Peds Exam 2 Practice Questions

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply 1. the child has symptoms of a cold 2. the child had a previous anaphylactic reaction to the vaccine 3. the mother reports that the child is having intermittent episodes of diarrhea 4. the mother reports that the child has not had an appetite and has been fussy 5. the child has a disorder that caused a severely deficient immune system 6. the mother reports that the child has recently been exposed to an infectious disease

2. the child had a previous anaphylactic reaction to the vaccine 5. the child has a disorder that caused a severely deficient immune system

The nurse is caring for a child diagnosed with erythema infectiosum (fifth disease). Which clinical manifestation should the nurse expect to note in the child? a. an intense fiery red edematous rash on the cheeks b. pinkish-rose maculopapular rash on the face, neck and scalp c. reddish and pinpoint petechiae spots found on the soft palate d. small bluish white spots with a red base found on the buccal mucosa

a. an intense fiery red edematous rash on the cheeks

the nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding? a.frequent swallowing b. a decreased pulse rate c. complaints of discomfort d. an elevation in blood pressure

a. frequent swallowing

the nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by ratory synctial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply a. place the infant in a private room b. ensure that the infant's head is in a flexed position c. wear a mask, gown, and gloves when in contact with the infant d. place the infant in a tent that delivers warm humidified air e. position the infant on the side, with the head lower than the chest f. ensure that nurses caring for the infant with RSV do not care for other high risk children

a. place the infant in a private room c. wear a mask, gown, and gloves, when in contact with the infant f. ensure that nurses caring for the infant with RSV do not care for other high risk children

the nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review? a. creatine level b. prothrombin time c. sedimentation rate d. blood urea nitrogen level

b. prothrombin time

the nurse is preparing to care for a child after a tonsillectomy. the nurse documents on the plan of care to place the child in which position? a. supine b. side lying c. high fowlers d. trendelenburg's

b. side lying (or prone to promote drainage)

after a tonsillectomy, the nurse reviews the surgeon's postoperative prescriptions. Which prescription should the nurse question? a. monitor for bleeding b. suction every 2 hours c. give no milk or milk products d. give clear, cool liquids when awake and alert

b. suction every 2 hours (should only be PRN)

the emergency department nurse is caring for a child diagnosed with epiglottis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction? a. the child exhibits nasal flaring and bradycardia b. the child is leaning forward with the chin thrust out c. the child has a low grade fever and complains of a sore throat d. the child is learning backward, supporting herself or himself with the hands and arms

b. the chid is leaning forward with the chin thrust out

a pediatric client with ventricular septal defect repair is placed on a maintenance dosage of digoxin. The dosage is 8 mcg/kg/day, and the client's weight is 7.2 kg. The pediatrician prescribes the digoxin to be given twice daily. The nurse prepares how many mcg of digoxin to administer to the child at each dose? a. 12.6 mcg b. 21.4 mcg c. 28.8 mcg d. 32.2 mcg

c. 28.8 mcg

The nurse is assessing a child admitted with a diagnosis of rheumatic fever. Which significant question should the nurse ask the child's parent during the assessment? a. has your child had difficulty urinating? b. Has your child been exposed to anyone with chicken pox? c. Has any family member had a sore throat in the past few weeks? d. Has any family member had a GI disorder in the past few weeks?

C. Has any family member had a sore throat in the past few weeks?

which question should the nurse ask the parents of a child suspected of having glomerulonephritis? a. did your child fall off a bike onto the handlebars? b. has the child had persistent nausea and vomiting? c. has the child been itching or had a rash anytime in the last week? d. has the child had a sore throat or a throat infection in the last few weeks?

d. has the child had a sore throat or a throat infection in the last few weeks?

The nurse is providing medication instructions to a parent. Which statement by the parent indicates the need for further instruction? A. "I should cuddle my child after giving medication." B. "I can give my child a frozen juice bar after he swallows the medication." C. "I should mix the the medication in the baby food and give it when I feed my child." D. "If my child does not like the taste of medicine, I should encourage him to pinch his nose and drink the medication through a straw."

"I should mix the medication in the baby food and give it when I feed my child."

the nurse caring for a child diagnosed with rubeola (measles) notes that the pediatrician has documented the presence of Koplik's spots. On the basis of this documentation, which observation is expected? 1. Pinpoint petechiae noted on both legs 2. Whitish vesicles located across the chest 3. Petechiae spots that are reddish and pinpoint on the soft palate 4. small, blue-white spots with a red base found on the buccal mucosa

4. small, blue-white spots with a red base found on the buccal mucosa

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction? a. we need o encourage our child to drink fluids b. coughing spells may be triggered by dust or smoke c. vomiting may occur when out child has coughing episodes d. we need to maintain droplet precautions and a quiet environment for at least 2 weeks

4. we need to maintain droplet precautions and a quiet environment for at least 2 weeks

the nurse admits a child to the hospital with a diagnosis of pyloric stenosis. On assessment, which data would the nurse expect to obtain when asking the percent about the child's symptoms? a. watery diarrhea b. projectile vomiting c. increased urine output d. vomiting large amounts of bile

b. projectile vomiting

a child has been diagnosed with acute otitis media of the right ear. Which interventions should the nurse include in the plan of care? select all that apply a. provide a soft diet b. position the child on the left side c. administer an antihistamine twice daily d. irrigate the right ear with normal saline every 8 hours e. administer ibuprofen for fever every 4 hours as prescribed and as needed f. instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy

a. provide a soft diet e. administer ibuprofen for fever every 4 hours as prescribed f. instruct the parents about the need to administer the prescribed antibiotics for the full course of therapy

after a tonsillectomy, a child begins to vomit bright red blood. the nurse should take which initial action? a. turn the child to the side b. administer the prescribed antiemetic c. maintain NPO status d. notify the primary health care provider

a. turn the child to the side

a 10 year old child with asthma is treated for an acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that is indicates a worsening of the condition? a. warm, dry skin b. decreased wheezing c. pulse rate of 90 beats per minute d. respirations of 18 breaths per minute

b. decreased wheezing (inability to move air)

the nurse assesses the vital signs of a 12 month old infant with a respiratory infection and notes that the respiratory rate is 35 breaths per minute. On the basis of this finding, which action is most appropriate? A. Administer oxygen b. document the findings c. notify the pediatrician d. reassess the respiratory rate in 15 minutes

b. document the findings

the nurse performing an admission assessment on a 2-year old child who has been diagnosed with nephrotic syndrome notes that which most common characteristic is associated with this syndrome? a. hypertension b. generalized edema c. increased urinary output d. frank, bright red blood in the urine

b. generalized edema

the nurse reviews the record of a child who is suspected to have glomerulonephritis. which statement by the child's parent should the nurse expect that is associated with this diagnosis? a. his pediatrician says his kidneys are working well b. i noticed his urine was the color of cola lately c. i'm so glad they didn't find any protein in his urine d. the nurse who admitted my child said his blood pressure was low

b. i noticed his urine was the color of cola lately

the nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? a. initiate strict enteric precautions b. move the infant to a private room c. leave the infant in the present room , because rsv is not contagious d. inform the staff that using standard precautions is all that is necessary when caring for the child

b. move the infant to a private room

the mother of a hospitalized 2 year old child with viral laryngotracheobronchitis (croup) asks the nurse why the pediatrician did not prescribe antibiotics. Which response should the nurse make? a. the child may be allergic to antibiotics b. the child is too young to receive antibiotics c. antibiotics are not indicated unless a bacterial infection is present d. the child still has the maternal antibodies from birth and doesn't need the antibiotics

c. antibiotics are not indicated unless a bacterial infection is present

An infant has just returned to the nursing unit after surgical repair of a cleft lip on the right side. The nurse should place the infant in which best position at this time? a. prone position b. on the stomach c. left lateral position d. right lateral position

c. left lateral position

A pediatrician's prescription reads "ampicillin sodium 125 mg IV every 6 hours." The medication label reads "when reconstitued with 7.4 mL of bacteriostatic water, the final concentration is 1g/7.4 mL" The nurse prepares to draw up how many milligrams to administer 1 dose? a. 1.1 ml b. 0.54 ml c. 7.425 ml d. 0.925 ml

d. 0.925

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? a. monitor the infant for a fever b. bring the infant back to the clinic c. apply a hot pack to the injection site d. apply a cold pack to the injection

d. apply a cold pack to the injection

a new parent expresses concern to the nurse regarding sudden infant death syndrome. she asks the nurse how to position her new infant for sleep. in which position should the nurse tell the parent to place the infant? a. side or prone b. back or prone c. stomach with the face turned d. back rather than on the stomach

d. back rather than on the stomach

the nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which sign of this disorder documented? a. watery diarrhea b. ribbon-like stools c. profuse projectile vomiting d. bright red blood and mucus in the stools

d. bright red blood and mucus in the stools

the clinic nurse reviews the record of an infant and notes that the primary healthcare provider has documented a diagnosis of suspected hirschsprung's disease. The nurse reviews the assessment findings documented in the record, knowing that which sign most likely led to the mother to seek health care for the infant? a. diarrhea b. projectile vomiting c. regurgitation of feedings d. foul-smelling ribbon-like stools

d. foul-smelling ribbon like stools

a chid with laryngotracheobronchitis (croup) is placed in a cool mist tent. the mother becomes concerned because the child is frightened, cying, and trying to climb out of the tent. which is the most appropriate nursing action? a. tell the mother that the child must stay in the tent b. place a toy in the tent to make the child feel more comfortable c. call the pediatrician and obtain a prescription for a sedative d. let the mother hold the child and direct the cool mist over the child's face

d. let the mother hold the child and direct the cool mist over the child's face

the nurse provides feeding instructions to a parent of an infant diagnosed with gastroesophageal reflux disease. which instruction should the nurse give to the parent to assist in reducing the episodes of emesis? a. provides less frequent, larger feedings b. burp the infant less frequently during feedings c. thin the feedings by adding water to the formula d. thicken the feedings by adding rice cereal to the formula

d. thicken the feedings by adding rice cereal to the formula

the mother of an 8 year old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? a. increase the dose of ibuprofen b. increase the frequency of ibuprofen c. encourage the child to lie on the left side d. encourage the child to lie on the right side

e. encourage the chid to lie on the right side