Peds
The nurse is assessing a child with coarctation of the aorta, the nurse would expect to find which of the following? Cyanosis Diminished or delayed femoral pulses Exercise intolerance Poor feeding pattern
Diminished or delayed femoral pulses
Known previously by the unacceptable term "Mongolism", due to the characteristic facial features?
Down Syndrome
The parents of a 9-year-old patient were informed by the nurse that asthma attacks may occur spontaneously or in response to a trigger. Which of the following common irritants might trigger an asthma attack? Dust mites Fatigue Siblings with asthma Hereditary disorder
Dust mites
An 8-month-old with Phenylketonuria is to be discharged. On the discharge instructions, the nurse should include which foods that should be avoided? Butter Eggs Soy Cow's milk Cheese Fruit Juice
Eggs Soy Cow's milk Cheese
A toddler with Clostridium difficile is prescribed a medication for peptic ulcer prophylaxis. Which of the following would the nurse expect to be prescribed? Metoclopramide Loperamide Ondansetron Famotidine
Famotidine
A 17-year-old boy is diagnosed with Hodgkins lymphoma. Which of the following laboratory findings is the pathologic hallmark of this disease? Identification of Philadelphia chromosome Liver and thyroid test Erythrocyte sedimentation rate's scans Identification of Reed-Sternberg cells
Identification of Reed-Sternberg cells
Treatment of Anemia?
Fe fortified formula and cereal. Oral Fe supplements x 3 months. Foods high in Fe include lean meats, braunschweiger, egg yolks, raisins, spinach, greens, legumes.
A nurse is caring for a preterm infant. Upon assessment, the infant has a wide pulse pressure and presence of a machine-like murmur at the left sternal border. She suspects patent ductus arteriosus. Which of the following promote closure of the ductus arteriosus? Digoxin Penicillin Erythromycin Indomethacin
Indomethacin
After a child comes to the emergency room with aspirin overdose, the nurse should take which of following priority actions? Administer an antacid Initiate gastric lavage as ordered Administer an osmostic laxative Obtain a urine specimen
Initiate gastric lavage as ordered
A first time mother rushed her 3-day-old neonate to the emergency room for diarrhea and vomiting. She thinks that her first breast milk, which is yellowish in color, is the cause of her child's condition. She asks the nurse if she could feed her baby with formula milk instead of breastmilk. How should you answer her? "I will inform your pediatrician" "Breastmilk, especially the first milk, contains a lot of nutrients that is essential for your baby" "You should not have feed your baby with your breast milk, it is infected" "Yes,you should shift to formula instead of breastmilk to relieve the diarrhea"
"Breastmilk, especially the first milk, contains a lot of nutrients that is essential for your baby"
A child with a history of seizures, controlled with an anticonvulsant, is brought to the clinic. His mother states that he has been very sleepy. To correct this, she reported that she cut his anticonvulsant dosage in half. How would you respond to the mother? "You should have increased the dose" "You should have discontinued the drug" "You should not change the dosage without talking to the physician first" You are correct in cutting the dosage in half, but next time you should bring your child to have a drug level drawn first
"You should not change the dosage without talking to the physician first"
The first course of Inactivated polio vaccine is given at the age of: 2, 4 and 6-18 months 6, 8 and 10 weeks Birth, 1 and 2 months 9 months in one dose only
2, 4, and 6-18 months
The nurse is caring for a child with rubella. Which of the following should the nurse include in the care plan? Administer codeine to relieve joint pain Administer cough suppressants as ordered Administer acetaminophen as prescribed for fever and joint pain Apply a lubricating jelly or emollient to the nose to help prevent excoriation
Administer acetaminophen as prescribed for fever and joint pain
A patient with cystic fibrosis is prescribed pancreatin. The nurse explains to the patient that this medication: Treats constipation Treats chronic cough Aids digestion Promotes repiratory secretions
Aids digestion
The nurse is assessing a 7-year-old patient and auscultates expiratory wheezes throughout the lungs. The nurse should administer which prescribed medication? Fluticasone/salmeterol Albuterol Theophylline Salmeterol
Albuterol
The parents of a newborn ask the nurse what is the chief danger associated with a tracheoesophageal fistula? The nurse replies: Esophageal dilatation Gastroesophageal reflux Aspiration into the lungs Difficulty in maintaining suction
Aspiration into the lungs
After undergoing a surgical resection of the femur due to osteogenic sarcoma, the nurse should immediately: Assess for neurologic and circulatory function Assess vital signs every 15 minutes Assess for pain Administer an antiemetic
Assess for neurologic and circulatory function
An 8-year-old child is seen at the clinic with complaints of pain, pustular drainage of the eyes and sensitivity to light. Upon assessment you observed reddened watery eyes. Based on the initial data, these symptoms are indicative of: Keratitis Stye Conjunctivitis Opthalmia neonatorum
Conjunctivitis
A 3-year-old boy is rushed to the hospital. Laboratory and diagnostic findings reveal a brain lesion. Which of the following is considered the most common assessment finding associated with a brain tumor? Headache Diminished reflexes Vision changes Projectile vomiting
Headache
A patient has been taking levocabastine ophthalmic drops, an antihistamine, for the treatment of allergic conjunctivitis. Which of the findings indicates that the patient is experiencing a side effect to this medication? Orange tears Tinnitus Headache Diplopia
Headache
After a cleft palate repair, why should the use of a drinking straw be avoided? It can cause bruising of the tissue It can interfere with air exchange It will lead to aspiration It can tear the suture line
It can tear the suture line
A 10-year-old male is admitted to the acute care facility after having a tonic-clonic seizure. What priority nursing action would the nurse do immediately after the seizure? Maintain a patent airway with the child lying on his side until he is alert and responsive Monitor vital signs and neurologic status every 15 minutes until the child is fully awake Provide a calm, restful environment Observe for signs and symptoms of respiratory distress
Maintain a patent airway with the child lying on his side until he is alert and responsive
When planning care for a 10-month-old infant with dehydration, which of the following interventions would be the most accurate for monitoring hydration status? Measuring intake and output Assessing skin turgor Checking electrolyte values Monitoring daily weight
Monitoring daily weight
A 3-month-old is admitted to the hospital with severe diarrhea for 3 days. The child has a fever, sunken fontanels, and dry skin. She is to receive nothing by mouth, only I.V. fluids. To prevent circulatory overload while she is receiving intravenous therapy, it is essential to take which of following measures? Monitoring urine output Palpating the anterior fontanel Monitoring the rate of IV flow Repositioning
Monitoring the rate of IV flow
A newborn baby is diagnosed with a neural tube defect, specifically, meningocele. Which of the following definitions most accurately describes meningocele? Out-pouching of the meninges through the cranium or vertebre Spinal cord and meninges protrude through the vertebrae defect Posterior laminae of the vertebrae fail to fuse Tumor of the spinal cord and accompanying nerve roots
Out-pouching of the meninges through the cranium or vertebre
A patient with multiple partial-thickness burns receives tramadol as needed. The nurse assessed the effectiveness of this medication by monitoring the patient's: Wound healing Pain rating White blood cell count Oxygen saturation
Pain rating
True club foot is fixed and not?
Passively corrected
A developmental anomaly characterized by the absence of the upper portion of one or more limb, so that the feet or hands are attached to the trunk?
Phocomelia
The nurse is caring for an infant admitted with gastroesophageal reflux. Which of the following symptoms is an early indication that the infant has gastroesophageal reflux? Currant jelly stools Projectile vomiting Regurgitation Steatorrhea
Regurgitation
Also called bronchiolitis, an acute viral infection. Primarily occurring in the winter and spring, rarely seen in children over 2 years of age?
Respiratory Syncytial Virus - RSV
The nurse is preparing a care plan for a 5-year-old with enuresis. Which of the following is an important nursing action to promote dryness? Insert a foley catheter Use a diaper at night Provide emotional support Retention control training
Retention control training
While caring for a child after undergoing a tonsillectomy, the child should be placed in what position to help facilitate drainage of secretions? Trendelenberg's Supine Side lying Reverse Trendelenberg's
Side laying
A child with myasthenia gravis complains of difficulty with chewing and facial movements. The physician orders neostigmine to improve muscle tone. What time should the patient take this medication to improve muscle tone while chewing? Thirty minutes before meals Before bed First thing in the morning With the first bite of a meal
Thirty minutes before meal
A 10-year-old girl is brought to the emergency department by her parents because of nausea, vomiting, and abdominal pain. The nurse suspects acute appendicitis. It would be most important to obtain which of the following information? Immunizations Date of last medical exam Time of last meal Time of last void
Time of last meal
When developing a teaching plan that focuses on initial prevention of rheumatic fever, which of the following instructions should the nurse include ? Using corticosteroids to reduce inflammation Providing antibiotics before dental work Treating streptococcal throat infections with antibiotics Administering antivirals for impetigo
Treating streptococcal throat infections with antibiotics
Medical treatment of RSV?
Two drugs available to the high risk population given monthly via IV (RSV immune globulin) or IM (palivizumab). Hospitalization will require IV therapy, and may include bronchodilators, corticosteroids, cough suppressants and antibiotics to prevent 2nd infections
Which of the following defects refers to the incomplete closure of the umbilical ring, resulting in the protrusion of the omentum and intestine through the opening? Communicating hydrocele Noncommunicating hydrocele Inguinal hernia Umbilical hernia
Umbilical hernia
Which of the following actions should be included in the teaching plan for the parents of a preschool-aged child with pediculosis capitis? Wash all of the family's clothing and linens Comb the child's hair each week Apply calamine lotion or burow's solution Administer topical anti-itch medication twice a day
Wash all the family's clothing and linens
The nurse is assessing a 3-year-old suspected of having retinoblastoma. Which of the following is the most common finding in a child with retinoblastoma? Blurred vision Headache Strabismus White pupil
White pupil
Medical Treatment of Otitis Media
5 - 10 days course of antibiotics, amoxicillin, sulfonamides, erythromycin, azithromycin. Analgesics and antipyretic Chronic OM may lead to the myringotomy with PE tubes
Medical treatment of Enuresis?
Tricyclic antidepressants (Tofranil), anticholinergic (Ditropan-oxybutyinin). Bladder training, restricting fluids after the evening meal. Wake child up/alarms
The nurse is inspecting a 4-year-old's mouth at a routine office visit. The child should have how many teeth? 12 24 16 20
20 teeth
When the number of RBC's and/or Hgb is below the normal range of 11.5-15.5?
Anemia
The nurse is assessing a patient suspected of having Hodgkin's lymphoma. The nurse would expect to note lymphadenopathy in which most common area? Mediastinal Cervical Axilla Inguinal
Cervical
Medial treatment of Croup?
High humidified cool mist (mist tent in the hospital). RT nebulizer treatments (racemic epinepherine). Corticorsteroids. Hydration.
A patient has been prescribed pancrelipase due to pancreatic insufficiency. The nurse should instruct the patient: Chew until medication is dissolved Take in the morning Take at bedtime Swallow whole, do not chew
Swallow whole, do not chew
The nurse is preparing to administer 6 units of lispro before breakfast. How many minutes before meals should the nurse administer this type of insulin? 60 minutes 15 minutes 45 minutes 30 minutes
15 minutes
A 4-month-old infant is brought to the hospital for recurrent vomiting. The child is diagnosed with gastroenteritis. To decrease vomiting, the child should be NPO for approximately how long? 5-10 hours 1-2 hours 8-14 hours 3-6 hours
3-6 hours
An 8-year-old sustained a femur fracture with an open wound. What type of traction should the nurse expect to be used? Fisk Buck's Thomas Splint 90-90
90-90
The nurse is assessing a child with pulmonary valve stenosis. The nurse would expect to find which of the following? Severe cyanosis at birth A thrill may be heard A systolic murmur heard over the left sternal border Clubbing and exertional dyspnea
A systolic murmur heard over the left sternal border
Which of the following types of immunity does an infant receive when given a MMR injection? Natural, passive Artificial, passive Artificial, active Natural, active
Artificial, active
A 9-year-old diagnosed with leukemia is also being treated for epilepsy. The physician prescribes carbamazepine 100 mg PO twice per day. The nurse should question this order because: Carbamazepine is for diabetes Carbamazepine causes bone marrow suppression Carbamazepine is not approved for children This is a lethal dose
Carbamazepine causes bone marrow suppression
Treatment of Down Syndrome?
Correct any serious congenital anomalies. Monitor for/tx otitis media and URI, predisposed toward. Periodic testing of thyroid. Plastic surgery has been performed in some cases to alter physical features and stigma related to Downs.
A condition produced in infants and children due to lack of thyroid hormone?
Cretinism
General term applied to a symptom complex characterized by hoarseness "barking" cough, varying degrees of respiratory stridor and distress?
Croup
The nurse is caring for a patient with an autistic disorder. Upon assessment the nurse records that the child has a labile mood. Which of the following symptoms suggest a labile mood? Crying suddenly followed immediately by giggling and laughing Repetitive hand movements Intensely preoccupied by objects that move Repeating words or phrases spoken by others
Crying suddenly followed immediately by giggling and laughing
(Undescended testes) - failure of the testicle to move from the abdominal cavity to the scrotum?
Cryptorchidism
A male infant was measured at 8 pounds 2 ounces at birth. Assuming the infant grows at a normal rate, what is the weight change at 6 months of age? Gain 3 pounds each month Quadruple the birth weight Triple the birth weight Double the birth weight
Double the birth weight
The most common type of obstetrical palsy from a traction injury of C5 and C6 spinal nerve with paralysis of the shoulder and upper arm?
Erbs Palsy
The nurse is caring for a toddler diagnosed with intussusception. When assessing a child for possible intussusception, which of the following would be least likely to provide valuable information? Abdominal palpation Stool inspection Pain pattern Family History
Family history
A 6-month-old infant with hydrocephalus is admitted to an acute care facility for insertion of a ventriculoperitoneal shunt. What is the best position for this patient post-operatively? High Fowler's Semi Fowler's Trendelenburg Flat
Flat
A 5-year-old boy is admitted to the hospital for acute glomerulonephritis. What is typically the first symptom? Proteinuria and azotemia Hypertension and hematuria Edema and fever Hematuria and proteinuria
Hematuria and proteinuria
The mother of a 2-year-old girl tells the emergency room nurse that she found the child playing with an empty bottle of aspirin and that there were pieces of aspirin in her mouth. The nurse should observe the child for symptoms of salicylate poisoning, which include? Hyperventilation Photophobia Facial flushing Diplopia
Hyperventilation
An 8-year-old with hemophilia has her leg splinted following a traumatic injury to the knee joint. The child complains of increased pain in the affected knee. Based on these findings, the cause of the pain is most likely due to: Increased bleeding Friction between adjacent articular joints Decreased circulation to affected extremity Muscle hypertrophy
Increased bleeding
The mother of an 8-year-old expresses surprise that her son is finally becoming more cooperative and understanding the consequences of his actions. This describes which of the following stages of development? Identity vs. Role confusion Initiative vs. Guilt Basic trust vs. Mistrust Industry vs. Inferiority
Industry vs. Inferiority
The nurse would administer the varicella zoster vaccine to a 15-month-old who has which of the following? Leukemia Mild upper respiratory tract infection Long term use of chemotherapy AIDS
Mild upper respiratory tract infection
A newborn baby with myelomeningocele is scheduled for surgical closure within 24 hours. The main reason for surgical repair is to do which of the following? Decrease the risk of developing seizures Prevent hydrocephalus Minimize infection and prevent further damage to the spinal cord and roots Correct the neurologic deficit
Minimize infection and prevent further damage to the spinal cord and roots
A 6-month-old boy is diagnosed with cryptorchidism. He is scheduled for surgery. What surgical intervention will the nurse prepare the child to correct the condition? Meatotomy Sclerotherapy Orchiectomy Orchiopexy
Orchiopexy
A child is admitted to the hospital with croup. The nurse expects the physician to order which nebulizer treatment? Racemic epinephrine Ipratropium Salmeterol Theophylline
Racemic epinephj
A 14-year-old girl has returned to the nursing unit after undergoing an appendectomy. To help relieve her discomfort and facilitate drainage, the nurse should place her in which position? Semi-Fowler's Trendelenburg Prone High-Fowler's
Semi-Fowler's
A 5-year-old is admitted to the hospital with DKA. To prevent cardiac arrhythmias, which lab result should the nurse be particularly aware of? Serum Calcium Serum Chloride Serum Potassium Serum Sodium
Sodium Potassium
Which of the following immunizations would the nurse expect to administer to a child who is HIV positive and severely immunocompromised? Tetanus Yellow Fever Tuberculosis Oral typhoid
Tetanus
Treatment for Cerebral Palsy?
The goal of treatment is to maximize independence.
A patient is prescribed diphenoxylate with atropine for severe diarrhea. The nurse should inform the patient about which possible side effect? Diarrhea Bradycardia Excessive tears Urinary retention
Urine retention
A 2-year-old child is rushed to the hospital with the following symptoms: abdominal mass upon palpation, abdominal pain, weight loss, and anorexia. Based on these findings, the nurse suspects the child to have neuroblastoma. Which of the following tests will help determine the extent of the tumor and metastases? Head CT Biopsy Lumbar puncture Urine sample with catecholamines
Biopsy
An inflammation of the stomach and intestines caused by a viral or bacterial infection?
Gastroenteritis
After several days in traction, the patient has a long leg fiber glass cast applied to his left leg. Before the patient is discharged, the nurse should instruct the patient on which of the following? "Be sure to keep your cast dry" "If itching occurs in the area that is unreachable, have a blunt object to scratch the area under the cast, and make sure to scratch gently" "Reinforce the cast with adhesive tape if any cracks occur" Have your friends sign their names on your cast
"Be sure to keep your cast dry"
A 11-month-old is brought to the emergency department for diarrhea and vomiting. The mother tells the nurse that her doctor said to " force fluids". She asks how much she should force the child to drink. How would you answer her? "To hydrate the infant, give him purified water instead of breastfeeding" "Give the infant plenty of fluids every 2 hours to replace the fluid loss" "Do not force fluids yet, it will worsen the vomiting" "Forcing fluids is not forcing your child to drink plenty of fluids but to gradually give fluids frequently"
"Forcing fluids is not forcing your child to drink plenty of fluids, but to gradually give fluids frequently
A newly admitted adolescent is being questioned by the nurse in regards to his health history. The nurse should follow up on which of the following patient statements? "When I am stressed out, I like to see my girlfriend" "My mood is always changing" "I only eat vegetables, I have lost 10 pounds in the past 3 weeks" "I have a lot of trouble waking up in the morning"
"I only eat vegetables, I have lost 10 pounds in the past 3 weeks"
After receiving iron therapy, the pediatric patient is ready for discharge. Which of the following statements by the mother would indicate the need for further instruction? "I should follow the dosage of iron therapy as prescribed" "I should give Anthony lean meats, fish and whole grain breads" It is important to give my child vitamin C "I shall encourage my child to eat yellow vegetables"
"I shall encourage my child to eat yellow vegetables"
A 13-year-old girl who was diagnosed with structural scoliosis after a routine screening at school is being fitted with a scoliosis brace. Which of the following statements by the patient indicates effective use of the brace? "I'll look forward to taking this thing off to take my bath every day" "I'm really glad that I can take this thing off whenever I get tired" "I sure am glad that I only have to wear this awful thing at night" I wonder if I can take the brace off when I go out to party
"I'll look forward to taking this thing off to take my bath every day"
A pediatric nurse is assessing children in a community outreach clinic. The nurse would expect an infant's first primary teeth to erupt at age: 7 months 12 months 8 months 10 months
7 months
Medical treatment of Gastroenteritis?
A stool culture may rule out bacterial causes of the illness. The objective of treatment is to replace fluids and electrolytes lost by diarrhea. Antibiotic therapy is not effective in viral illness. Antidiarrheal medications are generally not given, as they may prolong the infectious process.
A child is receiving chemotherapy after surgery for a neuroblastoma. Which of the following nursing interventions can help prevent or reduce nausea and vomiting during chemotherapy? Instructing parents to feed the child before the chemotherapy Providing a high-fiber diet before chemotherapy Encouraging increased fluid intake before and during chemotherapy Administering an antiemetic 30 minutes before chemotherapy
Administering an antiemetic 30 minutes before chemotherapy
A 3-year-old girl is seen in the emergency department for aspirating a coin. Upon assessment, the child has a violent cough, dyspnea, and is choking. Chest X-ray reveals the presence of a radiopaque object. The child undergoes a bronchoscopy in order to remove the coin. After the procedure, the nurse's first action is: Assess for signs of airway obstruction Provide external ice collar Keep the child NPO Check for return of gag reflex
Assess for signs of airway obstruction
A frantic father presents to the emergency room holding a limp child bleeding from the head. The nurse takes them back to the treatment room. What should the nurse do next? Call the physician Call security Assess the child for circulation and breathing Ask the father to leave and go to the waiting room
Assess the child for circulation and breathing
A 14-year-old adolescent with moderate cognitive impairment is admitted for knee surgery. During the rehabilitation period, the nurse's first nursing action is to: Encourage the mother to have family members and friends visit often Assess the child's daily routine Instruct the child to use the call light when she needs to use the bathroom Encourage the mother to bring in personal care items from home
Assess the child's daily routine
An X-ray confirms that the epiphyseal plate of a 10-year-old is fractured. The nurse would anticipate that the damage may result in which of the following? Osteomyelitis Bone growth disruption Permanent nerve damage Rheumatoid arthritis
Bone growth disruption
To confirm the diagnosis of acute lymphoblastic leukemia, the nurse would prepare the patient for which of the following tests? Complete blood count Bone marrow biopsy Blood culture Lumbar puncture
Bone marrow biopsy
A child is brought to the emergency room with a high fever, photophobia, and a headache. What important sign would a nurse use to check for meningeal irritation? McBurney's sign Ortolani sign Brudzinski's sign Cullen sign
Brudzinski's sign
The nurse is preparing a 7-year-old boy with leukemia for discharge. Which of the following discharge instructions should be included? Increase vitamin K intake Call the physician if you develop bruises Contact the physician if weight gain occurs Take a dose of protamine sulfate if signs of bleeding occur
Call the physician if you develop bruises
The parents of a 15-year-old with cystic fibrosis want to go on an extended vacation in the Caribbean. What anticipatory guidance should the nurse give the adolescent and her parents? Teach parents how to balance work so that they can spend a great deal of time caring for their child Caution parents to keep their children from overexertion or heat exposure The parents are asked to familiarize themselves with the necessary care measures The parents are asked to assume a great deal of responsibility for care of their child
Caution parents to keep their children from overexertion or heat exposure
A group of disorders characterized by loss of movement or loss of other nerve functions.
Cerebral Palsy (CP)
These disorders are caused by injuries to the brain that occur during fetal development or near the time of birth.
Cerebral Palsy (CP)
The nurse is caring for a newborn diagnosed with esophageal atresia and a tracheoesophageal fistula. Symptoms characteristic of this condition include: Visible peristalsis in the upper abdomen Refusal to take water or formula and sternal retraction Choking and coughing when being fed and unexplained cyanosis Frequent, loose stools and constant hunger
Choking and coughing when being fed and unexplained cyanosis
A 4-year-old African American is brought to the clinic for frequent nosebleeds and has pale mucous membranes. He is diagnosed to have iron deficiency anemia. He is scheduled to start iron therapy. The mother asks the nurse what is the cause of her son's illness. Which of the following is the correct response of the nurse? Chronic blood loss Structural defects of the gastrointestinal system, such as gastroesophageal reflux Low birthweight Inadequate intake
Chronic blood loss
Which of the following should be avoided if the neonate has hypospadias? Intravenous pyelography Circumcision Administration of diuretics Catheterization
Circumcision
The physician just applied a cast to a 6-year-old with a broken leg. Which of the following should the nurse do first? Instruct the patient that he must wait 72 hours before his friends can sign the cast Dispose of used supplies Rest the cast on a stainless steel tray Clean the surrounding skin before the cast dries
Clean the surrounding skin before the cast dries
A nurse is administering somatrem to a 7-year-old patient. The patient's mother asks about the purpose of this medication. Which of the following describes somatrem ? Used to treat Klinefelter syndrome Used to treat growth failure caused by hormone definciency Used to treat type 1 diabetes mellitus Used to treat congenital hypothyroidism
Used to treat growth failure caused by hormone deficiency
A nurse is caring for a child that has been hospitalized multiple times for leukemia. After observing the child using several coping mechanisms, the nurse designs a plan of care that includes: Telling the child to focus on the future Using therapeutic play so the child can act out his feelings Having the child discuss his feelings during the first therapy session Placing the child on psychiatric medications
Using therapeutic play so the child can act out his feelings
Medical treatment of Cryptorchidism
Usually the testicle will descend into the scrotum without any intervention during the first year of life. If this does not occur, hormonal injections may be given in an attempt to stimulate movement of the testicle into the scrotum. Surgery (orchiopexy) may be required if the hormonal treatment is not successful and is usually done before the age of 3 years.
A 2-month-old infant is rushed to the emergency room. Upon assessment, the nurse notes excessive sweating and fatigue and a loud, harsh holosystolic murmur along the left sternal border at the fourth intercostal space. The nurse suspects that the child must be experiencing what disease condition? Patent ductus arteriosus Aortic stenosis Ventricular septal defect Coarctation of aorta
Ventricular septal defect
The parents of a 3-year-old ask the nurse what are the defects associated with tetralogy of Fallot. The correct response by the nurse is: Ventricular septal defect, overriding aorta, pulmonic valve stenosis, and right ventricular hypertrophy Tricuspid valve atresia, atrial septal defect, ventricular septal defect and hypoplastic right ventricle Aorta exits from the right ventricle, pulmonary artery exits from left ventricle Coarctation of aorta, aortic valve stenosis, ventricular septal defect, and patent ductus arteriosus
Ventricular septal defect, overriding aorta, pulmonic valve stenosis, and right ventricular hypertrophy
The nurse is assessing an adolescent with von Willebrand disease. She complains of epistaxis and heavy menstrual blood flow. What is likely the cause of this disease? Von Willebrand factor deficiency Factor XI defect Factor IX deficiency Factor VIII defect
Von Willebrand factor deficiency
The nurse is discharging a 5-year-old that underwent a tonsillectomy. What important instruction should the nurse give to the child's parents to prevent further complications? Advise your child to restrict activity Offer frequent sips of clear liquid Give tablet analgesics to alleviate throat pain Watch for any signs of hemorrhage, such as an increased pulse or respiratory rate, frequent swallowing, throat clearing, and increased restlessness
Watch for any signs of hemorrhage, such as an increased pulse or respiratory rate, frequent swallowing, throat clearing, and increased restlessness
A patient has recently been prescribed to tetracycline for the treatment of acne vulgaris. The nurse should include which of the following in her teaching plan? Safe to take during pregnancy Take with a full glass of milk Take with meals Wear sunscreen for prolonged exposure to sunlight
Wear sunscreen for prolonged exposure to sunlight
The nurse is preparing to initiate a heparin infusion on a 8-year-old patient. Before initiating the infusion, it is critical that the nurse assesses the patient's: Pupil reactivity Heart sounds Blood pressure Weight
Weight
The nurse is caring for a preschooler with nephrotic syndrome. Which of the following signs and symptoms is a characteristic of minimal change nephrotic syndrome? Hypertension, hematuria and proteinuria Weight gain, edema, and proteinuria Hypertension, edema, and hematuria Proteinuria, fever, and hematuria
Weight gain, edema, and proteinuria
The nurse is caring for a patient with acute asthma. Which signs for asthma exacerbation does the nurse expect to find during a physical assessment? Anxiety Wheezing Productive cough Sternal retractions Chest tightness
Wheezing Sternal retractions
An inherited autosomial recessive trait multi-system effects on the body. Causes increased viscosity of mucous gland secretions, elevation of sweat electrolytes, increase in enzymatic contents of the saliva?
Cystic Fibrosis
A 6-month-old infant is seen in the emergency department for dehydration related to vomiting. Upon assessment by the nurse, which of the following clinical assessments would develop by a child with a 12% fluid loss? Excitability Hypertension Deep respirations Decreased urine output Decreased skin turgor Cool and mottled extremities
Deep respiration Decreased urine output Decreased skin turgor Cool and mottled extremities
A 9-year-old boy is rushed to the emergency room after falling from his bicycle. While assessing the child, the nurse should observe the extremities closely for which of the following signs and symptoms of a fracture? Abrasions, tachypnea, and pain Deformity, tachypnea and, cyanosis Fever, pain, and cyanosis Deformity, edema, and pain
Deformity, edema, pain
The nurse is caring for a 5-year-old who has frequent involuntary urination at night. She is diagnosed with nocturnal enuresis. What is the most likely cause? Urinary tract infection Vesicoureteral reflux Delayed bladder maturation Psychological stress
Delayed bladder maturation
Group of disorders related to abnormal development of the hip
Developmental Dysplasia of the Hip (DDH)
Nursing care for Developmental Dysplasia of the Hip?
Early detection - newborn assess with Ortolani, assess gluteal folds
A patient with a history of congestive heart failure is prescribed naproxen for the treatment of rheumatoid arthritis. The nurse should instruct the patient to report which of the following symptoms? Diarrhea Constipation Edema Weight loss Weight gain
Edema Weight gain
Bedwetting. Intentional or involuntary passage of urine into bed (usually at night) or into clothes during the day for children beyond the age when voluntary bladder control should be acquired?
Enuresis
Rare anomaly results from failure of urethral canalization?
Epispadias
A three-month-old, developmentally-delayed infant was admitted to the pediatrics unit. The nurse evaluates the infant for manifestations of cerebral palsy. Which of the following would the nurse note as a sign of CP? When pulled to a sitting position, there's a slight head lag Less than the 50th percentile measurement of head circumference Hypoactive reflexes Exaggerated arching of the neck
Exaggerated arching of the neck
The nurse is providing patient education to a newly diagnosed asthmatic. The nurse provides the steps for proper use of a metered dose inhaler. Which of the following are the correct steps? Place inhaler between open lips, press down on canister, start inhaling slowly, hold for 10 seconds,Exhale Exhale, place inhaler between open lips, press down on canister, start inhaling slowly, hold for 10 seconds Place inhaler between open lips, start inhaling slowly, press down on canister, hold for 10 seconds, Exhale Exhale, place inhaler between open lips, start inhaling slowly, press down on canister, hold for 10 seconds
Exhale, place inhaler between open lips, start inhaling slowly, press down on canister, hold for 10 seconds
A child is admitted to the hospital with an acute asthma exacerbation. Which of the following assessment findings is most likely to occur? Fine crackles Expiratory wheezes Split S2 Stridor
Expiratory wheezes
The nurse is assessing a 5-year-old diagnosed with hemolytic uremic syndrome (HUS). Which of the following signs and symptoms are associated with this disease? Extreme fatigue, tachypnea, and generalized rash Hematuria, fever, and generalized rash Fever, dyspnea, and decreased urine output Extreme fatigue, decreased urine output, and bloody stools
Extreme fatigue, decreased urine output, and bloody stools
The nurse is caring for a patient suspected of having hemophillia. Which of the following tests would the nurse expect to be ordered to confirm the diagnosis? Factor assays aPTT Platelet count PT & INR
Factor assays
A 7-year-old has symptoms of acute lymphoblastic leukemia (ALL). Upon admission to the hospital, she has petechiae on her trunk and extremities, epistaxis and tarry stools. In addition to the symptoms noted upon assessment, the patient may also have which of these symptoms? Eosinophilia Bradycardia Muscular twitching Fatigue
Fatigue
A nurse is making her plan of care for a patient with an atrial septal defect. Upon assessment, the nurse expected to find: Mild cyanosis that increases with crying and a characteristic murmur Absent femoral pulses, epixtaxis, and lower leg muscle cramps Poor feeding, fatigue, and a loud machine murmur Fatigue, dyspnea upon exertion, and an S2 split
Fatigue, dyspnea upon exertion, and an S2 split
A nurse is assessing a 5-year-old with multiple deformities of the limbs and joints. She also has a thin upper lip, small teeth, and trouble learning in school. The nurse suspects that these signs are most likely the result of which of the following? Klinefelter syndrome Fetal alcohol syndrome (FAS) Mercury poisoning Down's syndrome
Fetal alcohol syndrome (FAS)
The nurse is caring for a 10-year-old girl diagnosed with meningitis. The nurse would expect which of the following symptoms? Confusion, tinnitus, and blurred vision Neck stiffness, headache, and diarrhea Fever, headache, photophobia Neck stiffness, fever, and respiratory distress
Fever, headache, photophobia
To ensure optimum care for a patient with acute glomerulonephritis, the nurse's priority intervention should include: Encouraging active participation in care Providing scheduled rest periods Fluid and salt restriction Limiting protein intake
Fluid and salt restriction
A 9-year-old girl is admitted to the hospital with cystic fibrosis. She also has a history of frequent respiratory infections. The child's susceptibility to respiratory infections is directly related to the fact that cystic fibrosis causes which of these physiological alterations? Obstruction of the alveoli Formation of mucus plugs in the bronchioles Distention of the alveoli Collapsed lung
Formation of mucus plugs in the bronchioles
A toddler was prescribed azithromycin for an ear infection. His mother is worried about the side effects of the medication. The nurse explains that the most common side effects are non-life threatening and include: Cardiac symptoms Neurological symptoms GI symptoms Musculoskeletal symptoms
GI symptoms
The parents of a 7-year-old with Cystic Fibrosis are concerned about having another child and passing their affected genes to their future children. Which of the members of the health care team should the nurse refer the parents to? Genetic counselor Social worker Gynecologist Pediatrician
Genetic counselor
The nurse is preparing the mother for treatment of her newborn girl with hip dysplasia. Which of the following would the nurse do to assess a mother's ability to care for her child using a Pavlik harness? Have the mother remove and reapply the harness before the discharge Have the mother verbalize the purpose for using the device Request a home health care nurse visit after discharge Demonstrate to the mother how to remove and reapply the device
Have the mother remove and reapply the harness before the discharge
A teenager is prescribed a hormonal oral contraceptive. Which of the following findings indicates to the nurse that the patient is experiencing a serious side effect? Polyuria Tinnitus Distended abdomen Heat and swelling of the right lower extremity
Heat and swelling of the right lower extremity
A relatively common abnormality of the penis that appears as an abnormal Opening of the penis (meatus) on the under side of the penis rather than at the end.
Hypospadias
The nurse is assessing a neonatal boy. Upon assessment, the nurse notes that the urethral opening is at the lower aspect of the penis. Based on these findings, the nurse is correct to suspect which of the following disorders? Hypospadias with chordee Cryptorchidism Hypospadias Epispadias
Hypospadias
The physician orders an I.V. infusion of digoxin for a pediatric patient with heart failure. Which of the following increases the risk of developing digitalis toxicity? Hypothyroidism Hypomagnesemia Hypokalemia Hypermagnesemia Hypocalcemia
Hypothyroidism Hypomagensemia Hypokalemia
A nurse has given home care instructions to the parent of a child with head lice. Which of the following statements indicates that the instructions are correctly understood? I must ensure that all family members receive treatment I must discard all of my child's personal linens I must wash my child's hair with an antibacterial shampoo I must keep my child at home for at least one week after treatment
I must ensure that all family members receive treatment
Medical treatment of Epispadias?
IVP and ultrasound to evaluate the extent of the defect. No circumcision, prepuce is used for the repair. Surgical repair of epispadias is recommended. Leakage of urine (incontinence) may require a second-stage repair.
A child with acute glomerulonephritis (AGN) is being discharged from the hospital. In giving follow up information to his parents, it is important to teach which of the following known antecedent infections in acute glomerulonephritis (AGN)? Pneumonia Meningitis Herpes simplex Impetigo
Impetigo
An 8-year-old is brought to the emergency department by her mother. She is having intermittent episodes of loose stools and recurrent abdominal pain. The child is diagnosed with irritable bowel syndrome (IBS). Which of the following instructions will help reduce the frequency of symptoms? Avoid all carbohydrates Force fluids Increase intake of psyllium fiber supplements Increase intake of milk products
Increase intake of psyllium fiber supplements
A 7-year-old African American boy complains of fever, swelling of hands and feet and yellow sclera. He is diagnosed with sickle cell disease. The extent of tissue damage found in children with sickle disease results from which of the following? Elevated serum bilirubin levels Deoxygenated red blood cells Local tissue damage due to ischemia from obstructed circulation Autoimmune reaction from hypoxia
Local tissue damage due to ischemia from obstructed circulation
A 17-year-old patient with scoliosis is being cared for by a nurse. Which of the following will be most difficult for this patient? ADLs Adequate social support Physical therapy compliance Looking different from her friends
Looking different from her friends
The nurse is assessing an 8-year-old boy suspected of having Rocky Mountain spotted fever. Which of the following signs and symptoms would the nurse expect to find? Spasms of the jaw muscles and arching of the back Circular, outward expanding rash Stiff neck with a positive Kernig's sign Maculopapular rash that begins on the wrists and ankles and spreads centripetally
Maculopapular rash that begins on the wrists and ankles and spreads centripetally
Medical Treatment Cystic Fibrosis?
Manage pulmonary problems - tx infections, improve aeration, remove mucous secretions (pulmonary treatments 4X per day that includes nebulizer, postural drainage and clapping) Manage GI problems - replace pancreatic enzymes (taken when ever the child eats) high calorie and high protein diet
A 5-month-old girl is admitted to the hospital with chronic constipation, foul smelling, ribbon like stool and abdominal distention. Upon assessment, the nurse suspects Hirschprung disease. The diagnosis is confirmed if a barium enema reveals: Telescoping of intestine Pyloric mass Megacolon Obstructed colon
Megacolon
A patient presents to the clinic with tinea corporis. The nurse would expect the physician to prescribe: Amoxicillin Mupirocin ointment Cephalexin Miconazole cream
Miconazole cream
A 6-month-old infant with hydrocephalus is admitted to the hospital due to an enlarged head circumference, bulging fontanelles, and sunset eyes. What is the priority nursing care? Promote normal growth and development of the child Monitor for signs of increased intracranial pressure Monitor vital signs Measure head circumference
Monitor for signs of increased intracranial pressure
A child is admitted to the hospital after accidently consuming a bottle of acetaminophen. The nurse would expect to observe which clinical manifestations of acetaminophen poisoning? Confusion, diaphoresis, nausea, elevated INR Confusion, nausea, vomiting, agitation Nausea, vomiting, diaphoresis, elevated liver enzymes Nausea, confusion, hypotension
Nausea, vomiting, diaphoresis, elevated liver enzymes
Treatment for Developmental Dysplasia of the Hip?
Newborn - 6 mo. - place femur centered in acetabulum through flexion and abduction Pavlik harness. Worn 3-6 mo. Also have seen the use of double diapering. 6-18 mo. - deformity noted when child begins to walk, traction with casting (hip spica) Denis-Browne splint. Older child - open reduction with pre-op traction, cast post-op and rehab after cast
The nurse determines that teaching about sudden infant death syndrome has been effective when the patient's mother states: The cause is respiratory distress syndrome No definite cause of death is found at autopsy Breast feeding is a risk factor for SIDS Genetic disorders are a risk factor for SIDS
No definite cause of death is found at autopsy
The nurse is caring for a child with a high grade fever. The child's mother asks if she should give her child aspirin. How should the nurse respond? No, aspirin can cause severe adrenal dysfunction in children No, aspirin is not effective in reducing a fever No, give acetaminophen instead of aspirin Yes, aspirin with help decrease the fever
No, give acetaminophen instead of aspirin
The nurse observes the formation of new lesions on a patient suspected of having chickenpox. What necessary infection control precautions must the nurse implement? Wear a surgical mask when entering the room Wear protective gown, gloves and mask whenever you enter the patient's room Non-immune staff are required to wear a respirator mask Wear gloves when providing skin care to the patient Keep the patient in isolation
Non-immune staff are required to wear a respirator mask Wear gloves hen providing skin care to the patient Keep the patient in isolation
The nurse is caring for a child with congestive heart failure. Which of the following indicates the child and her parents are following the prescribed medical regimen? Normal weight for age Nausea and vomiting Pulse rate below 50 beats/min Use of daily antibiotics
Normal weight for age
A physician prescribes acetaminophen, 200 mg every 6 hours for a 12-month-old child who weighs 8 kg. The bottle concentration is 100 mg/ml and has a maximum dosage of 60 mg/kg/day. What should the nurse do next? Administer 4 ml Ask the physician for an increase dose Notify the physician and question the dosage Administer 2 ml
Notify the physician and question the dosage
Following enucleation of a patient with retinoblastoma, it is important for the nurse to do which of the following nursing actions? Apply pressure on the site frequently Observe for bright red drainage Assess vital signs Check for pupil reactivity in the affected eye
Observe for bright red drainage
A 2-year-old boy has an elevated lead level in his blood and urine. His treatment includes the administration of a chelating agent, edetate calcium disodium. Before the first dose of the chelating agent is given, which of these actions by the nurse is important? Observe urine output Put the patient in isolation Take blood pressure Weigh the patient
Observe urine output
The diagnosis of acute lymphoblastic leukemia is confirmed. The hematologic values include: white blood cell count of 6,000 cells/ml with a low blast cells, platelet count of 50,000, hemoglobin of 6 g/dl, and hematocrit of 16%. Which of these measures should be included in the patient's plan of care? Restriction of fresh fruits and vegtables Inject Vitamin K intramuscularly as prescribed Keeping her in reverse isolation Observing for dyspnea on exertion
Observing for dyspena on exertion
When developing a teaching plan for the parents of a child with aortic stenosis, the nurse would keep in mind that this disorder involves which of the following? A single vessel arising from both ventricles Obstruction of blood from the left ventricle Obstruction of blood flow from the right ventricle Return of blood to the heart without entry into the left atrium
Obstruction of blood from the left ventricle
When developing a plan of care for a patient with cystic fibrosis, which of the following must the nurse keep in mind? Decreased levels of sodium are found in sweat Obstruction of the exocrine glands occurs Pulmonary secretions are abnormally thin Cystic fibrosis is not hereditary
Obstruction of the exocrine glands occurs
A 7-year-old with cerebral palsy is hospitalized for complications. Before discharge, the patient's mother expresses concern over the child's ability to use utensils while eating. Which of the following people should be consulted to assist in patient care and education? Physical therapist Dietician Occupational therapist Palliative care nurse
Occupational therapist
Which of the following nursing actions would be inappropriate when caring for a child with HIV? Offering large amounts of fresh fruits and vegetables to improve immunoresponse Using good handwashing before handling the child Teach family about disease transmission Reverse isolation
Offering large amounts of fresh fruits and vegetables to improve immunoresponse
Treatment of Phocomelia?
Orthotics and prosthetics assess for additional defects. Multidisciplinary approach to care.
An inflammation of the middle ear?
Otitis Media
Which of the following tests would be used to diagnose HIV in an infant whose mother is HIV positive? Particle agglutination ELISA PCR Western blot
PCR
A 10-year-old male is admitted to the hospital with a fracture of the left femur. The patient is placed in skeletal traction for 2 days. The nurse immediately suspects peripheral neurovascular impairment due to: Abnormal mobility Tenderness and pain Muscle spasms Pallor, numbness, and absent peripheral pulses
Pallor, numbness, and absent peripheral pulses
A 10-year-old boy had a knee injury several months ago after playing basketball and has attributed his knee pain to this event. The nurse suspects osteogenic sarcoma after noting which common symptom? Low back pain Rapid bone growth Palpable mass close to the knee Fever and weight loss
Palpable mass close to the knee
The nurse is caring for a 3-year-old toddler diagnosed with cerebral palsy. What teaching measures to prevent contractures should the nurse reinforce to the toddler's parents? Give medication to reduce spasticity and rigidity Help the child with self-care activities to reduce fatigue Encourge their children to reach their fullest potential Parents understand passive exercises and games to play with the child that encourage active exercise
Parents understand passive exercises and games to play with the child that encourage active exercise
When providing patient education to a patient prescribed to clindamycin - benzoyl peroxide gel, the nurse should include which of the following side effects? Headaches Discolored urine Peeling Hair bleaching Photosensitivity Warts
Peeling Hair bleaching Photosensitivity
Which of the following is the priority nursing action to minimize risk of infection for a child with skeletal traction? Anticipate antibiotic administration Provide a well balanced diet Frequently assess vital signs and inspect insertion site Perform pin site care
Perform pin site care
A 6-month-old is being evaluated in the emergency department. The child appears cyanotic, has a whooping cough and is vomiting. The nurse suspects the child has: Rickettsia Rocky Mountain spotted fever Mycoplasma pneumonia Pertussis
Pertussis
Medical treatment for Attention Deficit?
Pharmacologic therapy - most frequently prescribed methylphenidate (Ritalin) and dextroamphetamine (Dexedrine). May see tricyclic antidepressants used.
A 4-year-old child is assessed by the nurse. The child has fair skin, musty odor from the urine, stunted growth, and intellectual disability. Based on this findings, the nurse should suspect which of the following metabolic disorders? Phenylketonuria Tay-Sach's disease Celiac disease Branched-chain ketoaciduria
Phenylketonuria
Primarily was seen as a s/e of thalidomide?
Phocomelia
An infant with clubfoot will have his final cast removed today. Which member of the health care team can the nurse expect to be consulted? Pharmacist Physical therapist Occupational therapist Respiratory therapist
Physical therapist
A woman with HIV recently gave birth to a baby boy. She asked the nurse why her baby is infected. Which of the follow can be a reason for transmission from the mother to the child? Placental exposure in utero Exposure of blood and mucous membranes during delivery Receiving of contaminated blood Using contaminated instruments during delivery Breast feeding
Placental exposure in utero Exposure of blood and mucous membranes during delivery Breast feeding
The nurse is assessing a 4-year-old complaining of a fever, chills, headache, and malaise with firm and tender cervical lymph nodes. What laboratory test is used to confirm the diagnosis of infectious mononucleosis? Positive Epstein-Barr virus antibody test Positive heterophile antibody test CBC revealing increased lymphocytes WBC count revealing leukocytosis
Positive Epstein-Barr virus antibody test
A 2-year-old child is admitted due to cardiac defect complications including fluid overload. The physician prescribes furosemide, 10 mg I.V., to be given every 2 hours, times 4 doses. The nurse would recognize which of the following laboratory results as a side effect of furosemide? Sodium, 136 mEq/L Potassium, 2.9 mEq/L Hemoglobin, 11.6 g/dl Magnesium, 2.3 mEq/L
Potassium, 2.9 mEq/L
After the corrective casting is done, an infant's congenital club foot is exposed to potential problems. Which of the following is an appropriate nursing diagnosis for her? Fear of stranger Risk for infection related to an incision Potential for alteration in tissue perfusion Alteration in skin integrity
Potential for alteration in tissue perfusion
The nurse is caring for a 14-year-old girl with scoliosis and a curvature greater than 50 degrees. The patient underwent a posterior spinal fusion with implants. Postoperatively, the priority nursing action to prevent complications is: Maintain skin integrity Prevent neurologic deficit Promote adequate bowel and bladder elimination Promote comfort
Prevent neurologic deficit
The nurse is caring for a 16-year-old female diagnosed with von Willebrand disease. Which of the following clinical findings will support this diagnosis? Increased INR Increased platelet count Prolonged aPTT Prolonged PT
Prolonged aPTT
A 6-year-old is brought into the emergency room with severe diarrhea. What is the priority nursing action? Administer antibiotic therapy as ordered Stool culture Start I.V. solution as ordered Administer antidiarrheal medication as ordered
Start I.V. solution as ordered
An acute, severe prolonged asthmatic attack that is not responsive to usual treatment is referred to as which of the following? Severe persistent asthma Moderate persistent asthma Status asthmaticus Mild intermittent asthma
Status asthmaticus
A 2-year-old boy is admitted to the hospital with celiac disease. Which of the following symptoms should be present upon assessment? Regurgitation, deficiency of fat soluble vitamins, and steatorrhea Steatorrhea, deficiency of fat soluble vitamins, malnutrition, and distended abdomen Steatorrhea, currant jelly stools, and regurgitation Regurgitation, projectile vomiting, and dehydration
Steatorrhea, deficiency of fat soluable vitamins, malnutrition, and distended abdomen
A 5-year-old is prescribed sulfamethoxazole/trimethoprim for the treatment of otitis media. Which severe adverse reaction is most common in drugs containing sulfa? Heart failure Renal failure Stevens-Johnson syndrome Hives
Stevens-Johnson syndrome
A primipara mother has delivered a newborn baby with a cleft lip. While assessing the newborn, the nurse should be alert for which of the following at risk for being compromised? Mobility Sucking ability Respiratory status GI function
Sucking ability
A nurse is educating a patient about Kawasaki disease. Which statement by the patient is correct? Sudden high fever is usually the initial symptom Initial presentation includes peeling of the skin on the hands It affects the thyroid gland Kawasaki disease most often occurs in young girls
Sudden high fever is usually the initial symptom
A patient taking doxycycline for the treatment of acne vulgaris is experiencing many side effects. To alleviate the most common side effect, the nurse should instruct the patient to do which of the following? Increase sunlight exposure Remain flat for 30 minutes after administration Take the medication with meals Take the medication on an empty stomach
Take the medication with meals
Congenital clubfoot, a common deformity in which the foot is twisted out of its normal shape or position?
Talpes
While assessing a newborn, the nurse suspects the presence of phenylketonuria. Which of the follow tests would confirm the diagnosis? Urinalysis Liver enzyme analysis Tandem mass spectrometry Guthrie test
Tandem mass spectrometry
A 7-month-old infant suspected of cerebral palsy is being assessed by the nurse. Which of the following activities, as stated by the patient's mother, indicates the possible presence of cerebral palsy? The infant does not move when startled The infant does not react to loud noises The infant is unable to use a spoon The infant is unable to roll over
The infant is unable to roll over
A newly diagnosed asthmatic is being instructed on proper use of a metered dose inhaler. The patient asks how he will know when the canister is empty, the nurse should respond: Check if the canister floats in water Count each dose you take Shake the canister and listen for fluid The number of remaining doses will be on the inhaler
The number of remaining doses will be on the inhaler
The nurse is preparing to administer a diphtheria, tetanus, and pertussis immunization to a 3-month-old boy. The infant's mother asks why he needs the DTaP immunization at this age. Which of the following information should be given to her? The possibility of allergic reactions to the diphtheria immunization increases as the child gets older The tetanus immunization should be completed before the infant develops the ability to crawl There is a high mortality rate in infants who have not been immunized to pertussis The immunization will be more effective if it is given before the thymus gland begins to atrophy
There is a high mortality rate in infants who have not been immunized to pertussis
A nurse is performing a developmental assessment on a 15 month-old. Which of the following findings is of most concern? Unable to put on clothing Unable to say 3 words Unable to run Unable to stand for 2 seconds
Unable to stand for 2 seconds
The leading cause of gastroenteritis in children?
Rotavirus
The nurse is caring for a 5-year-old girl who is hospitalized following abdominal surgery. She develops a fever of 39.5 degrees Celsius, a sore throat, and a red, macular rash on her chest and abdomen. Her tonsils are inflamed and enlarged. Based on these findings, the nurse would follow the protocol care for: Scarlet fever Mumps Pertussis Diptheria
Scarlet fever
The mother of a 6-year-old girl with congestive heart failure tells the emergency room nurse that she is worried and says "she's been so tired lately. She seems to get out of breath just walking around the house." Which of the following represents an effective nursing intervention to reduce cardiac demands and decrease cardiac workload? Allow frequent visits of relatives to calm the child Scheduling care to provide for uninterrupted rest periods Feeding the child 3 large meals per day Developing and implementing a consistent plan of care
Scheduling care to provide for uninterrupted rest periods
An infant is seen in the emergency department with the following signs and symptoms: irritability, coughing, sneezing, wheezing, diffuse rhonchi and rales, and intermittent fever. The child is diagnosed with respiratory syncytial virus. Which of the following positions will the nurse place the infant to facilitate breathing? Supine with head at the side Semi-fowler's position Supine position Trendelenburg
Semi-fowler's position
A nurse is caring for a 2-year-old child that has been hospitalized for 12 hours. Which of the following situations would most affect the child's behavior? Presence of nurses Lack of familiar toys Presence of other children Separation from parents
Separation from parents
A 7-year-old girl has been diagnosed with nephrotic syndrome. She appears bloated, weak, and eats less than what is expected. The physician recommends dietary protein in each meals to supplement the losses. In order to achieve a healthy diet and prevent worsening the condition, which of the following should be done? Avoid giving snacks, this will alter the child's feeding pattern Give her some candy as a reward when meals are finished Play with her while eating Serve her favorite food
Serve her favorite food
An eight-month-old infant recently had a seizure and is lethargic and bradycardic upon arriving at the emergency room. The X-ray result revealed a retinal hemorrhage. The nurse suspects that the child is showing signs and symptoms of: Sexual abuse Shaken baby syndrome Munchausen syndrome by proxy Mastoid bone fracture
Shaken baby syndrome
A patient with thrombocytopenia is prescribed desmopressin to promote the release of von Willebrand factor. The nurse assesses the patient for which of the following effects of desmopressin? Temperature Lengthened PTT Increase urine output Shortened aPTT
Shortened aPTT
When providing postoperative care for a child with a cleft palate, the nurse would place the child in which of the following positions? Side lying Prone Trendelenburg Supine with head elevated
Side lying
The nurse is assessing a 5-year-old after having a seizure. The patient's symptoms include headache, vision changes, vomiting, and papilledema. Which of the following diagnostics tests will support the diagnosis? X-ray Bone marrow biopsy CT Scan Lumbar puncture
CT Scan
The nurse is assessing a 4-month-old suspected of having cerebral palsy. Upon initial interview, which of the following statements by the mother would indicate that the infant may have cerebral palsy? "My baby cannot sit without support" "My baby cannot lift her head up, she is floppy" "My baby has not rolled all the way over yet" My baby's left hip tilts if I hold her upright
"My baby cannnot lift her heap up, she is floppy"
A 4-year-old has a foreign body in her eye. During the examination, the child refuses to allow the nurse to inspect her eye. What should the nurse say to the child? "Don't be upset, we can finish this later" "Would you like hold my flashlight?" "If you cooperate, this will end soon" "Don't be scared, I am not going to hurt you"
"Would you like to hold my flashlight?"
A toddler's parents ask the nurse how long the child is required to use a front facing car seat. How should the nurse respond? "The child can stop using the front facing car seat when he is mature enough" "Your child must be at least 50 inches tall" "Your child can stop using a front facing car seat when he weighs at least 40 pounds" "The child must be at least 6 years-old to use a regular seat belt"
"Your child can stop using a front facing car seat when he weighs at least 40 lbs
An 11-year-old complains of severe pain after an appendectomy. The physician orders fentanyl 25 mcg I.V., every 2 hours as needed. How soon after administration can the patient expect to feel relief? 30 minutes 1 minute 5-10 minutes 15 minutes
1 minute
The physician orders lidocaine-prilocaine cream to apply to the patient's skin before I.V. insertion. How long before the I.V. insertion should the nurse apply the cream? 30 minutes 15 minutes 1-2 hours 4 hours
1-2 hours
A nurse is preparing a blood transfusion for an anemic toddler. Which of the following blood transfusion matches would cause a hemolytic reaction? O-negative blood to a B-negative patient A-negative blood to an AB-negative patient A-negative blood to a B-negative patient B-negative blood to a B-positive patient
A-negative blood to a B-negative patient
Carrie, a 5-year-old with an umbilical hernia is transferred to the post-operative care unit. The priority nursing responsibilities for postoperative care include: Assess for hemorrhage Monitor vital signs Assess for signs of incarceration and strangulation Promote comfort
Assess for hemorrhage
A 9-year-old male is diagnosed with Wilm's tumor. Which of the following would the nurse expect to note as the most common symptom? Nausea and vomiting Pain during urination Hematuria Abdominal mass
Abdominal mass
A 3-year-old is admitted to the hospital suspected of having congenital heart disease. Which of the following assessment findings is most likely to be seen? Weight in 20th percentile since birth Mental retardation Frequent kidney infections Activity intolerance
Activity intolerance
A 15-month-old boy is seen at the outpatient department for a fever. His mother says that 3 days ago her child had a cough and runny nose. She also observed him pulling on his right ear. Based on these findings, the nurse should suspect? Sinusitis The flu Acute otitis media Acute otitis externa
Acute otitis media
A child with sickle cell anemia has ineffective tissue perfusion related to generalized infarcts. Which of the following interventions should the nurse prioritized in her plan of care? Position the patient on the left side Encourage bed rest Administer oxygen by nasal cannula as prescribed Administer pain medications
Administer oxygen by nasal cannula as prescribed
A 6-year-old is scheduled for brain surgery for the removal of a tumor. What preoperative nursing intervention is a priority? Shave the patient's head Administer stool softeners as prescribed Administer Solu-Medrol as prescribed Administer a cleansing enema
Administer stool softeners as prescribed
A 6-year-old girl is brought to the emergency department by her parents. The child appeared pale, dyspnic, edematous, pulse of 115 bpm, respirations of 38, and oxygen saturation of 80. Apical heart rate displaced down and laterally. Lungs have harsh rhonchi and rales on auscultation. A diagnosis of Congestive heart failure is made. What is the first priority intervention the nurse should do? Monitor arterial blood gas values Administer supplemental oxygen as ordered Institute cardiac monitoring Administer medications, such as digoxin and diuretics as ordered
Administer supplemental oxygen as ordered
A 15-year-old male's left leg is placed in skeletal traction. The primary purpose of this measure for him is to: Reduce pain Align the ends of the fractured bone Promote bone healing Control bleeding into tissues
Align the ends of the fractured bone
Which of the following infants is least likely to develop sudden infant death syndrome? An infant who sleeps prone An infant who is premature A bottle fed infant An infant with prenatal drug exposure An infant who sleeps supine
An infant who sleeps supine
Treatment of Erbs Palsy?
Any recovery occurs most rapidly during the first 6 months. At 3 months is the best predictor of recovery. If the child has a poor prognosis for recovery at 3 months, surgical exploration and possible repairs of the nerve roots. Use of immobilizer of the arm and shoulder, abduct, externally rotate, flex elbow, supinate the wrist
A 16-year-old patient is prescribed erythromycin for the treatment of pelvic inflammatory disease. The nurse should instruct the patient to take the medication: As prescribed, until adverse effects develop As prescribed, until the regimen is complete With an antacid As prescribed, until symptoms resolve
As prescribed, until the regimen is complete
Term applied to a persistent pattern of inattention and/or hyperactivity that is more frequent and severe than is typically observed in children of comparable development?
Attention Deficit - Hyperactivity Disorder (ADD - ADHD)
A child is admitted to the hospital due to an acute asthma exacerbation. The nurse is assessing the patient and immediately calls the physician after discovering which of the following? Large amounts of mucous Use of accessory muscles when breathing Auscultated wheezes suddenly stop in the lower right lobe Patient is short of breath
Ausculated wheezes suddenly stop in the lower right lobe
The mother of a 3-year-old expresses frustration due to her daughter's refusal to follow her directions. The nurse explains that this behavior is normal for her age as she is trying to meet which developmental need? Identity Autonomy Basic trust Initiative
Autonomy
The nurse is caring for a child scheduled for surgery due to osteogenic sarcoma. Which of the following interventions should be implemented? Massage the leg Avoid bearing weight on the affected leg Put warm compresses on the affected leg Exercise the leg to promote blood flow
Avoid bearing weight on the affected leg
The nurse is caring for a child scheduled for surgery due to Wilm's tumor. Which of the following nursing actions is a priority? Avoiding abdominal palpation Handling the child with care Placing the child in high fowler's position to facilitate breathing Monitoring bowel sounds for suspicion of an obstruction
Avoiding abdominal palpation
The nurse is caring for a 2-year-old with acute otitis media. Which of the following instructions should be included in the teaching plan for the parents of the child? Clean the inside of the ear canals with cotton swabs Place the child in a supine position to bottle feed Avoiding contact with people who have upper respiratory infections Finish the course of antivirals, even after symptoms disappear
Avoiding contact with people who have upper respiratory infections
A 8-year-old is prescribed clindamycin for the treatment of osteomyelitis. Which of the following symptoms indicates to the nurse that the patient is having an adverse reaction? Shortness of breath Tendon pain Constipation Bitter or metallic taste
Bitter or metallic taste
A nurse administers bacitracin ophthalmic ointment to a teenager with conjunctivitis. Which of the following symptoms indicates that the patient is experiencing a side effect of this medication? Blurred vision Strabismus Diplopia Amblyopia
Blurred vision
When planning ongoing nursing care for a child with recurrent nephrotic syndrome, which of the following areas of potential disturbances should be of priority consideration? Psychological development Sexual maturation Cognitive development Body image
Body image
An infant with secondary lactose intolerance is being discharged. The nurse should instruct the mother to avoid feeding the infant which of the following? Rice Breast milk Regular formula Cow's milk Rye Oats
Regular formula Cow's milk
Medical treatment of Hypospadias
Infants with hypospadias should not be circumcised. The foreskin should be preserved for later possible surgical repair. Surgery is usually completed before the child starts school. The penis is straightened and the hypospadiasdefect is corrected surgically using tissue grafts obtained from the intact foreskin
The nurse is assessing a 5-month-old girl who is confined due to congenital clubfoot. The infant is scheduled for corrective serial casting. Which of the following deformities would be present? Abduction of the ankle Inversion and adduction of the foot Dorsiflexion of the foot Pronation and abduction of the foot
Invasion and adduction of the foot
A 3-year-old girl is diagnosed with thalassemia major. The long term complications seen in a child with thalassemia major are related to which of the following? Cerebral edema Iron overload Bleeding Anemia
Iron overload
A 16-year-old girl is seen in the emergency department with intermittent episodes of loose stools and recurrent dull, crampy abdominal pain felt at the periumbilical area. Based on the assessment, what disorder is most likely? Peptic ulcer Crohn's disease Irritable bowel syndrome Appendicitis
Irritable bowel syndrome
A 6-month-old infant is found to have mild diarrhea accompanied by cramping at the lower abdomen after being breast fed. Based on these findings, what is the most likely cause? Irritable bowel syndrome Lactose intolerance Celiac disease Kwashiorkor
Lactose intolerance
When instructing a patient on how to instill eyedrops, the nurse should include which of the following steps? Pull back the upper eyelid and instill drop underneath upper eyelid Pull down the lower eyelid and place the drop into the "pocket" formed Rub eye after administration Instill the eyedrop in the corner of the eye and allow it to flow across the eye
Pull down the lower eyelid and place the drop into the "pocket" formed
A child is admitted to the hospital with croup. The nurse expects the physician to order which nebulizer treatment? Racemic epinephrine Ipratropium Salmeterol Theophylline
Racemic epinephrine
Treatment of Talpes?
Rapid growth of infancy allows for remodeling of the ankle. Correction through a series of manipulation and casting (approx. every 2 wks.). If manipulation and casting is not successful, surgical correction will be required.
Nursing care for Gastroenteritis?
Re-hydrate - Pedialyte, Infalyte and clear liquids. Avoid caffeinated soda. BRAT diet - bananas, rice, applesauce, toast or tea.
A mother brings her 7-year-old daughter to the clinic after several nights of bedwetting. The mother explains that her daughter never wet the bed until her baby brother was born. The nurse explains that this situation is considered what defense mechanism? Dissociation Regression Projection Repression
Regression
The nurse is assessing a child with a high grade fever. The child's mother tells the nurse that she will dress her child warmly if she has a fever and chills. Which of the following is a correct response from the nurse? This would stimulate the sweat glands, thus decreasing the fever Warm clothing is comforting to a child with a fever This would help to stop the chills and decrease the fever This increases the child's temperature and does not prevent shaking
This increases the child's temperature and does not prevent shaking
The nurse is administering inhalation therapy to a child with pneumonia. Inhalation therapy is expected to achieve which of these effects? To improve the effectiveness of cilia in the respiratory tract To increase the use of intercostal muscles in breathing To promote the exchange of gases in the alveoli To strengthen the movement of the diaphragm
To improve the effectiveness of cilia in the respiratory tract To promote the exchange of gases in the alveoli
The nurse is caring for a 15-month-old with acute otitis media that is having a myringotomy done. What is the purpose of this procedure? To correct a congenital malformation in the inner ear To increase pressure behind the tympanic membrane To promote drainage from the ear To irrigate the eustachian tube
To promote drainage from the ear
A patient is taking tacrolimus after receiving a kidney transplant. Which of the following symptoms indicates that the patient is experiencing a side effect of this medication? Polyuria Hypotension Hypokalemia Tremor
Tremor
Which of the following disorders leads to cyanosis and tachycardia caused by complete mixing of deoxygenated and oxygenated blood in the left side of the heart resulting in systemic desaturation and variable pulmonary obstruction? Aortic stenosis Tetralogy of Fallot Tricuspid atresia Mitral stenosis
Tricuspid atresia
The nurse is caring for an 8-year-old with increased intracranial pressure (ICP). Which statement by the parent would indicate the need for the nurse to reinforce the purpose for elevating the head of the bed 15 to 30 degrees? "Keeping the head of the bed elevated will decrease the pressure in his brain." "The head of bed elevation helps increase venous outflow." "This will maintain an adequate cerebral perfusion pressure." "When the head is raised it reduces the risk of blood clots."
When the head is raised it reduces the risk of blood clots
A nurse is admitting a 14-year-old patient with tuberculosis. Which of the following should be included in the patient education? You will have to take multiple drugs to treat tuberculosis Once treated, the disease will never come back You will always test positive for tuberculosis You may have to take medication for up to 5 months You must stay in isolation for 2 weeks
You will have to take multiple drugs to treat tuberculosis You will always test positive for tuberculosis You must stay in isolation for 2 weeks
