PRNU 132 Pediatric Study Questions

Stable no dehydration, Infants I & O urinary output is

2 ml.kg.hour

When assessing an infants intake and output the nurse recognizes that an appropriate urinary output is approximately

2ml/kg/hr

4. A 7 year-old weighing 30 kg is to receive 300mg of ampicillin q 8 hours. When reconstituted, the ampicillin vial contains 500mg per 5cc. how many milliliters should be administrated? a) 3 cc b) 0.3 cc c) 0.5 cc

3 cc

14. Your patient weighs 12 pounds. Convert this to Kilograms.

5.45 kg

Which of the following assessments in a child with bacterial meningitis would be most alarming for the nurse

A hemorrhagic, non-blanching rash

A three year old is diagnosed with eczema. The nurse will assess for: A: Pruritus B: Pustules C: Vesicles D: Lichenification

A: Pruritus

The prominent anatomic consequence is the hypertrophy of the left ventricular wall leading to increased end diastolic pressure

AS Aortic Stenosis

Incomplete fusion of endocardial cushions creates a large central atrioventricular valve, allowing blood to flow between all four chambers of the heart

AVC Atrioventricular Canal Defect

In the child with asthma the airway becomes chronically irritated and scarred results in

Air trapping

A 2 yo child is admitted to the hospital with asthma. He is wheezing, rr is 40 and O2 is 90%. Which of the following meds should child receive first?

Albuterol nebulizer

Based on which of the following assessments would a nurse suspect a pediatric patient has failure to thrive

An infant who refuses to eat when fed by parents

When a 3 year old refuses to take an oral medication, what is the most appropriate action to take? a) Delay administrating the medication until the child agrees. b) Document the child refused the medication and call the MD c) Ask the parents what has worked for them at home but remain firm the medication will be given on time

Ask the patient what has worked for them at home but remain firm the medication will be given on time

Abnormal opening that exists between the atria allowing blood from the higher pressure left atrium to flow to the lower pressure right atrium

Atrial spetal defect

When preparing the teaching plan for the parent of a child with asthma which of the following would the nurse include as evidence of an asthma exacerbation

Audible wheezing

A school aged child with a diagnosis of acute lymphocytic leukemia is admitted to the peds unit with a low grade fever. The nurse should anticipate having to administer which of the following immediately upon arrival to the unit

Broad spectrum IV antibiotic

When assessing a child's hair and scalp, the nurse notices what looks like dandruff but it does not flake off easily. The nurse suspects the child has: A: Scabies B: Eczema C: Pediculosis Capitus D: Impetigo

C: Pediculosis Capitus

Patient has high blood pressure and bounding pulses in arms; weak or absent femoral pulses and cool lower extremities with lower blood pressure

COA Coartation of the Aorta

The process of physical development from the head downward is called: • Cephalodistal • Cephalocaudal • Proximodistal • Proximocaudal

Cephalocaudal

15 When administering TPN to an infant/child, the RN hanging the TPN solution is responsible for checking the following ( check all that apply) a) Change IV Tubing every 48 hours b) Check the patients name and TPN solution against the MD order c) Check the patients arm band d) Add additives to the solution

Check the patient's name and TPN solution against the MD order, check the patient's arm band

A 2-month-old breast fed infant is successfully rehydrated with oral rehydration solutions for acute diarrhea. Instructions to the mom about breastfeeding should include which of the following

Continue breastfeeding

The nurse is caring for an infant admitted to the hospital with a respiratory syncytial virus infection (RSV), which of the following assessment would be concerning

RR 70 breaths per minute

A nurse should explain that ringworm(tinea) is

Spread by direct and indirect contact

One of the characteristic signs of CF is the presence of

Steatorrhea

Which of the following is characteristic of most neonatal seizures

Subtle and barely discernible

When evaluating the extent of an infants dehydration the nurse should recognize that the symptoms of severe dehydration (15%) include

Tachycardia, parched mucous membranes, sunken eyes, and fontanel

Which of the following is a sign of early congestive heart failure that the nurse should recognize?

Tachypnea

The single most important diagnostic laboratory test to detect renal problems is

U/A

Patients are at risk for bacterial endocarditis and pulmonary vascular obstructive disease, Eisenmenger syndrome may develop

VSD Ventricular Septal Defect

The school nurse is seeing a child who brought in poison ivy in his leaf collection. He said he just touched the leaf with his hands. The nurse should immediately

Wash hands thoroughly with antibacterial soap

In a non potty-trained child with nephritic syndrome the best way to detect fluid retention is which of the follow?

Weigh child daily

What is the most common malignant renal and intraabdominal tumor of childhood?

Wilms

10. Paul a 5 year old presents with fever, tachycardia and a history of vomiting and poor intake for the past 24 hours. You have an order for a bolus. a) What is the correct amount of fluid per kilo for a fluid resuscitation bolus______________ b) How fast should the bolus run?_______________ c) State 3 parameters that you would use to assess if the bolus was effective:

a) 20 b) As fast as you can c) afebrile, urine output, LOC

17 The physician orders acetaminophen 260 mg for a child weighing 44 lbs. The safe dosage range for acetaminophen is 10-15 mg/Kg/dose. A. What is the safe dosage range for this child? B. Is this a safe dose for this child?

a) 200-300 mg b) yes

9. Nancy is to receive 100ml of 0.45%NS with 20 mEq KCL to run over 4 hours. a) How many ml/hour would you administer? b) What is the maximum amount of KCL that is permitted to be infused IV per hour? c) What is a potential serious side effects that can occur during the infusion?

a) 25 ml/hour b) 0.5 mEq/jg/hour c) Arrythmias

16. Cloxacillin sodium 500 mg IV q 6h is ordered for a child weighing 17 Kg. You look up the safe dosage range for this drug and it states, "25mg/Kg/dose". A. What is the safe individual dose for this child? B. Is the ordered dose safe?

a) 425 mg b) No

18 The physician orders ibuprofen 100 mg po q 6h for a child weighing 22 pounds. The safe dosage range for ibuprofen is 5 - 10 mg/Kg/dose. A What is the safe dosage range for this child? B Is the ordered dose safe?

a) 50-100 mg b) yes

What are the symptoms of UTI in children?

a) Dysurua b) Frequency c) Abdominal pain

12 A one year old, 12 kg child has just returned from the OR/ recovery room after major orthopedic surgery. a) What parameters would you use to assess his pain? b) What is the correct dose of Tylenol for this child post op? c) What would be the expected dose of morphine ordered for this child based on his weight and age?

a) FLACC pain scale b) 120 mg c) 0.2-0.5 mg/kg

Insensible water loss can be increased by (choose all that apply) a) Phototherapy b) Fever c) Increased respiratory rate d) change in diet

a) Phototherapy b) Fever c) Increased respiratory rate

Which of the following is not a sign of impaired cardiac output in the pot-op cardiac surgery patient a. Increased urine output. b. Capillary refill time over 5 seconds. c. Weak thready pulses. d. Tachycardia.

a. Increased urine output

Which of the following is the most descriptive of family centered care?

Recognizes that the family is the constant in the childs life

A young child is diagnosed with vesicoureteral reflux. The nurse should know that this is usually associate with

Recurrent kidney infections

Which of the following statements helps to explain the growth and development of children? a. Development proceeds at a predictable rate. b. Sequence of developmental milestones is predictable. c. Rates of growth are consistent among children d. At times of rapid growth there is also acceleration of development

Sequence of developmental milestones is predictable

A nurse should expect a 3-year-old child to be able to perform which action? a. Ride a tricycle b. Tie shoelaces c. Roller skate d. Jump Rope

a. Ride a tricycle

While assessing a 2-month old infant, the nurse startles the infant suddenly to elicit: a. Palmar reflex b. Moro reflex c. Placing reflex d. Babinski reflex

...

3. A child has an IV order for 5% dextrose1/4 normal saline with 250 units of heparin per 500ml of IV solution. How many milliliters of heparin 1,000 units/ml are added? a) 0.25ml per 500ml of IV solution b) 0.4 ml per 500ml of IV solution c) 2.5ml per 1000mlof IV solution d) 4.0 ml per 1000 ml of IV solution

0.25 ml per 500 ml of IV solution

Chest PT is performed on children to aid in removal of pulmonary secretions. When should CPT be performed in relation to meals

1 hr before meals, or 1 hour after

20 The MD orders Morphine sulfate 1.5 mL IV. You have a vial of Morphine sulfate labeled 2 Mg/mL. How many mL(s) would you draw up to administer the prescribed dosage?

3 ml

6. You must administer methylprednisolone 125mg IV push now. How quickly would you give the medication?

3-15 minutes

Using Erikson's developmental theory, if a preschool age child does not achieve a sense of initiative, which of the following may result? a. Guilt b. Mistrust c. Autonomy d. Inferiority

a. Guilt

A 4 month old with acute gastroenteritis is hospitalized for dehydration. He last voided 6 hours ago (prior to admission). His weight on admission is 5.3 kg. His weight one week ago was 5.9 kg. What is his percent weight loss:

10%

19 Erythromycin suspension 250 mg is ordered. You have a vial of erythromycin 0.4 grams with directions to reconstitute the granules with water to achieve a concentration of 100mg/5cc. How many mL would you draw up to administer the prescribed dosage?

12.5 mg

2. The doctor has ordered gentamyacin 100mg IV q 8 h. Gentamyacin is available in a vial of 80mg/2ml. How many mls do you draw up? a) 1.75 ml b) 2.5 ml c) 3.25ml

2.5 ml

8. John has an order for Dilantin IV. What IV solution is Dilantin compatible with?________ What is the rate of administration for dilatin?__________

NS/ 1-3 mg/lg/min

11. What drug is used for a narcotic overdose?

Narcan (Naloxone)

Defect causes a characteristic machine like murmur. Administration of indomethacin has proved successful in treating this

PDA Patent Ductus Arteriosus

Which of the following are the most common signs and symptoms of leukemia related to bone marrow involvement

Petechia, infection and fatigue

Mrs. Jones brings her 2 yo in to the office because of a new rash. The nurse evaluate the rash and notes it to be non-blanching and on his trunk and lower legs. The finding is most likely

Petechiae

The mother of a 4 yo is concerned because her child began sucking his thumb shortly after admission to the hospital. What is the best response for the mom? a. This child is too old to do this, tell him to stop b. Your child is acting like a baby c. The doctor should be notified d. He is regressing from the stress and it is best to ignore the behavior

a.. He is regressing from the stress and it is best to ignore the behavior

The last vital sign in children to exhibit change from fluid volume deficit is a) pulse b) blood pressure c) respiratory rate

b) blood pressure

An infant with an unrepaired congenital heart defect is not gaining weight and is admitted to the hospital. To improve weight gain, the nurse can expect to: a. Increase the time of feedings to 45 minutes each feed. b. Increase the caloric density of the formula. c. Feed the infant hourly. d. Prepare the infant for cardiac surgery.

b. Increase the caloric density of the formula.

The nurse is teaching the parents of a preschooler information about urinary tract infection and means of reducing their recurrence. Which statement by the parents indicates the need for additional teaching? a) I should try to get her to drink a lot of water and juices b) I will buy her underwear a little large c) Soaking in a bubble bath will reduce irritation d) If I notice her starting to wet the bed I need to get her checked for a UTI

c) Soaking in a bubble bath will reduce irritation

What is the single most important factor to consider when communication with children? a. The child's physical condition b. Presence or absence of the child's parent c. Developmental level of the child d. Non-verbal behaviors of the child

c. Developmental level of the child

When preparing a toddler for a procedure such as a venipuncture the nurse should explain the procedure: • Just prior to the procedure • Only to the parents • Using picture books • Several times in advance of the procedure

• Just prior to the procedure

A school age child with acute diarrhea, and mild dehydration is being given oral rehydration solution (ORS). the child's mom calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which of the following

Continue to give ORS in small amounts

Which of the following terms best describes a group of people who share a set of values, beliefs, practices, social relationship, law, politics, economics, and norms of behavior?

Culture

The nurse plans to position a child with a Circumferential burn of the right leg: A: flat in bed B: with the right leg dependent C: on the left side D: with the right leg elevated

D: with the right leg elevated

The nurse observes a client with the neck and back arched and extremities severely extended away from his body. This type of posturing is called

Decerebrate

Following surgical correction of some congenital heat lesions a child should be given prophylactic antibiotics before

Dental procedures

Which of the following would be an important assessment finding in an 8 mo with diarrhea

Depressed anterior fontanel

Nurses counseling parents regarding the home care of the child with a cardiac defect before corrective surgery should stress which of the following

Desirability of promoting normalcy within the limits of the chill's condition

A 1 yo child is admitted to the ICU with a head injury. He is afebrile. He is sleepy and opens his eyes only to a shout. When he awakens he is agitated and restless. He anterior fontanel is bulging. The nurse suspects the child has

Elevated intracranial pressure

The nurse assesses the neonate immediately after birth. A tracheoesophageal fistula is to be suspected if which of the following is present

Excessive amount of frothy saliva in the mouth

An infant has weight loss, delayed capillary refill time, and decreased skin turgor. The priority nursing diagnosis is

Fluid volume deficit

When a hospitalized child has weight gain, fluid intake greater than fluid output and bounding pulses, the correct nursing diagnosis is

Fluid volume excess

Which of the following clinical manifestations would the nurse expect to find in an infant who has developed necrotizing enterocolitis (NEC)

Gastric residual and melena

When evaluating the urinalysis report of a child with acute glomerulonephritis, the nurse should expect

Hematuria and Proteinuria

Which of the following laboratory findings, in conjunction with the presenting symptoms indicates nephrosis

Hypoalbuminemia

An infant with an unrepaired congenital heart defect is not gaining weight and is admitted to the hospital. To improve weight gain the nurse can expect to

Increase the caloric density of the formula

1. The optimum route and site for administering diphtheria, tetanus and pertussis (DPT) immunization for a 6 month old is: a) Subcutaneous injection in the upper outer area of the gluteus maximus. b) Intramuscular injection in the upper outer aspect of the gluteus maximus c) Subcutaneous injection in the area of the vastus lateralis d) Intramuscular injection in the vastus lateralis

Intramuscular injection in the vastus lateralis

A neonate had corrective surgery 3 days ago for esophageal atresia. The nurse notices that after his Gastrostomy feeding there is often a back up of formula in the tube. The nurse should do which of the following?

Leave the Gastrostomy tube open and suspended after feedings.

A 2 yo child with hydrocephalus was admitted to the peds unit following the placement of a ventriculoperitoneal shunt. Which of the following is a necessary nursing intervention

Measure head circumference daily

The principle feature of acute renal failure is

Oliguria

You are assessing an infant brought in with diarrhea. He is lethargic and has dry mucous membranes. Which of the following would you recognize as an early sign of dehydration? a) Tachycardia b) Bradycardia c) Increased blood pressure d) Decreased blood pressure

a) Tachycardia

A 3 yo is scheduled to have a Wilms Tumor removed from the right kidney. The parents ask the nurse about which treatments will be necessary after recovery from surgery. The nurses explanation is based on the knowledge that

Chemotherapy with or without radiation is necessary

Which of the following assessment data might indicate Hirschsprung's disease in a young child

Constipation

Narrowing occurs at the entrance to the pulmonary artery. Resistance to blood flow causes right ventricular hypertrophy and decreased pulmonary blood flow

PS Pulomnic Stenosis

A 5 yo child has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for which of the following

Possible urinary tract infection

5. Kathy has received an overdose of heparin. What is used to reverse the action of heparin? a) Protamine sulfate b) Vitamin K c) Calcium gluconate

Protamine Sulfate

The priority nursing intervention for a school-aged child in status epilpticus is

Protect the child from injury

The nurse is caring for a toddler who is not toilet trained. There is an order for strict intake and output measurement. How will you most accurately measure the output? a) Estimate the output as small, medium or large and record in the record b) Weigh each diaper and record the amount of urine output as the weight of the diaper c) Subtract the weight of dry diaper from a wet diaper and record this amount d) Determine urine output by the number of diaper changes in each 24-hour period

c) Subtract the weight of dry diaper from a wet diaper and record this amount

When discussing injury prevention with adolescents the nurse should remember that a. Adolescents imitate adult actions. b. Adolescents understand risk prevention. c. Adolescents think no harm can come to them. d. Adolescents like to engage in solitary activities.

c. Adolescents think no harm can come to them

When teaching school-age children, it is helpful to use pictures to reinforce verbal description of procedures because these children are in the cognitive stage of: a. Preoperative thought b. Conventional thought c. Concrete operational thought d. Sensorimotor thought

c. Concrete operational thought

When the nurse is palpating the infants head the fontanels should feel a. Tense and bulging. b. Soft and sunken. c. Flat and firm. d. Flat and tense

c. Flat and Firm

Procedures performed on young children are usually done in the treatment room because a. It is the most aseptic environment for the treatment. b. Children are less afraid in a different environment. c. The child's room is considered "safe." d. The treatment room is soundproof.

c. The childs room is considered "safe"

A mother tells a nurse that her 22-month-old child says no to everything. When scolded she becomes angry and starts crying loudly but immediately wants to be held. What is the best interpretation of this behavior? a. The toddler isn't effectively coping with the stress/ b. The toddler's need for affection isn't being met. c. This is normal behavior for a 2 year old. d. This behavior suggests the need for counseling.

c. This is normal behavior for a 2 year old.

A urine analysis (UA) is ordered for a child with a positive strep throat culture who looks ill. The mom asks why this is ordered. Your answer is: a) The UA will indicate if the child has HIV b) Urinary Tract infections are common with strep throat c) Pyelonephritis is a possible complication with antibiotics d) Group A beta hemolytic streptococcus infections can be followed by the complication of acute glomerulonephritis

d) Group A beta hemolytic streptococcus infections can be followed by the complication of acute glomerulonephritis

When preparing to physically assess the abdomen of a four yo child which of the following interventions should occur first? a. Auscultate all 4 quadrants with a stethoscope. b. Percuss the abdomen very gently. c. Remove all of the child's clothing. d. Establish a rapport with the family.

d. Establish a rapport with the family

13 What behavioral interventions could you use to assist in pain management?

distractions, toys