Peds exam 2
A child with nephrotic syndrome is admitted to the pediatric unit. You understand that the management of this condition is primarily managed with? SATP
-Diuretics -Steroids
Following a bout of diarrhea, which foods should be offered to the school aged child?
Bananas and rice
Glomerulonephritis is an inflammation of the glomeruli or the kidney. Most commonly it occurs after?
Immunococcal strep virus infection
A 3-year-old boy is found to have X-linked Duchenne muscular dystrophy. Neither parent has muscular dystrophy. Which statement indicates that the parents understand how the disorder is transmitted?
"Our daughters may be carriers of the disease."
How should the nurse measure urinary output of an infant with dehydration?
Weighing the diaper
A client with gastroesophageal reflux disease (GERD) should make diet and lifestyle changes. What instructions should the nurse include in the client's discharge teaching? (Select all that apply).
-Avoid caffeine-containing products. -Chew thoroughly while eating slowly
The nurse is assessing a client with hyperthyroidism. Which clinical indicators are consistent with this diagnosis? (Select all that apply.)
-Emotional lability -Dyspnea on exertion -Hyperactive deep tendon reflexes
You are assessing a teenage child suspected of having early stage scoliosis. Which of the following clinical manifestations would you suspect to see? SATP
-Prominence of one scapula -Trunkal assymetry -Curved spinal column
The practitioner prescribes no weight bearing on a leg that has been casted because of a fracture of the femur. How should the nurse determine the appropriate length of the crutches for this child? Select all that apply.
-The crutches should reach 2 inches below the axillae. -There should be a snug fit under the axillae when the child walks.
An infant has been admitted for dehydration as a result of acute gastroenteritis and vomiting. The nurse administers lasted ringers solutions intravenously. The nurse includes the treatment has been effective after noting
3 wet diapers in 24 hours
Nephrotic syndrome is a clinical state characterized by which of the following? SATP
⁃ Hyperproteinuria ⁃ Hyperlipidemia ⁃ Hypoproteinemia ⁃ Edema
What should the nurse assess in the infant who has been diagnosed with hypertrophic pyloric stenosis?
An olive shaped mass in the right midline
The nurse explains to the parents of a child with DHD that the application of a pavlik harness is necessary. In what position will the harness hold the child's femur?
Abduction
Which is a causative factor of Hirschsprung disease?
Absences of parasympathetic ganglion cells in the portion of the colon
The parents of a boy born with hypospadias asks the nurse at what age should the repair of the congenital defect is performed? What is the most appropriate response by the nurse?
After 6 months and before 1 year of age
A severely dehydrated infant with gastroenteritis is admitted to the pediatric unit. Nothing-by-mouth (NPO) status is prescribed. The parents ask why their baby cannot be fed. The nurse explains that this is necessary to:
Allow the intestinal tract to rest
How does a nurse identify possible developmental dysplasia of the hip (DDH) during a newborn assessment?
Asymmetry of the gluteal folds
The urinary output of a 9-year-old child with acute glomerulonephritis decreases to 250 mL/24 hr. A diet low in sodium and potassium is prescribed. What should the nurse encourage the child to have for lunch?
Baked chicken, green beans, and lemonade
What should the nurse caring for a 6 y.o. with acute glomerulonephritis anticipate as the most difficult part of the care to implement?
Bed rest
The nurse is counseling the parents of a 12-year-old child with Duchenne muscular dystrophy about problems that may develop during adolescence. What body system does the nurse expect will be affected?
Cardiopulmonary
What color is in the urine of a patient experiencing acute glomerulonephritis?
Coca Cola
When caring for a 7 week old infant with hypothyroidism the nurse explains that the prevention of what complication is dependent upon the administration of oral thyroid replacement therapy and is critical for the child?
Cognitive impairment
A 4 year old child is admitted to the pediatrics unit with a diagnosis of WILMs tumor. Considering the unique needs of a child with this diagnosis, the nurse should place a sign on the child's bed that states?
Don't palpate the abdomen
A female client who has recurrent urinary tract infections (UTIs) is inquiring about the prevention of future UTIs. What information should the nurse include when teaching the client?
Drink 8 to 10 glasses of water each day
A 16 year old female client who has recurrent UTIs is acquiring about the prevention of UTIs. What information should the nurse include when teaching the client?
Drink 8-10 glasses of water each day
You are caring for a child experiencing acute glomerulonephritis you explain to the parents that this condition is a result of?
Exposure to virus
Which is a long term complication of cleft lip palate?
Faulty dentition
Which is a long term complication of a cleft lip and palate?
Faulty detention and possibility of impaired speech
A child with type 1 diabetes complains of feeling light headed. Blood sugar is 60, which of the following would be most appropriate.
Give 15 grams of carbs and retest blood sugar in 15 minutes
A child with Duchenne Muscular Dystrophy rises from the floor by walking up the thighs with the hands. How should the nurse record this observation?
Gower's sign
An 8-year-old child is found to have Legg-Calvé-Perthe disease. The health care provider orders an abduction brace 23 hours a day and non-weight-bearing activity. What should the nurse teach the parents to do?
Have the child transfer to a wheelchair, using the unaffected leg
A client has been taking levothyroxine (Synthroid) for hypothyroidism for three weeks. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestation?
Heat intolerance
The school nurse is teaching a middle school class about the hormones that regulate body function. Which information provided by the nurse is accurate?
Hormones are chemicals secreted by endocrine glands
A 5 year old has a temperature of 103.6 and is brought into emergency room by his mother. Which statement by the mother causes concern?
I administered aspirin to help with the fever a few hours go
A 10 year old is being evaluated for possible appendicitis and complains of nausea and sharp abdominal pain in the RLQ. An abdominal ultrasound is scheduled and a blood count has been obtained. The child vomits and finds the pain relieved and calls the nurse. Which should be the nurses next action?
Immediately notify the physician of the child's status
What is a priority problem for a newborn with a cleft lip palate?
Impaired attachment
A client with chronic osteomyelitis in the leg is scheduled to have a debridement of the infected bone. What should the nurse include in the postoperative plan of care?
Inform the client that the leg may be immobilized in a cast or splint
A 1 year old infant with a distended abdomen is admitted to the pediatric unit with a diagnosis of Hirschsprung. In which position should the nurse place the infant?
Lateral
Spinal fusion is performed in an adolescent with scoliosis. What postoperative nursing intervention is specifically related to surgery for scoliosis?
Log-rolling every 2 hours
The nurse is caring for a pre adolescent client in skeletal dunlop traction. Which of the following nursing interventions is appropriate for this child?
Make certain the child is maintained in correct body alignment
A 9 year old child, has been found to have legs-calve-perthes disease and is on bed rest. The nurse encourages the parents to look for something creative for the child to do or a hobby for the child to begin with the purpose of?
Meeting the developmental task of initiative
You understand diabetic teaching has been effective when the parents of a newly diagnosed child states that during an illness they will provide the child with?
More insulin
A nurse is assessing a client with hypothyroidism. The nurse expects the following clinical manifestations, EXCEPT?
Photophobia
An adolescent is found to have type 1 diabetes. The nurse plans to teach the adolescent that dietary control and exercise can help regulate the disorder. The following information needs to be included in the teaching plan except:
Prophylactic antibiotics
A nurse is caring for an infant with talipes equinovarus (clubfoot) who has had a corrective boot cast applied. Which peripheral vascular observation cannot be performed while the cast is in place?
Pulse
A teenage girl has been placed in a brace for the treatment of scoliosis, the mot common skeletal deformity of adolescence. The family asks what they can do to be more supportive. What suggestion of the nurse is most appropriate?
Purchasing clothes to disguise the cast
What is the priority patient problem for the parents of a newborn with cleft lip palate?
Risk for impaired attachment
A client is admitted for repair of bilateral inguinal hernia, before surgery the nurse asses the clients for signs that strangulation of the intestines may have occurred. What is an early sign of strangulation?
Sharp abdominal pain
When selecting patient problems for the 4 year old child with nephrosis, what should be the priority of the nurse?
Skin impairment
Which clinical finding should the nurse expect when assessing a client with hyperthyroidism?
Tachycardia
Which explanation is most accurate when the nurse teaches a client about intussusception of the bowel?
Telescoping of the proximal loop of the bowel into the distal loop
The mother of a newborn asks the nurse why the infant has to nurse so frequently. Which is the best response?
The newborns stomach capacity is small and peristalsis is more rapid than in older children
How would the infant with gastroesophageal (GER) be typically treated?
Thickening the formula or adding cereal to breast milk
What is the priory nursing goal for a 15 year old with graves disease?
Verbalizing the importance of adherence to the medication
A newborn with talipes equinovarus (club foot) and is wearing a cast. How often should the cast be changed?
Weekly
Following the surgical repair of a cleft palate, what should be used to prevent injury to the suture line?
cup
What is the hallmark sign of intussusception
currant jelly-like stools
You are assessing a 4 month old during a well baby visit, which of the following findings would warrant you to discuss with the provider your findings for the possible ultrasound of a developmental dysplasia of the hips.
unequal knee height
You are caring for an infant with suspect dehydration which of the following signs and symptoms indicate the clinical manifestations of dehydration?
• Skin- cold, dry, gray, loss of turgor • Eyes- sunken • Mucus membranes- dry • Fontanelles- sunken • Behavior- lethargic • Pulse- rapid, weak • BP- low • RR- rapid
A 9 year old child is in the hospital in skin traction after sustaining a simple fracture of the femur. Which of the following assessment should the nurse make during rounds with the child's orthopedic? SATP
⁃ Childs bowel sounds ⁃ Level of pain ⁃ Skin underneath bandage for signs of skin breakdown ⁃ Cap refill of childs toes
The nurse is assessing a client with HYPERTHYROIDISM, which clinical indicators are consistent with this diagnosis? SATA
⁃ Dyspnea on exertion ⁃ Emotional liability ⁃ Hyperactive DTR
The nurse is caring for a child with nephrotic syndrome with edema in the acute phase of the illness. Which of the following appropriate nursing interventions for the care of a child with this syndrome? SATP
⁃ Meticulous skin care to prevent impairment of edematous skin and a secondary infection ⁃ Daily weights ⁃ Monitoring intake and output
Clinical manifestations of pyloric stenosis typically include? SATP
⁃ Olive shaped mass on the epigastrium ⁃ Projectile vomiting
The goals in the management of diarrhea are? SATP
⁃ Treat the underlying cause ⁃ Restore the fluid and electrolyte balance ⁃ Maintain NPO status until cause of diarrhea is determined
Signs and symptoms of UTIs can include which of the following? SATP
⁃ Urinary frequency ⁃ Pain during urination ⁃ Foul smelling urine ⁃ Abdominal / flank pain
