Peds - exam 3
The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching?
"I have to stay on strict bed rest for 3 days."
The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching?
"My child should not eat bananas or kiwis"
A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response?
"Your child must lie quietly; sometimes a mild sedative is administered before the procedure."
The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct?
"you may need to increase the caloric density of your infants formula."
The Heimlich maneuver is recommended for airway obstruction in children older than _____ year(s).
1
A nurse is admitting an infant with asthma. What usually triggers asthma in infants?
A viral infection
Nursing interventions for the child after a cardiac catheterization should include which actions? (Select all that apply.)
Assess the affected extremity for temperature and color. Maintain a patent peripheral intravenous catheter until discharge
The nurse is admitting a school-age child with suspected Guillain-Barré syndrome (GBS). Which is a priority in the care for this child?
Assessing respiratory efforts
A nurse is caring for a school-age child with left unilateral pneumonia and pleural effusion. A chest tube has been inserted to promote continuous closed chest drainage. Which interventions should the nurse implement when caring for this child? (Select all that apply.)
Assessing the chest tube and drainage device for correct settings Administering prescribed doses of analgesia Monitoring for need of supplemental oxygen
Which defect results in increased pulmonary blood flow?
Atrial septal defect
Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include which action?
Avoid any latex products
An adolescent with juvenile idiopathic arthritis (JIA) is prescribed abatacept (Orencia). Which should the nurse teach the adolescent regarding this medication? (Select all that apply.)
Avoid receiving live immunizations while taking the medication. Before beginning this medication, a tuberculin screening test will be done.
The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)
Decreased urinary output Sweating (inappropriate) Fatigue
Using knowledge of child development, which is the best approach when preparing a toddler for a procedure?
Demonstrate the procedure on a doll
In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind?
Diet should be high in carbs and protein
Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. Which describes their action?
Dilate the bronchioles
The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which intervention should be included in the child's care? (Select all that apply.)
Encourage the child to drink 8 ounces of formula every 4 hours. Cluster care to encourage adequate rest. Place on noninvasive oxygen monitoring.
The nurse is caring for a 12-year-old child with a left leg below-the-knee amputation (BKA). The child had the surgery 1 week ago. Which intervention should the nurse plan to implement for this child?
Encourage the child to use an overhead bed trapeze when repositioning
A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, the nurse should prepare which medication for immediate administration?
Epi
Which type of croup is always considered a medical emergency?
Epiglottitis
The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy?
Extensor reflex at 7 months of age
The nurse is preparing a 12-year-old girl for a bone marrow aspiration. The girl tells the nurse she wants her mother with her "like before." What is the most appropriate nursing action?
Grant her request
Which is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures?
Heart failure
The nurse is conducting a staff in-service on common problems associated with myelomeningocele. Which common problem is associated with this defect?
Hydrocephalus
The nurse is planning a staff in-service on childhood spastic cerebral palsy. What characterizes spastic cerebral palsy?
Hypertonicity and poor control of posture, balance, and coordinated motion
Parents of a child with cystic fibrosis ask the nurse about genetic implications of the disorder. Which statement, made by the nurse, expresses accurately the genetic implications?
If it is present in a child, both parents are carries of this defective gene.
The nurse is caring for a child after heart surgery. What should the nurse do if evidence of cardiac tamponade is found?
Immediately report this to physician
Which would the nurse teach an adolescent is a complication of corticosteroids used in the treatment of juvenile idiopathic arthritis?
Immune Suppression
The parents of a child with cerebral palsy ask the nurse whether any drugs can decrease their child's spasticity. The nurse's response should be based on which statement?
Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available.
The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). Which is a beneficial effect of administering digoxin (Lanoxin)?
It decreases edema
Which should the nurse consider when preparing a school-age child and the family for heart surgery?
Let the child hear the sound of an ECG monitor
Which assessment findings should the nurse note in a school-age child with Duchenne muscular dystrophy (DMD)? (Select all that apply.)
Lordosis Gower sign Waddling gait
An adolescent is in traction. The purpose of the traction is to fatigue the muscle and reduce muscle spasm so that the bones can be realigned. Nursing actions should include which of the following?
Maintain continious traction to prevent muscle from contracting
A nurse is teaching nursing students about clinical manifestations of cystic fibrosis (CF). Which is/are the earliest recognizable clinical manifestation(s) of CF?
Meconium Ileus
The nurse is caring for a child with carbon monoxide poisoning associated with smoke inhalation. Which is essential in this child's care?
Monitor arterial blood gases
Which of the following medications is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)?
NSAIDs
The nurse is teaching a group of nursing students about newborns born with the congenital defect of myelomeningocele. Which common problem is associated with this defect?
Neurogenic bladder
Which of the following types of traction uses skin traction on the lower leg and a padded sling under the knee?
Russell
The nurse is caring for a preschool child with a cast applied recently for a fractured tibia. Which assessment findings indicate possible compartment syndrome? (Select all that apply.)
Severe pain not relieved by analgesics Tingling of extremity Inability to move extremity
Which drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child?
Short-acting B2 agonists
Cardiopulmonary resuscitation (CPR) is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible?
Carotid
The nurse is caring for a school-age child who has had a cardiac catheterization. The child tells the nurse that the bandage is "too wet." The nurse finds the bandage and bed soaked with blood. What is the priority nursing action?
Apply direct pressure above catheterization site
Which action by the school nurse is important in the prevention of rheumatic fever?
Refer children with sore throats for throat culture
Seventy-two hours after cardiac surgery, a young child has a temperature of 101° F. Which action should the nurse take?
Report findings to physican
The nurse is preparing an adolescent with scoliosis for a spinal surgical instrumentation placement procedure. Which consideration should the nurse include?
A chest tube anf urinary catheter may be required
A young girl has just injured her ankle at school. In addition to calling the child's parents, the most appropriate, immediate action by the school nurse is which of the following?
Apply ice
José is a 4-year-old child scheduled for a cardiac catheterization. What should be included in preoperative teaching?
Adapted to his level of development so that he can understand
Which is an important nursing consideration when chest tubes will be removed from a child?
Administer analgesics before the procedure
Which is an important nursing consideration when suctioning a young child who has had heart surgery?
Administer supplemental oxygen before and after suctioning
The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
Administering penicillin
The nurse is doing a pre-hospitalization orientation for a 7-year-old child who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that she will not be able to talk because of an endotracheal tube but that she will be able to talk when it is removed. This explanation is:
An appropriate part of the childs preparation
Which type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy?
Anaphylactic
A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered?
Before chest physiotherapy
Kristin, age 10 years, sustained a fracture in the epiphyseal plate of her right fibula when she fell out of a tree. When discussing this injury with her parents, the nurse should consider which of the following?
Bone growth can be affected by this type of fracture
A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of which diagnosis?
Bronchitis
Which of the following is a type of skin traction with legs in an extended position?
Buck extension
The nurse is assessing a child after a cardiac catheterization. Which complication should the nurse be assessing for?
Cardiac arrhythmia
Which is a common, serious complication of rheumatic fever?
Cardiac vavle damage
An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which interventions? (Select all that apply.)
Cluster care to conserve energy Administration of antibiotics
The nurse is assessing a child with acute epiglottitis. Examining the child's throat by using a tongue depressor might precipitate which symptom or condition?
Complete obstruction
A school-age child has been admitted with an acute asthma episode. The child is receiving oxygen by nasal prongs at 2 liters. How often should the nurse plan to monitor the child's pulse oximetry status?
Continous
The nurse is conducting discharge teaching to parents of a preschool child with myelomeningocele, repaired at birth, being discharged from the hospital after a urinary tract infection (UTI). Which should the nurse include in the discharge instructions related to management of the child's genitourinary function? (Select all that apply.)
Continue to perform the clean intermittent catheterizations (CIC) at home. Administer the oxybutynin chloride (Ditropan) as prescribed. Monitor for signs of a recurrent urinary tract infection.
The nurse is teaching a mother how to perform chest physical therapy and postural drainage on her 3-year-old child, who has cystic fibrosis. How should the nurse instruct the mother?
Cover the skin with a shirt or gown before percussing
The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which intervention should the nurse plan for the care of the myelomeningocele sac?
Covered with a sterile, moist, non adherent dressing
A child is admitted to the hospital with asthma. Which assessment findings support this diagnosis?
Nonproductive cough, wheezing
Which should the nurse expect to find in the cerebral spinal fluid (CSF) results of a child with Guillain-Barré syndrome (GBS)? (Select all that apply
Normal glucose Fewer than 10 white blood cells (WBCs/mm3)
Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included?
Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal.
Which is a clinical manifestation of the systemic venous congestion that can occur with heart failure?
Peripheral edema
A chest radiograph film is ordered for a child with suspected cardiac problems. Thechild's parent asks the nurse, "What will the radiograph show about the heart?" What knowledge about the x-ray should the nurse include in the response to the parents
Permanent record of heart size and configuration
The nurse is conducting a staff in-service on childhood-acquired heart diseases. Which is a major clinical manifestation of rheumatic fever?
Polyarthritis
The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? (Select all that apply.)
Positive Ortolani click Unequal gluteal folds
As part of the treatment for heart failure, the child takes the diuretic furosemide (Lasix). As part of teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in which nutrient?
Potassium
What does the surgical closure of the ductus arteriosus do?
Prevent the return of oxygenated blood to the lungs
The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease?
Progressive weakness and wasting of skeletal muscle
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. Which describes the most appropriate way to position and feed this neonate?
Prone, head turned to the side, and nipple-fed
The nurse is conducting a staff in-service on congenital heart defects. Which structural defect constitutes tetralogy of Fallot?
Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular Hypertrophy
It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because which disease or assessment findings may develop?
Slowed growth
Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?
Sweat chloride test
A child is being admitted to the hospital to be tested for cystic fibrosis (CF). Which tests should the nurse expect?
Sweat chloride test, stool for fat, chest radiograph films
Parents of two school-age children with asthma ask the nurse, "What sports can our children participate in?" The nurse should recommend which sport?
Swimming
Which would the nurse teach a patient when NSAID's are prescribed for treating juvenile idiopathic arthritis?
Take with food
The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant? (Select all that apply.)
Temperature instability Irritability Need Lethargy
What should be administered to a child with tetanus?
Tetanus immunoglobulin therapy.
A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow?
Tetralogy of Fallot
Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurse's reply should be based on which statement?
The child needs opportunities to play with peers
Which should the nurse consider when having consent forms signed for surgery and procedures on children?
The risks and benefits of a procedure are part of the consent process.
A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma?
There is a heightened airway reactivity
Effective lone-rescuer CPR on a 5-year-old child should include
Two breaths to every 30 chest compressions
Immobilization causes which of the following effects on the cardiovascular system?
Venous stasis
The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborn's defect?
Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves
A 5-year-old child is brought the Emergency Department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions? (Select all that apply.)
Vital signs Medical history Assessement of breath sounds Emergency airway equipment readily available
A child with cystic fibrosis (CF) is receiving recombinant human deoxyribonuclease (DNase). Which is an adverse effect of this medication?
Voice alters
Russell traction
uses skin traction on the lower leg and a padded sling under the knee. The combination of longitudinal and perpendicular traction allows realignment of the lower extremity and immobilizes the hips and knees in a flexed position.
Which explanation regarding cardiac catheterization is appropriate for a preschool Child?
When the procedure is done, you will have to keep your leg straight for at least 4 hours
An infant with an unrepaired tetralogy of Fallot defect is becoming extremely cyanotic during a routine blood draw. Which interventions should the nurse implement? Place in order from the highest-priority intervention to the lowest-priority intervention. Provide the answer using lowercase letters separated by commas
a. Place the infant in knee-chest position. b. Administer 100% oxygen by blow-by. c. Give morphine subcutaneously or by an existing intravenous line. d. Remain calm.
The nurse is planning a staff in-service on childhood spastic cerebral palsy. Spastic cerebral palsy is characterized by:
hypertonicity and poor control of posture, balance, and coordinated motion
Dunlop traction
is an upper-extremity traction used for fractures of the humerus.
Bryant traction
is skin traction with the legs flexed at a 90-degree angle at the hip
A nurse is caring for a child in acute respiratory failure. Which blood gas analysis indicates the child is still in respiratory acidosis?
pH 7.32, CO2 50
Buck extension
traction is a type of skin traction with the legs in an extended position. It is used primarily for short-term immobilization, preoperatively with dislocated hips, for correcting contractures, or for bone deformities such as Legg-Calvé-Perthes disease.
