Peds practice questions week 1
A 10-month-old is carried into the emergency department by her parents after she fell down 15 stairs in her walker. Which would be your highest priority nursing intervention? A. Assess airway while simultaneously maintaining cervical spine precautions. B. Assess airway, breathing, and circulation simultaneously. C. Prepare for diagnostic radiological testing to check for any injuries. D. Obtain venous access and draw blood for testing.
A
An adolescent is received in the PICU after scoliosis surgery. Using Maslow's Hierarchy of Needs as a guide, which problem takes priority? A. Hypotension related to analgesia. B. Fear of being left alone by parents. C. Frustration with postoperative immobility. D. Concern with the extensive skin incision.
A
Shortly before a child's elective surgery, the parents tell the nurse, "I am having second thoughts about my child undergoing this surgery." The nurse respects the parent's concern and calls the surgeon. What ethical/moral principle is represented by this situation? A. Autonomy. B. Equality. C. Fidelity. D. Justice.
A
Which intervention should the nurse implement for a newborn diagnosed with galactosemia? A. Eliminate all milk and lactose-containing foods. B. Encourage breastfeeding as long as possible. C. Encourage lactose-containing formulas. D. Avoid feeding soy-protein formula to the newborn.
A
Which signs and symptoms would the nurse expect to assess in a child with rheumatic fever? A. Ankle and knee joint pain. B. Negative group A beta streptococcal culture. C. Large red "bull eye" -appearing rash. D. Stiff neck with photophobia.
A
Which would be the nurse's best response if a mother asks if her baby still needs the Hib vaccine because he already had Hib? A. "Yes, it is recommended that the baby still the Hib vaccine." B. "No, if he has had Hib, he will not need to receive the vaccine." C. "Let me take a nasal swab first; if negative, he will receive the Hib vaccine." D. "The physician will order a blood test, and depending on results, your child may need the vaccine."
A
The nurse makes an error by giving the wrong medication to a client. An incident report is completed per hospital policy. What information should the nurse chart in the medical record? Select all that apply. A. Description of the specific occurrence. B. What treatment was given. C. Completion of the incident report. D. Date, time, and name of person completing the incident report. E. Nothing.
A, B
Expected nursing assessments of a newborn with suspected cystic fibrosis would include which of the following? Select all that apply. A. Observe frequency and nature of stools. B. Provide chest physical therapy. C. Observe for weight gain. D. Assess parents' compliance with fluid restrictions. E. Assess respiratory system frequently.
A, C
After receiving the change-of-shift report, the nurse prioritizes care for the day. Which child should the nurse assess first? A. A 1-month-old admitted 1 day ago with fever and possible sepsis. B. A 14-month-old with a tracheostomy admitted for respiratory syncytial virus (RSV) bronchitis. C. An 18-month-old with acute viral meningitis. D. A 7-year-old 1 day after an appendectomy.
B
An 18-month-old is discharged from the hospital after having a febrile seizure secondary to exanthem subitum (roseola)). On discharge, the mother asks the nurse if her 6-year-old twins will get sick. Which teaching about the transmission of rosela would be most accurate? A. The child should be isolated in the home until the vesicles have died. B. The child does not need to be isolated from the older siblings. C. Administer acetaminophen to the older siblings to prevent seizures. D. Monitor older children for seizure development.
B
An 18-year-old with a rash and itching in the groin area is concerned that he has contracted a sexually transmitted disease and does not want his parents to find out. The nurse's best response is: A. "We will need to contact your parents to let them know." B. "We will not contact your parents regarding this visit." C. "Who would you like us to contact about your visit here today." D. "We cannot promise that the hospital will not contact your parents."
B
An interdisciplinary team is assembled to review protocols for management of central intravenous lines. Which staff should be represented on the team? A. Experienced RNs and pharmacists. B. RNs, physicians, and pharmacists. C. RNs, LPNs/LVNs, and physicians. D. Charge nurses ad staff physicians.
B
The mother of a newborn asks the nurse when the infant will receive the first hepatitis B immunization. Which is the nurse's best response? A. "Babies receive the hepatitis B vaccine only if their mother is hepatitis B-positive." B. "The first dose of the hepatitis B vaccine will be given prior to discharge today." C. "The first dose of hepatitis B vaccine is given at 1 year of age." D. "Babies receive their first hepatitis B vaccine at 6 months of age."
B
The nurse is going to give a 6-month-old a dose of ceftriaxone (Rocephin) IM. What should the nurse do when the 1.5-mL dose arrives from the pharmacy? A. Administer the injection into the deltoid muscle. B. Divide the dose into two injections. C. Administer the injection into the dorsogluteal muscle. D. Give dose as a single injection into the vastus lateralis muscle.
B
What would be the priority nursing action on finding the varicella vaccine at room temperature on the shelf in the medication room? A. Ensure the varicella vaccine's integrity is intact; if intact, follow the five rights of medication administration. B. Do not administer this batch of vaccine. C. Ensure the varicella vaccine's integrity is intact; if intact, give the vaccine after verifying proper physician orders. D. Ask the mother if the child has had any prior reactions to varicella.
B
Which assessment is most important after any injury in a child? A. History of loss of consciousness and length of time unconscious. B. Serial assessments of level of consciousness. C. Initial neurological assessment. D, Initial vital signs and oxygen saturation level.
B
Which client is able to give informed consent for a surgical procedure in many U.S. states? A. A 13-year-old abused male. B. A 15-year-old pregnant female. C. A 16-year-old cancer patient. D. A 17-year-old college freshman.
B
Which foods would the nurse recommend to the mother of a 2-year-old with iron-deficiency anemia? A. 32 oz of whole cow's milk per day. B. Meats, eggs, and green vegetables. C. Fruits, whole grains, and rice. D. 8 oz of juice, three times per day.
B
Which intervention might the nurse anticipate in a 2-day-old infant diagnosed with maple syrup urine disease? A. High-protein, high-amino acid diet. B. Low-protein, limited amino acid diet. C. Low-protein, low-sodium diet. D. Phenylalnine-restricted diet.
B
Which signs and symptoms would the nurse expect to assess in a newborn with congenital hypothyroidism? A. Preterm, diarrhea, and tachycardia. B. Post-term, constipation, and bradycardia. C. High-pitched cry, colicky, and jittery. D. Lethargy, diarrhea, and tachycardia.
B
Which statement from parents of a newborn diagnosed with Tay-Sachs disease indicates successful understanding of the long-term prognosis? A. "If we give our baby a proper diet, early intervention, and physical therapy, he can live to adulthood." B. "He will have normal development for about 6 months before progressive development delays occur." C. "With intense physical therapy and early intervention, we can prevent developmental delays." D. "If we give our baby a lactose-free diet for life, we can minimize developmental delays and learning disabilities."
B
Which would be the priority intervention for a child suspected of having varicella (chickenpox)? A. Contact precautions. B. Contact and droplet respiratory precautions. C. Droplet respiratory precautions. D. Universal precautions and standard precautions.
B
Which would be the priority intervention for the newborn of a mother positive for hepatitis antigen? A. The newborn should be given the first dose of hepatitis B vaccine by 2 months of age. B. The newborn should receive the hepatitis B vaccine and hepatitis B immune globulin within 12 hours of birth. C. The newborn should receive the hepatitis B vaccine and hepatitis B immune globulin within 24 hours of birth. D. The newborn should receive hepatitis B immune globulin within 12 hours of birth.
B
When caring for an infant admitted for pyloric stenosis surgery, which tasks would be appropriate for the RN to delegate to a nursing assistant? Select all that apply. A. Physical assessment on admission. B. Vital signs every 4 hours. C. Discharge teaching for parents. D. Bed, bath, and change of linens. E. Daily weights.
B, D, E
A 6-month-old male is at his well-child checkup. The nurse weighs him, and his mother asks if his weight is normal for his age. The Nurse's best response is: A. "At 6 months, his weight should be approximately three times his birth weight." B. "Each child gains weight at his or her own pace." C. "At 6 months, his weight should be approximately twice his birth weight." D. "At 6 months, a child should weigh about 10 lb. more than his or her birth weight."
C
An adolescent had a diagnosis of new-onset diabetes. What would most influence a teenager's food choices as he begins to make changes in his diet? A. Parents and their dietary choices. B. Cultural background. C. Peers and their dietary choices. D. Television and other forms of media influence.
C
Assigning the right task to the right person is a principle of nursing delegation and assignment. Which scenario best meets this principle? A. A 4-month-old with Down syndrome is assigned to a nurse whose own child died of heart disease due to Down syndrome 6 months ago. B. A child with a central intravenous line that occluded on the previous shift is assigned to a new LPN/LVN. C. A child newly diagnosed with acute leukemia is assigned to an experienced pediatric oncology nurse who floated to the general pediatric unit. D. A child with new-onset type 1 diabetes is assigned to an RN who has four other complex-care clients.
C
At lunch, several nurses are discussing how difficult it is to care for an adolescent who constantly complains of pain unrelieved by morphine via patient-controlled analgesia (PCA) pump. One nurse comments, "The teen is addicted to drugs. What do you expect?" Which is the best response to this statement? A. "The teen should be moved to an adult unit, where the teen will be told what to do." B. "We should make sure that the teen has a nursing student to give the staff some relief." C. "Perhaps we should call a team conference to review the pain complaints and treatment." D. "I think we should speak with the physician about changing to non-narcotic pain medications."
C
During an adolescent's initial physical assessment, the nurse notes signs and symptoms of nutritional deficit. Which assessment led the nurse to this initial conclusion? A. Protein level within normal limits. B. Blood pressure is 110/66. C. Hair and nails are brittle and dry. D. Teeth appear to be eroded.
C
The mother of 10-year-old fraternal twins tells the nurse at their well-child checkup that she is concerned because her daughter has gained more weight and height than her twin brother. The mother is concerned that there is something wrong with her son. The nurse's best response is: A. "I understand your concern. I will talk with the physician, and we can draw some lab work." B. "Let me ask you whether your son has been ill lately." C. "It is normal for girls to grow a little taller and gain more weight than boys at this age." D. "It is normal for you to be concerned, but I am sure your son will catch up with your daughter eventually.
C
The mother of a 3-week-old infant tells the nurse she is residing in a homeless shelter and is concerned about her baby's mild cough, poor appetite, low-grade fever, weight loss, and fussiness over the past 2 weeks. Which nursing intervention would be the nurse's highest priority? A. Weigh the baby to have an accurate weight using standard precautions. B. Reassure the mother that the baby may only have a cold, which can last a few weeks. C. Immediately initiate droplet face-mask precautions and isolate the infant. D. Take a rectal temperature while completing the assessment using standard precautions.
C
Which instruction would be of highest priority for the mother of an infant receiving his first oral rotavirus vaccine? A. "Call the physician if he develops fever or cough." B. "Call the physician if he develops fever, redness, or swelling at the injection site." C. "Call the physician if he develops a bloody stool or diarrhea." D. "Call the physician if he develops constipation and irritability."
C
Which medication is most important to have available in all clinics and offices if immunizations are administered? A. Diphenhydramine (Benadryl) injection. B. Diphenhydramine (Benadryl) liquid. C. Epinephrine 1 : 1000 injection. D. Epinephrine 1 : 10,000 injection.
C
Which treatment would the nurse anticipate for a 2-week-old boy diagnosed with PKU? A. There is no treatment or special diet. B. A high-phenylalanine diet. C. A low-phenylalanine diet. D. The mother would be advised not to breastfeed the infant.
C
The nurse realizes that a 3 ½-year-old's mother needs further education about the Denver Developmental Screening Test when she states: Select all that apply. A. "It screens for gross motor skills." B. "It screens for fine motor skills." C. "It screens for intelligence level." D. "It screens for language development." E. "It screens for school readiness."
C, E
The nurse received a telephone call from a staff member who works on another unit. The member is inquiring about the tests results of a friend's child, who is hospitalized on the nurse's unit. Which response is appropriate? Select all that apply. A. Summarize the test results, because they are within the normal range. B. Move to a private phone to prevent being overheard before sharing the information. C. Decline to give out information. D. Direct the staff member to the test results in the hospital electronic medical record. E. Suggest the staff member to ask the child's parent about the test result.
C, E
Which statements would indicate to the nurse that a school-age child is not developmentally on track for age? Select all that apply. A. The chikld is able to follow a four-to-five step command B. The child started wetting the bed on admission to the hospital C. The child has an imaginary friend named Kelly D. The enjoys playing board games with her sister E. The child is not able to follow rules
C, E
A 2-year-old admitted to the hospital 2 days ago has been crying and is inconsolable much of the time. The nurse's best response to the child's parents who are concerned about this behavior is that the child is in the: A. Detachment phase of separation anxiety, which is normal for children during hospitalization. B. Despair stage of separation anxiety, which is normal for children during hospitalization. C. Bargaining stage of separation anxiety, which is normal for children during hospitalization. D. Protest stage of separation anxiety, which is normal for children during hospitalization.
D
A child with a newly applied left leg cast initially feels fine, then starts to cry and tells his mother his leg hurts. Which assessment would be the nurse's first priority? A. Cast integrity. B. Neurovascular integrity. C. Musculoskeletal integrity. D. Soft tissue integrity.
D
According to developmental theories, which important event is essential to the development of the toddler? A. The child learns to feed self. B. The child develops friendships. C. The child learns to walk. D. The child participates in being potty-trained.
D
An 8-day-old was admitted to the hospital with vomiting and dehydration. The newborn's heart rate is 170, respiratory rate is 44, blood pressure is 85/52, and temperature is 99 F (32.2 C). What is the nurse's best response to the parents who ask if the vital signs are normal? A. "The blood pressure is elevated, but the other vital signs are within normal limits." B. "The temperature is elevated, but the other vital signs are within normal limits." C. "The respiratory rate is elevated, but the other vital signs are within normal limits." D. "The heart rate is elevated, but the other vital signs are within normal limits."
D
An adolescent is seen in ED and diagnosed with a bowel obstruction. Despite the nurse's best attempt to explain the reason for a nasogastric (NG) tube, the teen refuses to let the nurse insert the tube. The parent's approach is also ineffective. Which would be most appropriate for the nurse to do first? A. Obtain an order for sedation, physically restrain the client, and insert the tube. B. Page the physician and document the client's refusal to accept the nasogastric tube. C. Explain the against-medical-advice (AMA) form to the adolescent and parent. D. Notify the hospital's client advocate to meet with the adolescent and parent.
D
For a school-age child who has Kawasaki disease and is taking aspirin, which laboratory value should be reported to the physician? A. Blood urea nitrogen 18 mg/dL. B. Hematocrit 42%. C. Potassium 3.8 mEq/L. D. PT 14.6 sec.
D
Individually identifiable health information may not be: A. Faxed. B. Mailed C. Copied. D. Sold.
D
It is a busy day on the pediatric unit, and the nurses are short-staffed. A school-age child is scheduled to undergo an invasive radiological procedure. Which staff member would be most appropriate to meet the child's support needs by accompanying the child to the radiology department? A. The staff nurse with the least busy assignment. B. The staff nurse assigned to this child. C. A volunteer grandparent who is on the unit. D. The child-life worker for the unit.
D
Which approach should the nurse use to gather information from a child brought to the ED for suspected child abuse? A. Promise the child that her parents will not know what she tells the nurse. B. Promise the child that she will not have to see the suspected abuser again. C. Use correct anatomical terms to discuss body parts. D. Tell the child that the abuse is not her fault and that she is a good person.
D
Which is the most appropriate teaching to the parents of a child in the emergency department after a near-drowning if the child is awake, alert, and has n respiratory distress? A. "Your child will most likely be discharged, and you watch for any cough or trouble breathing." B. "Your child will need to have a preventative tube for breathing and ventilation to ensure the lungs are clear." C. "Your child will be fine, but sometimes antibiotics are started as a preventative." D. "Your child will most likely be admitted for at least 24 hours and observed for respiratory distress or any swelling of the brain."
D
Which of the following is a component of family-centered care? A. Reinforce all parenting practices. B. Accept all cultural practices and rituals. C. Guarantee that financial needs are met. D. Recognize family strengths.
D
Which statement accurately describes how the nurse should approach an 11-year-old t do a physical assessment? A. Ask the child's parents to remain in the room during the physical exam. B. Auscultate the heart, lungs, and abdomen first. C. Explain that the physical exam will not hurt. D. Explain what the nurse will be doing in basic understandable terms.
D
Which would be the most therapeutic response for the mother of a 6-month-old who tells the nurse she does not want her infant to have the DTaP vaccine because the infant had localized redness the last time she received the vaccine? A. "I will let the physician know, and we will not administer the DTaP vaccination today." B. "Every child has that allergic reaction, and your child will still get the DTaP today." C. "I will let the physician know that you refuse further immunizations for your daughter." D. "Would you mind if we discussed your concerns."
D
