Peds Exam 3
A patient has been diagnosed with Meckel's diverticulum. The nurse knows that this mean the patient is struggling with which of the following? A) An out pouching in the lower part of the small intestine B) Painless lump in the left or right groin C) Occurs when their pyloric is tight D) This occurs when there is bleeding in the GI tract
ANS: A
A preschooler has celiac disease. Her mother is preparing a gluten-free diet. By preparing which breakfast foods would you believe she understands the diet? A) Eggs and orange juice B) Wheat toast and grape jelly C) Cheerios (oat cereal) and skim milk D) Rye toast and peanut butter
ANS: A
A 13 year old female has just been diagnosed cystic fibrosis and ask about the etiology of this disease. Which of the following statements by the nurse explains this illness? A) Occurs because air leaks into space between the lungs and chest walls B) This is a hereditary disease. They are missing a protein that makes secretions thin C) Occurs when their pyloric is cyanotic and doesn't allows food to get to the small intestines D) This is the build up of fat in the liver cells
AND: B
A nurse is calculating the hourly maintenance fluid rate for a child who weighs 25 kg.
ANS: 1600mL/24 hr Rational: the formula is: 100 mL for each of the first 10 kg + 50 mL for each Kg 11-20 + 20 mL for each additional kg
A 14-year-old girl is diagnosed as having scoliosis. When doing scoliosis screening with her, an important observation would be to note A) her posterior spine when she bends forward. B) the angle of the iliac crest when she bends forward. C) the posterior spine when she bends sideways. D) the angle of her lower chest when she sits down.
ANS: A
Which of the following measures would be most effective in aiding bronchodilation in a child with laryngotracheobronchitis? A) Urging the child to continue to take oral fluids B) Administering an oral analgesic C) Teaching the child to take long, slow breaths D) Assisting with racemic epinephrine nebulizer therapy
ANS: D
Which of the following positions is most appropriate following a feeding for an infant who has had surgery for pyloric stenosis? A) Supine with feet elevated B) Fowler's C) Prone D) Right side
ANS: D
You see a 3-year-old boy in an ambulatory setting for localized wheezing on auscultation. Which statement by his mother would be most important to report? A) She gives the child hard candy as an afternoon treat. B) The child has two cousins who have many allergies. C) She likes the child to play by himself for 15 minutes every afternoon. D) The child was eating peanuts yesterday.
ANS: D
A mother comes into the ER and reports that her infant did not pass their meconium in the first 24 hour. Furthermore, the mother says that her child taste salty. Which of the following issues does the nurse assume regarding these symptoms? A) Cystic Fibrosis B) Kwashiorkor C) Hepatitis D) Pneumothorax
ANS: A
Following surgery for pyloric stenosis, an infant should be well-bubbled following feedings primarily to prevent A) pressure on the incision line. B) abdominal discomfort. C) contaminating flatulence. D) intestinal obstruction.
ANS: A
Signs of increased intracranial pressure for which you would assess are A) increased temperature, decreased respiratory rate. B) numbness of fingers, decreased temperature. C) increased pulse rate, decreased blood pressure. D) decreased level of consciousness, increased respiratory rate.
ANS: A
A patient is diagnosed with pyloric stenosis. The nurse recognizes which of the following are symptoms of pyloric stenosis? (Select all that apply) A) Projectile vomiting B) Current Jelly stool C) Sour-smelling vomitus without bile D) Ascites E) Metabolic Alkalosis
ANS: A,C,E
A 12 year old patient has recently been diagnosed with asthma. Which of the following statements by the nurse would explain the etiology of asthma? A) it is due to a viral infection that attacks the respiratory system B) It is a hyper responsiveness to triggers that cause inflamation in the air way C) It is an infection that inflames the air sacs in one or both lungs D) It is a hereditary disease that affects the lungs and digestive system
ANS: B
A patient has been diagnosed with Kwashiorkor. A nurse translates this as meaning which of the following? A) This patient got this by taking too many NSAIDS B) There is a lack of protein in this patients blood C) The bowels are not moving as frequently as they should D) The intestines of this patient have become twisted
ANS: B
A 2-year-old is diagnosed with osteomyelitis. Which of the following would you anticipate as a primary nursing intervention to include in the child's plan of care? A) Maintaining intravenous antibiotic therapy B) Keeping the child quiet while in skeletal traction C) Restricting fluid to encourage red cell production D) Assisting the child with crutch walking
ANS: A
A 2-month-old boy is admitted to the emergency room with severe diarrhea. Intravenous fluid is prescribed for him. Before adding potassium to this solution, which assessment would you record? A) He has voided. B) He cries with tears. C) His hands are restrained. D) He "attunes" to a music box.
ANS: A
A 4-year-old girl has been admitted to the hospital with a diagnosis of pneumococcal pneumonia. Her parents are extremely distraught over her condition and the fact she has not wanted to eat anything for the past 2 days. Which nursing approach would be most important to take to help alleviate the high anxiety level of these parents? A) Allow the parents to remain with the child as much as possible. B) Encourage the parents to return home and get some rest. C) Tell the parents that their child is receiving the best care possible. D) Avoid telling the parents unnecessary facts regarding her prognosis.
ANS: A
An adolescent boy is diagnosed with hepatitis A. Which problem should be considered when planning care? A) He will become fatigued easily. B) He will be very irritable and perhaps require sedation. C) Hypothermia is common. D) His urine will be dark and infectious.
ANS: A
The acid-base imbalance that tends to occur with diarrhea is A) metabolic acidosis. B) metabolic alkalosis. C) high serum pH. D) normal serum pH.
ANS: A
What measure at home could help a child with an upper respiratory infection breathe more easily? A) Increasing room humidity B) Limiting fluid intake C) Enforcing strict bed rest D) Playing "rapid breathing" games
ANS: A
A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect?(Select all that apply.) A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects D. Falling to the floorE. Having a piercing cry
ANS: A,B,C
A nurse is caring for an adolescent who has sustained a closed head injury. Which of the following areclinical manifestations of increased intracranial pressure (ICP)? (Select all that apply.) A. Report of headache B. Alteration in pupillary response C. Increased motor response D. Increased sleeping E. Increased sensory respons
ANS: A,B,D
A 12 year old patient has been vomiting for 2 days. The nurse can assume that this patient has which of the following acid- base balance? A) Respiratory acidosis B) Metabolic Alkalosis C) Respiratory Alkalosis D) Metabolic Acidosis
ANS: B
A 2-year-old boy is seen for acute laryngotracheobronchitis. Which of the following observations would lead you to suspect that airway occlusion is occurring? A) He states he is tired and wants to sleep. B) His respiratory rate is gradually increasing. C) His cough is becoming harsher. D) His nasal discharge is increasing.
ANS: B
A 6 week old patient has been diagnosed with obstruction of the bile ducts. Which of the following issues would the nurse be most concerned about regarding this disease? A) Large fatty stools B) The lack of absorption of fat and fat soluble vitamins C) Fluid around the peritoneum D) Pain and tenderness at McBurney's point
ANS: B
A 7-year-old is seen with pauciarticular juvenile arthritis. She notices extreme pain when she wakes in the morning. The best advice you can give her parents would be to A) have her take 325 mg of aspirin immediately on arising. B) encourage her to take a warm bath each morning before school. C) have her do isotonic exercises until the pain is gone. D) encourage her to remain in bed until the pain is gone.
ANS: B
A doctor explains to the family that their child's intestines has become twisted creating a blockage. The nurse recognizes this as being connected to which of the following diseases? A) Intussusception B) Volvulus with malrotation C) Necrotizing enterocolitis D) Short bowel syndrome
ANS: B
A nurse is assessing a infant. The mother expresses concerns that the child is not latching well. Upon assessment the nurse notices that the child is struggling to breathe out of their nose. Which of the following respiratory issues can the nurse assume this patient has? A) Acute Nasopharyngitis B) Choanal atresia C) Pharyngitis D) Retropharyngeal abscess
ANS: B
A nurse is assessing a neonate. Upon assessment the nurses hears stridor and intercontinental retractions. The nurse assumes this child has which of the following respiratory disorders? A) Laryngitis B) Congenital Laryngomalacia C) Epistaxis D) Pharyngitis
ANS: B
A nurse is assessing a patients chart an sees that they have an infection that has lead to swelling inside the trachea. Upon assessment the nurse notices a "Barking cough" as well as a slight fever and drooling on the right side of the child's mouth. Which of the respiratory disorders would this nurse assume this patient has based on these symptoms? A) Congenital Tracheomalacia B) Laryngotracheobronchitis (Croup) C) Bronchiolitis D) Acute Nasopharyngitis
ANS: B
A nurse recognizes which of the following patients as being at risk for Necrotizing enterocolitis? A) A patient in pre school at age 3 B) A infant who has had an extended stay in the hospital C) A 4 year old female who has been vomiting for 2 days D) An active toddler
ANS: B
A school-aged child develops a nosebleed (epistaxis). Which of the following would you do? A) Elevate the head of the bed slightly and apply pressure to the forehead. B) Sit the child upright and apply pressure to the sides of the nose. C) Turn the child's head to the side and press on the nasal ridge. D) Keep the child flat and apply pressure to the bridge of the nose.
ANS: B
A school-aged girl with Crohn's disease will receive total parenteral nutrition (TPN) for the next 6 weeks. Which of the following would best help her accept this? A) Help her ambulate with the bottles. B) Provide some time to talk to her several times a day. C) Help her give the bottles nicknames and personalities. D) Explain that TPN substitutes for normal food.
ANS: B
An infant has surgery to relieve pyloric stenosis. Which of the following nursing diagnoses would apply in the immediate postoperative period? A) Excess fluid volume related to increased fluid intake prescribed postoperatively B) Risk for infection of incision line, related to disruption of skin barrier during surgery C) Ineffective tissue perfusion related to pressure on heart chambers D) Anxiety related to new feeding method used postoperatively
ANS: B
To help meet the nutritional needs of a child with pneumonia, you would A) encourage reducing fluid intake. B) offer small, frequent feedings. C) encourage intake of three large meals daily. D) suggest feeding by enteral tube feedings.
ANS: B
Wheezing in children is best heard A) with the child supine. B) as the child exhales. C) as the child cries. D) without a stethoscope.
ANS: B
When providing diaper care to an infant after pyloric stenosis surgery, which approach is indicated? A) Diapers should be folded so that the incision line is well covered to prevent infection. B) Diapers should be folded so that the incision line does not become contaminated. C) Diapers should not be used. D) Sterile diapers should be used.
ANS: B
Which of the follow education about the treatment of an infant with Congenital Tracheomalacia, should the nurse provide to the parents? A) Your child will be on this treatment of antibiotics for 6 weeks B) We will provide supportive treatment until you child is old enough for surgery C) Teach them how to administer the epinephrine D) This child needs to be intubated imminently
ANS: B
Which of the following nursing diagnoses would be most appropriate for a child with pneumonia during the acute phase of illness? A) Excess fluid volume related to excessive mucus production B) Activity intolerance related to poor oxygen-carbon dioxide exchange C) Altered urinary elimination related to hypervolemic state D) Pain related to swelling of abdominal lymph nodes
ANS: B
You care for a 12-year-old girl with Crohn's disease. A primary assessment you would want to make when caring for her would be to note if A) lung sounds are clear. B) she has a temperature. C) her joints are not swollen. D) she has a headache.
ANS: B
You meet a child with a slipped 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-aged children
ANS: B
A 3 year old male patient was admitted to the ER the parents of this patient said that the child woke up from a nap with a high fever, and drooling. After a few more minutes the child completely stopped breathing and thats when he was rushed to the ER. The nurse would associate these symptoms with which of the following diseases? A) Bronchial obstruction B) Epiglottitis C) Bronchiolitis D) Bronchopulmonary dysplasia
ANS: B Rational This is an emergency where a bacteria causes inflammation in the epiglottis causing a "lid" to form over the wind pip
A patient has been diagnosed with intussuscption. Which of the following complications of this Intestinal disorder should the nurse assess for? A) Peritonitis B) Sepsis from a perforation C) Lack of absorption of vitamins D) loss of memory
ANS: B Rational: Intussuscption occurs when one segment telescopes on itself and causes a intestinal blockage
A nurse reads on a 16 month old patients chart that they have acute nasopharyngitis. A nurse would recognize this as meaning which if the following? A) The patient has an obstruction in the nasal pharynx B) This patient has the common cold C) This patient has inflammation in the pharynx D) This patient has a collection of pus in the back of the throat
ANS: B Rational: A: Choanal atresia C: Pharyngitis D: Retropharyngeal abscess
A nurse would most likely assess which of the following patients for primary atelectasis? A) A 30 year old male with 3 broken ribs B)A infant born at 24 weeks C) A 12 year old patient with a hernia that is pushing against the lungs D) A 6 year old who aspirated while in the pool
ANS: B Rational: Primary occurs in preemies And secondary occurs because of aspiration, disease, or obstruction
A nurse is assessing a child. Which of the following are clinical manifestations of Legg-Calve-Perthes disease?(Select all that apply.) A. Longer affected leg B. Hip stiffness C. Intense pain D. Limited ROM E. Limp with walking
ANS: B,D,E
A 4-year-old girl has acute nasopharyngitis (a common cold). Which of the following measures would you want to teach her parents? A) Healthy children rarely have more than one cold per year. B) Typically the child will pull her ear when a cold is present. C) A cough that accompanies a cold should rarely be suppressed. D) An antibiotic is prescribed for children under 5 years of age.
ANS: C
A 6 year old patient comes into the ER with a Epistaxis. Which of the following interventions should the nurse Suggest? A) 6 weeks of antibiotics B) Give child honey C) Have them pinch their nose and lean forward D) Give child tylenol
ANS: C
A nurse is assessing a 11 year old patient who is dehydrated. The nurse understands that which of the following types of dehydration is the most common in children? A) Hypertonic B) Hypotonic C) Isotonic
ANS: C
A nurse is caring for a school-age client who possibly has Reye syndrome. Which of the following is arisk factor for developing Reye syndrome? A. Recent history of infectious cystitis caused by Candida B. Recent history of bacterial otitis media C. Recent episode of gastroenteritis D. Recent episode of Haemophilus influenzae meningitis
ANS: C
If an adolescent has hepatitis B, what would be an important nursing action? A) Conscientious collection of stool for ova and parasites B) Strict calculation of caloric and vitamin B intake C) Strict enforcement of standard precautions D) Close observation to detect cerebral hallucinations
ANS: C
When helping parents plan care for a child with Legg-Calvé-Perthes disease, you would teach them that the usual therapy for children with this disorder is A) surgery with supporting rods. B) passive range-of-motion exercises TID. C) a nonweight-bearing period. D) exercise to increase muscle strength of the knee joint.
ANS: C
Which of the following assessments suggests that an infant with diarrhea is severely dehydrated? A) Moist and flushed skin, fontanelles depressed B) Salty saliva and tears with crying C) Elevated hematocrit and depressed eye globes D) Low specific gravity of urine, moist skin
ANS: C
You care for a 4-year-old with meningitis. A primary nursing goal would be to A) increase stimulation opportunities to prevent coma. B) provide an opportunity for therapeutic play. C) reduce the pain related to nuchal rigidity. D) inspect the teeth for obvious caries.
ANS: C
A nurse recognizes which of the following patients to be at the most risk for Bronchopulmonary dysplasia (BPD) ? A) 4 year old patient with fractured rips B) 11 year old child who has a hypersensitivity to grass C) A neonate who has been in the NICU for a long time D) A 2 year-old on bed rest
ANS: C Rational: Bronchopulmonary dysplasia can cause lung scaring. Assess for pulmonary disease with these infants
A 6-month-old boy is diagnosed with pyloric stenosis. When you take a health history from his mother, which symptom would you expect to hear her describe? A) Refusal to eat B) Vomiting about 2 hours after feeding C) Chronic diarrhea D) Vomiting immediately after feeding
ANS: D
A nurse is caring for a 4-month-old infant who has meningitis. Which of the following findings isassociated with this diagnosis? A. Depressed anterior fontanel B. Constipation C. Presence of the rooting reflex D. High-pitched cry
ANS: D
A nurse is caring for a child. Which of the following diagnostic procedure should the nurse prepare thechild for to determine if the child has Legg-Calve-Perthes disease? A. Bone biopsy B. Genetic testing C. MRI D. Radiographs
ANS: D
An 8-month-old boy is diagnosed as having cerebral palsy. Which finding would make you suspect that he has this? A) He cries when held in a ventral suspension position. B) He holds his back very straight when in a sitting position. C) He bears weight on both feet when held upright. D) He has a strong Moro reflex when startled.
ANS: D
The physician of a child with juvenile arthritis asks you to telephone the school to arrange a new activity program for her. A change you would anticipate arranging for her is to A) be excused from all extracurricular activities. B) begin school earlier in the day than other children. C) be excused from all swimming classes. D) modify her physical program.
ANS: D
