosis

A nurse is caring for a child who has DM1. Which of the following are manifestations of diabetic ketoacidosis? Select all that apply

1. Dehydration 2. Mental Confusion 3. Fruity breath

A nurse is teaching the parent of a child who has a growth hormone deficiency. Which of the following are complications of untreated growth hormone deficiency? Select all that apply

1. Delayed sexual development 2. Premature aging 3. Increased epiphyseal closure

A nurse is caring for a child who sustained a fracture. Which of the following actions should the nurse take? Select all that apply

1. Elevate the affected area 2. Assess neurovascular status frequently 3. Stabilize the injury

A nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? Select all that apply

1. Febrile Episodes 2. Hypoglycemia 3. Sodium imbalances

A nurse is teaching adolescent who has DM about manifestations of hypoglycemia. Which of the following findings should the nurse include in the teaching? Select all that apply

1. Hunger 2. Irritability 3. Sweating and pallor

Which are clinical manifestations of increased intracranial pressure (ICP) in infants? (Select all that apply.)

1. Irritability 2. Distended scalp veins

A nurse is assessing an infant who has a suspected UTI. Which of the following are expected findings? Select all that apply

1. Irritability 2. Vomiting 3. Fever

A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? Select all that apply

1. Loss of consciousness 2. Appearance of daydreaming 3. Dropping held objects

A nurse is caring for a child who has ICP. Which of the following actions should the nurse take? Select all that apply

1. Maintain a quiet environment 2. Administer a stool softener 3. Maintain body alignment

A nurse is reviewing sick day management with a parent of a child who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? Select all that apply

1. Monitor blood glucose levels q3hrs 2. Test urine for ketones

A nurse is caring for an infant who has ambiguous genitalia. Which of the following actions should the nurse take? Select all that apply

1. Prepare child for surgery 2. Refer the family for genetic couseling 3. Explain the need for a chromosomal analysis

A nurse is caring for an adolescent who has a closed injury. Which of the following findings are indications of increased intracranial pressure? Select all that apply

1. Report of headache 2. Alteration in pupillary response 3. Increased sleeping

A nurse is assessing a child who has a UTI. Which of the following are manifestations of a UTI. Select all that apply

1. Swelling of face 2. Pallor 3. Fatigue

A nurse is caring for an infant who has obstructive uropathy. Which of the following findings should the nurse expect? Select all that apply

1. Urinary tract infection 2. Hydronephrosis

A nurse is assessing a child who has nephrotic syndrome. Which of the following findings should the nurse expect? Select all that apply

1. Urine dipstick +2 protein 2. Edema in the ankles 3. Hyperlipidemia 4. Anorexia

A nurse is reviewing treatment options with the guardian of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? Select all that apply

1. Vagal nerve stimulator 2. Additional antiepileptic medications 3. Corpus callosotomy 4. Focal resection

The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record?

15

A child with growth hormone (GH) deficiency is receiving GH therapy. When is the best time for the GH to be administered?

At bedtime

Which is the most appropriate nursing diagnosis for the child with acute glomerulonephritis?

Fluid Volume Excess related to decreased plasma filtration

Which type of seizure involves both hemispheres of the brain?

Generalized

The nurse is caring for an 11-year-old boy who has recently been diagnosed with diabetes. Which should be included in the teaching plan for daily injections?

He is old enough to give most of his own injections.

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis to show during the acute phase?

Hematuria, proteinuria

Which statement is descriptive of renal transplantation in children?

It is the preferred means of renal replacement therapy in children.

The parent of a child with diabetes mellitus asks the nurse when urine testing will be necessary. The nurse should explain that urine testing is necessary for which?

Ketonuria is suspected.

A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. What does this finding suggest?

Leaking of cerebrospinal fluid (CSF)

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which is the most essential part of the nursing assessment to detect early signs of a worsening condition?

Level of consciousness

Which drug should the nurse expect to administer to a preschool child who has increased intracranial pressure (ICP) resulting from cerebral edema?

Mannitol (Osmitrol)

What is an appropriate nursing intervention when caring for an unconscious child?

Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How should the nurse interpret these findings?

Neurosurgical emergency

The nurse is taking care of a child who is alert but showing signs of increased intracranial pressure. Which test is contraindicated in this case?

Oculovestibular response

The nurse is conducting an admission assessment on a school-age child with acute renal failure. Which are the primary clinical manifestations the nurse expects to find with this condition?

Oliguria and hypertension

Type 1 diabetes mellitus is suspected in an adolescent. Which clinical manifestation may be present?

Poor wound healing

A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take?

Position the child in a side lying position

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. Which is an appropriate nursing goal related to this?

Prevent infection

A nurse is assessing a child who has short stature. Which of the following findings would indicate a GH deficiency?

Proportional height to weight

Which is an objective of care for a 10-year-old child with minimal change nephrotic syndrome?

Reduce excretion of urinary protein.

The nurse notes that a child has lost 8 pounds after 4 days of hospitalization for acute glomerulonephritis. What is most likely the cause of the weight loss?

Reduction of edema

The nurse is teaching parents about prevention of urinary tract infections in children. Which factor predisposes the urinary tract to infection?

Short urethra in young girls

A 10-year-old boy on a bicycle has been hit by a car in front of the school. The school nurse immediately assesses airway, breathing, and circulation. What is the next nursing action?

Stabilize neck and spine

A nurse is in the emergency department is assessing a child following a MVC. The child is unresponsive, has spontaneous respirations of 22/min and has a laceration on the forehead that is bleeding. Which of the following actions should the nurse take first?

Stabilize the child's neck

A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school. Breathing is not impaired, but some postictal confusion occurs. What is the most appropriate initial action by the school nurse?

Stay with child and have someone call emergency medical service (EMS)

The nurse is teaching parents of a child with chronic renal failure (CRF) about the use of recombinant human erythropoietin (rHuEPO) subcutaneous injections. Which statement indicates the parents have understood the teaching?

The red blood cell count should begin to improve with these injections."

An adolescent is being seen in the clinic for evaluation of acromegaly. The nurse understands that which occurs with acromegaly?

There is excess growth hormone (GH) after closure of the epiphyseal plates.

Which clinical manifestation would be seen in a child with chronic renal failure?

Unpleasant "uremic" breath odor

A mother asks the nurse what would be the first indication that acute glomerulonephritis is improving. What is the nurse's best response?

Urinary output will increase

The nurse is teaching the parent about the diet of a child experiencing severe edema associated with acute glomerulonephritis. Which information should the nurse include in the teaching?

You will need to avoid adding salt to your child's food."

A toddler fell out of a second-story window. She had a brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she "seems fine." Which explanation should the nurse give?

Your child may have a brain injury and the CT can rule one out.

A child is brought to the emergency department after experiencing a seizure at school. There is no previous history of seizures. The father tells the nurse that he cannot believe the child has epilepsy. What is the nurse's best response?

"The seizure may or may not mean that your child has epilepsy."

A nurse is teaching a parent of a child who has a urinary tract infection. Which of the following should the nurse include in the teaching? Select all that apply

1. Avoid bubble baths 2. Empty bladder completely with each void 3. Watch for manifestations

A nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? Select all that apply

1. Muscular weakness in lower extremities 2. Unsteady, wide based or waddling gait

Which statement best describes a subdural hematoma?

Bleeding occurs between the dura and the cerebrum

A nurse is caring for a school aged child who has acute glomerulonephritis. Which of the following findings should the nurse report to the provider.

Blood creatinine of 1.3

A nurse is caring for a preschooler who has a nephrotic syndrome. Which of the following findings should the nurse report to the provider?

Blood protein 5.0

An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. The nurse should suspect which type of head injury?

Brainstem

The nurse is caring for a child with acute renal failure. Which clinical manifestation should the nurse recognize as a sign of hyperkalemia?

Cardiac arrhythmia

A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on which knowledge?

Children are better able to manage the diabetes

A nurse is caring for a child who is taking mannitol for cerebral edema. Which of the findings should the nurse monitor for as an effect of mannitol?

Confusion

Which is instituted for the therapeutic management of minimal change nephrotic syndrome?

Corticosteroids

The nurse is admitting a school-age child in acute renal failure with reduced glomerular filtration rate. Which urine test is the most useful clinical indication of glomerular filtration rate?

Creatinine

Which is considered a cardinal sign of diabetes mellitus?

Frequent urination

When should the nurse recommend medical attention for a child with a slight head injury?

Is confused or has abnormal behavior

The nurse is planning care for an 8-year-old child with a concussion. Which is descriptive of a concussion?

It is a transient and reversible neuronal dysfunction

When taking the history of a child hospitalized with Reye syndrome, the nurse should not be surprised that a week ago the child had recovered from:

varicella

Children taking phenobarbital (phenobarbital sodium) and/or phenytoin (Dilantin) may experience a deficiency of:

vitamin D and folic acid

Which of the following types of seizures may be difficult to detect?

Absence

Which is characteristic of the immune-mediated type 1 diabetes mellitus?

Age at onset is usually younger than 20 years

A nurse is teaching a group of caregivers about fractures. Which of the following information should the nurse include in the teaching?

" Epiphyseal plate injuries can result in altered bone growth."

A nurse is teaching a child who has DM1 about self care. Which of the following statements by the child indicates understanding of the teaching?

" I should increase my insulin with exercise."

A parent of a school age child who has GH deficiency asks the nurse how long the child will need to take injections for growth delay. Which of the following responses should the nurse make?

" Injections might be stopped once your child grows less than 1 inch/year."

A nurse is caring for a toddler who has hip dysplasia and has been placed in a hip spica cast. The child's guardian asks the nurse why a Pavlik harness is not being used. Which of the following responses should the nurse make?

" The Pavlik harness is used for infants less than 6 months of age."

A nurse is teaching a school aged child who has DM about insulin administration. Which of the following should the nurse include in the teaching?

" You should give four to six injections in one area before switching sites."

A nurse is caring for a child who has cerebral palsy. Which of the following medications should the nurse expect to administer to treat painful muscle spasms? Select all that apply

1. Baclofen 2. Diazepam

A nurse is caring for an infant and notices an audible click in their left hip. Which of the following diagnostic test should the nurse expect the provider to perform? Select all that apply.

1. Barlow test 2. Ortolani test

A nurse is assessing a child who has Legg-Calve-Perthes disease. Which of the following findings should the nurse expect? Select all the apply

1. Hip Stiffness 2. Back pain 3. Limited ROM 4. Limp with walking

A nurse is caring for a child who has acute post-streptoccal glomerulonephritis. Which of the following manifestations should the nurse expect? Select all that apply

1. Periorbital edema 2. Ill appearance 3. Hypertension

The nurse is caring for an infant with a suspected urinary tract infection. Which clinical manifestations should be expected? (Select all that apply.)

1. Persistent diaper rash 2. Vomiting 3. Failure to gain weight

A nurse is caring for a school age child who has juvenile idiopathic arthritis. Which of the following home care instructions should the nurse include in the teaching? Select all that apply

1. Provide extra time for completion of ADLs 2. Perform ROM exercises

A nurse is caring for an infant who has a myelomeningocele. Which of the following actions should the nurse include in the pre-operative plan of care?

Apply a sterile, moist dressing on the sac.

A nurse is caring for a child who has enuresis. Which of the following is a complication of enuresis?

Emotional problems

A nurse is developing a plan of care for a toddler who has cerebral palsy. Which of the following actions should the nurse include?

Evaluate the toddler's need for an evaluation of hearing ability

One of the clinical manifestations of chronic renal failure is uremic frost. Which best describes this term?

Deposits of urea crystals on skin

What is an important nursing intervention when caring for a child who is experiencing a seizure?

Describe and record the seizure activity observed.

A nasal spray of desmopressin acetate (DDAVP) is used to treat which disorder?

Diabetes insipidus

A nurse is planning care of a child who has a UTI. Which of the following interventions should the nurse include?

Evaluate the child's self esteem

A nurse is caring for an infant who has a hydrocele. Which of the following actions should the nurse take?

Explain to parents that the issue will self resolve

A nurse is completing preoperative teaching with an adolescent client who is scheduled to receive spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching?

" You will need to receive blood."

A young child's parents call the nurse after their child was bitten by a raccoon in the woods. The nurse's recommendation should be based on which statement?

Antirabies prophylaxis must be initiated.

A nurse is caring for a child who is in a plaster spica cast. Which of the following actions should the nurse take?

Apply moleskin to the edges of the cast?

The nurse has documented that a child's level of consciousness is obtunded. Which describes this level of consciousness?

Arousable with stimulation

A nurse is assessing a child who has chronic renal failure. Which of the following findings should the nurse expect?

Delayed growth