Peds Book questions

•A newborn with rectal atresia is rushed to surgery shortly after birth. What teaching from the nurse would best prepare the mother to know what to expect when she sees her infant after surgery? •"Your son will have a colostomy with a bag on his abdomen and an IV" •"Your son will have an IV line, an oxygen source, a dressing, and a colostomy bag" •"He will have a colostomy with a bag, a feeding tube, and an oxygen mask" •"He will be wearing a diaper and have an abdominal dressing and soft restraints"

"Your son will have an IV line, an oxygen source, a dressing, and a colostomy bag"

•A 7 year old child with vomiting has been rehydrated with IV fluids and given an antiemetic. What should the nurse recommend for the child's diet? •Regular diet •Clear liquids •Low residue diet •High carbohydrate diet

Clear liquids

Because children with celiac disease must limit their intake of products containing gluten in wheat, rye, oats, and barley, they are at risk for which of the following nutritional deficiencies? Select all that apply. A. Iron deficiency anemia B. Folic acid deficiency C. Zinc deficiency D. Vitamin A, D, E, and K deficiency E. Vitamin B12 deficiency

A,B,D

A 5-month-old infant is seen in the well-child clinic for a complaint of vomiting and failure to grow. His birth weight was 7 lb, and he now weighs 8 lb, 10 oz. The infant's mother reports that he is taking 4 to 7 oz of formula every 4 to 5 hours, but he "spits up a lot after eating and then is hungry again." The child is noted to be alert but appears malnourished. The mother reports that his stools are brown in color, and he has 1 to 2 bowel movements every day. Based on these findings, the nurse anticipates the infant has: A. Meckel diverticulum B. Hypertrophic pyloric stenosis C. Intussusception D. Hirschprung disease

B

A burn injury involving the epidermis and varying degrees of the dermal layer that is painful, moist, red, and blistered describes which of the following? A. Superficial or first-degree burn B. Partial-thickness or second-degree burn C. Full-thickness or third-degree burn D. Fourth-degree burn

B

The greatest threat to life as a result of dehydration in children is: A. Oliguria B. Shock C. Arrhythmia D. Hypotension

B

The nurse caring for a 4-month-old infant with biliary atresia and significant urticaria can anticipate administering: A. Diphenhydramine B. Ursodiol (ursodeoxycholic acid) C. Loratidine D. Zantac

B

Hepatitis A virus is transmitted by which of the following? Select all that apply. A. Breast milk from mother with HAV B. Ingestion of contaminated food C. Fecal-oral route D. Casual contact with infected person E. Blood transfusion

B,C

A 10-year-old child suffered extensive second- and third-degree burns in an apartment fire. His weight is 75 lb (34 kg). Fluid replacement therapy will optimally: A. Result in an hourly urine output of 1 ml/kg B. Result in an hourly urine output of 20 ml/kg C. Result in an hourly urine output of 30 ml/kg D. Maintain a systolic blood pressure in the 95th percentile for the child's weight

C

A 16-month-old has a history of diarrhea for 3 days with poor oral intake. He received intravenous fluids, has tolerated some oral fluids in the emergency department, and is being discharged home. Instructions for diet for this child should include: A. BRAT diet (bananas, rice, applesauce, and toast) for 24 hours, then a soft diet as tolerated B. Chicken or beef broth for 24 hours, then resume a soft diet C. Offer a regular diet as child's appetite warrants D. Keep on clear liquids and toast for 24 hours

C

A 3-year-old boy is seen in the clinic at 8:30 pm with a history of vomiting for 2 days and poor oral intake; he has voided once since the previous day. Examination reveals a lethargic child sitting on the mother's lap. He has a capillary refill of 4 seconds, apical heart rate of 128, respiratory rate of 32, and poor skin turgor. Stated body weight is 25 kg. Based on this information, the nurse anticipates performing which of the following? A. Demonstrating to the mother how to give 5 to 10 ml of Pedialyte by mouth every 5 to 10 minutes B. Administering an intravenous fluid bolus of 450 ml of 5% dextrose in water over 60 minutes C. Administering an intravenous fluid bolus of 500 ml of 0.9% normal saline over 20 minutes D. Administering an intravenous fluid bolus of 1000 ml of 5% dextrose and 0.45% normal saline over 30 minutes

C

A 4-day-old infant is seen in the emergency department for a possible seizure earlier in the day. The infant was being breastfed but without much success, so an aunt gave him a bottle of water. The infant continued to cry, and the mother was too exhausted to breastfeed, so another bottle of water was given while someone went to the store to purchase infant formula. The pregnancy, delivery, and postpartum history reveal no particular problems for this term infant that might contribute to seizures. The physical examination is unremarkable, with the exception of hypertonic reflexes. The infant is awake, alert, and sucking on his fists. Diagnostic studies are obtained, including an electrocardiogram. The nurse anticipates which of the following as the possible explanation for the infant's condition? A. Serum potassium of 3.9 mEq B. Serum glucose of 69 mg C. Serum sodium of 118 mEq D. Arterial pH of 7.34

C

A formerly preterm infant who had surgery for necrotizing enterocolitis is now 6 months old and has short-bowel syndrome. He is unable to absorb most nutrients taken by mouth and is totally dependent on parenteral nutrition, which he receives via a central venous catheter. The clinic nurse following this infant is aware that this infant should be closely observed for the development of: A. Gastroesophageal reflux B. Chronic diarrhea C. Cholestasis D. Failure to thrive

C

The most common type of dehydration in children occurs when electrolyte and water deficits are present in approximately balanced proportions. This is called ________________ dehydration. A. Hypotonic B. Hypertonic C. Isotonic D. Hyponatremic

C

•Which of the following best describes the incidence of pyloric stenosis? •Females are affected more often than males •African American infants are affected more often than Caucasian infants •Preterm infants are affected more often than full-term infants •Firstborn infants are affected more often than later born infants

Preterm infants are affected more often than full-term infants

•An infant preparing for abdominal surgery is NPO. What should the nurse instruct the mother to encourage while her infant is in the pre-operative period? •Using a pacifier frequently •Provide a CHG bath •Continually holding the infant •Providing ice chips

Using a pacifier frequently

•A child is being admitted with the diagnosis of dehydration. What is the nurse's first responsibility? •Orient the family to the unit •Get vital signs •Weigh the patient •Start and IV

Weigh the patient

•Which children are most at risk for fluid and electrolyte imbalances? •Infants •Preschoolers •School-aged children •Adolescents

infants

•A 4-month-old male infant has been seen in the pediatrician's office several times for a distended abdomen, irritability, and constipation. A diagnosis of Hirschsprung disease is suspected and further testing is scheduled to confirm. What test should the nurse educate the parents about? •X-ray •Abdominal ultrasound •Rectal biopsy •Barium enema

rectal biopsy

•A 2-month-old infant is admitted for suspected pyloric stenosis after recurrent vomiting. Which of the following arterial blood gas results would be most likely? •pH = 7.48 pCO2 = 45 HCO3 = 32 •pH = 7.47 pCO2 = 33 HCO3 = 26 •pH = 7.30 pCO2 = 35 HCO3 = 26 •pH = 7.30 pCO2 = 35 HCO3 = 19

•pH = 7.48 pCO2 = 45 HCO3 = 32

•A 7-year-old child with a history of chronic constipation is brought to the emergency department with abdominal pain and vomiting. Appendicitis has not been ruled out. What procedure by the nurse would be contraindicated at this time? •IV insertion •Enema administration •Abdominal ultrasound Rebound tenderness assessment

Enema administration