Peds Final Exam Review
The nurse is developing a plan of care for a 7 year old child with type 1 DM. The child reports participating in athletics at 1300 each day. Which step will be part of the plan?
checking glucose levels more frequently.
The nurse is orienting a new nurse to the pediatric burn unit. Which statement made by the nurse inicates an understanding of a difference in tx between children and adults
children require more fluid for their weight than adults.
The nurse is examining a child with hypoparathyroidism. The nurse would expect to assess which signs and symptoms? Select all that apply.
chvostek, trousseau (hypocalcemia)
The client has been prescribed antihistamines and a round of corticosteroids to treat an allergic reaction to an unknown food source. Which statement by the client indicates he understands the allergic condition and medication regimen?
corticosteriods help the inflammation I may have to undergo intradermal testing to determine what I am allergic to Once we figure out what I am allergic to, it is important for me to avoid that allergen
A young child is brought to the emergency department and requires advanced life support. The nurse is preparing to administer medication to maintain the child blood pressure and systemic perfusion. Which of the following might the nurse administer?
epinephrine, dopamine, dobutamine
A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client?
excess fluid volume
the nurse is caring for a pediatric client with burn injuries. The parents are in tears and state, "this is my fault, I should not have left my child alone in the kitchen." What is the nurses interpretation of this behavior?
feelings of blame are natural when a child is burned
The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone?
growth hormone
When describing the negative feedback system that controls endocrine function, the nurse explains that a decreased secretion of which correlates with a decrease in blood glucose levels?
insulin
A child with allergic rhinitis is prescribed a nasal antihistamine spray. When advising the parents about the use of the sprays, what should the nurse explain about the rebound phenomenon?
it causes an increase in nasal secretions after an initial decrease
The nurse is performing CPR on a child who is a victim of a near-drowning experience. How should the nurse open the child's airway to provide breaths?
jaw-thrust maneuver
When educating parents of preschoolers what is most important to include in your presentation?
keep chemicals in locked cabinets
A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning?
keep cleaning solutions locked up
the nurse is preparing to perform a dressing change on a newlely admitted 2 year old child with partial thickness burns to the torso and legs. The client's vital signs are HR 124 beats/min, resp 22 breaths min, BP 79/40, and O2 98% on room air. Which pain medication is the best choice?
ketamine
a nursing instructor teaching a class about immunity asks the students to identify the organs of the immune system. Which would the nursing instructor want them to include.
lymph nodes, bone marrow, thymus, spleen, tonsils
a community health nurse is creating a presentation to a group of parents on the normal growth and development of early adolescence. What info specific to an adolescent's social and emotional development should the nurse include?
need for privacy, desire for peer accpetance, desire for independence
A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information when the students identify which system is most consistently affected by metabolic disorders?
nervous system
The nurse is preforming discharge teaching to the parents of a 2-year old child who suffered burn injuries. Which recommendations is appropriate regarding burn safety?
practice fire drills, keep children away from grills, ovens, and irons, maintain the hot water heater at or below 120 F (48.9C)
A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms?
syndrome of inappropriate antidiuretic hormone
A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement?
take glucometer readings as ordered (IV glucocorticoids raise glucose levels and often require coverage with insulin)
The child has a peanut allergy and accidentally ate food that contained peanuts. Which clinical manifestations of anaphylaxis should the nurse expect to find? Select all that apply.
the child states that his tongue feels "too big" for his mouth, the child has developed hives on his face and trunk, the child states he feels like he might throw up, the child states that he feels like he might faint
the nurse is providing teaching to a child with new-onset type 1 diabetes. Which statements made by the child demonstrates understanding of the pathophysiology of diabetes.
"I do not make enough insulin on my own" "I can tell my glucose is getting high if I feel extra tired" Insulin injections will help maintain my glucose levels
the nurse providing dietary education to a 7 year old child with type 1 DM. Which statement by the child demonstrates an understanding of his/her dietary needs?
"I need to count my carbohydrates for each meal"
the nurse is providing teaching to a child on the benefits of getting an insulin pump. Which statement made by the child demonstrates an understanding of the teaching?
"I will give myself fewer injections with an insulin pump"
the nurse working in a health care providers office is caring for a child with type 1 DM who has elevated BG despite taking insulin. The child presents with a sore throat, runny nose, and a cough. Which statement by the nurse is most appropriate?
"You will need to check your glucose more often while you are sick"
the nurse is caring for a 7-year-old child diagnosed with type 1 diabetes. Which statement made by the child is accurate regarding BG monitoring?
"I will need to use the side of my fingertip to get blood"
An adolescent client has just been diagnosed with systemic lupus erythematosus (SLE). Following client education about the disease, which statement by the client demonstrates understanding of SLE?
"SLE is an autoimmune disorder that I will always have, with times of flare- ups and times of minimal to no symptoms."
The nurse is reviewing discharge instructions with a 14 year old client who has recovered from acute chest syndrome. What should the nurse include in the teaching?
Avoid extreme temperatures, maintain hydration, practice hand hygiene
The nurse assesses a 2 year old toddler for a normal check up. The client is accompanied by a parent. Which action is appropriate for the assessment?
Let the toddler play with a sethoscope before auscultating breath sounds
When receiving a transfusion of PRBCs, a school-aged child begins to experience itchy skin, hives, and wheezes. What should the nurse do first? for this child.
Stop the transfusion.
the nurse is caring for a 2 year old child admitted for second degree burns. The parents ask if their child will recieve any food. Which statement by the nurse is best.
We will begin feeing him through a nasogastric tube
Which nursing intervention is priority when caring for a child with HIV?
administer prescribed medications
The nurse is caring for a 2 year old child who presents with partial thickness burns covering both arms and legs. Once the total body surface is calculated, which intervention is priority?
infuse IV fluids
The nurse is caring for a 2 year old child with burn injuries. The parents are expressing guilt and remorse. What can the nurse do to address the psychosocial needs of the family?
involve the parents in the pain management plan, provide resources on community support groups, request that the parents remain in the room during dressing changes
the nurse is reviewing laboratory values on four clients. Which client should the nurse assess first?
nighttime glucose of 60.
a 10-year-old boy has just arrived by ambulance at the ER following a motor vehicle accident, and a nurse is assessing him. Which 3 body systems should the nurse evaluate first?
respiratory, cardiovascular, neurologic
the nurse is caring for a 7-year-old child newly diagnosed with type 1 diabetes. The nurse is developing a plan of care for the child. Which steps would be appropriate to include?
rotate injection sites for insulin adminstration, incorporate dietary education on counting carbohydrates, maintain BG level from 70-180
The nurse is caring for a teenager recently diagnosed with Addison disease. Which findings can be anticipated by the nurse? Select all that apply.
sodium level 128, potassium level 5.6, muscular weakness
the nurse is caring for a 2 year old child seen for a growth and development check. Which traits indicate normal growth and development for a child this age?
stands on tiptoes, follows simple instructions, prefers using the right hand for tasks
The nurse is preparing an educational program for members of the office staff. The topic is the warning signs of primary immunodeficiency. What information should be included? Select all apply.
two or more episodes of severe sinusitis in 1 year, failure to thrive in an infant, two or more serious infections such as sepsis, history of infections requiring IV antibiotics to clear
The nurse is caring for a 7 year old child new to insulin therapy. Which interventions are appropriate to use with a 7 year old child?
use concise and concrete terms when instructing, allow client to make choices in relation to care, have a parent do a return demonstration of insulin adminstration, provide a doll for the client to give a short with a needleless syringe.
The nurse is providing teaching about food substitutions when cooking for the child with an allergy to eggs. Which response indicates a need for further teaching?
"I can use egg whites when baking, but not the yolk"
The nurse is monitoring the CD4 count of an infant who has contracted HIV from the mother in utero. The nurse is concerned that treatment with antiretroviral therapy is not effective when noting which CD4 level?
1300 (normal 1500 - anything lower may indicate that the therapy is not effective)
a 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result?
8.5% (less than 8 at 6-12 years old)
The nurse is caring for a child and notes periorbital edema on the left eye with urticaria. Which action by the nurse is priority?
Assess lung sounds bilaterally
A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?
Avoid unattended baths for the toddler
A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?
BG level (hypoglycemia)
A 7-year-old child is rushed into the emergency room after being stung by a yellow jacket. The child is nauseated and vomiting and is experiencing itching and swelling on the arm where stung. He is having trouble breathing. Which type of hypersensitivity response is the child experiencing?
Type 1 anaphylaxis
An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child?
acetylcysteine
the nurse is caring for a 7-year-old child newly diagnosed with type 1 DM. The child is receiving an insulin infusion. The last BG reading was 414 one hour ago. Upon recheck, the BG reading is 325. Which action by the nurse would be best?
adjust the insulin regimen as prescribed
A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority?
administering 100% oxygen by mask
the nurse is caring for a child with type 1 DM. The child's morning BG was 112. The child has insulin aspart, regular insulin, and insulin glargine prescribed. Which action by the nurse is best ?
adminster the prescribed dose of insulin glargine (given to steady glucose levels and not given based on individual glucose reading)
A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be?
assess the child's airway and manage airway patency
A child is exhibiting symptomatic bradycardia that has been unresponsive to ventilation and oxygenation. Which of the following would the nurse expect to be administered?
atropine
An unconscious client is brought to the emergency department after ingesting too much prescribed medication. What is the highest priority nursing intervention?
establish a patent airway
A 12-year-old boy has broken his arm and is showing signs and symptoms of shock. Which of the following would the nurse do first?
establish a suitable IV site
A 9-year-old girl has just been diagnosed with graves disease. Which symptom should the nurse expect in this child? Select all that apply.
exophthalmos (protruding eyes), moist skin, nervousness, increase basal metabolic rate
A nurse is conducting a physical examination of a 12-year-old girl with suspected systemic lupus erythematosus (SLE). How would the nurse best interview the girl?
have you noticed any hair loss or redness on your face?
Which nursing diagnosis will the nurse select as appropriate for the child with atopic dermatitis? Select all that apply.
impaired skin integrity related to skin barrier function anxiety related to continuing or uncontrolled allergic response powerlessness related to difficulty determining cause of allergy
the nurse is providing discharge teaching to the parents of a 2 year old child with burn injuries. What is the priority for performing dressing changes at home?
infection prevention
A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back, which of the following would be most appropriate to do?
logroll the child to the side
nursing students correctly label the group of cells whose job is to ingest, engulf, and neutralize pathogens as:
macrophages (mature white blood cells)
The nurse is reviewing the immunization schedule with the parent of a child who is HIV positive. What information should the nurse provide? Select all that apply.
pneumoccocal vaccine can be given the variceclla vaccine should not be given if the child is symptomatic if the CD4 count is low, the measles, mumpls, and rubella vaccine should not be given
The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication?
this medication must be given by injection
the nurse is caring for a child with partial thickness (2nd degree) burns to the arms. Which is the most appropriate action to prevent alterations in thermoregulation?
use fluid warmer for IV fluids
the nurse is caring for a client who suffered burn injuries to the arms. The arms have blisters, moist red skin, blanching, and sensation in tact. What type of tx plan is expected for this type of burn injury?
use of moisturizers application of cool, dampl cloths (partial thickness)
what should be included in the teaching plan for a child with type 1 DM who is going home on insulin therapy?
It is absolutely normal for the growing child to require an increase in insulin; this does not mean that the condition is getting worse
The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply.
NS, LR
The nurse is caring for a child with type 1 diabetes. The child is currently nauseated, sweaty, and has clammy skin. Which nursing intervention would take priority?
Obtain glucose reading
The nurse is reviewing safety concerns with the parents of a 7-year-old child. Which statement made by the parents is correct?
Our child will use a life-jacket when swimming
A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time?
Preparation for an emergency endoscopy to remove the batteries
A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication if she becomes pregnant. The nurse integrates understanding of which of the following when responding to the client?
Regulation of thyroid medication is more difficult because the thyroid glandincreases in size during pregnancy
A child has been prescribed Stimate (esmopressin) acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse?
Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that will slow down your urine output
A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning?
avoid unattended baths for the toddler
The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best?
I am here to answer your questions and be with you during this difficult time."
The nurse is providing discharge teaching to the parents of a 7-year-old child. Which statement made by the parents demonstrates an understanding of parenting tips for a child this age?
I should teach my child how to make healthy food choices
The nurse is speaking with the parents of a school-aged child recently diagnosed with DM regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching?
If I notice changes in my son like tearfulness or irritabilty, his blood sugar may be high. (signs of HYPOglycemia)
The nurse has completed an education session with parents of children diagnosed with food allergies. Which statement by a parent would indicate a need for additional education?
If we need to use the epipen, we will need to notify her physicians office the next business day
A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be most appropriate?
"As endocrine functions become more stable throughout childhood, alterations become more apparent."
a nurse is discussing psychosocial development of adolescents with the parents of a 13 year old child. The parents are concerned because the adolescent seems to value the opinions and beliefs of friends more than those of the parents. What guidance can the nurse provide to the parents?
be open to listening to the child's ideas recognize that the child is trying to assert independence
A nurse is adminstering a blood transfusion to a child. About 35 minutes after beginning the transfusion, the child develops pruritus and urticaria. Some wheezing is noted. Which action would the nurse take first?
Discontinue the transfusion.
Which type of diet should be included in the plan of care for a child diagnosed with Addison disease?
High-protein, low-carbohydrate, high-sodium diet
A school nurse is preparing to present a class on safety to a group of 12-year-old students. What info should the nurse include in the presentation.
Seat belts should be worn at all times, bicycle helments should be worn whenever riding a bike, protective padding is a must for skateboarders
The nurse is caring for a pediatric client who has a compromised immune system. When reviewing laboratory results, which bone marrow component identifies a dysfunction in bone marrow production?
T lymphocytes and B lymphocytes Rationale: Bone marrow produces B lymphocytes and T lymphocytes. Macrophages are mature white blood cells involved with phagocytosis of an invading pathogen. Antigens are foreign substances capable of stimulating an immune response. Hapten formation occurs when a substance becomes antigenic when it combines with a higher weight molecule, usually a protein.
The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has growth hormone deficiency. Which finding would supoort this medical diagnosis.
The bone scan would show bone age would be two or more deviations below normal
a young client is admitted to the hospital directly from the clinic. The physician suspects a problem with the child's immune system. What test does the nurse anticipate the physician will order for this client?
blood analysis
A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first?
blood glucose level
A child is brought into the ED. After assessing a child's airway, breathing, and circulation, which of the following would the nurse do next?
Assess LOC
the nurse is working in a health care provider's office and is performing a routine check-up for a 2-year-old child. The nurse is reviewing home safety with the parents. Which statement by the parents indicates an understanding of home safety?
all cleaning products are kept locked in cabinets under the sink
the nurse is instructing parents on how atopic disorders affect the child. For which disorder would the nurse provide information and counseling?
allergic rhinitis, asthma, eczema, hay fever
Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone?
antidiuretic hormone
A child is brought into the emergency department. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next?
assess LOC
The nurse is called into a toddler's room. The child's mother says "he's having trouble breathing." What should the nurse do first?
assess the patency of the child's airway
The adoptive parents of a child who is 7 years old and HIV positive are concerned about telling their child about his condition. What information can be provided by the nurse?
When providing health information to a child of this age it should be simplistic and at the child's level of understanding
the nurse is providing education in class to parents on burn safety. Which statement by a participant indicates a proper understanding of what the parent should do if the child suffers a superficial (first degree) burn at home?
administer acetaminophen for pain
A 7-year-old child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? Select all that apply.
administer epinephrine as ordered, adminster oxygen, initiate intravenous access
The nurse is caring for a 24-month-old child with a fever of 101°F. The child also exhibits a toxic appearance. Which of the following would the nurse expect to implement?
administering antibiotics as ordered
the nurse is preparing to perform a dressing change on a client with burns. Which intervention comes first.?
adminster IV morphine