Test 2 Pediatric Nursing NCLEX Practice | Quiz #3: 50 Questions

Nurse Oliver is attending to a child with Cushing's syndrome. Which of the following nursing interventions would be most necessary?

Handling the child carefully to prevent bruising. The nurse should handle the child carefully because Cushing's syndrome causes capillary fragility, resulting in easy bruising and calcium excretion, resulting in osteoporosis. Glucocorticoids also increase catabolism of proteinaceous tissues such as collagen, causing skin atrophy fragility with striae and easy bruising.

Nurse Aries entered the room of a child with hypopituitarism and was asked by the couple about the condition of their child. Which of the following phrases if stated by the nurse best describes the condition?

Linear growth retardation with skeletal proportions normal for chronologic age. Although linear growth retardation occurs in hypopituitarism, delayed epiphyseal maturation allows for normal skeletal proportions. A population of full-term infants born with either isolated CGHD or multiple pituitary hormone deficiencies had normal lengths and weights at birth. By 6 and 12 months of age, all manifested growth deceleration.

While examining a 2-year-old child, Nurse Victoria sees that the anterior fontanel is open. She should:

Notify the doctor Because the anterior fontanel normally closes between ages 12 and 18 months, the nurse should notify the doctor promptly of this finding. The fontanel can enlarge in the first few months of life, and the median age of closure is 13.8 months. By three months of age, the anterior fontanel is closed in 1 percent of infants; by 12 months, it is closed in 38 percent; and by 24 months, it is closed in 96 percent.

A 1-year-old child is diagnosed with scabies. Which of the following medicines is expected to be prescribed?

Permethrin Permethrin and Lindane are used against scabies, but lindane is contraindicated for children below two years old because of the risk of seizures and neurotoxicity. Topical permethrin 5% cream is effective and widely used. The cream is typically applied once a week for two weeks (a total of 2 treatments). However, this treatment is occasionally associated with scabies resistance, poor patient compliance, and rare allergic reactions.

Preferred nurses at the Nurseslabs Medical Center are about to perform a procedure related to a genitourinary (GU) problem to a group of pediatric patients. Which of the following groups would find it especially extra stressful?

Preschoolers In general, preschoolers have more fears because of their fantasies, contributing to fears of the simplest procedures. Castration fears are also prominent at this age and may be heightened by procedures related to GU problems. The human brain is wired to alert us to and protect us from danger. Back in the day, that could mean a panther or wolf attack—so some trepidation around furry creatures is clearly in order. While babies and toddlers are usually scared of animals, too, things get turned up a notch when an active imagination kicks in at this age, explains Dr. Chansky.

An 11-year-old girl with celiac disease was discharged from the hospital. An appropriate teaching was carried out by the nurse if the parents are aware of avoiding which of the following?

Wheat Children with celiac disease cannot tolerate or digest gluten. Therefore, because of its gluten content, wheat and wheat-containing products must be avoided. Celiac disease is an autoimmune condition that causes severe damage to the lining of the small intestine. Gluten — a protein found in wheat, barley, and rye — triggers its symptoms.

Nurse Henry admits a child with suspected type 1 DM; Which of the following questions should the nurse ask the parents?

"Has the child experienced nocturia or bedwetting?" Bedwetting in children who have previously stayed dry at night is often an early sign of diabetes. Type 1 diabetes is a disease when the pancreas that produces insulin and helps get sugars (glucose) into the cells does not produce insulin. As most children with type 1 diabetes are otherwise healthy, history and physical health is usually limited to the assessment of pertinent diabetes care.

What should be the initial bolus of crystalloid fluid replacement for a pediatric patient in shock?

20 ml/kg Fluid volume replacement must be calculated to the child's weight to avoid overhydration. Initial fluid bolus is administered at 20 ml/kg, followed by another 20 ml/kg bolus if there is no improvement in fluid status. Shock is a life-threatening manifestation of circulatory failure. Circulatory shock leads to cellular and tissue hypoxia resulting in cellular death and dysfunction of vital organs.

The nurse is giving instructions to a mother with a child receiving a liquid oral iron supplement. The nurse tells the mother to:

Administer it using a straw. An oral liquid iron supplement should be given with a straw because the medicine will stain the teeth. Mix each dose in water, fruit juice, or tomato juice. You may use a drinking tube or straw to help keep the iron supplement from getting on the teeth.

Janae has a seizure disorder; which of the following would be the lowest priority when caring for her?

Assessing for signs and symptoms of increased intracranial pressure (ICP) Signs and symptoms of increased intracranial pressure (ICP) are not associated with seizure activity and therefore would be the lowest priority. A sudden alteration in consciousness with associated motor movements is the common description of a convulsive seizure. For generalized seizures with associated motor movements, the convulsion typically has a stiffening or tonic phase followed by clonic movements - rhythmic phased motor movements.

What is most likely the underlying physiology of primary enuresis?

Delayed bladder maturation The most likely cause of primary enuresis is delayed or incomplete maturation of the bladder. Primary enuresis is that which occurs in a child who has not been dry for at least 6 months, whereas secondary enuresis is the one that has an onset after a period of nocturnal dryness of at least 6 months.

In diagnosing seizure disorder, which of the following is the most beneficial?

EEG The EEG recognizes abnormal electrical activity in the brain. The pattern of multiple spikes can assist in the diagnosis of particular seizure disorders. Electroencephalography (EEG) is a biomarker for epilepsy. Focal or generalized epileptiform discharges constitute the EEG hallmark of seizure activity. Frequently EEG is obtained as a risk-stratification tool for a patient with a seizure of possibility of seizures.

Nurse Dorothy is caring for a child with Cushing's syndrome. Which of the following should she include in the plan of care?

Encourage a diet high in potassium. The elevation of cortisol level in Cushing's disease causes a decrease in the level of potassium, a condition called hypokalemia. At high levels, cortisol stimulates the tubules that control the absorption of electrolytes in the kidneys to excrete more potassium into the urine.

Will is being assessed by Nurse Lucas for possible intussusception. Which of the following would be least likely to provide valuable information?

Family history Because intussusception is not believed to have familial tendencies, obtaining a family history would provide the least amount of information. The causes of intussusception are not clearly known. About 90% of cases of intussusception in children arise from an unknown cause. They can include infections, anatomical factors, and altered motility.

Baby Ellie is diagnosed with gastroesophageal reflux (GER). Which of the following nursing diagnoses would be inappropriate?

Impaired oral mucous membrane GER is the backflow of gastric contents into the esophagus resulting from relaxation or incompetence of the lower esophageal (cardiac) sphincter. No alteration in the oral mucous membranes occurs with this disorder.

Tiffany is diagnosed with increased intracranial pressure (ICP); which of the following if stated by her parents would indicate a need for Nurse Charlie to reexplain the purpose for elevating the head of the bed at a 10 to 20-degree angle?

Increase intrathoracic pressure Head elevation decreases, not increases, intrathoracic pressure. In most patients with intracranial hypertension, head and trunk elevation up to 30 degrees is useful in helping to decrease ICP, providing that a safe CPP of at least 70 mmHg or even 80 mmHg is maintained.

Nurse Chole is evaluating a female child with acute post-streptococcal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement?

Increased urine output Increased urine output, a sign of improving kidney function, typically is the first sign that a child with acute post-streptococcal glomerulonephritis (APSGN) is improving. PSGN typically presents with features of the nephritic syndrome such as hematuria, oliguria, hypertension, and edema, though it can also present with significant proteinuria.

The nurse is aware that the following laboratory values support a diagnosis of pyelonephritis?

Pyuria Pyelonephritis is diagnosed by the presence of leukocytosis, hematuria, pyuria, and bacteriuria. A urinary specimen should be obtained for a urinalysis. On urinalysis, one should look for pyuria as it is the most common finding in patients with acute pyelonephritis.

Dr. Jones prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child?

To decrease proteinuria The primary purpose of administering corticosteroids to a child with nephritic syndrome is to decrease proteinuria. It helps relieve the inflammation in the kidney and promotes healing. The proteinuria usually ranges in the sub nephrotic range (less than 3.5 g/day), but it can go up to the nephrotic range. A 24-hours urinary protein assay is required if the attendant nephrotic syndrome is suspected.

Hannah's child is scheduled for surgery due to myelomeningocele; the primary reason for surgical repair is which of the following?

To reduce the risk of infection Surgical closure decreases the risk of infection stemming from damage to the fragile sac, which can lead to meningitis. Prenatal surgery was proven to be more effective than postnatal surgery in lowering the occurrence of future complications.

Which type of diabetes mellitus (DM) most likely results from heterogenous risk factors, making it preventable?

Type 2 Type 2 DM is a complex disorder of various causes with social, behavioral, and environmental risk factors. The disorder may be prevented by encouraging lifestyle modification for children at risk. Hyperglycemia results when there is a relative lack of insulin compared to glucose in the blood. In type 2 diabetes mellitus, insulin resistance first leads to increased insulin production by the beta cells of the pancreas. When the beta cells are unable to produce enough insulin to maintain euglycemia, hyperglycemia results.