peds test 2

.Which of the following test aids in the diagnosis of cystic fibrosis(CF)?

Sweat test, stool for fat, chest x-ray films

.Which of the following describes moderate persistent asthma symptoms?

Symptoms seen on a daily basis

A 10 y.o in the Peds ER has symptoms of severe dehydration. What are signs of impending shock which needs to be monitored for in this child?

Tachycardia, cool skin, hypoxemia

Which statement is true concerning Fragile X syndrome?

The disease has no cure and pharmaceuticals are used to manage symptoms

A 10 month old infant has acute otitis media (AOM) and is being treated with oral antibiotics for the 3rd time in the past 8 months. What should the nurse include in the discharge teaching to the infants parents?

The infant will need a f/u visit for possible tympanostomy procedure and tubes

An initial action of the nurse in caring for a child with Status Asthmaticus is which of the following?

Administer beta 2 agonists as ordered

Which of the following are part of the stages of grief an individual may experience while dealing with the death of a child?

Ambivalence, Denial, Anger

What action should the school nurse take for a child who has a hematoma (black eye) with no hemorrhage into the anterior chamber?

Apply ice for the first 24 hr

When planning care for an 8 y.o boy with Down syndrome, the nurse should

Assess the child's current developmental level and plan care accordingly

.What behavior seen in children should be addressed by the nurse who is providing care to a child with chronic illness?

preschooler who refuses to participate in self-care

The nurse should expect the apical heart rate of a stabilized neonate to be which of the following ranges?

120-160 beats/min

A 10 y.o sustained a superficial 2nd degree partial thickness burn on his left arm during a BBQ. What is the expected time of healing for this injury?

3-4 weeks

A 46 lb 4 y.o pt is ordered to have acetaminophen 10 mg/kg/dose oral suspension. Medication bottle is labeled 300 mg/2 ml. Calculate the dose to be administered

3.1

What condition is defined as reduced visual acuity in one eye despite appropriate optical correction?

Amblyopia

What behavior seen in children should be addressed by the nurse who is providing care to a child with chronic illness?

An adolescent who is becoming more dependent on family

Select from the list below a reason for 'innocent' heart murmur in infants

Anemia

The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. Which of the following should the nurse consider an 'approach behavior' that results in parental movement toward adjustment?

Anticipating future problems and seeking guidance and answers

What structural defects constitute tetralogy of Fallot?

Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

Which of the following age range of children qualify to be included in Early Intervention programs

Birth-3

A 6 y.o in the peds Er has a diagnosis of hypovolemic shock. What are the most frequent causes of this type of shock in children?

Blood Loss

The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant?

Capillary refill of greater than 2 secs and weight loss

.What are common respiratory symptoms dying children experience? (SELECT ALL)

Cough, wheezing, shortness of breath

What intervention should be included in the nursing care of a child with autism spectrum disorder(ASD)?

Decrease auditory and visual simulation and Provide individualized care

.A 7 y.o child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death?

Difficulty swallowing

The practitioner has ordered a liquid oral antibiotic for a toddler with otitis media. The prescription reads 1 ½ tsp 4x/day.What should the nurse consider in teaching the mother how to give the medicine?

Disposable calibrated oral syringe

Transposition of the Great Vessel(TGV) is incompatible with life. Prostaglandin E is given to children with this medical emergency to keep which of the following shunts open in an infant with TGV?

Ductus Arterlosus

A 7 y.o child tested positive for Streptoccal Pharyngitis, but she's allergic to Penicillin. Which of the following antibiotics is indicated as a treatment option?

Erythromycin

The potential effects of chronic illness or disability on a child's development vary at different ages. Which of the following is a threat to a toddlers normal development?

Hindered mobility

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit?

Hypotonic dehydration

The nurse is teaching a group of female adolescents about toxic shock syndrome and the use of tampons. What statement by a participant indicates a need for additional teaching

I can use a superabsorbent tampon for more then 6 hrs

1.A 2 y.o has been placed in contact isolation because of diagnosis of respiratory syncytial virus(RSV)bronchlolitis. The father questions why the staff is wearing masks and gowns every time someone comes into the room. What is the best response by the nurse? I

It is important for the staff to wear the equipment to prevent spreading it to others

The nurse understands that a preschool child may react to death with what reaction?

Joking

The nurse notes that the parents of a critically ill child spend a lot of time talking to the parents of another child who is seriously ill. They talk with these parents more than the nurses. How should the nurse interpret this situation?

Parent to parent support is valuable

.When teaching a mother how to administer eye drops where should the nurse tell her to place them?

Place in the small sac that is formed when the lower eyelid is pulled down

.A 3 month old with a hypercyanotic spell. What should be the nurse's first action

Place the child in knee chest position

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates avoidance coping behaviors?

Refuses to agree to treatment, Avoids staff, family members, or child, Is unable to discuss possible loss of the child

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what

Regression

The nurse is assessing a 12 year old child with a foreign object in the left eye. What action should the nurse take?

Remove a freely movable object with the pointed corner of gauze pad moistened with water

4.A 4 y.o male is rushed to the emergency dpt during an acute severe prolonged asthma attack and is unresponsive to usual treatment. The condition is referred to as which of the following?

Status Asthmaticus

.A school nurse is educating a room full of 12-12 y.o females on health and hygiene issues. She included the following symptoms: high fever, vomiting, diarrhea, oliguria, and hypotension to best describe which illness?

Toxic Shock Syndrome(TSS)

An 8 month old child seen in the peds clinic with Otitis Media w Effusion(OME) what is the best treatment option for this child?

Tympanostomy tubes

A child's chart indicates Astigmatism. For what should the nurse assess?

Unequal curvatures in refractive apparatus

What are the early signs of cognitive impairment?

Unresponsiveness to the environment at 12 months of age, unable to speak 2-3 words at 24 months of age, head lag at 11 months of age

A child is recovering from Kawasaki disease (KD). The child should be monitored for which? a. Anemia b. Electrocardiograph (ECG) changes c. Elevated white blood cell count d. Decreased platelets

b

What child has a cyanotic congenital heart defect? a. An infant with patent ductus arteriosus b. A 1-year-old infant with atrial septal defect c. A 2-month-old infant with tetralogy of Fallot d. A 6-month-old infant with repaired ventricular septal defect

c

A child diagnosed with Coarctation of Aorta is scheduled for a f/u visit. While assessing the pediatric nurse would expect to find which of the following symptoms?

Absent or diminished femoral pulses

.What factor is most important for parents implementing do not resuscitate(DNR) orders

Acknowledgement by health care team that child has no realistic chance for cure

What finding is the most reliable guide to the adequacy of fluid replacement for a small child with burns?

Urinary output of 1-2 ml/kg of body weight/hr

A 2 y.o is scheduled to have a tonsillectomy. How would you educate the pt?

Use picture books and puppets and repeat explanation

A nurse is evaluating the management of a child with a history of asthma. Which statement from the mother quires further investigation?

When my child has an attack she usually has to use her rescue inhaler 4x before her breathing improves

.The nurse wants to provide a 3 month old infant with stimulation. What is the best toy for the nurse to provide?

Mobile with a music box

A 13 month old child seen in the peds clinic shows symptoms of tachycardia, tachypnea, cap refills of 3 sec, and slight weight loss since the last visit. Which level of dehydration is the child entering?

Moderate

Select the surgical procedures usually done in children to correct heart defects from the following list(SELECT ALL)

Modified Blalock-Taussig Shunt Bidirectional Glenn Shunt

What does the nurse recognize as physical signs of approaching death?(SELECT ALL)

Mottling of skin, Cheyne-Stokes respirations, decreased appetite and thirst

At which age do most children have an adult concept of death as being inevitable, universal, and irreversible

9-11 y.o.

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area with onset before age 3 years?

Ability to maintain eye contact

What drug is an angiotensin-converting enzyme(ACE) inhibitor?

Captopril(Capoten) and Enalapril(Vasotec)

The nurse is preparing to administer a liquid medication by a nasogastric feeding tube. What is the first thing the nurse should do?

Check the pH of the gastric aspirate

The nurse is preparing to give acetaminophen (Tylenol) to a child who has a fever. What nursing action is appropriate?

Check to be sure the Tylenol dose does not exceed 15mg/kg

Secondary prevention for cognitive impairment includes what activity?

Newborn screening for treatable inborn errors of metabolism

A 1 month old is admitted to the hospital. The infant's mother is 17 y.o and single and lives with her parents. Who signs the consent form for the 1 month old infant?

The infant's mother

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by what response

Guilt and anger

The parents of a 3 y.o admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family?

Help the family develop a written list of specific questions to ask the practitioner

Of the statements below what statement best represents infectious mononucleosis?

Lymphadenopathy is a common characteristic Clinical signs and symptoms and blood tests are both needed to establish the diagnosis

An 11 month old child seen in the Peds clinic is diagnosed with Isotonic Dehydration. Which of the following si true of Isotonic Dehydration?

Electrolyte and water deficits are in balanced proportions

.Which of the following is usually affected in cystic fibrosis, resulting in excess multisystem mucus build up that is difficult to clear?

Exocrine Gland

The nurse assesses the respiratory status of an infant. Which finding should be of most concern to the nurse

Expiratory grunting

4.Which of the following medication is commonly used to treat Kawasaki's Disease(KD)?

IVIG

Which behavior indicates an 18 month old is developing a non-adaptive reaction to a prolonged hospitalization?

Ignores mother when she arrives

A 6 y.o male in the peds ER has a history of fluid loss and dehydration over the past 12 hrs. The nursing assessment should include close monitoring for the possibility of which of the following?

Impending shock

A parent prepares to administer pancreatic enzymes to an infant with cystic fibrosis. As per education she received the best action to administer the enzymes is which of the following?

Increase the dose of pancreatic enzymes if infant is having frequent bulky stool

The Pediatric Nurse assigned to an 8 y.o is aware that the childs fluid need will be decreased in which of the following circumstances?

Increased Intercranial Pressure

A nurse in the Tb clinic is preparing to administer Directly Observed Therapy(DOT) to a pt with active Tb. Which of the following medications will the nurse expect to administer?

Isoniazid

A pediatric nurse is caring for a child who is terminally ill and expected to die. Which of the following procedures is usually no longer necessary during the terminal phase?

Measure vital signs

3. A 5 year old has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. Which of the following is the most important nursing intervention?

Orient him to his immediate surroundings

Select the statement that is true concerning upper respiratory infections(URI) in children under 2 years old

Over the counter medications are not recommended for treatment of the common cold

Verbal informed consent via the telephone for a minor child is appropriate when the parent is not available in person. Which of the following is true in this case?

The verbal consent is required to be in the presence of 2 witnesses

A 2 y.o child diagnosed with tetralogy of Fallot becomes upset, crying, and thrashing around when a blood specimen is obtained. The childs color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?

Place the child in knee to chest position

When giving oral liquids from a syringe to an infant or child, which is the best procedure to use

Place the tip of the syringe into the pocket formed between the lower teeth and cheek

Select the parts of the fetal circulation of the pediatric heart in the correct order as blood flows from the placenta to the fetus:

Placenta-umbilical vein-ductus venosusinferior vena cava-R atrium

A nurse is reviewing the laboratory values of a child with rheumatic heart disease. Which finding does the nurse conclude is related to this condition?

Positive antistreptolysin titer

5.Which of the following would be involved in the nursing care of a child with an atrial septal defect?

Preparing the child and family for cardiac catheterization

.A school nurse decides to initiate a safety program for increasing the use of bicycle helmets. The program is an example of

Primary prevention

.Which of the following should be included in the nursing care of a child with autism spectrum disorder(ASD)?

Provide a structured routine for the child to follow

.The physician suggests that surgery be performed for patent ductus arteriosus(PDA) to prevent which complication?

Pulmonary vascular congestion

.What is the best explanation for using pulse oximetry on young children to determine oxygen saturation?

Pulse oximetry is noninvasive

1A first-time mother asks you what type of toy would be best for her 2 ½ y.o. Your response is?

Push-pull toys, large balls, and stuffed animals

During a respiratory assessment, the nurse notes a sinking in of soft tissue relative to the cartilaginous and bony thorax. What is the term for this finding?

Retractions

.A nurse in the Tb clinic is preparing to administer Directly Observed Therapy(DOT) to a pt with active Tb. Which of the following medications will the nurse expect to administer

Rifampin

A nurse in the Tb clinic is preparing to teach a pt with active Tb about the medications. Which of the following medications will the pt need to take initially?

Rifampin, Isoniazid, Ethambutol

Tetralogy of fallout consists of pulmonic stenosis, overriding aorta, ventricular septal defect, and which of the following?

Right ventricular hypertrophy

What description applies to fragile X syndrome?

Second most common genetic cause of cognitive impairment primarily affects males and follows the pattern of X-linked dominant inheritance with reduced penetrance.

The Cochlear implantation is a safe surgical technique used to treat which of the following types of hearing loss in children?

Sensorineural

An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. Instructions to the parent should include which of the following? A. Administer all of the prescribed medication. B. Medication may take 24-48 hrs to make symptoms subside. C. Immediately stop giving medication if hearing loss develops. D. Stop giving medication and come to the clinic if fever is still present in 24 hours.

b

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? a. Fever b. Polyarthritis c. Osler nodes d. Janeway spots

b

A 15 y.o male referred to a cardiologist is diagnosed with Infective Endocarditis. Which of the following symptoms are usually seen with this condition?(SELECT ALL)

Murmur, Osler nodes, Janeway spots

The nurse is performing a physical assessment on a 7 y.o child. The parents state that the child has trouble seeing the board at school. What visual impairment should the nurse suspect?

Myopia or nearsightedness

A 2 y.o child is receiving digoxin(Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate

90 beats/min

A school age child with CF takes 4 enzyme capsules with meals. The child is having 4 or 5 bowel movements/day. The nurses action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what?

Needs to be increased to decrease the number of bowel movements/day

The nurse is interpreting a tuberculin skin test. If the nurse finds a result of an induration 5 mm or larger in which should the nurse document this finding as positive?

A child receiving immunosuppressive therapy, A child with a HIV infection, A child living in close contact with a known contagious case of tuberculosis

After returning from cardiac catheterization the nurse determines that the pulse distal to the catheter site is weaker. How does the nurse respond?

Observe this as a normal finding and record the data

A school age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone that means that the asthma control is what?

50-79% of a personal best and needs and increase in the usual therapy

The healthcare provider prescribes vancomycin 200 mg per intravenous piggyback(IVPB) q 6 h for a child with CF. The pharmacy send the meds to the unit in a 150 ml bag with directions to run the medication over 120 mins. What ml/hr will the nurse set the IV pump to run the medication over 120 mins?

75 ml/hr

Which of the following are clinical manifestations of a hearing impairment usually seen in infants?

Absence of babbling by 7 months, lack of startle reflex, responds to loud noises as opposed to the voice

A 5 y.o is seen in the urgent care clinic with the following history and symptoms of sudden onset of severe sore throat after going to bed, drooling and difficulty swallowing, axillary temperature of 102.2 F(39.0 C), clear breath sounds, and absence of cough. The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of?

Acute epiglottitis

The nurse caring for a 6 y.o child who has undergone cardiac catheterization 3 hrs ago notes the dressing and bed saturated with blood. Which initial action should the nurse take?

Apply pressure above the insertion site

What is the best method to verify the placement of a nasogastric tube before each use?

Aspiration of stomach contents

A 10 y.o sustained a full thickness 3rd degree burn on his left arm during a BBQ. What will be required for healing from this injury?

Autografting

A 4 y.o child seen in the ER has symptoms of Kawasaki Disease(KD). Of the symptoms listed below which can potentially develop and pose a high risk for children with KD?

Coronary artery aneurysm

During the assessment of a 9 y.o child the nurse notes excessive drooling, the child is fearful refuses to lay down. Which condition does the nurse suspect?

Epiglottitis

A parent of a child with a disability expresses guilt to the nurse about the child's condition. What nursing intervention is most appropriate in this situation?

Explore the parent's adjustment response

Select from list below a reason for 'Innocent' heart murmurs in infants?

Fever

A 5 y.o is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process?

Fever, cough, chest pain

When caring for the intravenous(IV) site on a child, the nurse should take which action?

Flush the site with normal saline per protocol

A 10 year old is seen in the developmental clinic with the following symptoms moderate cognitive impairment, mitral valve prolapse, autistic like behaviors such as social anxiety. Which of the diagnosis below do these symptoms best describe?

Fragile X Syndrome

A child who has a cardia catheterization is being discharged. What should the nurse include in the discharge instructions to the parents?

Give sponge baths for 3 days to prevent infection

What clinical finding may be present in an older child with Coarctation of the Aorta?

High blood pressure in the upper extremities

A 2 month old seen in peds clinic has symptoms of tachypnea, retractions, anorexia, apneic spells, copious nasal secretions and wheezing. Which of the following do these symptoms best describe?

RSV Bronchlolitis

A pediatric nurse who is caring for a 12 y.o pt with septic shock perceives a potential complication of fluid resuscitation upon which of the following?

Rales and rhonchi by auscultation

Which of the following is appropriate for a hospitalized infant

Rattles, squeaking toys, mobile toys

Which of the following actions by the school nurse is most important in the prevention of rheumatic fever(RF)

Refer children with sore throats for throat cultures

What strategy should the nurse recommend to parents, to get the siblings of a child with special needs involved in the child's care?

Request the sibling's help to design strategies that will work at home

A parent requests info on her infants hearing. Which of the following should the nurse say is a clinical manifestation of hearing impairment in an infant less than 12 months old?

Responds to loud noises as opposed to voice

A 14 month old boy is hospitalized with dehydration. He is inconsolable, screaming, and rejecting your physical contact. What best describes his response?

Separation Anxiety-PROTEST PHRASE

A child with heart failure is in Lanoxin(digoxin). The laboratory value a nurse must closely monitor is which?

Serum Potassium

The Pediatric Nurse assigned to an 8 y.o is aware that the child's fluid need will be increased in which of the following circumstances?

Shock

What drug is usually given first in the emergency treatment of an acute severe asthma episode in a young child?

Short acting beta2-agonists

The nurse understands that a preschool age child may react to death with what reaction?

Showing regressive behaviors

A nurse is reading a physician's progress notes in the client's record and reads that the physician has documented 'insensible fluid loss of approximately 800 ml daily.' The nurse understands that this type of fluid loss can mainly occur through?

Skin

What is a principle of palliative care that can be included in the care of children?

Uses a multidisciplinary approach