Practice Qs Peds Final

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4. The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? "Start brushing her teeth after all the baby teeth come in." "Use a washcloth with toothpaste to clean her mouth." "Clean your baby's gums, then new teeth, with a washcloth." "Rinse your baby's mouth with water after every feeding."

"Clean your baby's gums, then new teeth, with a washcloth."

5. The nurse is caring for an adolescent who says, "I'm sick of this. I wish I weren't alive anymore." What is the best response by the nurse? "I often feel sad and sick of things." "Have you thought about hurting yourself?" "Are you trying to escape your problems?" "Do your parents know about this feeling?"

"Have you thought about hurting yourself?"

2YO Ingestied GM Iron Pills -Age/Stage affect risk of ingestion?

-Curiosity -Decreased taste development -Mimicing -Learning to do fine motor skills

What are two causes of tachycardia?

-Hypovolemia -Hypoxia

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Choose all that apply.) 1 Accept the adolescent as a unique individual 2 Provide strict, inflexible rules 3 Listen and try to be open to the adolescent's views 4 Screen all of his or her friends 5 Respect the adolescent's privacy 6 Provide unconditional love

1 Accept the adolescent as a unique individual 3 Listen and try to be open to the adolescent's views 5 Respect the adolescent's privacy 6 Provide unconditional love

4. The nurse is caring for a child who has just been admitted to the pediatric unit with sickle cell crisis. He is complaining that his right arm and leg hurt. What is the priority nursing intervention? 1 Administer pain medication every 3 hours intravenously until pain is controlled. 2 Perform passive range of motion of the arm and leg to maintain function. 3 Try acetaminophen for pain first, moving up to opioids only if needed. 4 Use narcotic analgesics and warm compresses as needed to control the pain.

1 Administer pain medication every 3 hours intravenously until pain is controlled.

4. What is the best advice about nutrition for the toddler? 1 Encourage cup drinking and give water between meals and snacks. 2 Encourage unlimited milk intake, because toddlers need the protein for growth. 3 Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. 4 Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.

1 Encourage cup drinking and give water between meals and snacks.

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? 1 Hesitancy and disfluency are normal during this period of development. 2 Reading to the child will help model appropriate speech. 3 Expressive language concerns warrant a developmental evaluation. 4 The mother should ask her child's physician for a speech therapy evaluation.

1 Hesitancy and disfluency are normal during this period of development.

3. Sam, age 11, has a diagnosis of rheumatic fever and has missed school for a week. What is the most likely cause of this problem? 1 previous streptococcal throat infection 2 history of open heart surgery at 5 years of age 3 playing too much soccer and not getting enough rest 4 exposure to a sibling with pneumonia

1 previous streptococcal throat infection

Tetralogy of Fallot (TOF) involves which defects? Select all that apply. 1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 3. Left ventricular hypertrophy. 4. Pulmonic stenosis (PS). 5. Pulmonic atresia. 6. Overriding aorta. 7. Patent ductus arteriosus (PDA).

1, 2, 4, 6 TOF is a congenital defect with a ventricular septal defect, right ventricular hypertrophy, pulmonary valve stenosis, and overriding aorta.

Which statement by the parent of a child using an albuterol inhaler leads the nurse to believe that further education is needed on how to administer the medication? 1. "I should administer two quick puffs of the albuterol inhaler using a spacer." 2. "I should always use a spacer when administering the albuterol inhaler." 3. "I should be sure that my child is in an upright position when administering the inhaler." 4. "I should always shake the inhaler before administering a dose."

1. "I should administer two quick puffs of the albuterol inhaler using a spacer."

Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay? 1. "My child is able to stand but is not yet taking steps independently." 2. "My child has a vocabulary of approximately 15 words." 3. "My child is still sucking his thumb." 4. "My child seems to be quite wary of strangers."

1. "My child is able to stand but is not yet taking steps independently."

The parent of a child being evaluated for celiac disease asks the nurse why it is important to make dietary changes. Select the nurse's best response. 1. "The body's response to gluten causes damage to the mucosal cells in the intestine, leading to absorption problems." 2. "The body's response to consumption of anything containing gluten is to create special cells called villi, which leads to more diarrhea." 3. "The body's response to gluten causes the intestine to become more porous and hang on to more of the fat-soluble vitamins, leading to vitamin toxicity." 4. "The body's response to gluten causes damage to the mucosal cells, leading to malabsorption of water and hard, constipated stools."

1. "The body's response to gluten causes damage to the mucosal cells in the intestine, leading to absorption problems."

The parent of a child who is being treated for Haemophilus influenzae meningitis tells the nurse that the family is being treated prophylactically with rifampin (Rifadin). Which should the nurse include in teaching about this medication? 1. "The drug will change the color of the urine to orange-red, so you should protect your undergarments as it will cause staining." 2. "Adverse effects of the drug may cause urinary retention." 3. "The drug is given to treat meningitis." 4. "You will need to continue taking the drug for 7 days."

1. "The drug will change the color of the urine to orange-red, so you should protect your undergarments as it will cause staining."

Which response about safety measures is the most appropriate advice for the 2-year-old's mother who had her older home remodeled to reduce the lead level? 1. "Wash and dry the child's hands and face before he eats." 2. "Remodeling the home to remove the lead is all you need to do." 3. "It is best to use hot water to prepare the child's food to decrease the lead." 4. "Diet does not matter in reducing lead levels in the child."

1. "Wash and dry the child's hands and face before he eats."

A 3-year-old is hospitalized for an ASD repair. The parents have decided to go home for a few hours to spend time with her siblings. The child asks when her mommy and daddy will be back. The nurse's best response is: 1. "Your mommy and daddy will be back after your nap." 2. "Your mommy and daddy will be back at 6:00 p.m." 3. "Your mommy and daddy will be back later this evening." 4. "Your mommy and daddy will be back in 3 hours."

1. "Your mommy and daddy will be back after your nap." Preschoolers understand time in relation to events.

The onset of Humalog insulin is: 1. 10 to 15 minutes. 2. 30 minutes to 1 hour. 3. 1 to 2 hours. 4. 2 to 4 hours.

1. 10 to 15 minutes.

Which child is at highest risk for requiring hospitalization to treat respiratory syncytial virus (RSV)? 1. A 2-month-old who was born at 32 weeks. 2. A 16-month-old with a tracheostomy. 3. A 3-year-old with a congenital heart defect. 4. A 4-year-old who was born at 30 weeks.

1. A 2-month-old who was born at 32 weeks. The younger the child, the greater the risk for developing complications related to RSV. This infant is at highest risk because of age and premature status.

Which child is at risk for developing glomerulonephritis? 1. A 3-year-old who had impetigo 1 week ago. 2. A 5-year-old with a history of five UTIs in the previous year. 3. A 6-year-old with new-onset type 1 diabetes. 4. A 10-year-old recovering from viral pneumonia.

1. A 3-year-old who had impetigo 1 week ago. Group A Stept

A 6-month-old is prescribed 2.5% hydrocortisone for topical treatment of eczema. The nurse instructs the parent not to use the cream for more than a week. What is the primary reason for this instruction? 1. Adverse effects, such as skin atrophy and fragility, can occur with long-term treatment. 2. If after a week there is no improvement, then a stronger dose is required. 3. The drug loses its efficacy after prolonged use. 4. If no improvement is seen after a week, an antibiotic should be prescribed.

1. Adverse effects, such as skin atrophy and fragility, can occur with long-term treatment.

Which interventions decrease cardiac demands in an infant with congestive heart failure (CHF)? Select all that apply. 1. Allow parents to hold and rock their child. 2. Feed only when the infant is crying. 3. Keep the child uncovered to promote low body temperature. 4. Make frequent position changes. 5. Feed the child when sucking the fists. 6. Change bed linens only when necessary. 7. Organize nursing activities.

1. Allow parents to hold and rock their child. 4. Make frequent position changes. 5. Feed the child when sucking the fists. 6. Change bed linens only when necessary. 7. Organize nursing activities.

What can a nurse do to reinforce a 5-year-old's intellectual initiative when he asks about his upcoming surgery? 1. Answer the child's questions about his upcoming surgery in simple terms. 2. Provide the child with a book that has vivid illustrations about his surgery. 3. Tell the child he should wait and ask the doctor his questions. 4. Tell the child that she will answer his questions at a later time.

1. Answer the child's questions about his upcoming surgery in simple terms

A 13-year-old just returned from surgery for scoliosis. Which nursing intervention(s) is/are appropriate in the first 24 hours? Select all that apply. 1. Assess for pain. 2. Logroll to change positions. 3. Get the teen to the bathroom 12 to 24 hours after surgery. 4. Check neurological status. 5. Monitor blood pressure.

1. Assess for pain. 2. Logroll to change positions. 4. Check neurological status. 5. Monitor blood pressure.

A 16-year-old being treated for hypertension has laboratory values of hemoglobin B 16 g/dL, hematocrit level 43%, sodium 139 mEq/L, potassium 4.4 mEq/L, and total cholesterol of 220 mg/dL. Which drug does the nurse suspect the patient takes based on the total cholesterol? 1. Beta blockers. 2. Calcium channel blockers. 3. ACE inhibitors. 4. Diuretics.

1. Beta blockers. Beta blockers are used with caution in patients with hyperlipidemia, hyperglycemia, and impotence.

Which is the nurse's best response to the parent of a child diagnosed with epiglottitis who asks what the treatment will be? 1. Complete a course of intravenous antibiotics. 2. Surgery to remove the tonsils. 3. 10 days of aerosolized ribavirin. 4. No intervention.

1. Complete a course of intravenous antibiotics.

Which are the most serious complications for a child with Kawasaki disease (KD)? Select all that apply. 1. Coronary thrombosis. 2. Coronary stenosis. 3. Coronary artery aneurysm.

1. Coronary thrombosis. 2. Coronary stenosis. 3. Coronary artery aneurysm. Thrombosis, stenosis, and aneurysm affect blood vessels. The child with KD has hypercoagulability and an increased sedimentation rate due to inflammation.

Which assessment finding should the nurse observe following administration of albuterol (Proventil)? 1. Decrease in wheezing. 2. Decrease in respiratory rate from 34 to 22. 3. Decrease in blood pressure. 4. Decrease in heart rate.

1. Decrease in wheezing.

Which would be appropriate anticipatory guidance during the well-care visit of a 17-year-old? 1. Discuss alcohol use and potential for alcohol poisoning. 2. Discuss secondary sex characteristics that will develop. 3. Teach about anger management and safe sex. 4. Teach about peer pressure and desire for independence.

1. Discuss alcohol use and potential for alcohol poisoning.

In preparing the patient and family for hospital discharge, which of the following signs and symptoms of shunt malfunction and infection should the nurse include in the teaching plan? Select all that apply. 1. Emesis, lethargy. 2. A change in neurological behavior. 3. Fever, irritability. 4. Diarrhea or constipation. 5. Redness along the shunt system.

1. Emesis, lethargy. 2. A change in neurological behavior. 3. Fever, irritability. 5. Redness along the shunt system.

1. Emesis, lethargy. 2. A change in neurological behavior. 3. Fever, irritability. 5. Redness along the shunt system. Diarrhea, no constipation

Why is indomethacin given to a preterm neonate? 1. Encourage ductal closure. 2. Prevent hypertension. 3. Promote release of surfactant. 4. Protect the immature liver.

1. Encourage ductal closure.

A 3-month-old with spina bifida is admitted to the nurse's unit. Which gross motor skills should the nurse assess at this age? 1. Head control. 2. Pincer grasp. 3. Sitting alone. 4. Rolling over.

1. Head control.

A 5-month-old with a lumbar myelomeningocele is admitted to the unit with an Arnold-Chiari malformation. The infant has which other diagnosis? 1. Hydrocephalus. 2. Anencephaly. 3. Tethering of the spinal cord. 4. Perinatal hemorrhage.

1. Hydrocephalus.

What are S/E of Beta Blockers? Select all that apply. 1. Hyperlipidemia 2. Edema 3. Hypoglycemia 4. Impotence 5. Ototoxicity

1. Hyperlipidemia 3. Hypoglycemia 4. Impotence

The nurse is interviewing the parents of a 6-year-old who has been experiencing constipation. Which could be a causative factor? Select all that apply. 1. Hypothyroidism. 2. Muscular dystrophy. 3. Myelomeningocele. 4. Drinks a lot of milk. 5. Active in sports.

1. Hypothyroidism. 2. Muscular dystrophy. 3. Myelomeningocele. 4. Drinks a lot of milk. 2. Weakened abdominal muscles can be seen in muscular dystrophy and can lead to constipation. 3. Myelomeningocele affects the innervationof the rectum and can lead to constipation.

The nurse is caring for a newborn with esophageal atresia. When reviewing the mother's history, which would the nurse expect to find? 1. Maternal polyhydramnios. 2. Pregnancy lasting more than 38 weeks. 3. Poor nutrition during pregnancy. 4. Alcohol consumption during pregnancy.

1. Maternal polyhydramnios is present because the infant cannot swallow and absorb the amniotic fluid in utero.

What are complications of Growth Hormone Deficiency? Select all that apply. 1. Metabolism Probs 2. Hyperglycemia 3. Hypoglycemia 4. Diabetes 5. Slipped Capital Epiphysis 6. Sodium Retention 7. Edema

1. Metabolism Probs 3. Hypoglycemia 4. Diabetes 5. Slipped Capital Epiphysis 6. Sodium Retention 7. Edema

Expected nursing assessments of a newborn with suspected cystic fibrosis would include: 1. Observe frequency and nature of stools. 2. Provide chest physical therapy. 3. Observe for weight gain. 4. Assess parent's compliance with fluid restrictions.

1. Observe frequency and nature of stools. Keyword = Newborn

Hypoxic spells in the infant with a congenital heart defect (CHD) can cause which ofthe following? Select all that apply. 1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 5. Viral pericarditis. 6. Brain damage. 7. Alkalosis.

1. Polycythemia. 2. Blood clots. 3. Cerebrovascular accident. 4. Developmental delays. 6. Brain damage.

Which finding would the nurse consider abnormal when performing a physical assessment on a 6-month-old? 1. Posterior fontanel is open. 2. Anterior fontanel is open. 3. Beginning signs of tooth eruption. 4. Able to track and follow objects.

1. Posterior fontanel is open. 1. The posterior fontanel should close between 6 and 8 weeks of age. The anterior fontanel usually closes between 12 and 18 months.

What does the therapeutic management of cystic fibrosis (CF) patients include? Select all that apply. 1. Providing a high-protein, high-calorie diet. 2. Providing a high-fat, high-carbohydrate diet. 3. Encouraging exercise. 4. Minimizing pulmonary complication. 5. Encouraging medication compliance.

1. Providing a high-protein, high-calorie diet. 3. Encouraging exercise. 4. Minimizing pulmonary complication. 5. Encouraging medication compliance.

An innocent murmur has which characteristics? Select all that apply. 1. Short induration. 2. S2 murmur. 3. Loudest in the pulmonic area. 4. Fixed and can be heard in many positions. 5. Grade III or less.

1. Short induration. 3. Loudest in the pulmonic area. 5. Grade III or less.

The nurse is working in a school health clinic, and a teen mentions that her older sister just had a baby born with a myelomeningocele. The teen is wondering if there is anything she can do to prevent this from happening to her baby when she decides to have children. Which is the best response? 1. Take a multivitamin with folic acid daily. 2. Eat more fruits and vegetables daily. 3. Have breakfast every morning. 4. There is nothing that can be done to decrease the risk.

1. Take a multivitamin with folic acid daily.

Which should the nurse include in the discharge teaching plan for a child beginning growth hormone therapy? 1. The child is expected to grow 3 to 5 inches during the first year of treatment. 2. The parents must measure the child's weight and height daily. 3. The parents will need to continue the therapy until the child is 21 years old. 4. There are no side effects from taking growth hormones.

1. The child is expected to grow 3 to 5 inches during the first year of treatment.

A 4-year-old hospitalized with FTT has orders for daily weights, strict intake and output, and calorie counts. Which action by the nurse would be a concern? 1. The nurse weighs the child every morning after breakfast. 2. The nurse weighs the child with no clothing except for undergarments. 3. The nurse sits with the child while the child eats her meals. 4. The nurse weighs the child using the same scale every morning.

1. The nurse weighs the child every morning after breakfast.

Which should the nurse teach the child and parents about montelukast (Singulair) ordered for moderate persistent asthma? Select all that apply. 1. This is an add-on medication to the child's regular medications. 2. It can be given when the child needs it. 3. It is not to be used to treat acute episodes. 4. The parents will need to give up smoking. 5. The child will require chest physiotherapy in conjunction with the medication.

1. This is an add-on medication to the child's regular medications. 3. It is not to be used to treat acute episodes.

Which syndrome is associated with Growth Hormone Deficiency? 1. Turner 2. Down 3. Edwards 4. Epiglottis

1. Turner

1. Ventricular septal defect (VSD). 2. Right ventricular hypertrophy. 4. Pulmonic stenosis (PS). 6. Overriding aorta.

The nurse is doing discharge teaching for a 3-month-old (INFANT) with a new shunt placed for hydrocephalus. Which are signs and symptoms of hydrocephalus that the parents may see if the shunt malfunctions? Select all that apply. 1. Vomiting. 2. Irritability. 3. Poor feeding. 4. Headache. 5. Sunken fontanel. 6. Seizures. 7. Inability to wake up infant. 8. Hyperactivity.

1. Vomiting. 2. Irritability. 3. Poor feeding. 6. Seizures. 7. Inability to wake up infant. No HA per cannot assess in infant

A 2-year-old is brought to the emergency department for fever and ear pain. The parents report the child has had many ear infections and that polyethylene tubes have been recommended, but the parents cannot afford surgery. The child is diagnosed with bilateral otitis media. The toddler is carrying a baby bottle full of juice, and a parent is carrying a pack of cigarettes. Which one preventive measure could be taught to the parents to decrease the incidence of ear infections? 1. Wean the toddler from the bottle. 2. Give the toddler a decongestant before bedtime. 3. Encourage the parent to smoke outside the house. 4. Have the child's hearing checked.

1. Wean the toddler from the bottle.

1. The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: 1 Learning from repeating tasks 2 Developing a sense of worth and competence 3 Using fantasy and magical thinking to cope with problems 4 Developing a sense of trust

2 Developing a sense of worth and competence

In developing a weight-loss plan for an adolescent, which would the nurse include? (Choose all that apply.) 1 Have parents make all of the meal plans. 2 Eat slowly and place the fork down between each bite. 3 Have the family exercise together. 4 Refer to an adolescent weight-loss program. 5 Keep a food and exercise diary.

2 Eat slowly and place the fork down between each bite. 3 Have the family exercise together. 4 Refer to an adolescent weight-loss program. 5 Keep a food and exercise diary.

To gain cooperation from a toddler, what is the best approach by the nurse? 1 Immediately pick the toddler up from the mother's lap. 2 Kneel in front of the toddler while he or she is on the mother's lap. 3 Do the nursing tasks quickly so the toddler can play. 4 Ask the toddler if it is okay if you begin the needed task.

2 Kneel in front of the toddler while he or she is on the mother's lap.

5. Which assessment finding is considered normal in children? 1 Irregular respiratory rate and rhythm 2 Split S2 and sinus arrhythmia 3 Decreased heart rate with crying 4 Genu varum past the age of 5 years

2 Split S2 and sinus arrhythmia

3. Which is associated with early adolescence? (Choose all that apply.) 1 Uses scientific reasoning to solve problems 2 Still at times wants to be dependent upon parents 3 Incorporates own set of morals and values 4 Is influenced by peers and values memberships in cliques

2 Still at times wants to be dependent upon parents 4 Is influenced by peers and values memberships in cliques

A first-time parent is discussing developmental milestones with the nurse. The nurse tells the client that she can reasonably experience her child to achieve which of the following by 1 yo? 1. Walking 2. Rolling side-to-side 3. Transferring things from hand-to-hand 4. Respond selectively to words 5. Vocalizing sounds (coos)

2, 3, 4, 5 Walking = 18 months Roll side to side, transferring hand to hand, selectively responding to words, vocalized coos = By 1 YO

A parent with a toddler who has ambiguous genitalia asks the nurse how long it will be before the child identifies his or her gender. Which is the best answer? 1. "A child does not know his or her gender until he or she is a teen." 2. "A child knows his or her gender by the age of 18 to 30 months." 3. "A child knows from the time of birth what his or her gender is." 4. "A child of 4 to 6 years is beginning to learn his or her gender."

2. "A child knows his or her gender by the age of 18 to 30 months." Erikson's stages of psychosexual development define a 2-year-old as in the "autonomy vs. shame and doubt" stage. The 2-year-old explores the body and is given specific behaviors that indicate the gender.

Parents confide to the nurse that their child, who is 35 months old, does not talk and spends hours sitting on the floor watching the ceiling fan go around. They are concerned their child may have autism. The nurse should ask the parents which question? 1. "Does your child have brothers or sisters?" 2. "Does your child seek you out for comfort and love?" 3. "Do you have trouble getting babysitters for your child?" 4. "Does your child receive speech therapy?"

2. "Does your child seek you out for comfort and love?" Problem building relationships

3-year-old boy has been hospitalized because he fell down the stairs. His mother is crying and states, "This is all my fault." Which is the nurse's best response? 1. "Accidents happen. You shouldn't blame yourself." 2. "Falls are one of the most common injuries in this age group." 3. "It may be a good idea to put a baby gate on the stairs." 4. "Your son should be proficient at walking down the stairs by now."

2. "Falls are one of the most common injuries in this age group."

A 3-year-old is attending her grandfather's funeral. Her parents told her that her grandfather is in heaven with God. Which statement describes a 3-year-old child's understanding of spirituality? 1. "The body is here with us on Earth, and the spirit is in heaven." 2. "He is in heaven. Is this heaven?" 3. "The spirit is no longer in his body." 4. "He won't need his body in heaven."

2. "He is in heaven. Is this heaven?" 3YO = Literally thinkers

The mother of an 11-month-old with iron deficiency anemia tells the nurse that her infant is currently taking iron and a multivitamin. Which statement made by the mother should be of concern to the nurse? 1. "I give the iron and multivitamin at the same time each morning." 2. "I give the iron and multivitamin in the morning 6-oz bottle." 3. "I give the iron and multivitamin 2 hours before I feed the morning bottle." 4. "I give the iron and multivitamin in oral syringes toward the back of the cheek."

2. "I give the iron and multivitamin in the morning 6-oz bottle." Never mix meds

Which statement by an infant's mother leads the nurse to believe that she needs further education about the nutritional needs of a 6-month-old? 1. "I will continue to breastfeed my son and will give him rice cereal three times a day." 2. "I will start my son on fruits and gradually introduce vegetables." 3. "I will start my son on carrots and will introduce one new vegetable every few days." 4. "I will not give my son any more than 8 ounces of baby juice per day."

2. "I will start my son on fruits and gradually introduce vegetables."

Which should the nurse tell the parent of an infant with spina bifida? 1. "Bone growth will be more than that of babies who are not sick because your baby will be less active." 2. "Physical and occupational therapy will be helpful to stimulate the senses and improve cognitive skills." 3. "Nutritional needs for your infant will be calculated based on activity level." 4. "Fine motor skills will be delayed because of the disability."

2. "Physical and occupational therapy will be helpful to stimulate the senses and improve cognitive skills."

After receiving the change-of-shift report, the nurse prioritizes care for the day. Which child should the nurse assess first? 1. 1-month-old admitted 1 day ago with fever and possible sepsis. 2. 14-month-old with a tracheostomy admitted for respiratory syncytial virus (RSV) bronchiolitis. 3. 18-month-old with acute viral meningitis. 4. 7-year-old 1 day after an appendectomy.

2. 14-month-old with a tracheostomy admitted for respiratory syncytial virus (RSV) bronchiolitis. Following the ABCs (airway, breathing, circulation), this baby has the greatest potential for a life-threatening complication if the tracheostomy becomes obstructed by mucus.

A 10-kg toddler is diagnosed with acute renal failure (ARF), is afebrile, and has a 24-hour urine output of 110 mL. After calculating daily fluid maintenance, which would the nurse expect the toddler's daily allotment of fluids to be? 1. Sips of clear fluids and ice chips only. 2. 350 mL of oral and intravenous fluids. 3. 1000 mL of oral and intravenous fluids. 4. 2000 mL of oral and intravenous fluids.

2. 350 mL of oral and intravenous fluids. 350 mL is approximately a third of the daily fluid requirement and is recommended for the child in the oliguric phase of ARF. If the child were febrile, the fluid intake would be increased.

Which of the following is a (are) reason(s) to do a lumbar puncture on a child with a diagnosis of leukemia? Select all that apply. 1. Rule out meningitis. 2. Assess the central nervous system for infiltration. 3. Give intrathecal chemotherapy. 4. Determine increased intracranial pressure. 5. Stage the leukemia.

2. A lumbar puncture is done to assess the central nervous system by obtaining a specimen that can determine the presence of leukemic cells. 3. Chemotherapy can also be given with a spinal tap.

A child has been seen by the school nurse for dizziness since the start of the school term. It happens when standing in line for recess and homeroom. The child now reports that she would rather sit and watch her friends play hopscotch because she cannot count out loud and jump at the same time. When the nurse asks her if her chest ever hurts, she says yes. Based on this history, the nurse suspects that she has: 1. Ventricular septal defect (VSD). 2. Aortic stenosis (AS). 3. Mitral valve prolapse. 4. Tricuspid atresia.

2. Aortic stenosis (AS).

A fixed splitting of the S2 heart sound is heard in an otherwise healthy child. This is a diagnostic sign of which cardiac defect? 1. Mitral regurgitation. 2. Atrial septal defect. 3. Functional murmur. 4. Pericardial friction rub.

2. Atrial septal defect.

A child has a Glasgow Coma Scale of 3, HR of 88 beats per minute and regular, respiratory rate of 22, BP of 78/52, and blood sugar of 35 mg/dL. The nurse asks the caregiver about accidental ingestion of which drug? 1. Calcium channel blocker. 2. Beta blocker. 3. ACE inhibiter. 4. ARB.

2. Beta blocker. The beta blocker not only affects the heart and lungs but also blocks the beta sites in the liver, reducing the amount of glycogen available for use, causing hypoglycemia. The lower HR and BP also suggest ingestion of a cardiac medication.

The school nurse has been following a child who comes to the office frequently for vague complaints of dizziness and headache. Today, she is brought in after fainting in the cafeteria following a nosebleed. Her BP is 122/85, and her radial pulses are bounding. The nurse suspects she has: 1. Transposition of the great vessels. 2. Coarctation of the aorta (COA). 3. Aortic stenosis (AS). 4. Pulmonic stenosis (PS).

2. Coarctation of the aorta (COA).

Which should a nurse anticipate to be prescribed in chelation therapy in a child receiving frequent blood transfusions? 1. Dalteparin sodium (Fragmin). 2. Deferoxamine (Desferal). 3. Diclofenac (Voltaren). 4. Diltiazem (Cardizem).

2. Deferoxamine (Desferal).

A 5-year-old boy has always been one of the shortest children in class. His mother tells the school nurse that her husband is 6 tall and she is 57. What should the nurse tell the child's mother? 1. He is expected to grow about 3 inches every year from ages 6 to 9 years. 2. He is expected to grow about 2 inches every year from ages 6 to 9 years. 3. He should be seen by an endocrinologist for growth-hormone injections. 4. His growth should be re-evaluated when he is 7 years old.

2. He is expected to grow about 2 inches every year from ages 6 to 9 years.

The clinical manifestations of minimal change nephrotic syndrome (MCNS) are due to which of the following? 1. Chemical changes in the composition of albumin. 2. Increased permeability of the glomeruli. 3. Obstruction of the capillaries of the glomeruli. 4. Loss of the kidney's ability to excrete waste and concentrate urine.

2. Increased permeability of the glomeruli.

Which stressor is common in hospitalized toddlers? Select all that apply. 1. Social isolation. 2. Interrupted routine. 3. Sleep disturbances. 4. Self-concept disturbances. 5. Fear of being hurt.

2. Interrupted routine. 3. Sleep disturbances. 5. Fear of being hurt. Isolation, self-concept = teen

75. While assisting with a lumbar puncture procedure on an infant or small child, the nurse should do which of the following? 1. Have the patient in a clean diaper to avoid contamination of the site. 2. Monitor the patient's cardiorespiratory status at all times. 3. Position the patient in the prone position with the head to the left. 4. Start an intravenous line to facilitate use of conscious sedation

2. Monitor the patient's cardiorespiratory status at all times.

Which toy is the best choice for a 12-month-old? 1. Baby doll. 2. Musical rattle. 3. Board book. 4. Colorful beads.

2. Musical rattle A musical rattle is the perfect toy for this child. Infants have short attention spans and enjoy auditory and visual stimulation.

An infant is born with a sac protruding through the spine, containing cerebrospinal fluid (CSF), a portion of the meninges, and nerve roots. This condition is referred to as: 1. Meningocele. 2. Myelomeningocele. 3. Spina bifida occulta. 4. Anencephaly.

2. Myelomeningocele.

How does the nurse interpret the laboratory analysis of a stool sample containing excessive amounts of azotorrhea and steatorrhea in a child with cystic fibrosis (CF)? The values indicate the child is... 1. Not compliant with taking her vitamins. 2. Not compliant with taking her enzymes. 3. Eating too many foods high in fat. 4. Eating too many foods high in fiber.

2. Not compliant with taking her enzymes.

Which toxicity is specific to gentamicin? 1. Hepatatoxicity. 2. Ototoxicity. 3. Myocardial toxicity. 4. Neurotoxicity.

2. Ototoxicity + Nephro

While assessing a newborn with respiratory distress, the nurse auscultates a machine-like heart murmur. Other findings are a wide pulse pressure, periods of apnea, increased PaCO2, and decreased PO2. The nurse suspects that the newborn has: 1. Pulmonary hypertension. 2. Patent ductus arteriosus (PDA). 3. Ventricular septal defect (VSD). 4. Bronchopulmonary dysplasia.

2. Patent ductus arteriosus (PDA).

Which activity can the nurse provide for a 9-year-old to encourage a sense of industry? 1. Allow the child to choose what time to take his medication. 2. Provide the child with the homework his teacher has sent. 3. Allow the child to assist with his bath. 4. Allow the child to help with his dressing change.

2. Provide the child with the homework his teacher has sent.

The nurse is caring for an 8-year-old girl whose parents indicate she has developed spastic movements of her extremities and trunk, facial grimace, and speech disturbances. They state it seems worse when she is anxious and does not occur while sleeping. The nurse questions the parents about which recent illness? 1. Kawasaki disease (KD). 2. Strep throat. 3. Malignant hypertension. 4. Atrial fibrillation.

2. Strep throat.

Which should the nurse include in teaching parents about administrating pancreatic enzymes to their child? 1. The enzymes may be chewed or swallowed. 2. The capsules may be opened and sprinkled over acidic food. 3. Give the same amount of the medicine with meals and snacks. 4. Store the enzymes in the refrigerator.

2. The capsules may be opened and sprinkled over acidic food.

The parent of a child with cystic fibrosis (CF) is excited about the possibility of the child receiving a double lung transplant. What should the parent understand? 1. The transplant will cure the child of CF and allow the child to lead a long and healthy life. 2. The transplant will not cure the child of CF but will allow the child to have a longer life. 3. The transplant will help to reverse the multisystem damage that has been caused by CF. 4. The transplant will be the child's only chance at surviving long enough to graduate college.

2. The transplant will not cure the child of CF but will allow the child to have a longer life.

The nurse knows that young infants are at risk for injury from shaken baby syndrome (SBS) because: 1. The anterior fontanel is open. 2. They have insufficient musculoskeletal support and a disproportionate head-to-body ratio. 3. They have an immature vascular system with veins and arteries that are more superficial. 4. The nurse knows there is immature myelination of the nervous system in a young infant.

2. They have insufficient musculoskeletal support and a disproportionate head-to-body ratio.

2. A child with hemophilia fell while riding his bicycle. He was wearing a helmet and did not lose consciousness. He has a mild abrasion on his knee that is not oozing. He is complaining of abdominal pain. What is the priority nursing assessment? 1 Perform neurologic checks. 2 Assess ability to void frequently. 3 Carefully assess his abdomen. 4 Examine his knee frequently.

3 Carefully assess his abdomen. Per internal bleeding

1. The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: 1 Problematic; the child is old enough to begin to have a basis in reality. 2 Normal, because the child is hospitalized and out of her routine. 3 Normal for this stage of growth and development. 4 Problematic, as it interferes with needed nursing care.

3 Normal for this stage of growth and development.

2. The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? 1 The toddler should have a developmental evaluation as soon as possible. 2 If the mother would read to the child, then speech would develop faster. 3 Receptive language normally develops earlier than expressive language. 4 The mother should ask her child's physician for a speech therapy evaluation.

3 Receptive language normally develops earlier than expressive language.

2. An adolescent girl who has been receiving treatment for anorexia nervosa has failed to gain weight over the past week despite eating all of her meals and snacks. What is the priority nursing intervention? 1 Increase the teen's daily caloric intake by at least 500 calories. 2 Ensure that the teen's entire fluid intake includes calories. 3 Supervise the teen for 2 hours after all meals and snacks. 4 Assess the teen's anxiety level to determine need for medicatio

3 Supervise the teen for 2 hours after all meals and snacks.

1. A 5-year-old boy visits the pediatric office with an upper respiratory infection. Which approach would give the nurse the most information about the child's developmental level? 1 Playing a game with the child. 2 Talking with the child about the teddy bear next to him. 3 Using a screening tool during a follow-up office visit. 4 Asking the 10-year-old sibling about the child.

3 Using a screening tool during a follow-up office visit.

3. A 14-year-old with thalassemia asks for your assistance in choosing her afternoon snack. Which choice is the most appropriate? 1 peanut butter with rice cake 2 small spinach salad 3 apple slices with cheddar cheese 4 small burger on wheat bun

3 apple slices with cheddar cheese

A three year old should be able to complete the following EXCEPT: 1. Saying no often 2. Using limited vocabulary of 500-3000 words 3. 10 word sentences 4. Believe adults know everything.

3. three year olds speak in 3 or 4 word sentences.

Which instruction would be of highest priority for the mother of an infant receiving his first oral rotavirus vaccine? 1. "Call the physician if he develops fever or cough." 2. "Call the physician if he develops fever, redness, or swelling at the injection site." 3. "Call the physician if he develops a bloody stool or diarrhea." 4. "Call the physician if he develops constipation and irritability."

3. "Call the physician if he develops a bloody stool or diarrhea." There is a very small incidence of infants developing intussusception, signaled by the onset of bloody stool or diarrhea after receiving oral rotavirus vaccine.

Which statement by the mother of a child with rheumatic fever (RF) shows she has good understanding of the care of her child? 1. "I will apply heat to his swollen joints to promote circulation." 2. "I will have him do gentle stretching exercises to prevent contractures." 3. "I will give him the aspirin that is ordered for pain and inflammation." 4. "I will apply cold packs to his swollen joints to reduce pain."

3. "I will give him the aspirin that is ordered for pain and inflammation."

The nurse is caring for an infant with pyloric stenosis. The parent asks if any future children will likely have pyloric stenosis. Select the nurse's best response. 1. "You seem worried; would you like to discuss your concerns?" 2. "It is very rare for a family to have more than one child with pyloric stenosis." 3. "Pyloric stenosis can run in families. It is more common among males." 4. "Although there can be a genetic link, it is very unusual for girls to have pyloric stenosis."

3. "Pyloric stenosis can run in families. It is more common among males."

Which is the nurse's best response to the parent of an infant diagnosed with the first otitis media who wonders about long-term effects? 1. "The child could suffer hearing loss." 2. "The child could suffer some speech delays." 3. "The child could suffer recurrent ear infections." 4. "The child could require ear tubes."

3. "The child could suffer recurrent ear infections."

A parent asks the nurse how it will be determined if their child has respiratory syncytial virus (RSV). Which is the nurse's best response? 1. "We will do a simple blood test to determine whether your child has RSV." 2. "There is no specific test for RSV. The diagnosis is made based on the child's symptoms." 3. "We will swab your child's nose and send that specimen for testing." 4. "We will have to send a viral culture to an outside lab for testing."

3. "We will swab your child's nose and send that specimen for testing."

The parent of an infant with cystic fibrosis (CF) asks the nurse how to meet the child's increased nutritional needs. Which is the nurse's best suggestion? 1. "You may need to increase the number of fresh fruits and vegetables you give your child." 2. "You may need to advance your child's diet to whole cow's milk because it is higher in fat than formula." 3. "You may need to change your child to a higher-calorie formula." 4. "You may need to increase your child's carbohydrate intake."

3. "You may need to change your child to a higher-calorie formula."

A parent asks the nurse what will need to be done to relieve the constipation of her child who also has cystic fibrosis (CF). Which is the nurse's best response? 1. "Your child likely has an obstruction and will require surgery." 2. "Your child will likely be given IV fluids." 3. "Your child will likely be given MiraLAX." 4. "Your child will be placed on a clear liquid diet."

3. "Your child will likely be given MiraLAX."

A 3-year-old admitted to the hospital with croup has the following vital signs: heart rate 90, respiratory rate 44, blood pressure 100/52, and temperature 98.8°F (37.1°C). The parents ask the nurse if these vital signs are normal. The nurse's best response is: 1. "Your son's blood pressure is elevated, but the other vital signs are within the normal range.." 2. "Your son's temperature is elevated, but the other vital signs are within the normal range.." 3. "Your son's respiratory rate is elevated, but the other vital signs are within the normal range." 4. "Your son's heart rate is elevated, but the other vital signs are within the normal range."

3. "Your son's respiratory rate is elevated, but the other vital signs are within the normal range." Should be between 20 and 30

What time would the nurse most likely see signs and symptoms of hypoglycemia after administering NPH insulin at 0730? 1. 0930 to 1030. 2. 1130 to 1430. 3. 1130 to 1930. 4. 1530 to 1930.

3. 1130 to 1930 Peak time for NPH insulin is 4 to 12 hours

Which assessment indicates that the parent of a 7-year-old is following the prescribed treatment for congestive heart failure (CHF)? 1. HR of 56 beats per minute. 2. Elevated red blood cell count. 3. 50th percentile height and weight for age. 4. Urine output of 0.5 cc/kg/hr.

3. 50th percentile height and weight for age.

A child with minimal change nephrotic syndrome (MCNS) has generalized edema. The skin appears stretched, and areas of breakdown are noted over the bony prominences. The child has been receiving Lasix twice daily for several days. Which does the nurse expect to be included in the treatment plan to reduce edema? 1. An increase in the amount and frequency of Lasix. 2. Addition of a second diuretic, such as mannitol. 3. Administration of intravenous albumin. 4. Elimination of all fluids and sodium from the child's diet.

3. Administration of intravenous albumin.

Which should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath? 1. Prednisone. 2. Singulair (montelukast). 3. Albuterol. 4. Flovent (fluticasone).

3. Albuterol.

The nurse is taking care of a child with sickle cell disease. The nurse is aware that which of the following problems is (are) associated with sickle cell disease? Select all that apply. 1. Polycythemia. 2. Hemarthrosis. 3. Aplastic crisis. 4. Thrombocytopenia. 5. Splenic sequestration. 6. Vaso-occlusive crisis.

3. Aplastic crisis. 5. Splenic sequestration. 6. Vaso-occlusive crisis.

Which action is a developmentally appropriate method for eliciting a 4-year-old's cooperation in obtaining the blood pressure? 1. Have the child's parents help put on the blood pressure cuff. 2. Tell the child that if he sits still, the blood pressure machine will go quickly. 3. Ask the child if he feels a squeezing of his arm. 4. Tell the child that measuring the blood pressure will not hurt.

3. Ask the child if he feels a squeezing of his arm.

What should parents understand is one of the most common causes of injury and death for a 7-month-old infant? 1. Poisoning. 2. Child abuse. 3. Aspiration. 4. Dog bites.

3. Aspiration.

A newborn with a repaired myelomeningocele is assessed for hydrocephalus. Which would the nurse expect in an infant with hydrocephalus? 1. Low-pitched cry and depressed fontanel. 2. Low-pitched cry and bulging fontanel. 3. Bulging fontanel and downwardly rotated eyes. 4. Depressed fontanel and upwardly rotated eyes.

3. Bulging fontanel and downwardly rotated eyes.

A child diagnosed with acute renal failure (ARF) complains of "not feeling well," having "butterflies in the chest," and arms and legs "feeling like Jell-O." The cardiac monitor shows that the QRS complex is wider than before and that an occasional premature ventricular contraction (PVC) is seen. Which would the nurse expect to administer? 1. An isotonic saline solution with 20 mEq KCl/L. 2. Sodium bicarbonate via slow intravenous push. 3. Calcium gluconate via slow intravenous push. 4. Oral potassium supplements.

3. Calcium gluconate via slow intravenous push.

The nurse is caring for a 9-month-old with diarrhea secondary to rotavirus. The child has not vomited and is mildly dehydrated. Which is likely to be included in the discharge teaching? 1. Administer Imodium as needed. 2. Administer Kaopectate as needed. 3. Continue breastfeeding per routine. 4. The infant may return to day care 24 hours after antibiotics have been started.

3. Continue breastfeeding per routine.

The nurse should tell the parents of a child with Duchenne (pseudohypertrophic) muscular dystrophy that some of the progressive complications include: 1. Dry skin and hair, hirsutism, protruding tongue, and mental retardation. 2. Anorexia, gingival hyperplasia, and dry skin and hair. 3. Contractures, obesity, and pulmonary infections. 4. Trembling, frequent loss of consciousness, and slurred speech.

3. Contractures, obesity, and pulmonary infections.

How can the nurse best facilitate the trust relationship between infant and parents while the infant is hospitalized? The nurse should: 1. Encourage the parents to remain at their child's bedside as much as possible. 2. Keep parents informed about all aspects of their child's condition. 3. Encourage the parents to hold their child as much as possible. 4. Advise the parents to participate actively in their child's care.

3. Encourage the parents to hold their child as much as possible.

Which should the nurse do to prevent separation anxiety in a hospitalized toddler? 1. Assume the parental role when parents are not able to be at the bedside. 2. Encourage the parents to always remain at the bedside. 3. Establish a routine similar to that of the child's home. 4. Rotate nursing staff so the child becomes comfortable with a variety of nurses.

3. Establish a routine similar to that of the child's home. Not feasible for parents to be at bedside all the time. Though, it is encouraged.

Which plan would be appropriate in helping to control congestive heart failure (CHF) in an infant? 1. Promoting fluid restriction. 2. Feeding a low-salt formula. 3. Feeding in semi-Fowler position. 4. Encouraging breast milk.

3. Feeding in semi-Fowler position.

To treat a common manifestation of Reye syndrome, which medication would the nurse expect to have readily available? 1. Lasix. 2. Insulin. 3. Glucose. 4. Morphine.

3. Glucose.

Which is diagnostic for epiglottitis? 1. Blood test. 2. Throat swab. 3. Lateral neck x-ray of the soft tissue. 4. Signs and symptoms.

3. Lateral neck x-ray of the soft tissue.

Which information will be most helpful in teaching parents about the primary prevention of foreign body aspiration? 1. Signs and symptoms of foreign body aspiration. 2. Therapeutic management of foreign body aspiration. 3. Most common objects that toddlers aspirate. 4. Risks associated with foreign body aspiration.

3. Most common objects that toddlers aspirate.

Which is a toxic reaction in a child taking digoxin (Lanoxin)? 1. Weight gain. 2. Tachycardia. 3. Nausea and vomiting. 4. Seizures.

3. Nausea and vomiting.

How will a child with respiratory distress and stridor and who is diagnosed with RSV be treated? 1. Intravenous antibiotics. 2. Intravenous steroids. 3. Nebulized racemic epinephrine. 4. Alternating doses of Tylenol and Motrin.

3. Nebulized racemic epinephrine.

A child in the emergency room is being treated with albuterol (Proventil) aerosol treatments for an acute asthma attack. She requires treatments every 2 hours. Which adverse effect of the medication would the nurse expect? 1. Lethargy and bradycardia. 2. Decreased blood pressure and dizziness. 3. Nervousness and tachycardia. 4. Increased blood pressure and fatigue.

3. Nervousness and tachycardia.

A child is diagnosed with chronic constipation that has been unresponsive to dietary and activity changes. Which pharmacological measure is most appropriate? 1. Natural supplements and herbs. 2. Stimulant laxative. 3. Osmotic agent. 4. Pharmacological measures are not used in pediatric constipation.

3. Osmotic agent. AKA Stool Softener

An 11-month-old was born at 28 weeks' gestation and required 2 weeks of ventilation. The baby is currently well and is being seen in the clinic. The physician recommends that the baby receive preventive therapy for respiratory syncytial virus (RSV) for the next 5 months since winter is approaching. Which medication will be ordered? 1. Respiratory syncytial virus immune globulin (RespiGam). 2. Ribavirin. 3. Palivizumab (Synagis). 4. Pneumococcal vaccine.

3. Palivizumab (Synagis).

The mother of a child 2 years 6 months has arranged a play date with the neighbor and her child 2 years 9 months. During the play date the two mothers should expect that the children will do which of the following? 1. Share and trade their toys while playing. 2. Play with one another with little or no conflict. 3. Play alongside one another but not actively with one another. 4. Only play with one or two items, ignoring most of the other toys.

3. Play alongside one another but not actively with one another. Toddlers engage in parallel play. They often play alongside another child, but they rarely engage in activities with the other child.

A 12-year-old with type 2 diabetes mellitus presents with a fever and a 2-day history of vomiting. The nurse observes that the child's breath has a fruity odor and breathing is deep and rapid. Which should the nurse do first? 1. Offer the child 8 oz of clear non-caloric fluid. 2. Test the child's urine for ketones. 3. Prepare the child for an IV infusion. 4. Offer the child 25 g of carbohydrates.

3. Prepare the child for an IV infusion. DKA = LIFE THREATENING

Which drug is most important in treating an infant with transposition of the greatvessels? 1. Digoxin (Lanoxin). 2. Antibiotics. 3. Prostaglandin E. 4. Diuretics.

3. Prostaglandin E.

Which medication should the nurse give to a child diagnosed with transposition of the great vessels? 1. Ibuprofen. 2. Betamethasone. 3. Prostaglandin E. 4. Indocin.

3. Prostaglandin E.

Which nursing action is most appropriate to gain information about how a child is feeling? 1. Actively attempt to make friends with the child before asking about her feelings. 2. Ask the child's parents what feelings she has expressed in regard to her diagnosis. 3. Provide the child with some paper to draw a picture of how she is feeling. 4. Ask the child direct questions about how she is feeling.

3. Provide the child with some paper to draw a picture of how she is feeling.

A first time mother ask you what type of toy would be best for her 2.5 YO. Your response is: 1. CDs 2. Board Games 3. Push/Pull 4. Marbles

3. Push Pull

Which outcome is expected in a breastfed newborn? 1. Voids spontaneously within 12 hours of life. 2. Loses 10% of body weight in the first 5 days. 3. Regains birth weight by the 14th day of life. 4. Awakens spontaneously for all feedings.

3. Regains birth weight by the 14th day of life.

Which technique should the nurse suggest to the mother of an 8-year-old who does not want to complete her chores? 1. Grounding. 2. Time-out. 3. Reward system. 4. Spanking.

3. Reward system. School-age children usually respond very well to a reward system and often enjoy the rewards so much that they will continue chores without continual reminders.

The most common cardiac dysrhythmia in pediatrics is: 1. Ventricular tachycardia. 2. Sinus bradycardia. 3. Supraventricular tachycardia. 4. First-degree heart block.

3. Supraventricular tachycardia.

Which statement would indicate to the nurse that a school-age child is not developmentally on track for age? 1. The child is able to follow a four- to five-step command. 2. The child started wetting the bed on admission to the hospital. 3. The child has an imaginary friend named Kelly. 4. The child enjoys playing board games with her sister.

3. The child has an imaginary friend named Kelly.

Parents are concerned that their pediatrician suspects Turner syndrome in their newborn. Which physical characteristics lead to this suspicion? 1. Cleft lip and palate. 2. Weak, high-pitched cry. 3. Webbed neck and lymphedema. 4. Long arms and small genitalia.

3. Webbed neck and lymphedema.

1. The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse? 1 "It's okay to start puréed solids at this age if fed via the bottle." 2 "Infants don't require solid food until 12 months of age." 3 "Solid foods should be delayed until age 6 months, when the infant can handle a spoon on his own." 4 "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

4 "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

5. The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration? 1 A lack of fully developed hearing. 2 A less discriminating sense of touch. 3 Visual acuity that has not fully developed. 4 A less discriminating sense of taste.

4 A less discriminating sense of taste.

2. A 2-day-old infant was just diagnosed with aortic stenosis. What is the most likely nursing assessment finding? 1 gallop and rales 2 blood pressure discrepancies in the extremities 3 right ventricular hypertrophy on ECG 4 heart murmur

4 heart murmur

The parents of a 7-year-old tell the nurse they do not understand the difference between chronic renal failure (CRF) and acute renal failure (ARF). Which is the nurse's best response? 1. "There really is not much difference because the terms are used interchangeably." 2. "Most children experience ARF. It is highly unusual for a child to experience CRF." 3. "CRF tends to occur suddenly and is irreversible." 4. "ARF is often reversible, whereas CRF results in permanent deterioration of kidney function."

4. "ARF is often reversible, whereas CRF results in permanent deterioration of kidney function."

The parent of a child with croup tells the nurse that her other child just had croup and it cleared up in a couple of days without intervention. She asks the nurse why this child is exhibiting worse symptoms and needs to be hospitalized. Which is the nurse's best response? 1. "Some children just react differently to viruses. It is best to treat each child as an individual." 2. "Younger children have wider airways that make it easier for bacteria to enter and colonize." 3. "Younger children have short and wide eustachian tubes, making them more susceptible to respiratory infections." 4. "Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

4. "Children younger than 3 years usually exhibit worse symptoms because their immune systems are not as developed."

A parent asks the nurse how to prevent the child from having minimal change nephrotic syndrome (MCNS) again. Which is the nurse's best response? 1. "It is very rare for a child to have a relapse after having fully recovered." 2. "Unfortunately, many children have cycles of relapses, and there is very little that can be done to prevent it." 3. "Your child is much less likely to get sick again if sodium is decreased in the diet." 4. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

4. "Try to keep your child away from sick children because relapses have been associated with infectious illnesses."

A 2-year-old has just been diagnosed with cystic fibrosis (CF). The parents ask the nurse what early respiratory symptoms they should expect to see in their child. Which is the nurse's best response? 1. "You can expect your child to develop a barrel-shaped chest." 2. "You can expect your child to develop a chronic productive cough." 3. "You can expect your child to develop bronchiectasis." 4. "You can expect your child to develop wheezing respirations."

4. "You can expect your child to develop wheezing respirations."

The nurse is working in the newborn nursery and accidentally bumps the crib of one of the babies. This baby demonstrates a Moro reflex. The nurse sees this baby in which posture? 1. Trunk extended upward and head lifted. 2. When placed on abdomen, crawling movement occurs. 3. A "fencing" posture. 4. Extremities extended and abducted and fingers fanned.

4. Extremities extended and abducted and fingers fanned.

70. Which are early signs and symptoms of hydrocephalus in infants? 1. Confusion, headache, diplopia. 2. Rapid head growth, poor feeding, confusion. 3. Papilledema, irritability, headache. 4. Full fontanels, poor feeding, rapid head growth.

4. Full fontanels, poor feeding, rapid head growth.

Which are early signs and symptoms of hydrocephalus in infants? 1. Confusion, headache, diplopia. 2. Rapid head growth, poor feeding, confusion. 3. Papilledema, irritability, headache. 4. Full fontanels, poor feeding, rapid head growth.

4. Full fontanels, poor feeding, rapid head growth.

Which physical findings would be of most concern in an infant with respiratory distress? 1. Tachypnea. 2. Mild retractions. 3. Wheezing. 4. Grunting.

4. Grunting.

What should be the nurse's first action with a child who has a high fever, dysphagia, drooling, tachycardia, and tachypnea? 1. Immediate IV placement. 2. Immediate respiratory treatment. 3. Thorough physical assessment. 4. Lateral neck radiographs.

4. Lateral neck radiographs.

Ribavirin (Virazole) is prescribed for a hospitalized child with respiratory syncytial virus (RSV). The nurse prepares to administer the medication by which route? 1. Oral. 2. Subcutaneous. 3. Intramuscular. 4. Oxygen tent.

4. Oxygen tent.

Which should be the nurse's immediate action when a newborn begins to cough and choke and becomes cyanotic while feeding? 1. Inform the physician of the situation. 2. Have the mother stop feeding the infant, and observe to see if the choking episode resolves on its own. 3. Immediately determine the infant's oxygen saturation, and have the mother stop feeding the infant. 4. Take the infant from the mother, and administer blow-by oxygen while obtaining the infant's oxygen saturation.

4. Take the infant from the mother, and administer blow-by oxygen while obtaining the infant's oxygen saturation.

Which would the nurse explain to parents about the inheritance of cystic fibrosis? 1. CF is an autosomal-dominant trait passed on from the child's mother. 2. CF is an autosomal-dominant trait passed on from the child's father. 3. The child of parents who are both carriers of the gene for CF has a 50% chance of acquiring CF. 4. The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.

4. The child of a mother who has CF and a father who is a carrier of the gene for CF has a 50% chance of acquiring CF.

According to developmental theories, which important event is essential to the development of the toddler? 1. The child learns to feed self. 2. The child develops friendships. 3. The child learns to walk. 4. The child participates in being potty-trained.

4. The child participates in being potty-trained.

Which can elicit the Gower sign? Have the patient: 1. Close the eyes and touch the nose with alternating index fingers. 2. Hop on one foot and then the other. 3. Bend from the waist to touch the toes. 4. Walk like a duck and rise from a squatting position.

4. Walk like a duck and rise from a squatting position.

Which drug should not be used to control secondary hypertension in a sexually active adolescent female who uses intermittent birth control? 1. Beta blockers. 2. Calcium channel blockers. 3. ACE inhibitors. 4. Diuretics.

ACE inhibitors and angiotensin II receptor blockers can cause birth defects. The others are not teratogenic.

1. The nurse is caring for a 6-year-old with juvenile idiopathic arthritis. The mother states that she has trouble getting her daughter out of bed in the morning and believes the girl's behavior is due to a desire to avoid going to school. What is the best advice by the nurse? 1 Refer the girl to a psychologist for evaluation of school phobia related to chronic illness. 2 Administer a warm bath every morning before school. 3 Give the child her prescribed NSAIDs 30 minutes before getting out of bed. 4 Allow her to stay in bed some mornings if she wants.

Administer a warm bath every morning before school.

1. A child on the pediatric unit has morning laboratory results of Hgb 10.0, Hct 30.2, WBC 24,000, and platelets 20,000. What is the priority nursing assessment? Assess for pallor, fatigue, and tachycardia. Monitor for fever. Assess for bruising or bleeding. Determine intake and output.

Assess for bruising or bleeding. Platelets below 140 K... bleeding risk

What would the nurse advise the parent of a child with a barky cough that gets worse at night? 1. Take the child outside into the more humid night air for 15 minutes. 2. Take the child to the ER immediately. 3. Give the child an over-the-counter cough suppressant. 4. Give the child warm liquids to soothe the throat.

Barky Cough = Croup Croup = Humidity 1. Take the child outside into the more humid night air for 15 minutes.

Order of Assessment for Child in ER -Pupil rxn -Presence of cough -HR/Cap -Brusing -Work of Breathing

Check Cough Work of Breathing HR/Cap Pupil Rxn Bruising

How is CPR different for a child v. adult?

Child = start compressions/breaths first Adult = call first

When an infant is born with a herniation of the abdominal wall with intestine present and the peritoneal sac absent, it is called...

Gastroschisis.

12 YO Type II Diabeters BS 50 -Which is best action? Ambulation Check VS Check UO OJ

Give OJ

4. When monitoring the blood glucose level of a 12-year-old child with type 2 DM, your reading is 50 mg/dL. Which is the most appropriate action? 1 Encourage the child to get out of bed and increase activity. 2 Take the child's vital signs. 3 Ask the child about frequent urine output. 4 Give the child 4 oz of orange juice.

Give the child 4 oz of orange juice.

Indomethacin v. Prostaglandin E

I = close P = open

Preschooler (5 YO) -V/D, Fever, 100 02, 104.5 Temp, HR 144, RR 22, BP 70/50, Difficulty to arose, slow cap refill

NS Bolus per Dehydration

12 YO Bike Crash W/O helmet, 99.2 HR 100 RR 24, breathing easily, BP 102/70 Priority? Neuro Status IV bolus Cervical Colar Check Bowel Sounds

Neuro Status

What is polycythemia?

Overproduction of RBCs

Why does pulmonary edema occur in a near-drowning?

Per fluid depleting surfactant, alveoli filled with water, moves into pulmonary tissue

Potty Trained. Developmental theorists like Erickson and Freud believe that toilet training is the essential event that must be mastered by the toddler.

3. Which activities will promote weight loss in an obese school-age child? (Choose all that apply.) Unlimited computer and TV time Role modeling by family Becoming active in sports Eating unstructured meals Involving child in meal planning and grocery shopping Drinking three glasses of water per day

Role modeling by family Becoming active in sports Involving child in meal planning and grocery shopping

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