peds practice questions
A baby with myelomeningocele is admitted to the neonatal intensive care unit. Which of the following signs/symptoms would the nurse expect to see?
Bilateral lower limb paralysis
In recognizing Hemolytic Uremic Syndrome (HUS), which lab value does the nurse expect to see? a. BUN 15 b. Platelet count 80,000 c. Serum Creatinine 0.7 d. Urine specific gravity 1.020
b. Platelet count 80,000
An 11 month old child is receiving chemotherapy for a diagnosis of acute lymphoblastic leukemia (ALL). Which of the following vaccinations is safe for the nurse to administer to the child? a. Varicella b. MMR c. PCV d. Influenza
c. PCV
A 4-year-old child is being evaluated for hydrocephalus. The nurse notes which of the following as early signs of hydrocephalus in this child? Select all that apply.
- Early morning headache - Vomiting upon waking in the morning
A child is admitted to the pediatric unit with a diagnosis of meninigitis. Which of the following actions should the nurse perform?
- Raise the head of the bed - Administer IV antibiotics as prescribed - Place the child on droplet isolation - Dim the lights in the room
A 4-year-old has had a ventriculoperitoneal (VP) shunt in place since birth. The parents called the triage nurse at the primary health care provider office and stated that when the child awoke, he complained of a "bad" headache, adn he vomited shortly thereafter Which of the following actions by the nurse is appropriate?
Advise the parents to have the child seen in the emergency department (ED)
A nurse is assessing a child who is receiving IV chemotherapy. Assessment findings include extravasation of the tissues surrounding the IV insertion site. In which order should the nurse take the following actions? (Place in order from first step to last step). 1. remove IV line 2. stop the infusion 3. elevate the extremity 4. notify the provider
2. stop the infusion 4. notify the provider 3. elevate the extremity 1. remove IV line
Asplenic children are at increased risk for which of the following:
Bacterial infections
A nurse is assessing a 6 month old infant at a well-child visit. The nurse should notify the provider about which of the following assessment findings?
An reddened annular lesion with raised borders
Spasticity in an infant may be an early sign of:
Cerebral Palsy
A nurse is planning to teach a 9-year-old child who has a diagnosis of diabetes mellitus. The nurse should identify that school-age children are attempting to master which of the following developmental tasks?
Industry vs Inferiority
The type of seizure that first presents during infancy in which the infant goes into a "jack knife" posture is:
Infantile spasm
The most useful tool for diagnosing epilepsy is:
EEG
The nurse is developing a plan of care for a child recently diagnosed with Cerebral Palsy (CP). Which should be the nurse's priority goal?
Ensure the child reaches full potential
A nurse is assessing an infant who is at risk for increased intracranial pressure (ICP). Which of the following findings should indicate to the nurse that this complication is developing?
High-pitched cry
When assessing the neurological status of an 8-month-old, the nurse should check for which of the following?
Interaction with staff
Which should the nurse do first when caring for an infant who just had a repair of a myelomeningocele?
Measure head circumference
Which will help a school-aged child with muscular dystrophy stay active longer?
Normal activities, such as swimming
A nurse is providing dietary teaching to the parent of a toddler who has cystic fibrosis. Which of the following instructions should the nurse include?
Provide a high-fat diet for the toddler
The mother of an HIV-positive infant who is 2 mo questions the nurse about which childhood immunizations her child will be able to receive. Which immunizations should an HIV-positive child be able to receive according to the CDC recommendation for immunizing infants who are HIV positive? Select All That Apply. a. DTaP b. HiB c. Hepatitis B d. MMR e. IPV
a. DTaP b. HiB c. Hepatitis B e. IPV
A nurse is assessing a preschooler who has influenza and the reports the new onset of a sore throat and difficulty swallowing. Which of the following findings is the priority for the nurse to report to the provider?
The child is drooling
A 5 kg client is in CHF due to an uncorrected PDA. The RSD for Lasix is 0.5-2 mg/kg/dose. O2 sat is 90%, baseline O2 sat is 88%. Which order should the nurse question? a. Call the provider if 02 sat drops below 92% b. Administer O2 @ 1-2 L via nasal cannula if O2 sats drop below 87% c. Administer Lasix 8 mg IV X 1 d. Restrict total fluid intake to 500 cc/day
a. Call the provider if 02 sat drops below 92%
Which demonstrates appropriate supervision by the parent of a 15-year-old who has had Type 1 DM x 1 1/2 years? a. Check glucometer log regularly for frequency and pattern of blood sugars b. Recalculate carbohydrate count after each meal c. Require the adolescent to text the parent before each meal about their choices d. Watch them perform each finger stick with lancet
a. Check glucometer log regularly for frequency and pattern of blood sugars
A nurse is creating a plan of care for an 18 month old toddler with cerebral palsy. Which of the following interventions should the nurse include?
Use manual jaw control when feeding the toddler
A nurse is assessing a 2-month-old infant who has a ventricular septal defect (VSD). Which of the following findings should the nurse report to the provider?
Weight gain of 4lbs
A 9-year-old child with Chronic Renal Failure has suffered extreme brain and heart damage from a hypoxic episode while in the ICU for severe peritonitis. The parents have signed a DNR. Which statement by the nurse is inappropriate when asked by the parents what they should tell their 16-year-old child about this decision? a. "He is very mature for his age. I think he will be able to handle it well; he understands how sick his sister has been, but it is your decision about whether to tell him or not. If it was my child, I would hesitate telling him the entirety of the situation." b. "Although your child may not handle the news very well, it is important to discuss the potential outcomes of this situation with him so that he can begin to cope with his grief and identify whether he needs additional support systems." c. "Your child should be informed of the decision you have made. The hospital chaplain is able to come up if you would like, to help you and your child cope with this difficult situation." d. "It is appropriate to share this information with him. I want to call the Child Life specialist to come talk to you about how to do this so that he can better cope with this difficult deci
a. "He is very mature for his age. I think he will be able to handle it well; he understands how sick his sister has been, but it is your decision about whether to tell him or not. If it was my child, I would hesitate telling him the entirety of the situation."
A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. The parents ask why their child is receiving this medication. What information about the medication should the nurse provide? a. "Helps reduce the uric acid level caused by cell destruction." b. "Used to make chemotherapy work better." c. "Given to reduce the nausea and vomiting associated with chemotherapy." d. "Helps decrease pain in the bone marrow."
a. "Helps reduce the uric acid level caused by cell destruction."
A child is weighing 39 kg is diagnosed with Kawasaki's after 6 days of fever. Which interventions would the nurse expect to implement? Select All That Apply. Selected Answers: a. Administer IVIG b. Administer platelet infusion c. Obtain echocardiogram d. Place client on droplet precautions e. Administer high dose Aspirin
a. Administer IVIG c. Obtain echocardiogram e. Administer high dose Aspirin
The nurse has taught dietary restrictions to a 7-year-old child who has celiac disease. After teaching, the child is allowed to choose a meal from the hospital menu. The nurse evaluates that teaching was effective when the child chooses which of the following? a. Baked chicken, green beans, and slice of cornbread b. Ham and cheese sandwich with lettuce and tomato on rye toast c. Beef patty on hamburger bun and home fries d. Beef and barley soup, rice cakes, and celery
a. Baked chicken, green beans, and slice of cornbread
A child has been diagnosed with acute lymphoblastic leukemia (ALL). With which of thefollowing signs/symptoms did the child likely present to the primary health care provider? Select All That Apply. a. Bruising b. Jaundice c. Lethargy d. Erythema e. Rash
a. Bruising c. Lethargy
Of the following conditions, which can occur due to a stressful life event to a previously healthy pediatric patient? a. Constipation b. Celiac disease c. Intussusception d. Cystic Fibrosis
a. Constipation
The nurse is assesing a 2-month-old as a part of the routine well visit at the primary care clinic. The mother notes the infant has frequent vomiting. On assessment, the nurse notes wheezing bilaterally. The growth charts are as expected and the child seems to be gaining weight and growing appropriately. These findings suggest the infant may have which of the following? a. GERD b. These are all normal findings and the infant is fine c. Pyloric Stenosis d. Hirschsprung's Disease
a. GERD
A 4 year old child has clusters of vesicles and honey-crusted lesions on the philtrum and right naris. What condition and treatment does the nurse anticipate? a. Impetigo, treat with topcial mupirocin b. Molluscum contagiosum, treat with topical keratolytic c. Herpes Simplex, treat with oral acyclovir d. Acne vulgaris, treat with topical benzoyl peroxide
a. Impetigo, treat with topcial mupirocin
A nurse is caring for a 2 year-old who underwent an exploratory abdominal surgery less than 12 hours ago, after being shot with a pellet gun. The nurse can use of comfort and distraction techniques to assist with pain relief in the child. Of the following, which is the best additional practice for the nurse in reducing pain for the patient? a. Opioid pain medication is an expected treatment in the first shifts following abdominal surgery in children b. PRN Tylenol until she can tolerate PO pain medication is the standard of care following invasive pediatric surgery c. A PCA device is the most appropriate means of managing this patient's pain since it will allow her to feel more control d. The nurse can provide additional play therapy to distract the patient from experiencing pain related to the surgical procedure
a. Opioid pain medication is an expected treatment in the first shifts following abdominal surgery in children
The nurse is taking a health history from an adolescent with hemophilia. The nurse should ask the client whether he is experiencing any signs and symptoms of which of the following illnesses? a. Osteoarthritis b. Asthma c. Diabetes mellitus d. Hypothyrodism
a. Osteoarthritis
A nurse is assessing an infant for urinary tract infection (UTI). Which assessment findings should the nurse expect? Select all that apply. Selected Answers: a. Poor weight gain b. Enuresis c. Fever or hypothermia d. Change in urine odor or color e. Voiding urgency
a. Poor weight gain c. Fever or hypothermia d. Change in urine odor or color
A newborn is extremely cyanotic and has a loud harsh murmur. An echocardiogram reveals Transposition of the Great Vessels. What is the nurse's highest priority? a. Prepare a dose of Prostaglandin E b. Teach the parents how to reposition to shunt the baby's blood flow c. Administer a dose of Indomethacin if HR is above 100 d. Arrange for transport to nearest children's hospital, 6 hours away
a. Prepare a dose of Prostaglandin E
The nurse is developing a plan of care to prevent separation behaviors in children who are hospitalized for long periods of time. Which of the following items should the nurse include in the plan of care? Select all that apply. a. Provide the child with the child's favorite transitional object b. Admit the child to the patient room that is closest to the nurses' station c. When possible, assign the same nurse to care for the child each day d. Inform the parents that at least one person must stay with the child at all times during the hospitalization. e. Tape pictures of the child's friends and family members to the walls of the child's hospital room
a. Provide the child with the child's favorite transitional object b. Admit the child to the patient room that is closest to the nurses' station c. When possible, assign the same nurse to care for the child each day e. Tape pictures of the child's friends and family members to the walls of the child's hospital room
A 4-year-old is admitted with hypovolemic shock. Initial vital signs: T 99.2 HR 130 RR 31 BP 100/60. The nurse returns to take a 2nd set of vital signs an hour later. Which set of vital signs would be most concerning to the nurse? a. T 97.8 HR 62 RR 15 BP 90/54 b. T 99.0 HR 148 RR 29 BP 98/64 c. T 99.7 HR 118 RR 24 BP 108/64 d. T 101.0 HR 138 RR 28 BP 104/68
a. T 97.8 HR 62 RR 15 BP 90/54
A 5-year-old is diagnosed with Acute Glomerulonephritis. Which signs and symptoms would be expected findings by the nurse? Select All That Apply. a. Tea-colored urine b. No protein in urine c. Urinary frequency & urgency d. Mom reports he has been tired for the past week e. 1+ Peripheral edema f. Polyuria
a. Tea-colored urine d. Mom reports he has been tired for the past week e. 1+ Peripheral edema
According to Piaget's Cognitive Stages of Development, a nurse caring for a toddler who recently had surgery should remember that: a. Toddlers are not capable of rating or scoring their pain using the Numeric Rating Scale b. Toddlers can process concrete, basic explanations about their pain medication's action c. Toddlers are able to demonstrate their pain through imitation and story telling d. Toddles are able to understand it will take time for the medication to take effect and are able to distract themselves until it does
a. Toddlers are not capable of rating or scoring their pain using the Numeric Rating Scale
Select all that apply. Which interventions does the nurse use to advise parent in helping develop personal hygiene skills for a preschooler? a. Use a sticker reward chart to keep track of days when child remembers to brush teeth without reminder b. Allow child to choose what time each night to take their bath c. Teach child to use floss on their own and tell them to swish mouthwash for 1 minute d. Have a "tooth brushing song" that plays to help child know how long to brush e. Suggest parent keep their distance during morning activities and not provide any reminders so child will become more accountable f. Use colored bath gel to cover all of body areas to help with not missing important parts to wash
a. Use a sticker reward chart to keep track of days when child remembers to brush teeth without reminder d. Have a "tooth brushing song" that plays to help child know how long to brush f. Use colored bath gel to cover all of body areas to help with not missing important parts to wash
A 12 year old boy with a history of sickle cell anemia and a diagnosis of vaso-occlusive crisis is being assessed by the admitting nurse in the ED. Which of the following signs/symptoms would the nurse expect to see? Select All That Apply. a. Pain level 2/10 b. Hematuria c. Elevated liver enzymes d. Hematocrit 39% e. Priapism
b. Hematuria c. Elevated liver enzymes e. Priapism
Select all that apply. Which interventions does the nurse use to advise parent in helping develop personal hygiene skills for a preschooler? a. Use colored bath gel to cover all of body areas to help with not missing important parts to wash b. Have a "tooth brushing song" that plays to help child know how long to brush c. Suggest parent keep their distance during morning activities and not provide any reminders so child will become more accountable d. Allow child to choose what time each night to take their bath e. Teach child to use floss on their own and tell them to swish mouthwash for 1 minute f. Use a sticker reward chart to keep track of days when child remembers to brush teeth without reminder
a. Use colored bath gel to cover all of body areas to help with not missing important parts to wash b. Have a "tooth brushing song" that plays to help child know how long to brush f. Use a sticker reward chart to keep track of days when child remembers to brush teeth without reminder
A pediatric nurse is caring for a male patient who has undergone a hydrocele repair. While assessing the patient, the nurse notices that the scrotum is swollen and discolored. These findings are: a. normal, and indicates no need for intervention b. abnormal, and indicates the presence of hemorrhaging c. abnormal, and indicates the need for a cool compress. d. normal, and indicates the need for a position change
a. normal, and indicates no need for intervention
What would the nurse advise the parent of a child with a barking-like cough that gets worse at night? a. place a humidifier next to the child's crib overnight b. take the child to the emergency department immediately c. give the child an over-the-counter cough suppressant d. give the child warm liquids to soothe the throat
a. place a humidifier next to the child's crib overnight
A client underwent cleft palate repair has just returned from surgery with elbow restraints in place. The parents question why their child must have the restraints. The nurse would give which of the following as the best explanation to the parents? a. "This device is frequently used postoperatively to protect the IV site in small children." b. "Elbow restraints are used postoperatively to keep children's hands away from the surgical site." c. "The restraints will help us maintain proper body alignment." d. "The restraints help maintain the child's NPO status."
b. "Elbow restraints are used postoperatively to keep children's hands away from the surgical site."
Which child in the waiting room of a pediatrician's office does the nurse recognize as being behind developmental expectations? a. 17 yo filling out their "teen health questionnaire" across the room from their parent and asking the receptionist if the information is private b. 11 yo diagnosed with cystic fibrosis for 10 yrs and the nurse sees the parent putting the albuterol inhaler in child's mouth and telling them how to breathe it in c. 14 yo asking their mom how long this appointment will take because they want to get back to school in time for lunch to see their friends d. 12 yo working on their math homework while waiting for their appointment, tells their dad that they "don't need any help"
b. 11 yo diagnosed with cystic fibrosis for 10 yrs and the nurse sees the parent putting the albuterol inhaler in child's mouth and telling them how to breathe it in
Which child with asthma should the nurse see first? a. A 16-year-old who is speaking in short sentences, is wheezing, is sitting upright, and has an oxygen saturation of 93% b. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93% c. A 5-year-old who is speaking in complete sentences, is pink in color, is wheezing bilaterally, and has an oxygen saturation of 93% d. A 9-year-old who is quiet, is pale in color, and is wheezing bilaterally with an oxygen saturation of 92
b. A 12-month-old who has a mild cry, is pale in color, has diminished breath sounds, and has an oxygen saturation of 93%
Which of the following characteristics would cause the nurse to consider pyloric stenosis as a possible concern for an infant admitted with a week long history of vomiting and poor feeds? a. Appropriate growth patterns b. Acts hungry after vomiting c. Diarrhea d. Sausage shaped mass palpable in the abdomen
b. Acts hungry after vomiting
Which of the following labs would be most beneficial for identifying the nutrition status of a patient recently diagnosed with Inflammatory Bowel Disease? a. Amylase and lipase b. Albumin and pre-albumin c. ESR d. CBC with differential
b. Albumin and pre-albumin
A nurse is caring for a child who has acute glomerulonephritis. Which of the following actions is the nurse's priority? a. Place child on no potassium diet b. Check the child's daily weight c. Educate the parents about potential complications d. Maintain a saline lock on the peripheral IV
b. Check the child's daily weight
Which of the following is an appropriate goal for a child being treated for osteomyelitis? a. Prohibiting all activities b. Complete antibiotic therapy as prescribed c. Encourage a low fat diet d. Restrict visitors
b. Complete antibiotic therapy as prescribed
The infant with bronchopulmonary dysplasia (BPD) who has RSV bronchiolitis is a candidate for which treatment? a. Erythromycin intravenously b. Cool humidified oxygen c. Intermittent positive pressure ventilation d. Pancreatic enzymes
b. Cool humidified oxygen
A nurse is caring for a 3-year-old child weighing 13kg, who has been diagnosed with Nephrotic Syndrome. When completing orders for this client, which of the following should the nurse question? a. Furosemide 4mg IV q6h b. D51/2NS at maintenance rate of 60cc/hr c. Methylprednisolone 6mg IV BID d. 25% Albumin 3g IV x 1
b. D51/2NS at maintenance rate of 60cc/hr
A 15-month-old is in the clinic with a Hemoglobin of 9.1. Vital signs: HR 120 RR 26 Sat 98% on room air. She lives with her mom and grandmother, who both report she is a picky eater and has frequent tantrums. Which is most likely to be part of an ineffective treatment plan? a. Encourage child to eat iron-fortified cereal puffs during snacktime, limit drinking milk to 2 cups a day b. Encourage child to drink at least 4 cups of milk daily; schedule hemoglobin recheck in 6 months c. Administer iron PO daily; give iron with a 1/2 cup of low sugar orange juice or serving of vitamin C rich fruit d. Administer iron PO daily; recheck hemoglobin 4 weeks to monitor for improvement
b. Encourage child to drink at least 4 cups of milk daily; schedule hemoglobin recheck in 6 months
The client is a 24-month-old with a history of 4 days of diarrhea. Weight: 40lbs. Initial vital signs: T 98.4 HR 170 RR 48 BP 92/62 O2 sat 92% on room air. Lab results: BUN 22 Serum creatinine 2.8. Urine output: 20 cc in 1 wet diaper over 4 hours. Which order would the nurse question? a. D5 0.25%NS at 59 cc/hr b. IV NS bolus of 500cc c. Apply O2 via NC to keep O2 sat at 94% OR higher d. Insert a foley; strict Is and Os
b. IV NS bolus of 500cc
How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of steatorrhea (fatty stool) in a child with Cystic Fibrosis? The values indicate the child is: a. Eating too many foods high in fiber b. Not compliant with taking pancreatic enzymes c. Eating too many foods high in fat d. Not compliant with taking vitamins
b. Not compliant with taking pancreatic enzymes
A nurse is caring for an infant who has been diagnosed with intussusception, has a hard, rigid abdomen and the following vital signs: T 101.8, HR 181, BP 68/36. Which of the following is an appropriate action by the nurse? a. Prepare to start an IV, administer fluids and antibiotics b. Notify provider of potential development of perforation or peritonitis c. Prepare to accompany infant to Radiology for a reducing enema d. Prepare to accompany infant to CT scan to confirm diagnosis
b. Notify provider of potential development of perforation or peritonitis
Which child in the oncology unit would be placed on both neutropenic and thrombocytopenic precautions based on their current labs? a. Platelet (Plt) count 60,000; WBC 1200; Hgb 8.8; Bands 9%; Polys 9% b. Plt count 42,000; WBC 300; Hgb 7.8; Bands 9%; Polys 7% c. Plt count 20,000; WBC 2100; Hgb 8.7; Bands 12%; Polys 12% d. Plt count 55,000; WBC 2800; Hgb 7.7; Bands 6%; Polys 6
b. Plt count 42,000; WBC 300; Hgb 7.8; Bands 9%; Polys 7%
A ten-month-old child has been diagnosed with gastroenteritis. He attends a child-care facility. What is the most likely cause of his illness? a. Cryptosporidium b. Rotavirus c. Salmonella d. Clostridium difficle
b. Rotavirus
Which of the following would not be a concern for a nurse caring for a patient receiving morphine via an epidural? Select all that apply. a. Hypotension b. Diarrhea c. Urinary retention d. Tachypnea e. Pruritis
b. diarrhea d. tachypnea
A 12 week gestation African American woman asks her OB/GYN nurse whether her baby could be born with sickle cell disease. Which of the following replies is appropriate for the nurse to give? a. "It is possible because 1 out of every 500 African Americans is diagnosed with sickle cell disease." b. "If either you or the baby's father has sickle cell anemia (SCA), your child may be born with the disease." c. "The baby could only have sickle cell anemia if both the baby's father and you carry a sickle cell gene." d. "If the child is a boy, he could have sickle cell anemia, but if the child is a girl, she will definitely be healthy."
c. "The baby could only have sickle cell anemia if both the baby's father and you carry a sickle cell gene."
Which child can be discharged without further evaluation? a. A 6-year-old who has been having vomiting and diarrhea for 2 days and has decreased urine output b. A 10-year-old who has just returned from a Scout camping trip and has had several episodes of diarrhea c. A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet d. A 2-year-old who has had 24 hours of watery diarrhea that has changed to bloody diarrhea in the past 12 hours
c. A 2-year-old who had a relapse of one diarrhea episode after restarting a normal diet
After repositioning a child diagnosed with Tetralogy of Fallot to reshunt blood flow, what is the next priority intervention if repositioning is not effective? a. Children diagnosed with Tetralogy of Fallot do not require interventions for reshunting blood flow b. Administer an emergency dose of epinephrine c. Administer oxygen d. Reposition again in order to increase the intrathoracic pressure
c. Administer oxygen
For a sickle cell patient experiencing a vaso-occulsive crisis, which of the following is the priority nursing intervention? a. Administering PO NSAIDs b. Applying cold compresses to painful areas c. Administering IV Opioids d. Administering multiple fluid boluses
c. Administering IV Opioids
Considering Piaget's developmental stages, the nurse should expect a 6-year-old with Type 1 DM to struggle the most with mastering which of the following skills? a. Carbohydrate counting with adult assistance b. Finger stick with lancet c. Checking blood sugar 3x/daily ac; random spot check x1 during the day d. Reporting blood sugar reading to adult to have it recorded into a log book
c. Checking blood sugar 3x/daily ac; random spot check x1 during the day
Of the following, which indicates the most severe dehydration in a 4-year-old? a. HR 136, RR 32, pale, no urine x 5 hours, capillary refill 3 seconds b. HR 110, RR 30, urine specific gravity 1.020, crying with IV initiation c. HR 140, RR 42, no urine x 7 hours, does not look at parent when name is called d. HR 104, RR 50, capillary refill 3 seconds, begins whimpering when nurse enters room
c. HR 140, RR 42, no urine x 7 hours, does not look at parent when name is called
Which of the following should be done to protect the central nervous system from the invasion of malignant cells in a child newly diagnosed with leukemia? a. Cranial and spinal radiation b. Intravenous steroid therapy c. Intrathecal chemotherapy d. High dose intravenous chemotherapy
c. Intrathecal chemotherapy
Of the following advice, which would be most helpful for the parents of a baby with GERD? a. Medications ae generally necessary to prevent further problems b. Most babies continue to vomit until they are walking; at around one year of age c. Laying prone after eating will decrease the amount of vomiting d. Increase the interval between feedings to a minimum of four hours
c. Laying prone after eating will decrease the amount of vomiting
A 5 year old has several firm, small (2 mm), flesh colored umbilicated papules on right forearm. The lesions have been present for 3 months and have increased in number. What is the most likely skin condition? a. Scabies b. Furuncle c. Molluscum contagiosum d. Coxsackie Virus
c. Molluscum contagiosum
A 6-week-old infant is brought into the pediatrician's office with a history of frequent vomiting after feedings and failure to gain weight. The diagnosis of GERD is made. While planning teaching on feeding techniques with the parents, the nurse should include instructions to do which of the following? a. Change from milk based formula to soy based formula b. Dilute the formula c. Position the infant at a 30-45 degree angle after feedings d. Delay burping to prevent vomiting
c. Position the infant at a 30-45 degree angle after feedings
A 9-year-old client arrives in the ER. Which findings would require urgent notification of the provider? a. HR 100, RR 22, grabbing ears repeatedly b. Croupy cough, inspiratory stridor when crying, O2 sat 98% c. RR 58, drooling and sitting leaning forward d. O2 sat 97%, rhonchi on auscultation, episodes of crying
c. RR 58, drooling and sitting leaning forward
The nurse can expect initial treatment of a sprain to include which of the following : a. Rest, ice, compression, elevation, Tylenol b. Rest, heat, compression, elevation, and Ibuprofen c. Rest, ice, compression, elevation, and NSAIDs d. Heat, ROM exercises, compression, elevation, and NSAIDs
c. Rest, ice, compression, elevation, and NSAIDs
A nurse is caring for a 4-week-old admitted for (NEC) Necrotizing Enterocolitis and subsequent bowel resection. The parents have questions regarding this new diagnosis and the pain their child may experience. Which response by the nurse would demonstrate proper knowledge of pain management? a. Comfort measures, such as pacifiers and swaddling, are adequate measures for a child this age b. PRN IV medication should be given on a regular schedule to prevent pain this infant may be experiencing in this early post-operative period because a small infant's pain cannot be reliably scored or rated c. Scheduled IV medication should be given on a regular schedule to prevent pain in order to properly address the level of pain this infant may be experiencing in early post-operative period d. Due to potential adverse effects, such as respiratory depression, it is too risky to give a patient this age opioid pain medication
c. Scheduled IV medication should be given on a regular schedule to prevent pain in order to properly address the level of pain this infant may be experiencing in early post-operative period
A child with type 1 diabetes mellitus has been diagnosed with ketoacidosis. Which of the following laboratory findings is consistent with the diagnosis? a. Potassium level: 3.9mEq/L b. Fasting blood glucose: 124mg/dL c. Serum pH: 7.24 d. Hemoglobin A1C: 5.5%
c. Serum pH: 7.24
The nurse instructs the parents about postoperative feeding after their infant's pylooromyotomy. The nurse evaluates that the parents understand the instructions when the parents state that they will do which of the following? a. Avoid burping the baby after feeding to prevent vomiting b. Rock the baby to sleep after feeding to keep the baby calm c. Slowly increase the volume of feed offered according to the provider orders d. Maintain the infant on antiemetics to prevent vomiting
c. Slowly increase the volume of feed
A 10-year-old boy has been admitted with a diagnosis of rule out appendicitis. While the nurse is conducting a routine assessment, the boy states, "It doesn't hurt anymore." The nurse suspects which of the folllowing? a. This is a method the boy uses to receive attention b. The boy is having difficulty expressing his pain adequately c. The appendix has ruptured d. The boy is afraid of going to surgery
c. The appendix has ruptured
A nurse is assessing an infant diagnosed with Hirschsprung's Disease. Which of the following assessment findings should the nurse expect if conducting a rectal exam on this patient? a. Impacted stool with fissures b. Soft stool, normal tone c. Tight anal canal with no stool in the rectal vault d. Large, dilated rectum
c. Tight anal canal with no stool in the rectal vault
A 15-year-old is having orthopedic surgery that will result in a cast on her right arm. How can the pre-op nurse most effectively prepare this child for their post-operative appearance? a. do not mention this to the teenager, they would do best if they found out after the procedure b. allow them to show their understanding by demonstrating on a stuffed animal c. show the teenager different cast options and allow them to choose their favorite color d. tell the teenager "when you wake up, you will have a cast on your right arm"
c. show the teenager different cast options and allow them to choose their favorite color
A child with asthma comes to the ED for shortness of breath and audible wheezing. The mother reports giving fluticasone inhaler approximately 10 minutes ago. What is the best response by the nurse? a. "Since you gave your child that inhaler, why did you bring him to the ER?" b. "Giving that inhaler should help your child breathe better soon." c. "Good thinking! Fluticasone is a good medicine for an acute episode. On the other hand, your child should take albuterol daily at home, in order to prevent an asthma attack." d. "Fluticasone is a good medicine for daily use to prevent an asthma attack. However, in this situation, we will administer albuterol for his acute episode."
d. "Fluticasone is a good medicine for daily use to prevent an asthma attack. However, in this situation, we will administer albuterol for his acute episode."
A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask? a. "Has your child had any injuries recently?" b. "Was your son born with this cardiac defect?" c. "Have you given your child aspirin in the past 2 weeks?" d. "Has your son had a sore throat recently?"
d. "Has your son had a sore throat recently?"
The parent of a 10-month-old is being interviewed by the nurse preceding an examination by the pediatric nurse practitioner and states, "My baby loves all kinds of food, and he always drinks his milk from a sippy cup, except in the evenng when he wants a bottle." Which of the following follow-up questions is most important for the nurse to ask? a. "Have you fed your child any foods that he can feed himself, like cereal and peas?" b."Have you decided when you will wean your child from the bottle entirely?" c. "Which fruits and vegetables have you fed your child so far?" d. "Is you child drinking cow's milk from the sippy cup and bottle?"
d. "Is you child drinking cow's milk from the sippy cup and bottle?"
The parent of a child recently diagnosed with Celiac Disease is discussing the disease with the clinic nurse. Which parent statement represents a good understanding of the disease or treatment needs? a. "Managing and understanding my child's bowel patterns is really the most important thing I need to focus on; there are not other major symptoms to worry about." b. "I am surprised she has Celiac Disease; it is usually diagnosed with frequent constipation and projectile vomiting." c. "This is a hard disease to cope with because it will cause so many respiratory issues." d. "We will need to change many of the food products we use, including our breads and pastas, to manage this disease as effectively as possible."
d. "We will need to change many of the food products we use, including our breads and pastas, to manage this disease as effectively as possible."
A nurse is attempting to get a 5-year-old child's cooperation when auscultating heart sounds. Which of the following comments is most likely to elicit the child's cooperation? a. "its time for me to listen to your heart go boom boom" b. "let me show you a picture of a heart and where i want to listen" c. "did you know that your heart beats in your chest?" d. "would you like to listen to the sounds your heart makes?"
d. "would you like to listen to this sounds your heart makes?"
For which client would position change to reshunt blood flow be the initial priority intervention? a. 5 month old with CoA, HR 50, RR 10, 02 sat 60% b. 3 week old with VSD, HR 100, RR 40, O2 sat 76% c. 4 year old with PDA, HR 110, RR 42, O2 sat 88% d. 9 month old with ToF, HR 70, RR 14, O2 sat 50%
d. 9 month old with ToF, HR 70, RR 14, O2 sat 50%
Which of the following medications would be contraindicated for a 15-year-old diagnosed with ITP? a. Amoxicillin b. Decongestant c. Acetaminophen d. Aspirin
d. Aspirin
A 2 mo child has not received any immunizations. Which immunizations should the nurse give? a. DTaP, Hib, HepB, MCV, varicella b. DTaP, Hib, HepB, HPV, IPV, Rota c. DTaP, Hib, HepB, PCV, HepA d. DTaP, Hib, HepB, PCV, Rota
d. DTaP, Hib, HepB, PCV, Rota
What action is contraindicated when a child with Down syndrome is hospitalized? a. Assess the child's hearing and visual capabilities b. Determine the child's vocabulary for specific body functions c. Have meals served at the child's usual meal times d. Encourage parents to leave the child alone for extended periods of time
d. Encourage parents to leave the child alone for extended periods of time
An adolescent is seen in clinic for a possible diagnosis of Hodgkin disease. The nurse is aware that which of the following symptoms should make the provider suspect Hodgkin disease? a. Anorexia with weight loss b. Enlarged liver with jaundice c. Fever, fatigue and pain in the joints d. Enlarged, painless, and movable lymph nodes in the cervical areas
d. Enlarged, painless, and movable lymph nodes in the cervical areas
A newborn has been diagnosed with a congenital heart defect. What is a key priority the nurse should ensure is complete for the child prior to discharge? a. Prepare a dose of Prostaglandin E b. Ensure the parent has signed a DNR c. Ensure that the surgery pre-op checklist has been completed and the parent has signed consent d. Ensure an echocardiogram has been done
d. Ensure an echocardiogram has been done
A recently hospitalized 10 year old is repeatedly refusing treatments and yelling at his parents saying, "I don't want to do this! I'm scared! No!" The parents want him to have the treatments as prescribed. Which action by the nurses would be most appropriate? a. Inform child about procedures 5 minutes beforehand; Tell them to be quiet so procedure will go quicker b. Begin procedures when child is asleep or distracted; do not give child any warning before procedures c. Tell child about each procedure about 30 minutes prior; bargain or bribe child to participate d. Explain the process of the treatment using a favorite toy or game prior to the treatment
d. Explain the process of the treatment using a favorite toy or game prior to the treatment
A toddler has been diagnosed with iron-deficiency anemia. Which of the following information should the nurse educate the parents regarding medication administration? a. Add iron elixir to morning bottle b. Administer the medicine directly before meals c. Crush the tablets and mix the medicine with his applesauce d. Have the child drink orange juice right after taking the medicine
d. Have the child drink orange juice right after taking the medicine
Of the following, which child does the nurse recognize as needing to be placed on thrombocytopenic precautions? a. Platelet (Plt) count 152,000; Hgb 12.8; oozing Broviac site b. Plt count 50,000; Hgb 11.7; light green/yellow drainage from NG tube c. Plt count 47,000; Hgb 10.3; moist mucus membranes d. Plt count 49,000; WBC 17,000; report of hematuria
d. Plt count 49,000; WBC 17,000; report of hematuria
A baby that was born 5 minutes earlier is tachypneic, tachycardic, and markedly cyanotic. A STAT echocardiogram confirms the presence of a cyanotic congenital cardiac defect. Which of the following defects would be consistent with the assessment findings? a. Atrial septal defect b. Patent ductus arteriosus c. Ventricular septal defect d. Transposition of the Great Vessels
d. Transposition of the Great Vessels
While doing CPR for a 9-yr-old, where do you check the pulse? a. Brachial artery b. Temporal artery c. Femoral artery d. Carotid artery
d. carotid artery
Which of the following laboratory tests will be ordered to determine the presence of the HIV antigen in an infant whose parent is HIV positive? a. Western blot b. CD4 cell count c. IgG levels d. p24 antigen assay
d. p24 antigen assay
