PEDS Exam 3 - Review Questions

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When developing a teaching plan to prevent urinary tract infection, which of the following should be included? (Select all that apply.) 1. Wearing underwear made of synthetic material such as nylon 2. Maintaining adequate fluid intake 3. Keeping urine alkaline by avoiding acidic beverages 4. Avoiding urination before and after intercourse 5. Avoiding bubble baths and tight clothing 6. Emptying bladder with each urination

Answer: 2,5,6 Fluid intake helps dilute urine and minimize infection potential, bubble baths and tight clothing may act as irritants, and emptying the bladder fully with each urination prevents stasis. Children and teens should wear cotton underwear, keep their urine acidic, and void before and after intercourse (if sexually active).

The nurse is assisting a primary health care provider with an assessment of a child with a diagnosis of suspected appendicitis. In assessing the intensity and progression of the pain, the primary health care provider palpates the child at McBurney's point. What response does the nurse expect the child to have during the examination? 1.Pain in the upper right side 2.Pain when extending the leg 3.Pain when the right thigh is drawn up 4.Pain in the lower right side between the umbilicus and the iliac crest

Answer: 4 Pain in the lower right side, halfway between the umbilicus and the crest of the ileum at McBurney's point is the best known symptom of appendicitis. Extending the leg causes pain but is not the McBurney's point. The client may rest with the right thigh drawn up to relieve pain.

Once a bone marrow aspiration results positive, which exam will check for CNS involvement? A. Lumbar Puncture B. PET C. CT D. MRI

Answer: A A bone marrow aspiration is a procedure used to diagnose and monitor certain blood disorders and cancers. If the results of a bone marrow aspiration are positive, meaning abnormal cells or cancerous cells are found, it indicates the possibility of systemic involvement. Since the question specifically asks about checking for central nervous system (CNS) involvement, a lumbar puncture would be the most appropriate exam. A lumbar puncture involves collecting cerebrospinal fluid (CSF) from the spinal canal, which can be analyzed for the presence of abnormal cells or other indicators of CNS involvement.

A school age child who has suspected osteo sarcoma would have which elevated lab value? A. Alkaline Phosphate B. Blood Glucose C. Hematocrit D. Serum Potasium

Answer: A Alkaline phosphate is an enzyme found in the liver, bones, and other tissues. An elevated level of alkaline phosphate in the blood can indicate bone or liver disease. In the case of a school-age child with suspected osteosarcoma, which is a type of bone cancer, an elevated level of alkaline phosphate may be observed. This is because osteosarcoma can cause the destruction of bone tissue, leading to the release of alkaline phosphate into the bloodstream. Therefore, an elevated lab value of alkaline phosphate would be expected in a child with suspected osteosarcoma.

For a positive diagnosis, bone marrow aspiration must be performed on what site? A.Iliac Spine B.Lumbar Spine C.Femur D.Zygomatic bone

Answer: A Bone marrow aspiration is a procedure in which a small sample of bone marrow is taken for diagnostic purposes. The iliac spine, also known as the iliac crest, is a common site for bone marrow aspiration. It is easily accessible and provides a good representation of the bone marrow. The lumbar spine and femur are not typically used for bone marrow aspiration. The zygomatic bone, also known as the cheekbone, is not related to bone marrow aspiration.

Which of the following is a common bone tumor that infiltrates the soft tissue around the bone. A. Ewing's sarcoma B.Osteosarcoma C.Wilm's tumor D.Non-Hodgkin's lymphoma

Answer: A Ewing's sarcoma is a common bone tumor that infiltrates the soft tissue around the bone. It is a type of cancer that primarily affects children and young adults. Ewing's sarcoma is characterized by the abnormal growth of cells in the bones or soft tissues, leading to the formation of tumors. These tumors often infiltrate the surrounding soft tissue, causing pain, swelling, and limited mobility. Early diagnosis and treatment are crucial for managing Ewing's sarcoma and improving patient outcomes.

Occurs when large numbers of tumor cells are rapidly destroyed and released into blood stream faster than the body can eliminate: A. Tumor Lysis Syndrome B. Superior Vena Cava Syndrome C. Hypercalcemia D. Spinal Chord Compression

Answer: A Tumor lysis syndrome occurs when a large number of tumor cells are destroyed and released into the bloodstream at a faster rate than the body can eliminate them. This can lead to the release of various substances, such as potassium, phosphate, and uric acid, which can overwhelm the body's normal elimination mechanisms. This can result in electrolyte imbalances, kidney dysfunction, and other complications.

When preparing a patient of surgical interventions r/t Osteosarcoma, what should be included in the patient/family teaching? (select all that apply) A.Exercise to strengthen upper arms B.Prepare for extensive physical therapy C.Discuss the importance for the patient to grieve the loss of the limb D.Introduce patient to support groups E.Focus on what the patient cannot do

Answer: A., B., C., D. The patient/family teaching for a patient undergoing surgical interventions for Osteosarcoma should include the following: exercise to strengthen upper arms, preparing for extensive physical therapy, discussing the importance for the patient to grieve the loss of the limb, and introducing the patient to support groups. These interventions are important for the patient's physical recovery, emotional well-being, and adjustment to the changes in their body and lifestyle. Focusing on what the patient cannot do may have a negative impact on their mental health and overall recovery, so it should not be included in the teaching.

Select all that apply. When performing mouth care on a Chemo Patient, the nurse should not use: A. Malox/Benadryl/HO B. Listerine C. Toothbrush D. Dental floss E. Cotton Swab F. Viscous Lidocaine

Answer: B., C., D. When performing mouth care on a Chemo patient, the nurse should not use Listerine, toothbrush, or dental floss. Listerine contains alcohol which can irritate and dry out the mucous membranes in the mouth. A toothbrush and dental floss can cause trauma to the gums and increase the risk of bleeding and infection. It is important to use gentle methods of mouth care such as a soft toothbrush, saline solution, or a mouthwash specifically designed for chemotherapy patients.

A young child who was diagnosed with Hirschsprung's disease has a fever and watery explosive diarrhea. Which of the following would the nurse do first? 1. Administer an anti-diarrheal 2. Notify the physician immediately 3. Nothing-these findings are normal in Hirschsprung's 4. Monitor the child every 30 min

Answer: 2 For the child with Hirschsprung's disease, fever and explosive diarrhea indicate enterocolitis, a life-threatening situation. Therefore, the physician should be notified directly.

The nurse is performing an assessment on a child admitted to the hospital with a probable diagnosis of nephrotic syndrome. Which assessment findings should the nurse expect to observe? Select all that apply. 1. Pallor 2. Edema 3. Anorexia 4. Proteinuria 5. Weight loss 6. Decreased serum lipids

Answer: 1,2,3,4 Nephrotic syndrome is a kidney disorder characterized by massive proteinuria, hypoalbuminemia, edema, elevated serum lipids, anorexia, and pallor. The child gains weight.

The nurse is reviewing the record of a child with a diagnosis of pyloric stenosis. Which data should the nurse expect to note as having been documented in the child's record? 1.Watery diarrhea 2.Projectile vomiting 3.Increased urine output 4.Vomiting large amounts of bile

Answer: 2 Signs and symptoms of pyloric stenosis include projectile, nonbilious vomiting; irritability; hunger and crying; constipation; and signs of dehydration, including a decrease in urine output.

The father of a child with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. The nurse knows that: 1. The antibiotic therapy the child is receiving can influence increases in blood pressure. 2. The child can develop hypotension at any time because of the damage to the kidneys. 3. A child with this illness can have sudden increases in blood pressure without warning. 4. Blood pressure must be maintained within normal limits to make sure that the kidneys do not stop working.

Answer:3 1.Antibiotics do not cause increases in blood pressure unless an allergic reaction occurs 2.The damage to the kidneys causes the blood pressure to increase drastically. 3.The illness can cause spikes in blood pressure without warning, causing concern about blood flow to the major organs of the body. 4.The goal is to maintain the blood pressure at a normal range, but the kidneys will not stop working if the blood pressure changes.

What is the peak onset for Acute Lymphocytic Leukemia? A. 3-5 years B.10-12 years C. 3-5 months D. 12-14 years

Answer: A The peak onset for Acute Lymphocytic Leukemia is typically between 3-5 years of age. This means that the highest number of cases of this type of leukemia occur in children within this age range. It is important to note that while this is the peak onset, Acute Lymphocytic Leukemia can still occur in individuals of other age groups as well.


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