PEDS EXAM #4

Nursing care of a child with a fractured extremity to whom there is suspected compartment syndrome includes which of the following (SATA)

Edema Numbness Weak pulse (or no pulse)

A nurse is creating a plan of care for a child who has sickle cell anemia. Which of the following interventions should the nurse include in the plan?

Observe for indications of hypokalemia.

A nurse is caring for a child on the oncology unit. The child's parents are asking the nurse about the cancer diagnosis. Which of the following information should the nurse provide the parents about the most common malignant renal and intra-abdominal tumor of childhood?

Wilm's tumor

The nurse is caring for a child with leukemia. The nurse should be aware that children being treated for leukemia may experience which of the following complications? Select all that apply. 1. Anemia. 2. Infection. 3. Bleeding tendencies. 4. Bone deformities. 5. Polycythemia.

1. Anemia. 2. Infection. 3. Bleeding tendencies.

Which of the following activities should a nurse suggest for a client diagnosed with hemophilia? Select all that apply. 1. Swimming. 2. Golf. 3. Hiking. 4. Fishing. 5. Soccer.

1. Swimming. 2. Golf. 3. Hiking. 4. Fishing.

A nurse is teaching a parent of a child with hemophilia how to control a minor bleeding episode. Which of the following statements by the parent indicates a need for further teaching?

"I will apply heat"

A school nurse identifies that a child has pediculosis capitis and educates the child's parents about the condition. Which of the following statements by the parents indicates an understanding of the teaching? A. "All recently used clothing, bedding, and towels must be washed in hot water." B. "My child must be free from nits before returning to school." C. "I will treat all the family members to be on the safe side." D. "Toys that can't be dry cleaned or washed must be thrown out."

A. "All recently used clothing, bedding, and towels must be washed in hot water."

A school nurse is assessing a child for pediculosis capitis. Which of the following manifestations should the nurserecognize as an indication of this condition? A. Firmly attached white particles on the hair B. Itching and scratching of the head C. Patchy areas of hair loss D. Thick yellow crusted lesion on a red base

A. Firmly attached white particles on the hair

Which would the nurse most likely find in the history of a child with hemolytic uremic syndrome? SATA

A. Vomiting and diarrhea before admission B. Anorexia and bruising

A nurse is assessing a toddler who has acute nephrotic syndrome. Which of the following findings should the nurse report to the provider? A. yellow nasal discharge B. facial edema C. poor appetite D. irritability

A. yellow nasal discharge

A nurse is planning care for an adolescent who has scoliosis and requires surgical intervention. Which of the following behaviors by the adolescent should the nurse anticipate because it is most common reaction? A) Identity crisis B) Body image changes C) Feelings of displacement D) Lots of privacy

B) Body image changes

A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which state should the nurse make? A. "The blood supply to the bone is disrupted." B. "Normal bone growth can be affected" C. "Bone Marrow can be lost though the fracture" D. "the younger the child the longer the healing process will take"

B. "Normal bone growth can be affected"

Which needs to be present to diagnose hemolytic uremic syndrome (HUS)? A. Increased red blood cells with a low reticulocyte count, increased platelet count, and renal failure. B. Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure. C. Increased red blood cells with a high reticulocyte count, increased platelet count, and renal failure. D. Decreased red blood cells with a low reticulocyte count, decreased platelet count,a nd renal failure.

B. Decreased red blood cells with a high reticulocyte count, decreased platelet count, and renal failure.

A 9-year-old is in a spica cast and complains of pain 1 hour after receiving intravenous opioid analgesia. What should the nurse do first? A.Give more pain mediction. B. Perform a neuromuscular assessment. C. Call the surgeon for orders. D. Change the child's position.

B. Perform a neuromuscular assessment.

The nurse is caring for a toddler whose parents states while bathing she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority? A.) Schedule the child for an abdominal ultrasound B.) Instruct the parent to avoid pressing on the abdominal area C.) Determine if the child is having pain D.) Obtain a urine specimen for urinalysis

B.) Instruct the parent to avoid pressing on the abdominal area

A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Lab- oratory results indicate that the child is neutropenic, and protective isolation procedures are initiated. The grandmother of the child visits and brings a fresh bouquet of flowers picked from her garden, and asks the nurse for a vase for the flowers. Which response should the nurse provide to the grandmother? A."I have a vase in the utility room, and I will get it for you." B. "I will get the vase and wash it well before you put the flowers in it." C. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time." D. "When you bring the flowers into the room, place them on the bedside stand as far away from the child as possible."

C. "The flowers from your garden are beautiful, but should not be placed in the child's room at this time."

A nurse is discharging a child who has sickle cell anemia after an acute crisis episode. Which of the following instructions should the nurse include in the teaching? A. Monitor your child's temperature daily B. Restrict outdoor play activity to 1 hour per day C. Offer fluids to your child multiple times every day D. Apply cold compresses when your child expresses pain

C. Offer fluids to your child multiple times every day

A nurse is assessing a child who is in sickle cell crisis. Which of the following findings should the nurse expect? A. High Fever B. Bradycardia C. Pain D. Constipation

C. Pain

Which of the following measures should the nurse teach the parent of a child with hemophilia to do first if the child sustains an injury to a joint causing bleeding? A. Give the child a dose of Tylenol. B. Immobilize the joint, and elevate the extremity. C. Apply heat to the area. D. Administer factor per the home-care protocol.

D. Administer factor per the home-care protocol.

A nurse is caring for a toddler who has a fractured right femur and is in Bryant traction. When determining that the traction is appropriately assembled, the nurse should observe which of the following? A. Skin straps maintain the leg in an extended position. B. Weights are attached to a pin that is inserted into the femur. C. A padded sling is under the knee of the affected leg. D. The buttocks is elevated slightly off of the bed.

D. The buttocks is elevated slightly off of the bed.

The nurse caring for a child with osteomyelitis assesses poor appetite. Which intervention(s) is/are most appropriate for this child? Select all that apply

High-calorie liquids are sometimes received better when the child has a poor appetite. Offering favorite foods can sometimes tempt the child to eat, even with a poor appetite. Small, frequent meals might increase daily caloric intake.

A nurse on an oncology unit is assessing a child who has a brain tumor. Which of the following findings should the nurse expect?

Hyporeflexia

The clinical manifestations of minimal change nephrotic syndrome are due to which of the following?

Increased permeability of the glomeruli

The nurse is reinforcing instructions to the mother of a preschool child who was recently diagnosed with pediculosis capitis (head lice). Which item should be included in discussions to prevent a reinfestation?

Seal nonwashable items in a plastic bag for 2 to 3 weeks in a warm place if they cannot be vacuumed or dry cleaned.

The nurse is caring for a child being treated for ALL. Laboratory results indicate that the child has a white blood cell count of 5000/mm 3 with 5% polys and 3% bands. Which of the following analyses is most appropriate? 1. The absolute neutrophil count is 400/mm 3 , and the child is neutropenic. 2. The absolute neutrophil count is 800/mm 3 , and the child is neutropenic. 3. The absolute neutrophil count is 4000/mm 3 , and the child is not neutropenic. 4. The absolute neutrophil count is 5800/mm 3 , and the child is not neutropenic.

1. The absolute neutrophil count is 400/mm 3 , and the child is neutropenic.

A 13 year old just returned from surgery for scoliosis. which nursing interventions is/are appropriate in the first 24 hours. select all that apply 1. asses for pain 2. log roll to change positions 3. get the teen to the bathroom 12-24 hours after surgery 4. check neurological status 5. monitor bp

1. asses for pain 2. log roll to change positions 4. check neurological status 5. monitor bp

The nurse tells the parent that other conditions can be associated with congenital clubfoot. Select all that apply. 1. Myelomeningocele. 2. Cerebral palsy. 3. Diastrophic dwarfism. 4. Breech position in utero. 5. Prematurity. 6. Fetal alcohol syndrome.

1.Myelomeningocele. 2. Cerebral palsy. 3. Diastrophic dwarfism.

The parent of a child diagnosed with osteomyelitis asks how the child acquired the illness. Which is the nurse's best response? 1. "Direct inoculation of the bone from stepping barefoot on a sharp stick." 2. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone." 3. "The blood supply to the bone was disrupted because of the child's diabetes." 4. "An infection of the upper respiratory tract."

2. "An infection from a scratched mosquito bite carried the infection through the bloodstream to the bone."

Which of the following is the best method to prevent the spread of infection to an immunosuppressed child? 1. Administer antibiotics prophylactically to the child. 2. Have people wash their hands prior to contact with the child. 3. Assign the same nurses to care for the child each day. 4. Limit visitors to family members only.

2. Have people wash their hands prior to contact with the child.

When a child is suspected of having osteomyelitis, the nurse can prepare the family to expect which of the following. select all that apply 1. pain medication is contraindicated so that symptoms are not masked 2. blood cultures will be obtained 3. pus will be aspirated from the subperiosteum 4. an iv line with antibiotics will be started 5. surgery will be necessary

2. blood cultures will be obtained 3. pus will be aspirated from the subperiosteum 4. an iv line with antibiotics will be started

What is the most important when teaching a parent about preventing osteomyelitis 1. parents can stop worrying about bone infection once their child reaches school age 2. parents need to clean open wounds thoroughly with soap and water 3. children will always get a fever if they have osteomyelitis 4. children should wear long pants when playing outside because their legs might get scratched

2. parents need to clean open wounds thoroughly with soap and water

Which would the nurse expect to assess on a 3-week-old infant with developmental dysplasia of the hip (DDH)? Select all that apply. 1. Excessive hip abduction. 2. Femoral lengthening of an affected leg. 3. Asymmetry of gluteal and thigh folds. 4. Pain when lying prone. 5. Positive Ortolani test

3. Asymmetry of gluteal and thigh folds. 5. Positive Ortolani test

The parent of a 3-week-old states that the infant was recasted this morning for clubfoot and has been crying for the past hour. Which intervention should the nurse suggest the parent do first? 1. Give pain medication. 2. Reposition the infant in the crib. 3. Check the neurocirculatory status of the foot. 4. Use a cool blow-dryer to blow into the cast to control itching.

3. Check the neurocirculatory status of the foot.

A teen is seen in clinic for a possible diagnosis of Hodgkin disease. The nurse is aware that which of the following symptoms should make the physicians suspect Hodgkin disease? 1. Fever, fatigue, and pain in the joints. 2. Anorexia with weight loss. 3. Enlarged, painless, and movable lymph nodes in the cervical area. 4. Enlarged liver with jaundice.

3. Enlarged, painless, and movable lymph nodes in the cervical area.

Which should the nurse stress to the parents of an infant in a Pavlik harness for treat- ment of developmental dysplasia of the hip (DDH)? 1. Put socks on over the foot pieces of the harness to help stabilize the harness. 2. Use lotions or powder on the skin to prevent rubbing of straps. 3. Remove harness during diaper changes for ease of cleaning diaper area. 4. Check under the straps at least two to three times daily for red areas.

3. Remove harness during diaper changes for ease of cleaning diaper area. 4. Check under the straps at least two to three times daily for red areas.

A 12-year-old diagnosed with scoliosis is to wear a brace for 23 hours a day. What is the most likely reason the child will not wear it for that duration? 1. Pain from the brace. 2. Difficulty in putting the brace on. 3. Self-consciousness about appearance. 4. Not understanding what the brace is for.

3. Self-consciousness about appearance.

16. The nurse expects the blood culture report of an 8-year-old with septic arthritis to grow which causative organism? 1. Streptococcus pneumoniae. 2. Escherichia coli. 3. Staphylococcus aureus. 4. Neisseria gonorrhoeae.

3. Staphylococcus aureus.

When teaching parents about osteosarcoma, the nurse knows instruction has been successful when a parent says that this type of cancer is common in which age group? 1. Infancy. 2. Toddlers. 3. School-age children. 4. Adolescents.

4. Adolescents.

An infant of a mother infected with HIV is seen in the clinic each month and is being monitored for symptoms indicative of human immunodeficiency virus (HIV) infection. The nurse assesses the infant, knowing that which infection is the most common opportunistic infection of children infected with HIV? 1. Meningitis 2. Gastroenteritis 3. Cytomegalovirus infection 4. Pneumocystis jiroveci pneumonia

4. Pneumocystis jiroveci pneumonia

A nurse is admitting a child who has leukemia. Which of the following clients should the nurse place in the same room with this child? A. A child who has nephrotic syndrome B. A child recovering from a ruptured appendix C. A child who has rheumatic fever D. A child who has cystic fibrosis

A. A child who has nephrotic syndrome

Which of the following measures should be implemented for a child with von Willebrand disease who has a nosebleed? A. Apply pressure to the nose for at least 10 minutes. B. Have the child lie supine and quiet. C. Avoid packing of the nostrils. D. Encourage the child to swallow frequently.

A. Apply pressure to the nose for at least 10 minutes.

A child with hemolytic uremic syndrome (HUS) is very pale and lethargic. Stools have progressed from watery to bloody diarrhea. Blood work indicates low hemoglo- bin and hematocrit levels. The child has not had any urine output in 24 hours. The nurse expects administration of blood products and what else to be added to the plan of care? A. Initiation of dialysis. B. Close observation of the child's hemodynamic status. C. Diuretic therapy to force urinary output. D. Monitoring of urinary output.

A. Initiation of dialysis.

A nurse is caring for a child who has Legg-Calve-Perthes dsiease and is Buck extension traction. Which of the following actions should the nurse take? A. Reposition the child every 2 hours B. Remove the traction boot during baths C. Apply antibiotic ointment to pin site daily D. Reduce fluid intake

A. Reposition the child ever 2 hours

6. A child with hemophilia A fell and injured a knee while playing outside. The knee is swollen and painful. Which of the following measures should be taken to stop the bleeding? Select all that apply. A. The extremity should be immobilized. B. The extremity should be elevated. C. Warm moist compresses should be applied to decrease pain. D. Passive range-of-motion exercises should be administered to the extremity. E. Factor VIII should be administered.

A. The extremity should be immobilized. B. The extremity should be elevated. E. Factor VIII should be administered.

A nurse is caring for a 5-year-old who has a fracture of the tibia involving the growth plate. When providing information to the parents, the nurse should indicate that: A. This is a serious injury that could cause long-term growth issues. B. The fracture usually heals within 6 weeks without further complications. C. The child will never be able to play contact sports. D. Fractures involving the growth plate require pain medication.

A. This is a serious injury that could cause long-term growth issues.

Original A child is admitted to the hospital for treatment of suspected bacterial meningitis. What the priority of care for this child? A. Providing environmental stimulation to keep child awake B. Administering antibiotic therapy as soon as it is available C. Initiating isolation precautions as soon as diagnosis is confirmed D. Administering sedatives and analgesics on a preventative schedule to manage pain

B. Administering antibiotic therapy as soon as it is available

A 10-year-old with severe factor VIII deficiency falls, injures an elbow, and is brought to the ER. The nurse should prepare which of the following? A. An IM injection of factor VIII. B. An IV infusion of factor VIII. C. An injection of desmopressin. D. An IV infusion of platelets.

B. An IV infusion of factor VIII.

A nurse is assessing a 1-year-old toddler notices a large abdominal mass and pink-tinged urine on the diaper. Which of the following disorders should the nurse suspect?

Wilms' tumor

A nurse is performing an assessment on a 10 yo child suspected to have Hodgkins disease. which assessment findings are specifically characteristic of this disease? SATA a. abdominal pain b. fever and malaise c. anorexia and weight loss d. painful, enlarged inguinal lymph nodese. painless, firm, and movable adenopathy in cervical area

a. abdominal pain d. painful, enlarged inguinal lymph nodese. painless, firm, and movable adenopathy in cervical area

A nurse is providing discharge instructions to a parent and his school age child who has juvenile idiopathic arthritis. Which of the following instructions should the nurse include? a. encourage the child to take a 45 min nap daily b. allow the child to stay home on days when her joints are painful c. apply cool compresses for 20 mins every hours d. administer prednisone on an alternate-day schedule

d. administer prednisone on an alternate-day schedule