Peds Final Exam Practice Questions
The caregiver of a child diagnosed with celiac disease tells the nurse that the child has large amounts of bulky stools and what looks like fat in the stools. The clinical manifestation this caregiver is describing is: A. severe diarrhea. B. projectile stools. C. currant jelly stools. D. steatorrhea.
D. steatorrhea.
The nurse is assessing a 2-month-old for signs and symptoms of increased intracranial pressure. Which of the following would the nurse expect to assess? Select all that apply. · decreased blood pressure · Increased appetite · Bulging fontanel · Resistance to being held
-Bulging fontanel -Resistance to being held
What is a common accidental fracture in children?
-Clavicle
What are some sites and characteristics of injury bruising that might reflect abuse?
-patterned -difference colors and stages of healing -Ear, genital area, large marks, doesn't match the history, ligature marks
Expected urine output in the infant and child?
0.5-2mL/kg/hour -Around 1mL is easy to remember
This child has been diagnosed with asthma and the child has been on a stepwise approach. Rank the order in which the nurse would administer the following drugs as the child's condition worsens a. Albuterol as needed (SABA) b. Low-dose inhaled corticosteroid c. Medium-dose inhaled corticosteroid d. Medium dose inhaled corticosteroid and salmeterol (LABA- maintenance)
A,B,C,D
A 7-year-old boy has experienced repeated urinary tract infections (UTIs). His older sister also experienced repeated UTIs and was diagnosed with vesicoureteral reflux, a condition that tends to appear in families. Therefore, the nurse suspects this same condition in this client. Which diagnostic tests would confirm this suspicion? A. Urinalysis B. Cystoscopy C. Urine culture D. Blood urea nitrogen test
B. Cystoscopy
A 8-month-old has a hyper cyanotic spell while crying during an IV placement. What is the priority nursing action? A. Administer IV Lasix per providers' order B. Initiate a fluid bolus C. Place the child in the knee-chest position D. Administer oxygen
C- Place the child in the knee-chest position -Shunting of blood causes deoxygenated blood to go into systemic circulation, this position increases the pressure and increases oxygenated blood circulation.
A toddler has moderate respiratory distress, is mildly cyanotic, and has increased work of breathing, with a respiratory rate of 40. What is the priority nursing intervention? A. 100% oxygen and provision of comfort B. airway maintenance and continued reassessment C. Airway maintenance and 100% oxygen by mask. D. pulse oximetry monitoring
C. Airway maintenance and 100% oxygen by mask.
The nurse is collecting data on a 6-year-old child admitted with acute glomerulonephritis. Which vital sign would the nurse anticipate with this child's diagnosis? A. Respirations 24 per minute B. Pulse rate 112 bpm C. Blood pressure 136/84 D. Pulse oximetry 93% on room air
C. Blood pressure 136/84
The nurse is caring for a 6-year-old child with acute glomerulonephritis. When reviewing the client's laboratory results, which result is most important to review with the health care provider? A. White blood cells: 8,000/µL (8.0 ×109/L) B. Negative for respiratory syncytial virus (RSV) C. Positive culture for group A streptococcus D. Urine culture positive for contaminants
C. Positive culture for group A streptococcus
Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vaso-occlusive crisis? A. Circulatory collapse B. Cardiomegaly, systolic murmur C. Hepatomegaly, intrahepatic cholestasis D. Painful swelling of hands and feet, painful joints
D. Painful swelling of hands and feet, painful joints
The caregiver of a child being treated at home for acute glomerulonephritis calls the nurse reporting that her daughter has just had a convulsion. The child is resting comfortably but the caregiver would like to know what to do. The nurse would instruct the caregiver to take which action? A. Give the child fluids and report back to the nurse in a few hours. B. Give the child a diuretic and report back to the nurse in a few hours. C. Weigh the child in the same clothes she had been weighed in the day before and report the two weights to the nurse while the nurse is on the phone. D. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.
D. Take the child's blood pressure and report the findings to the nurse while the nurse is still on the phone.
A parent asks if her newborn's undescended testicles will need surgery to repair. What is the best response by the nurse? A. If the infant is having swelling or pain, then surgery will be performed. B. Surgery is not needed for this type of problem. C. This problem needs to be corrected immediately in the newborn period. D. There is a chance the testicles will descend on their own.
D. There is a chance the testicles will descend on their own.
1. The nurse is caring for a 2-year-old child who has had surgery. When assessing this child's pain, which of the following development characteristics would the nurse need to keep in mind? A. Understands time B. Fears bodily mutilation or injury C. Uses delays to put off treatment D. Uses words for pain such as owie, boo-boo, or hurt
D. Uses words for pain such as owie, boo-boo, or hurt
A nurse examining a neonate is unable to identify the fetal stomach. The nurse knows that this sign strongly indicates which condition? A. hernia B. pyloric stenosis C. duodenal atresia D. esophageal atresia (EA)
D. esophageal atresia (EA)
A child is admitted with a temperature, 101.2°F (38.4°C); pulse rate 100 beats/min; respirations 24 breaths/min. On admission the pain is localized in right lower quadrant. Legs are drawn up against the abdomen. Bowel sounds are sluggish. Rebound tenderness is present. White blood cell count of 17,000/mm3. Ultrasound confirms appendicitis. Which instruction would the nurse give to the child and the parent?
Do not rub or put pressure on the abdomen
What are some signs of nephritis?
Edema Proteinuria Hypoalbuminemia
How is cystic fibrosis diagnosed?
Sweat chloride test
Because the absorption of fat-soluble vitamins is decreased in cystic fibrosis, which vitamin supplementation is necessary?
Vitamins A, D, E, K
While interviewing an adolescent boy with depression, he reveals to the nurse that he has considered hurting himself. Which response by the nurse would be most appropriate? a. "Tell me exactly how you would hurt yourself." b. "Why would you want to hurt yourself." c. "Do your parents know that you want to hurt yourself?" d. "Have you discussed this with anyone else?"
a. "Tell me exactly how you would hurt yourself." -Avoid why questions and yes/no questions
A child with leukemia received chemotherapy about 10 days ago. She presents today with a temperature of 100.4°F, an absolute neutrophil count of 500, and mild bleeding of the gums. What is the priority nursing intervention? a. Administer IV antibiotics as ordered. b. Provide vigorous oral care frequently with a firm toothbrush. c. Monitor pulse and blood pressure for changes. d. Administer packed red blood cell transfusion
a. Administer IV antibiotics as ordered.
Which of the following is a condition in which pancytopenia occurs? a. Sickle cell anemia b. Aplastic anemia c. Thalassemia major d. Iron deficiency anemia
b. Aplastic anemia -pancytopenia occurs when there are low amounts of RBC's, WBC's, and platelets
A group of nursing students is reviewing information about child abuse and neglect and the effects on children. The students demonstrate understanding of the information when they identify which of the following as accurate? Select all that apply. a. The effects of abuse are manifested in multiple ways. b. Most abused children exhibit signs that are readily apparent. c. Abused children may experience a fear of failure but are motivated to achieve. d. Vulnerability to abuse depends on the child's age and sex. e. Evidence of abuse is often clear-cut.
a. The effects of abuse are manifested in multiple ways. c. Vulnerability to abuse depends on the child's age and sex.
Nonaccidental head trauma can lead to which of the following signs and symptoms? Select all that apply. a. failure to thrive b. sunken fontanel c. vomiting d. irritability e. fatigue
a. failure to thrive c. vomiting d. irritability e. fatigue
Which of the following are defects of Tetralogy of Fallot? a. pulmonary stenosis b. ASD c. VSD d. overriding aorta e. right ventricular hypertrophy
a. pulmonary stenosis c. VSD d. overriding aorta e. right ventricular hypertrophy
What is the desired outcome of prednisone administration for nephrotic syndrome? a. Administer the drug until the protein increases in the urine b. Administer the drug until the child is free of proteinuria for 3 days c. The child has an increased appetite and weight loss d. The child is able to receive scheduled live vaccines
b. Administer the drug until the child is free of proteinuria for 3 days
A 10-year-old child on a regular diet refuses to eat the food on her meal tray. She requests chicken nuggets, French fries, and ice cream. What is the best nursing action? a. Negotiate with the child to eat at least part of the food on the tray. b. Ask that the child's desired foods be sent up from the kitchen. c. Remove a privilege. d. Offer the child cereal and milk from stock on the nursing unit.
b. Ask that the child's desired foods be sent up from the kitchen.
The nurse is collecting data from the caregivers of a child admitted with seizures. Which statement indicates the child most likely had an absence seizure? a. His arms had jerking movements and his legs and face- tonic-clonic b. He was just staring into space and was totally unaware c. He kept smacking his lips and rubbing his hands- focal d. He is usually very coordinated, but he could not even walk without falling
b. He was just staring into space and was totally unaware a- tonic clonic c- focal d. prodromal period
The nurse is teaching an in-service program to a group of nurses on the topic of gastrointestinal disorders. The nurses in the group make the following statements. Which statement is most accurate related to the diagnosis of gastroesophageal reflux? a. A thickened, elongated muscle causes an obstruction at the end of the stomach. b. In this disorder the sphincter that leads into the stomach is relaxed. c. There are recurrent paroxysmal bouts of abdominal pain. d. A partial or complete intestinal obstruction occurs.
b. In this disorder the sphincter that leads into the stomach is relaxed.
While assessing a 4-month-old infant, the nurse notes that the baby experiences a hypercyanotic spell. What is the priority nursing action? a. Provide supplemental oxygen by face mask. b. Place the infant in a knee-to-chest position. c. Administer a dose of IV morphine sulfate. d. Begin cardiopulmonary resuscitation.
b. Place the infant in a knee-to-chest position.
Which of the following would cause the nurse to suspect nephrotic syndrome? a. Weight loss b. Proteinuria c. Hypotension d. Diarrhea
b. Proteinuria -in nephrotic syndrome, there is damage to the glomerular membrane causing it to become more permeable. This allow protein to leak into the urine.
A hospitalized child is immobilized. Which of the following is most important in their care? a. Allow for private room b. Allow child to wear their favorite hat c. Allow them to have a wheelchair in the playroom
c. Allow them to have a wheelchair in the playroom
The nurse is caring for a child who has had diarrhea and vomiting for the past several days. What is the priority nursing assessment? a. Determine the child's weight. b. Ask if the family has traveled outside of the country. c. Assess circulation and perfusion. d. Send a stool specimen to the lab
c. Assess circulation and perfusion.
The nurse examining a child who was diagnosed with ALL 6 months ago. The child exhibits pallor, eccymoses, and petechiae. The nurse interprets that these findings indicate the cancer has invaded what part of the body? a. Lymph nodes b. Liver c. Blood stream d. Bone marrow
d. Bone marrow
An otherwise healthy 2-year-old with recurrent lower UTI's is afebrile. What is priority action? a. Fluid restriction to decrease need to urinate- no, do not want urinary stasis b. Low sodium diet c. Encourage potty training d. Check for urinary reflux- VCUG test
d. Check for urinary reflux- VCUG test -Allows for visualization of the urinary tract and bladder. Want to know if there is problem with urine flow that is causing the recurrent infections (particularly urine stasis)
A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? a. Numeric b. FACES c. Oucher d. FLACC
d. FLACC
The nurse is collecting data on a 5-year-old admitted with the diagnosis of congestive heart failure. Which clinical manifestation observed during the physical assessment is consistent with this diagnosis? a. Jerking movement of the arms and legs b. Scissoring of the legs with toes pointed down -cerebral palsy c. Spooning of the fingernails d. Failure to gain weight
d. Failure to gain weight
A mother calls the doctor's office and tells the nurse that she is concerned because her 4-month-old keeps "spitting up" with every feeding. What would indicate that the child is regurgitating as opposed to vomiting? a. Continues until stomach is empty b. Is projected 1 ft away from infant c. Is curdled and extremely sour smelling d. Only occurs with feeding
d. Only occurs with feeding
A boy with Duchenne muscular dystrophy is admitted to the pediatric unit. He has an ineffective cough. Lung auscultation reveals diminished breath sounds. What is the priority nursing intervention? a. Apply supplemental oxygen. b. Notify the respiratory therapist. c. Monitor pulse oximetry. d. Position for adequate airway clearance
d. Position for adequate airway clearance.
Which of the urine specific gravity lab results would be expected if a child was dehydrated? a. 1.0 b. 1.010 c. 1.030 d. 1.005
c. 1.030 -It would be HIGH. -normal should be closest to 1.0 which is the specific gravity of water
A 3-month-old infant presents with a history of vomiting after feeding. The plan for the infant is to rule out GER. What information from the history would lead the nurse to believe that this infant may need further intervention? a. small "spits" after feeding b. sleeps through the night c. difficult to burp d. poor weight gain
d. poor weight gain
The caregiver of a 1-year-old boy calls the nurse, upset that his wife has just told him that their son is being given a hormone. His wife says that the pediatrician called it human chorionic gonadotropic hormone but that is all she understood. The nurse most accurately clarifies the caregiver's question by making which statement regarding the son's treatment? A. "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place." B. "Without the treatment your child's gonads will not reach normal size." C. "Your child's testes have not dropped, so the hormone is being administered to avoid causing degeneration until they do." D. "Without the hormone your son will have fluid that will collect in his scrotum."
A. "The doctor is hoping that the hormone will cause your son's undropped testes to move into their proper place."
At a well-child visit, hydrocephalus may be suspected in an infant if upon assessment the nurse finds: A. A rapid increase in head circumference B. Increase in weight since last visit C. Narrow sutures D. Sunken fontanels
A. A rapid increase in head circumference
A child is hospitalized with a diagnosis of sickle cell crisis. The nurse has done an assessment with the above findings. Which intervention is the nurse's priority in providing care? 118, RR 22, 90%, pain 10/10. A. Administer IV fluids B. Maintain the client in NPO C. Administer blood transfusion Provide pain management
A. Administer IV fluids -Dehydration is the main cause of sickling
A child is being evaluated for renal and urinary tract disease. What would the nurse expect to be ordered to evaluate the child's glomerular filtration rate? A. Creatinine clearance rate B. Urinalysis C. Kidneys, ureter, and bladder x-ray D. Computed tomography scan
A. Creatinine clearance rate
A group of nursing students are reviewing information about urinary tract infections in children. The students demonstrate understanding of the information when they identify which of the following organisms as most commonly involved? A. Escherichia coli B. Klebsiella C. Streptococcus D. Chlamydia
A. Escherichia coli
The nurse is caring for a child with nephrotic syndrome. The child is noted to have edema. The edema would most likely be seen where on this child? A. Eyes B. Fingers C. Abdomen D. Sacrum
A. Eyes
The nurse is caring for a 12-year-old child with cerebral palsy who is unable to communicate verbally. When assessing this child's pain, which assessment tool would the nurse most likely use? A. Face, legs, activity, cry, and consolability (FLACC.descriptors) B. Numeric rating scale C. Adolescent Pediatric Pain Tool (APPT) D. Pain diary
A. Face, legs, activity, cry, and consolability (FLACC.descriptors)
A nurse is assisting a 9-year-old child with Crohn disease to complete her menu for the next day. The nurse emphasizes food choice based on the understanding that dietary management for this condition focuses on which of the following? Select all that apply.
A. High calorie B. High protein C. High carbohydrate
What would cause a nurse to suspect that infection has developed under a cast? A. Hot spots felt on cast surface B. Cold toes C. Increased respirations Complaints of paresthesia
A. Hot spots felt on cast surface
A 10-year-old male presents with low-grade fever, nausea, and abdominal pain. The nurse examining him suspects appendicitis and checks for rebound tenderness in what quadrant? A. Lower right B. Upper right C. Upper left D. Lower left
A. Lower right
Acute post-step glomerulonephritis management includes which of the following? Select all that apply. A. Observe for elevated Anti streptolysin B. Bed rest and antifungal if not previously treated C. Strict I and O and not added sodium diet D. Monitor BP and administer furosemide
A. Observe for elevated Anti streptolysin C. Strict I and O and not added sodium diet D. Monitor BP and administer furosemide
A 3-month-old boy is found to have undescended testes. The parents are concerned. What should the nurse anticipate as the next step for this client? A. Reassess the client's testes at 6 months of age. B. Schedule emergency orchiopexy to correct the condition. C. Administer low-dose human chorionic gonadotropin hormone. D. Perform karyotyping to establish the client's gender.
A. Reassess the client's testes at 6 months of age.
A newborn is diagnosed with hypospadias and the parents want the newborn to be circumcised. What would be the best response by the nurse? A. The foreskin is needed for repair. B. The circumcision may predispose the newborn to renal failure. C. Circumcision with hypospadias will cause meatal stenosis. D. Circumcision is usually performed after 1 year of age.
A. The foreskin is needed for repair.
Which of the following congenital heart defects leads to increased pulmonary blood flow? A. Ventricular Septal defect B. Coarctation of the aorta C. Tetralogy of Fallot D. Hypoplastic left heart syndrome
A. Ventricular Septal defect
A healthcare provider and other health team members are discussing congenital heart disorders that increase pulmonary blood flow. Which disorders are topics for this discussion?
A. Ventricular septal defect B. Patent ductus arteriosus C. Atrioventricular canal defect
The caregiver of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine "looks funny." He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100℉ (37.8℃). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have: A. acute glomerulonephritis. B. lipoid nephrosis (idiopathic nephrotic syndrome). C. rheumatic fever. D. a urinary tract infection.
A. acute glomerulonephritis.
Most urinary tract infections seen in children are caused by: A. intestinal bacteria. B. fungal infections. C. hereditary causes. D. dietary insufficiencies
A. intestinal bacteria.
Which of the following medications might be used in GERD? Select all that apply. A. metoclopromide (prokinetic) B. omeprazole (PPI) C. cimetidine (H-2 blocker) D. metronidazole ( antibiotic) loperamide (antidiarrheal)
A. metoclopromide (prokinetic) B. omeprazole (PPI) C. cimetidine (H-2 blocker)
Which of the following is a sign of Down's Syndrome? A. oblique palpebral fissures B. tall stature C. hypertonic D. large head
A. oblique palpebral fissures
The nurse is caring for a child with cystic fibrosis who receives pancreatic enzymes. Which statement by the child's mother indicates an understanding of how to administer the supplemental enzymes? A. "I will decrease the dose by half if my child is having frequent, bulky stools." B. "The enzymes should be given at the beginning of each meal and snack." C. "I will stop the enzymes if my child is receiving antibiotics." D. "Between meals is the best time for me to give the enzymes."
B. "The enzymes should be given at the beginning of each meal and snack."
A neonatal nurse teaches students how to recognize gastrointestinal disorders in infants. The nurse tells the students that failure of the newborn to pass meconium in the first 24 hours after birth may indicate what disease? A. Gastroenteritis B. Hirschsprung disease C. Short bowel syndrome (SBS) D. Ulcerative colitis (UC)
B. Hirschsprung disease
The goal of therapeutic management of vesicoureteral reflux (VUR) is: A. prevention of hypotension B. prevention of renal scarring C. to administer antibiotic prophylaxis D. to increase urinary output
B. prevention of renal scarring
A nurse is obtaining the history from a parent of a child who experiences absence seizures. Which of the following would the nurse expect the mother to describe? A. Brief, sudden onset with muscles that become tense B. Loss of motor activity accompanied by a blank stare C. Sudden, brief jerking motions of a muscle group D. Loss of muscle tone and loss of consciousness
B. Loss of motor activity accompanied by a blank stare
A mother asks the nurse why her infant who was born at 34 weeks gestation is being prescribed ferrous sulfate. What is the most appropriate response? A. Infants with pyloric stenosis require ferrous sulfate B. Preterm infants are at higher risk for iron-deficiency anemia C. Your infant may have been having excessive diarrhea D. Ferrous sulfate helps improve red blood cell formation
B. Preterm infants are at higher risk for iron-deficiency anemia -get iron from mother, but when the baby is preterm, they do not get the full store
A child is undergoing diagnostic testing for nephrotic syndrome. When reviewing the results of the testing, which of the following would the nurse expect to find? Select all that apply. A. Hematuria B. Proteinuria C. Hypoalbuminemia D. Neutropenia E. Hypercholesterolemia
B. Proteinuria C. Hypoalbminemia E. Hypercholesterolemia
When providing care to a child with vesicoureteral reflux (VUR), which nursing diagnosis would be the priority? A. Activity intolerance B. Risk for infection C. Imbalanced nutrition less than body requirements D. Excess fluid volume
B. Risk for infection -due to urine flow in the opposite direction and possible bacteria in the ureter
A 5-month-old infant with RSV bronchiolitis is in respiratory distress. The baby has copious secretions, increased work of breathing, cyanosis, and a respiratory rate of 78. What is the most appropriate nursing intervention? A. Alert the physician or nurse practitioner to the situation and ask for an order for a STAT chest radiograph. B. Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure. C. Bring the emergency equipment to the room and begin bag-valve-mask ventilation. D. Attempt to calm the infant by placing him in his mother's lap and offering him a bottle.
B. Suction secretions, provide 100% oxygen via mask, and anticipate respiratory failure.
The child's hydration status often indicates the severity of the current GI illness. Which of the following might be signs of dehydration? Select all that apply. A. oral mucosa is moist B. skin turgor is elastic C. skin is tenting D. absence of tears urine output of 1 mL/kg/hour
B. Tenting of the skin D. Absence of tears
An RN is examining a newborn male. The RN palpates one testicle in the scrotal sac but the other testicle needs to be "milked" down into the scrotal sac. Choose the best nursing action. A. notify the provider B. document the findings C. suspect cryptorchidism D. suspect hydrocele
B. document the findings
An RN is caring for a child with suspected Acute Post-streptococcal glomerulonephritis (APSGN). Which of the following questions would make the RN suspect this diagnosis? A. edema and proteinuria B. hematuria and a recent sore throat C. hypotension and recent URI D. pale colored urine and low BUN
B. hematuria and a recent sore throat
A 10-year-old child is admitted to the hospital due to history of seizure activity. As his nurse, you are called into the room by his mother, who states he is having a seizure. What would be the priority nursing intervention? A. Prevention of injury by restraining the child B. Prevention of injury by placing a tongue blade in the child's mouth C. Prevention of injury by placing the child on his side and opening his airway D. Prevention of injury by removing the child from his bed
C. Prevention of injury by placing the child on his side and opening his airway
The nurse is caring for a 5-month-old boy with an undescended left testis. What would the nurse identify as indicative of true cryptorchidism? A. Testis can briefly be brought into scrotum B. Fluid detected in scrotal sac C. Testis cannot be "milked" down inguinal canal D. Venous varicosity detected along the spermatic cord
C. Testis cannot be "milked" down inguinal canal
The nurse is conducting an assessment of a 5-year-old boy. During the assessment, the nurse notes that the child does not maintain eye contact or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion? A. The child has a long face and prominent jaw. B. The child has a slight decrease in head circumference. C. The child constantly opens and closes his hands. D. The child is highly active and inattentive
C. The child constantly opens and closes his hands.
The nurse is collecting data for a child diagnosed with acute glomerulonephritis. What would the nurse likely find in this child's history? A. The child is being treated for asthma. B. The child has a sibling with the same diagnosis. C. The child recently had an ear infection. D. The child had a congenital heart defect
C. The child recently had an ear infection.
Which of the following is a late sign of respiratory distress and impending respiratory failure? A. retractions B. nasal flaring C. slow irregular breathing D. restlessness
C. slow irregular breathing
A 3-year-old child is scheduled for a surgery to correct undescended testes. For what postoperative consideration would the nurse want to prepare the parents? A. a liquid diet for 3 days B. the need for maintaining a semi-Fowler position C. some discomfort at the surgery site D. the need for complete bed rest for 10 days
C. some discomfort at the surgery site
An 11-week-old boy is being admitted to the pediatric unit with a diagnosis of rule out pyloric stenosis. As the admitting nurse beginning the interview which question will you ask?
Can you describe to me a typical feeding routine, specifically what occurs after he finishes his bottle? -with pyloric stenosis, there will typically be projectile vomiting directly after feedings. The baby will then be hungry again and appear to always be hungry. -The baby will need surgical repair to release pressure in the passageway
______________ is a congenital defect in which the urethral opening is located on the dorsal side (upper surface) of the penis.
Epispadias
A toddler with nephrotic syndrome is admitted to the pediatric intensive care unit. Which of the following lab results will the RN expect? A. low WBCs B. hyperalbuminemia C. low serum cholesterol D. proteinuria
D. proteinuria
_____________ is a urethral defect in which the opening is on the ventral surface of the penis rather than at the end of the penis.
Hypospadias
Where does normal bruising occur?
Over bony prominences (forhead, shin, knees.) and they are generally singular -normally in the front of the body -Consistent with the history
What factors are associated with child abuse and maltreatment?
Poverty, prematurity, low birth weight, cerebral palsy, chronic illness, congnitive or intellectual disability, and frustrating behaviors For the abuser- poverty, drug and alcohol use, domestic violence
A mother is alarmed because her 6-week-old boy has begun vomiting almost immediately after every feeding. In the past week, the vomiting has grown more forceful, with the vomit projecting several feet from his mouth. He is always hungry again just after vomiting. At the physician's office, the nurse holds the child and gives him a bottle of water. While he drinks, she notes an olive-size lump in his right abdomen. Which condition should the nurse suspect in this child?
Pyloric Stenosis
A 6-month-old has GERD. Which of the following would not be included in parent teaching? a. Avoid placing the infant in the prone position b. Upright positioning after feeding c. Administer omeprazole on time d. Reassurance that most children outgrow GERD
a. Avoid placing the infant in the prone position -You would want to caution the family about placing them in this position after feedings, but would still want the baby to have tummy time for development and muscle strengthening
The nurse is caring for a child admitted with gastroesophageal reflux (GER). Which clinical manifestation would likely be seen in this child? a. Effortless vomiting just after the child has eaten b. Bouts of diarrhea with failure to gain weight c. Forceful vomiting followed by the child being eager to eat again d. Severe constipation with occasional ribbon-like stools
a. Effortless vomiting just after the child has eaten
Which type of Croup is always considered a medical emergency? a. Epiglottitis b. Spasmodic croup c. Laryngitis d. Larygotracheobronchitis
a. Epiglottitis -leaning forward, tripoding, drooling, airway is constricted. The nurse will not stick anything in the mouth and will prepare for intubation.
A child with intussusception requires surgical repair. The RN explains this is necessary to: a. Fix the telescoping of the intestine b. Fight the infection causing the problem c. Replace lost electrolytes d. Make a surgical incision to release the pylorus muscle
a. Fix the telescoping of the intestine -Sometimes change in pressure with barium aor air enema can be therapeutic, and it goes away on its own.
During a physical examination of a 13 year old boy, the nurse observes a single, enlarged, rubbery feeling cervical lymph node in the armpit. The boy also reports unexplained loss of weight, night sweats, and malaise. Which condition should the nurse suspect? a. Hodgkin b. Non-Hodgkin c. ALL d. AML
a. Hodgkin
1. In which developmental stage is the child first able to localize pain and describe both the amount and intensity of the pain felt? a. Preschool stage b. Toddler stage c. School age stage Adolescent stage
a. Preschool stage
Which of the following are associated with child abuse? Select all that apply a. children do not want to admit that their parent or relative hurt them b. abuse and neglect are more prevalent among the poor c. the largest percentage of those affected are between 5 and 7 years old d. history of child abuse is associated with development of depression e. a risk factor for being an abuser is extreme stress
a. children do not want to admit that their parent or relative hurt them b. abuse and neglect are more prevalent among the poor d. history of child abuse is associated with development of depression e. a risk factor for being an abuser is extreme stress
The nurse is caring for a 5-year-old child with a congenital heart anomaly causing chronic cyanosis. When performing the history and physical examination, what is the nurse least likely to assess? a. obesity from overeating b. clubbing of the nail beds c. squatting during play activities d. exercise intolerance
a. obesity from overeating
A nurse is caring for an infant who is experiencing heart failure. Which of the following would the nurse most likely include in the infant's plan of care? Select all that apply. a. Providing large, less frequent feedings b. Administering oxygen therapy c. Administering diuretic therapy d. Placing the infant in a prone position
b. Administering oxygen therapy c. Administering diuretic therapy
In caring for an infant diagnosed with pyloric stenosis the nurse would anticipate which intervention? a. Change the infant's diet to one that is lactose-free. b. Prepare the infant for surgery. c. Assist in doing a barium enema procedure on the infant. d. Medicate the infant with analgesics
b. Prepare the infant for surgery. -pressure buildup needs to be fixed
A child is brought to the clinic for an evaluation. The nurse suspects that the child has leukemia based on assessment of which of the following? Select all that apply. a. Weight gain b. Splenomegaly c. Lymphadenopathy d. Increased platelet count e. Elevated leukocyte count
b. Splenomegaly c. Lymphadenopathy e. Elevated leukocyte count
When caring for a child with a cast the nurse will perform frequent checks to identify signs of compromise including: (Select all that apply) a. shortened capillary refill b. increased pain c. pale skin color d. cool skin e. decreased pulse
b. increased pain c. pale skin color e. decreased pulse
A child is admitted with low WBC's. Chose the priority action a. monitor airway b. prevent infection c. assess peripheral pulses d. Avoid trauma/bleeding
b. prevent infection -decreased immune cells and function
A. Initiate appropriate isolation precautions and begin intravenous antibiotics. The nurse has received report on four children. Which child should the nurse see first? a. An adolescent admitted after an MVA who is oriented to person place b. A toddler in a persistent vegetative state with a low-grade fever c. A preschool child with a head injury and decreasing level of consciousness d. A school aged child in a coma with stable vital signs
c. A preschool child with a head injury and decreasing level of consciousness
The nurse is caring for a child after a cardiac catheterization. What is the nursing priority? a. Check pulses above the catheter insertion site for strength and quality. b. Allow early ambulation to encourage activity participation. c. Assess extremity distal to the insertion site for temperature and color. d. Change the dressing to evaluate the site for infection
c. Assess extremity distal to the insertion site for temperature and color.
A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment? a. Assess for pallor, fatigue, and tachycardia. b. Monitor for fever. c. Assess for bruising or bleeding. d. Determine intake and output.
c. Assess for bruising or bleeding.
5-year-old has been diagnosed with Wilms tumor. What is the priority nursing intervention for this child? a. Educate the parents about dialysis, as the kidney will be removed. b. Measure abdominal girth every shift. c. Avoid palpating the child's abdomen. d. Monitor BUN and creatinine every 4 hours.
c. Avoid palpating the child's abdomen.
A 2 year old is suspected of having FTT. What is the most concerning? a. parents neglected to bring child in for flu vaccine for the last two years b. Child was at 5% for weight and 90th% for height at 12 month visit c. Child was at 50% for weight at 18 month check up then 10% at 2 year d. Child has has 4 cold in the last year
c. Child was at 50% for weight at 18 month check up then 10% at 2 year -FTT is characterized by a sudden change in growth trajectory
An 11-year-old boy has come to the school nurse more than 15 times for somatic complaints during the first quarter of school year and has subsequently left school after each visit. Which action by the school nurse would be most appropriate? a. Talk to the student's teacher. b. Make an unannounced home visit on a day the child is not in school. c. Contact the child's parents to discuss the situation. d. Keep a log of the child's attendance and continue to monitor the situation
c. Contact the child's parents to discuss the situation.
A 7-year-old child with cerebral palsy has been admitted to the hospital. Which information is most important for the nurse to obtain in the history? a. Age that the child learned to walk b. Parents' expectations of the child's development c. Functional status related to eating and mobility d. Birth history to identify cause of cerebral palsy
c. Functional status related to eating and mobility
The RN teaches the nursing students to recognize Hirschsprung disease. Teaching was successful when students state: a. I would ask about jelly-like stools b. I would ask about any current diarrhea c. I would check history to see if baby passed meconium at birth d. I would check vital signs for fever
c. I would check history to see if baby passed meconium at birth -This disease occurs when there are missing nerve cells in the muscles of the baby's colon which can lead to megacolon/obstruction -jelly like stools =intussusception
A child is to undergo a tympanostomy tube placement in a freestanding outpatient surgery center. What is the major disadvantage associated with this location? a. Increased risk for infection b. Increased health care costs c. Need to be transferred if overnight stay is required d. Increased disruption of family functioning
c. Need to be transferred if overnight stay is required
The nurse is assessing a 10-day-old infant for dehydration. Which finding indicates severe dehydration? a. Soft and flat fontanels (fontanelles) b. lood pressure of 80/42 mm Hg c. Tenting of skin d. Pale and slightly dry mucosa
c. Tenting of skin
A child presents with a 2-day history of fever, abdominal pain, occasional vomiting, and decreased oral intake. Which finding would the nurse prioritize for immediate reporting to the physician? a. temperature 101.9°F b. Parents will be leaving the child alone in the hospital. c. rebound tenderness and abdominal guarding d. Child can tolerate only sips of fluid without nausea.
c. rebound tenderness and abdominal guarding
The nurse is preparing a 5-year-old boy for surgery on his lower leg. His mother is helping him into the hospital gown and the boy fights removal of his underwear. What is the most appropriate nursing action? a. Allow the mother to remove the underwear. b. Tell the boy he is acting childishly. c. Notify the OR that the underwear is on. d. Allow the boy to keep his underwear on.
d. Allow the boy to keep his underwear on.
A child with leukemia has the following AM laboratory results: Hgb 8.0, Hct 24.2, WBC 8,000, platelets 150,000. What is the priority nursing assessment? a. Monitor for fever. b. Assess for bruising or bleeding. c. Determine intake and output. d. Assess for pallor, fatigue, and tachycardia.
d. Assess for pallor, fatigue, and tachycardia.
A child is admitted with low platelets. Chose the priority action a. monitor airway b. prevent infection c. assess peripheral pulses d. Avoid trauma/bleeding
d. Avoid trauma/bleeding
A child is diagnosed with intussusception. The nurse anticipates that what action would be attempted first to reduce this condition? a. Upper endoscopy b. Endoscopic retrograde cholangiopancreatography c. Surgery d. Barium enema
d. Barium enema
A 6-week-old infant is diagnosed with pyloric stenosis. When taking a health history from the parent, which symptom would the nurse expect to hear described? a. Chronic diarrhea b. Vomiting about 2 hours after feeding c. Refusal to eat d. Vomiting immediately after feeding
d. Vomiting immediately after feeding
A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? a. gallop and rales b. blood pressure discrepancies in the extremities c. right ventricular hypertrophy on ECG d. heart murmur
d. heart murmur