peds exam 3
1 the emergency department nurse is assessing a 2 year old child with a burn injury covering 42% of the body surface area. which considerations related to the clients age should the nurse take? SATA a- shorter airway b- smaller tonsils c- immature immune system d- thinner skin e- more communicative
1 A- shorter airway C- immature immune system D- thinner skin
10 A nurse is working with a 12-year-old girl with osteomyelitis who is recovering from surgery. What nursing interventions should be implemented? Select all that apply. a- Administration of IV antibiotics at the hospital b- Instruct the parents on how to care for an IV line at home c- Instruct the parents regarding the importance of maintaining bed rest d- Institute infection-control precautions related to drainage tubes e- Cast care of the affected limb f- Instruction to the parents regarding proper traction of the limb
10 a- Administration of IV antibiotics at the hospital b- Instruct the parents on how to care for an IV line at home c- Instruct the parents regarding the importance of maintaining bed rest d- Institute infection-control precautions related to drainage tubes
11 A 3-year-old child is admitted to the hospital with osteomyelitis of the right femur. The nurse would expect to start an IV and antibiotic after blood is drawn for which lab test? a- hemoglobin and hematocrit b- white blood cell count c- culture d- platelets
11 c- culture
20 A nurse is providing care for a child who requires intravenous fluid replacement. The child has burns over 32% of the body and weighs 40 lb (18.1 kg). Using the above formula, how much fluid should the nurse administer over the first 8 hours? Record your answer using one decimal place.
1158.4 formula will be given on test answer choice A i think
12 The type of traction in which tape, rubber, or plastic materials are used to indirectly exert pull on a fractured bone is which type of traction? a- Skin traction b- Skeletal traction c- Dunlop traction d- Balanced suspension traction
12 a- Skin traction
13 The nurse is caring for a child with osteomyelitis. Which nursing instruction provides accurate information to the parents? Select all that apply. a- caused by Staphylococcus aureus b- An abscess forms, ruptures, and spreads the infection in the metaphysis of the bone. c- Transmission-based precautions are followed if the wound is draining. d- Antibiotic treatment is started promptly. e- Corticosteroids are the treatment of choice.
13 a- caused by Staphylococcus aureus b- An abscess forms, ruptures, and spreads the infection in the metaphysis of the bone. c- Transmission-based precautions are followed if the wound is draining. d- Antibiotic treatment is started promptly.
14 The nurse caring for a child who has been put into a leg cast must be on the alert for signs of nerve and muscle damage. Which symptom might be an early warning signal that the child has developed compartment syndrome? The child: a- cannot plantarflex his foot. b- feels increasing severe pain. c- has a weak femoral pulse. d- has blue-looking nail beds on the toes.
14 b- feels increasing severe pain.
15 The nurse meets a child with a slipped capital femoral epiphysis. In what type of child does this usually occur? a- Tall, thin girls b- Obese adolescent boys c- Preadolescent girls d- Active school-age children
15 b- Obese adolescent boys
16 A nurse is conducting a physical examination on an 11-year-old boy with Legg-Calvé-Perthes disease. Which assessment finding would be expected? a- Trendelenburg gait b- lordosis c- kyphosis d- loss of strength in ankle dorsiflexion
16 a- Trendelenburg gait
17 The mother of a 9-year-old boy brings the boy to the clinic for an evaluation because he has a fever. The history reveals a recent trauma to the knee. The nurse inspects the joint. Which of the following would lead the nurse to suspect osteomyelitis? Select all that apply. a- edema of the area b- localized tenderness c- pain on palpation d- coolness of the area e- drainage from the area
17 a- edema of the area b- localized tenderness c- pain on palpation
18 A parent calls the pediatric clinic and tells the nurse that the child has developed a large rash. Which question is most important for the nurse to ask the parent? a- "What more can you tell me about the rash?" b- "How long has the child had the rash?" c- "Is the child up to date on immunizations?" d- "Has there been a change in your child's behavior?"
18 a- "What more can you tell me about the rash?"
19 A nurse is providing care to a 3-year-old child hospitalized with second-degree (partial-thickness) and deep partial-thickness burns to the dorsal portion of both legs. The nurse is preparing to change the child's dressings. Which action(s) should the nurse take to elicit the child's cooperation in the dressing change? Select all that apply. a- Have the parent instruct the child to cooperate with the nurse. b- Tell the child to watch television while the dressing is changed. c- Allow the child to decide which leg's dressing to change first. d- Permit the child to choose a method of distraction. e- Encourage the parent to hold the child's hand during the dressing change.
19 c- Allow the child to decide which leg's dressing to change first. d- Permit the child to choose a method of distraction. e- Encourage the parent to hold the child's hand during the dressing change.
2 the intensive care unit nurse is caring for a 7 year old child with a diagnosis of diabetic ketoacidosis who is receiving an insulin infusion. the childs last blood glucose level is 68 mg/dl (3.77 mmol/l). what action should the nurse take first? a- stop the insulin infusion b- perform a neuro assessment c- notify the hcp d- repeat the blood glucose test
2 A- stop the infusion
21 An intensive care nurse has received the above hand-off report from the emergency department nurse. Thirty minutes later, the nurse assesses the child again. Which assessment finding should the nurse investigate further? a- blood pressure 100/56 mm Hg b- temperature 100.5°F (38.1°C) c- O2 saturation 96% (0.96) on 2L d- Pain level 8 out of 10
21 b- temperature 100.5°F (38.1°C)
22 The nurse is caring for a child with severe burns receiving fluid resuscitation and has been monitoring the child closely over the past 2 hours for changes. The child weighs 74 lb (33.6 kg). Changes in which finding(s) listed would lead the nurse to notify the health care provider immediately? Select all that apply. a- temperature b- level of consciousness c- capillary refill d- bowel sounds e- urine output
22 a- temperature b- level of consciousness c- capillary refill e- urine output
23 The nurse is performing an assessment of a 7-year-old child with a spider bite . The child has had worsening pain over the past week and has had a fever with chills for past 24 hours. Which finding(s) prompts the nurse to anticipate treatment for cellulitis? Select all that apply. a- fever b- chills c- erythema d- cool skin around the infected area e- lymphadenopathy
23 a- fever b- chills c- erythema
24 The nurse is caring for a school-aged child with Down syndrome in the home setting. Which assessment finding would alert the nurse to notify the health care provider immediately? a- The child develops freckles on the nasal bridge. b- The child reports neck pain. c- The child's tongue is enlarged. d- The child has cafe-au-lait spots.
24 b- The child reports neck pain.
25 The nurse is providing education to the parents of a child with phenylketonuria (PKU). Which statement(s) demonstrates an understanding of proper nutrition for PKU? Select all that apply. a- "We will avoid providing meat and poultry products." b- "Foods high in phenylalanine are to be avoided." c- "We need to check nutrition labels for aspartame." d- "Egg whites are a good source of protein." e- "A low carbohydrate diet is recommended."
25 a- "We will avoid providing meat and poultry products." b- "Foods high in phenylalanine are to be avoided." c- "We need to check nutrition labels for aspartame."
26 An infant is diagnosed with phenylketonuria (PKU). After teaching the parent about diet for the infant, the nurse determines that teaching was successful when the parent states that the infant should avoid which food(s)? Select all that apply. a- ice cream b- eggs c- fruits d- nuts e- vegetables
26 a- ice cream b- eggs d- nuts
27 A nurse is reviewing the laboratory results for a 6-year-old child during a pediatric clinic visit. Based on the laboratory results, what question is most appropriate for the nurse to ask the parents? WBC 5100/uL RBC 3.2uL Hemoglobin 7.5 g/dL Hematocrit 23.1 Platelets 178 uL a- "What has your child's activity level been like recently?" b- "Has your child been exposed to any illnesses lately?" c- "Have you noticed any unexplained bruising on your child?" d- "Have you noticed any color changes in your child's bowel movements?"
27 a- "What has your child's activity level been like recently?"
28 A client with severe chronic anemia is receiving ongoing transfusion therapy. The nurse frequently assesses the client for what major complication of this therapy? a- toxic iron overload b- fibrin clots c- chronic idiopathic thrombocytic purpura d- vaso-occlusive crisis
28 a- toxic iron overload
29 The nurse treating clients with hemophilia knows that if bleeding is not treated effectively, which body part is at greatest risk for the development of chronic, disabling disease? a- Joints b- Heart c- Liver d- Kidneys
29 a- Joints
3 the nurse is assessing the circulation of the affected limb for a 12 year old client in the emergency department with an ulnar fracture. what should the nurse include in the assessment? SATA a- capillary refill b- skin temperature c- distal pulses d- numbness e- heart rate
3 A- cap refill B- skin temp C- distal pulses
30 A child with sickle cell anemia is scheduled for a splenectomy. After the parents receive teaching about the rationale for this surgery, the nurse determines that the teaching was successful when the parents make which statement? a- "The surgery should help prevent any further crisis episodes." b- "It will help to decrease the amount of anemia." c- "The surgery is being done to cure the condition." d- "It will help to reduce the number of infections the child will get."
30 b- "It will help to decrease the amount of anemia."
31 The nurse is caring for a child with sickle-cell anemia admitted to the pediatric unit. The child reports severe pain and fever. The nurse notes the following laboratory values: white blood cells 18,000/mm3, hemoglobin 6.6 mg/dl (66 g/L), and bilirubin 8 mg/dl (136.83 µmol/L). Which nursing action is priority? a- Initiate intravenous access. b- Administer pain medication. c- Assess the child's temperature. d- Begin an exchange transfusion.
31 a- Initiate intravenous access.
32 The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply. a- The child's pulse is 52 beats per minute. b- The child states that his tongue feels "too big" for his mouth. c- The child has developed hives on his face and trunk. d- The child states he feels like he might "throw up". e- The child states that he feels like he might faint.
32 b- The child states that his tongue feels "too big" for his mouth. c- The child has developed hives on his face and trunk. d- The child states he feels like he might "throw up". e- The child states that he feels like he might fain
33 Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply. a- Impaired skin integrity related to skin barrier function b- Delayed growth related to chronicity of immune disorder c- Ineffective breathing pattern related to allergic bronchospasm d- Anxiety related to continuing or uncontrolled allergic response e- Powerlessness related to difficulty determining a cause of allergy
33 a- Impaired skin integrity related to skin barrier function d- Anxiety related to continuing or uncontrolled allergic response e- Powerlessness related to difficulty determining a cause of allergy
34 A nurse is preparing a presentation for a group of nurses about human immunodeficiency virus infection. Which of the following would the nurse include as the major means of transmission responsible for almost all new HIV infections in the pre-adolescent population? a- mother-to-child transmission b- blood transfusions c- clotting factor administration d- exposure to contaminated body fluid
34 a- mother-to-child transmission this one she didnt clarify sooooo could be blood transfusions- question this
35 Which treatments are common to both systemic lupus erythematosus and juvenile idiopathic arthritis? Select all that apply. A- corticosteroids B- nonsteroidal anti-inflammatory drugs (NSAIDs) C- antimalarials D- antipyretics E- antirheumatics
35 A- corticosteroids B- nonsteroidal anti-inflammatory drugs (NSAIDs)
36 A 9-year-old girl has just been diagnosed with Graves disease. Which symptom should the nurse expect in this child? Select all that apply. A-Exophthalmos (protruding eyes) B- Moist skin C- Nervousness D- Increased basal metabolic rate E- Obesity F- Lethargy
36 A-Exophthalmos (protruding eyes) B- Moist skin C- Nervousness D- Increased basal metabolic rate
38 A school-aged girl is diagnosed as having Cushing syndrome from long-term therapy with oral prednisone. This means that the child: a- appears pale and fatigued. b- has purple striae on her abdomen. c- is excessively tall for her age. d- has hypoglycemia.
38 b- has purple striae on her abdomen.
39 When discussing congenital adrenal hyperplasia with a child's parents, the nurse would advise them that administration of which drug is anticipated? a- Calcium b- Vitamin D c- Hydrocortisone d- Growth hormone
39 c- Hydrocortisone
4 the nurse is preparing to administer maintenance iv fluid for a 2 year old client admitted for dehydration. the clients weight is 14.8 kg. based on this information, what should be the clients daily infusion rate? a- 1240 cc b- 1400 cc c- 52 cc d- 58 cc
4 A- 1240 cc
40 The nurse is caring for 1-month-old girl with thyrotoxicosis. What finding would the nurse expect to assess? a- The child has a strong appetite but fails to thrive. b- Observation reveals lethargy and irritability. c- Skin is cool, dry, and scaly to the touch. d- The child is hypoactive and hypotonic.
40 a- The child has a strong appetite but fails to thrive.
41 The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement? a- Instructing the parents to report adverse reactions to the growth hormone treatment b- Teaching the parents how to administer the desmopressin acetate c- Informing the parents that treatment stops when puberty begins d- Educating the parents to report signs of acute adrenal crisis
41 b- Teaching the parents how to administer the desmopressin acetate
42 The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? a- Hypernatremia b- Bradycardia c- Hypertension d- Hyperkalemia
42 d- Hyperkalemia
43 The nurse is caring for an 11-year-old child who has type 2 diabetes mellitus. The child has been vomiting for 48 hours and the breath has a fruity odor. The nurse notes that respirations are deep and rapid with a temperature of 102°F (38.9°C). Which intervention would be most appropriate? a- Give the child 8 ounces of clear liquid. b- Test the child's urine to detect the presence of ketones. c- Prepare for IV insertion. d- Give the child 25 g of carbohydrates.
43 c- Prepare for IV insertion.
44 A nurse on the pediatric floor is taking care of a 12-year-old child with diabetes insipidus (DI). Which fact would the nurse understand about this disease? a- DI can be managed by short-term treatment with hormone replacement medications. b- DI can cause anorexia if appropriate meals are not planned. c- DI can be managed with vasopressin given as lifelong treatment. d- DI requires strict fluid restrictions until it resolves.
44 c- DI can be managed with vasopressin given as lifelong treatment.
45 A nurse is providing care to a 16-year-old adolescent brought to the emergency department with suspected opioid toxicity. Which finding best supports opioid toxicity? a- blood pressure b- mental status c- respirations d- skin
45 c- respirations
46 A toddler is brought to the emergency department after sustaining a life-threatening injury. During an assessment, the nurse utilizes the Glasgow Coma Scale. The toddler's score is 7. Based on this score, what inference can the nurse make about the child? a- Naloxone administration will be required. b- The child's neurologic system is intact. c- It will be necessary to intubate the child. d- The cardiovascular system is functioning normally.
46 c- It will be necessary to intubate the child.
47 The nurse is assessing a 10-year-old child with tachypnea and increased work of breathing. Which finding demonstrates the child is in the late stages of shock? a- stable blood pressure and cool extremities b- increased heart rate with weak distal pulses c- hypotension and capillary refill time greater than 5 seconds d- cool and clammy extremities
47 c- hypotension and capillary refill time greater than 5 seconds
48 The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply. a- 5% dextrose in water b- normal saline c- lactated Ringer's d- 10% dextrose in water e- 5% lactated Ringer's
48 b- normal saline c- lactated Ringer's
49 The parents of a child diagnosed with varicella are concerned about their other children getting it. The nurse instructs the parents that their child is contagious for how much longer now that the rash has appeared? a- until there are no more new lesions and lesions have crusted over b- for up to 8 days more after the rash initially appears c- for 4 days more now that the rash is present d- until the rash disappears, which is about 3 days
49 a- until there are no more new lesions and lesions have crusted over
5 A nurse is teaching the parents of a child who has been diagnosed with spina bifida. Which statement by the nurse would be the most accurate description of spina bifida? a- "It has little influence on the intellectual and perceptual abilities of the child." b- "It's a simple neurologic defect that's completely corrected surgically within 1 to 2 days after birth." c- "Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately." d- "It's a complex neurologic disability that involves a collaborative health team effort for the entire first year of life."
5 c- "Its presence indicates that many areas of the central nervous system (CNS) may not develop or function adequately."
50 A toddler is brought to the emergency department after ingesting a corrosive substance. Which intervention will the nurse implement as part of the treatment regimen? a- Induce vomiting. b- Administer sodium bicarbonate. c- Perform a respiratory assessment. d- Administer naloxone.
50 c- Perform a respiratory assessment.
6 Which of the following would the nurse expect to find initially in a child with Guillain-Barré syndrome? a- symmetric flaccid weakness b- ataxia c- sensory disturbances d- lower extremity pain
6 d- lower extremity pain
7 The nurse is caring for a 4-year-old boy with mild cerebral palsy. The mother shares with the nurse that she is struggling because all of her other friends have "normal" preschoolers. The mother feels that her friends are often insensitive and occasionally compare their children's milestones to her son. Which of the following would be the best way to address the mother's concerns? a- Provide positive encouragement to the mother. b- Encourage the mother to discuss her feelings. c- Discuss coping mechanisms used in the past. d- Refer the mother to a support group for parents.
7 d- Refer the mother to a support group for parents.
8 The child with a surgically repaired myelomeningocele has a neurogenic bladder. How will the nurse best explain this problem to the parents? a- "Your child cannot properly control holding urine or emptying the bladder. " b- "Old urine remains in the bladder because of poor emptying or overfilling, putting your child at risk for urinary tract infection." c- "Your child dribbles urine because the bladder either is overactive, pushing urine out, or is not active enough, becoming overfilled and causing urine to leak." d- "While your child is young, urine leaking from the bladder will not be a problem because diapering is expected."
8 c- "Your child dribbles urine because the bladder either is overactive, pushing urine out, or is not active enough, becoming overfilled and causing urine to leak."
9 A parent brings an 18-month-old child to the pediatrician's office for a well-child visit. The child has mild cerebral palsy that affects the child's gait. The nurse wants to assess the child's neuromuscular system. What is the best way for the nurse to make that assessment? a- Quietly observe the child at play while interviewing the parent. b- Ask the parent to describe the child's development. c- Get down to the child's level and interact with the child. d- Review the child's health history to determine if the child is on track developmentally.
9 a- Quietly observe the child at play while interviewing the parent.
36 A preschool-age child is being seen for a rash that occurred after the mother applied a sunscreen prior to permitting the child to swim at the beach. For which type of allergic reaction should the nurse prepare teaching materials for the mother? A- autoimmunity B- atopic dermatitis C- contact dermatitis D- delayed hypersensitivity
C- contact dermatitis
