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PEDS Exam 4 Testbank Arizona college
Which condition in a child should alert a nurse for increased fluid requirements? - CORRECT ANSWER fever A nurse is conducting an in-service on gastrointestinal disorders. The nurse includes that melena, the passage of black, tarry stools, suggests bleeding from which area? - CORRECT ANSWER upper gastrointestinal tract Which type of dehydration is defined as dehydration that occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportion? - CORRECT ANSWER isotonic dehydration A nurse is admitting an infant with dehydration caused from water loss in excess of electrolyte loss. Which type of dehydration is this infant experiencing? - CORRECT ANSWER hypertonic An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect? - CORRECT ANSWER poor skin turgor Parents call the clinic and report that their toddler has had acute diarrhea for 24 hours. The nurse should further ask the parents if the toddler has which associated factor that is causing the acute diarrhea? - CORRECT ANSWER antibiotic therapy Which pathogen is the viral pathogen that frequently causes acute diarrhea in young children? - CORRECT ANSWER rotavirus Which is a parasite that causes acute diarrhea? - CORRECT ANSWER Giardia lamblia A child is admitted with bacterial gastroenteritis. Which lab results of a stool specimen confirm this diagnosis? - CORRECT ANSWER neutrophils and RBC Which therapeutic management should the nurse prepare to initiate first for a child with acute diarrhea and moderate dehydration? - CORRECT ANSWER oral rehydration soultion A school-age child with diarrhea has been rehydrated. The nurse is discussing the childs diet with the family. Which statement by the parent would indicate a correct understanding of the teaching? - CORRECT ANSWER I should have my child eat a normal diet with easily digested foods for the next 48 hours. A young child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting. Therapeutic management of this child should begin with: - CORRECT ANSWER intravenous IV fluids
A mother calls the clinic nurse about her 4-year-old son who has acute diarrhea. She has been giving him the antidiarrheal drug loperamide (Imodium A-D). The nurses response should be based on knowledge that this drug is: - CORRECT ANSWER not indicated Constipation has recently become a problem for a school-age girl. She is healthy except for seasonal allergies that are being treated with antihistamines. The nurse should suspect that the constipation is most likely caused by: - CORRECT ANSWER antihistamines Which is a high-fiber food that the nurse should recommend for a child with chronic constipation? - CORRECT ANSWER popcorn Which therapeutic management treatment is implemented for children with Hirschsprung disease? a. Daily enemas - CORRECT ANSWER surgical removal of affected section of the bowel Enemas are ordered to empty the bowel preoperatively for a child with Hirschsprung disease. The enema solution should be: - CORRECT ANSWER normal saline. A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. The nurse should recognize that preparing this child psychologically is: - CORRECT ANSWER necessary because it will be an adjustment. The nurse is explaining to a parent how to care for a school-age child with vomiting associated with a viral illness. Which action should the nurse include? - CORRECT ANSWER Brush teeth or rinse mouth after vomiting. A 4-month-old infant has gastroesophageal reflux (GER) but is thriving without other complications. Which should the nurse suggest to minimize reflux? - CORRECT ANSWER thicken formula with rice cereal A histamine-receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with GER. The purpose of this is to: - CORRECT ANSWER reduce gastric acid production Which clinical manifestation would be the most suggestive of acute appendicitis? - CORRECT ANSWER Abdominal pain that is most intense at McBurney point When caring for a child with probable appendicitis, the nurse should be alert to recognize that which condition or symptom is a sign of perforation? - CORRECT ANSWER Sudden relief from pain
The nurse is caring for an infant whose cleft lip was repaired. Important aspects of this infants postoperative care include: - CORRECT ANSWER cleansing the suture line, supine and side-lying positions, arm restraints. During the first few days after surgery for cleft lip, which intervention should the nurse do? - CORRECT ANSWER Remove restraints periodically to cuddle infant. The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: - CORRECT ANSWER elevating the head but give nothing by mouth. Which type of hernia has an impaired blood supply to the herniated organ? - CORRECT ANSWER strangulated hernia Pyloric stenosis can best be described as: - CORRECT ANSWER hypertrophy of the pyloric muscle. Which observation made of the exposed abdomen is most indicative of pyloric stenosis?
- CORRECT ANSWER palpable olive like mass The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? - CORRECT ANSWER Visible peristalsis and weight loss An infant with pyloric stenosis experiences excessive vomiting that can result in: - CORRECT ANSWER metabolic alkalosis Invagination of one segment of bowel within another is called: - CORRECT ANSWER intussusception. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. Which nursing action is the most appropriate? - CORRECT ANSWER notify the practitioner Which is an important nursing consideration in the care of a child with celiac disease? - CORRECT ANSWER Refer to a nutritionist for detailed dietary instructions and education. An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include: - CORRECT ANSWER teaching family signs of central venous catheter infection. A nurse is receiving report on a newborn admitted yesterday after a gastroschisis repair. In the report, the nurse is told the newborn has a physicians prescription for an NG tube to low intermittent suction. The reporting nurse confirms that the NG tube is to low
intermittent suction and draining light green stomach contents. Upon initial assessment, the nurse notes that the newborn has pulled the NG tube out. Which is the priority action the nurse should take? - CORRECT ANSWER Replace the NG tube and continue the low intermittent suction. Parents of a child undergoing an endoscopy to rule out peptic ulcer disease (PUD) from H. pylori ask the nurse, If H. pylori is found will my child need another endoscopy to know that it is gone? Which is the nurses best response? - CORRECT ANSWER We can collect a stool sample and confirm that the H. pylori has been eradicated. A child has recurrent abdominal pain (RAP) and a dairy-free diet has been prescribed for 2 weeks. Which explanation is the reason for prescribing a dairy-free diet? - CORRECT ANSWER to rule out lactose intolerance A child who has just had definitive repair of a high rectal malformation is to be discharged. Which should the nurse address in the discharge preparation of this family? (Select all that apply.) - CORRECT ANSWER perineal found care reporting any changes in stopping patterns to the practitioner use of diet modification to prevent constipation Which is true concerning hepatitis B? (Select all that apply.) - CORRECT ANSWER hepatitis B can be prevented by HBV vaccine hepatitis B can be transferred to an infant of a breastfeeding mother onset of hepatitis B is insidious immunity to hepatitis B occurs after one attack A nurse is planning preoperative care for a newborn with tracheoesophageal fistula (TEF). Which interventions should the nurse plan to implement? (Select all that apply.) - CORRECT ANSWER Positioning with head elevated on a 30-degree plane Suctioning with a Replogle tube passed orally to the end of the pouch Gastrostomy tube to gravity drainage The nurse is preparing to care for an infant returning from pyloromyotomy surgery. Which prescribed orders should the nurse anticipate implementing? (Select all that apply.) - CORRECT ANSWER Administration of analgesics for pain IV fluids continued until tolerating PO Clear liquids as the first feeding
The nurse has documented that a childs level of consciousness is obtunded. Which describes this level of consciousness? - CORRECT ANSWER Arousable with stimulation The nurse has received report on four children. Which child should the nurse assess first? - CORRECT ANSWER A preschool child with a head injury and decreasing level of consciousness The nurse is performing a Glasgow Coma Scale on a school-age child with a head injury. The child opens eyes spontaneously, obeys commands, and is oriented to person, time, and place. Which is the score the nurse should record? - CORRECT ANSWER 15 The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. The nurse should interpret this as: - CORRECT ANSWER neurosurgical emergency The nurse is caring for a child with severe head trauma after a car accident. Which is an ominous sign that often precedes death? - CORRECT ANSWER periodic and irregular breathing The nurse is taking care of a child who is alert but showing signs of increased intracranial pressure. Which test is contraindicated in this case? - CORRECT ANSWER Oculovestibular response The nurse is preparing a school-age child for computed tomography (CT scan) to assess cerebral function. The nurse should include which statement in preparing the child? - CORRECT ANSWER the scan will not hurt Which neurologic diagnostic test gives a visualized horizontal and vertical cross-section of the brain at any axis? - CORRECT ANSWER CT scan Which is the priority nursing intervention for an unconscious child after a fall? - CORRECT ANSWER establish adequate airway Which drug should the nurse expect to administer to a preschool child who has increased intracranial pressure (ICP) resulting from cerebral edema? - CORRECT ANSWER mannitol (osmitrol) An appropriate nursing intervention when caring for an unconscious child should be to: - CORRECT ANSWER monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. The nurse is planning care for an 8-year-old child with a concussion. Which is descriptive of a concussion? - CORRECT ANSWER It is a transient and reversible neuronal dysfunction.
The nurse is teaching nursing students about childhood fractures. Which describes a compound skull fracture? - CORRECT ANSWER bone is exposed through skin Which statement best describes a subdural hematoma? - CORRECT ANSWER bleeding occurs between the dura and the cerebrum The nurse should recommend medical attention if a child with a slight head injury experiences: - CORRECT ANSWER confusion or abnormal behavior A 10-year-old boy on a bicycle has been hit by a car in front of the school. The school nurse immediately assesses airway, breathing, and circulation. The next nursing action: should be to - CORRECT ANSWER stabilize neck and spine An adolescent boy is brought to the emergency department after a motorcycle accident. His respirations are deep, periodic, and gasping. There are extreme fluctuations in blood pressure. Pupils are dilated and fixed. The nurse should suspect which type of head injury? - CORRECT ANSWER brainstem A child is unconscious after a motor vehicle accident. The watery discharge from the nose tests positive for glucose. The nurse should recognize that this suggests: - CORRECT ANSWER leaking of cerebrospinal fluid A toddler fell out of a second-story window. She had a brief loss of consciousness and vomited four times. Since admission, she has been alert and oriented. Her mother asks why a computed tomography (CT) scan is required when she seems fine. Which explanation should the nurse give? - CORRECT ANSWER your child may have a brain injury and a CT scan can rule one out The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. Which is the most essential part of the nursing assessment to detect early signs of a worsening condition? - CORRECT ANSWER level of consciousness A school-age child has sustained a head injury and multiple fractures after being thrown from a horse. The childs level of consciousness is variable. The parents tell the nurse that they think their child is in pain because of periodic crying and restlessness. The most appropriate nursing action is to: - CORRECT ANSWER discuss with practitioner what analgesia can be safely administered. A 5-year-old girl sustained a concussion when she fell out of a tree. In preparation for discharge, the nurse is discussing home care with her mother. Which statement made by the mother indicates a correct understanding of the teaching? - CORRECT ANSWER I should expect my child to have some behavioral changes after the accident. A 3-year-old child is hospitalized after a submersion injury. The childs mother complains to the nurse, Being at the hospital seems unnecessary when he is perfectly fine. The
Which is the initial clinical manifestation of generalized seizures? - CORRECT ANSWER losing consciousness Which of the following types of seizures may be difficult to detect? - CORRECT ANSWER absence An important nursing intervention when caring for a child who is experiencing a seizure would be to: - CORRECT ANSWER describe and record the seizure activity observed A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school. Breathing is not impaired, but some postictal confusion occurs. The most appropriate initial action by the school nurse is to: - CORRECT ANSWER stay with the child and have someone call EMS A child has been seizure-free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. The nurse includes which intervention in the response? - CORRECT ANSWER A step-wise approach will be used to reduce the dosage gradually. Children taking phenobarbital (phenobarbital sodium) and/or phenytoin (Dilantin) may experience a deficiency of: - CORRECT ANSWER vitamin D and folic acid Which clinical manifestations would suggest hydrocephalus in a neonate? - CORRECT ANSWER bulging fontanel and dilated scalp veins The nurse is monitoring a 7-year-old child post-surgical resection of an infratentorial brain tumor. Which vital sign findings indicate Cushings triad? - CORRECT ANSWER Bradycardia, hypertension, irregular respirations Which position should the nurse place a 10-year-old child after a large tumor was removed through a supratentorial craniotomy? - CORRECT ANSWER On the inoperative side with the head of bed elevated 20 to 30 degrees Which postoperative order does the nurse clarify with the surgeon before discharging the client who just had arthroscopic surgery on the right knee? - CORRECT ANSWER Administer two tablets of oxycodone/APAP (Tylox) every 4 hours for pain. An occupational therapist is treating a client with rheumatoid arthritis. Which assessment finding in the client does the nurse share with the occupational therapist? - CORRECT ANSWER Difficulty tying shoelaces and doing zippers on clothing The nurse is caring for a client who is to have a computed tomography (CT) scan of the leg. Which assessment question does the nurse ask the client before the procedure? - CORRECT ANSWER Do you have any allergies to shrimp, scallops, or other seafood?
The nurse is assessing a client who reports severe knee pain after a fall. Which question does the nurse ask to determine the radiation of the pain? - CORRECT ANSWER Does the pain move to another area from your knee? Which instruction does the nurse give to the client before he or she has electromyography (EMG)? - CORRECT ANSWER Do not take your cyclobenzaprine (Flexeril) on the 2 days before the test. The nurse is caring for a client with prostate cancer. Which laboratory finding indicates to the nurse that the cancer has metastasized to the bone? - CORRECT ANSWER Serum calcium, 21.6 mg/dL The nurse is caring for a client who presents with achy jaw pain. Which assessment technique does the nurse use to determine whether the client has inflammation of the temporomandibular joint (TMJ)? - CORRECT ANSWER Palpating the joint during movement for tenderness or crepitus The nurse is caring for a client who is able to flex the right arm forward without difficulty or pain but is unable to abduct the arm because of pain and muscle spasms. Which condition does the nurse suspect based on these assessment findings? - CORRECT ANSWER lesion in the rotator cuff The nurse is assessing a client who is suspected of having muscular dystrophy. Which statement by the client indicates that more teaching may be needed about the creatine kinase (CK) test that the health care provider has ordered? - CORRECT ANSWER The level of CK will be decreased with skeletal muscle disease. A client has cancer and a pacemaker, and suffers from claustrophobia. Which diagnostic test is the best indicator of the clients bone metastasis? - CORRECT ANSWER thallium bone scan Which client does the nurse assess first at the start of the nursing shift? - CORRECT ANSWER client who reports increased pain and swelling after and arthroscopy The nurse is performing a medical history and physical assessment on an older client. Which common findings in the older client are related to the musculoskeletal system? (Select all that apply.) - CORRECT ANSWER Decrease in bone density Atrophy of the muscle tissue Degeneration of cartilage Reduced range of motion of the joints
action? - CORRECT ANSWER Maintaining continuous traction and checking position of traction frequently Which is a type of skin traction with legs in an extended position? - CORRECT ANSWER buck extension Which type of traction uses skin traction on the lower leg and a padded sling under the knee? - CORRECT ANSWER Russell Four-year-old David is placed in Buck extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first? - CORRECT ANSWER notify the practitioner of the changes noted Which is an appropriate nursing intervention when caring for a child in traction? - CORRECT ANSWER Assess for tightness, weakness, or contractures in uninvolved joints and muscles. The nurse is teaching a family how to care for their infant in a Pavlik harness to treat developmental dysplasia of the hip. Which should be included? - CORRECT ANSWER Return to clinic every 1 to 2 weeks. A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation? - CORRECT ANSWER frequent, serial casting is tried first A 4-year-old child is newly diagnosed with Legg-Calv-Perthes disease. Nursing considerations should include which action? - CORRECT ANSWER Teaching the family the care and management of the corrective appliance The nurse is taking care of an adolescent diagnosed with kyphosis. Which describes this condition? - CORRECT ANSWER Increased convex angulation in the curve of the thoracic spine A school nurse is conducting a staff in-service to other school nurses on idiopathic scoliosis. During which period of child development does idiopathic scoliosis become most noticeable? - CORRECT ANSWER preadolescent growth spurt The nurse is preparing an adolescent with scoliosis for a Luque-rod segmental spinal instrumentation procedure. Which consideration should the nurse include? - CORRECT ANSWER Nasogastric intubation and urinary catheter may be required. The nurse is taking care of a 10-year-old child who has osteomyelitis. Which treatment plan is considered the primary method of treating osteomyelitis? - CORRECT ANSWER intravenous antibiotic therapy
A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma? - CORRECT ANSWER femur The nurse is taking care of an adolescent with osteosarcoma. The parents ask the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma? - CORRECT ANSWER Treatment usually consists of surgery and chemotherapy. An adolescent with osteosarcoma is scheduled for a leg amputation in 2 days. The nurses approach should include which action? - CORRECT ANSWER Answering questions with straightforward honesty Which medication is usually tried first when a child is diagnosed with juvenile idiopathic arthritis (JIA)? - CORRECT ANSWER Nonsteroidal anti-inflammatory drugs (NSAIDs) The nurse is caring for a school-age child diagnosed with juvenile idiopathic arthritis (JIA). Which intervention should be a priority? - CORRECT ANSWER Teach the child and family correct administration of medications. The nurse is caring for a 12-year-old child with a left leg below the knee amputation (BKA). The child had the surgery 1 week ago. Which intervention should the nurse plan to implement for this child? - CORRECT ANSWER Encourage the child to use an overhead bed trapeze when repositioning. A nurse is conducting discharge teaching for parents of an infant with osteogenesis imperfecta (OI). Further teaching is indicated if the parents make which statement? - CORRECT ANSWER Were glad there is a cure for this disorder. The nurse is caring for an adolescent with osteosarcoma being admitted to undergo chemotherapy. The adolescent had a right above-the-knee amputation 2 months ago and has been experiencing phantom limb pain. Which prescribed medication is appropriate to administer to relieve phantom limb pain? - CORRECT ANSWER Amitriptyline (Elavil) The nurse is caring for an infant with developmental dysplasia of the hip. Which clinical manifestations should the nurse expect to observe? (Select all that apply.) - CORRECT ANSWER Positive Ortolani click Unequal gluteal folds A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session? (Select all that apply.) - CORRECT ANSWER abdominal mass sore throat and ear pain
Which should the nurse expect to find in the cerebral spinal fluid (CSF) results of a child with Guillain-Barr syndrome (GBS)? (Select all that apply.) - CORRECT ANSWER Normal glucose Fewer than 10 white blood cells (WBCs/mm3) The nurse in the neonatal intensive care unit is caring for an infant with myelomeningocele scheduled for surgical repair in the morning. Which early signs of infection should the nurse monitor on this infant? (Select all that apply.) - CORRECT ANSWER temperature instability irritability lethargy The nurse is planning a staff in-service on childhood spastic cerebral palsy. Spastic cerebral palsy is characterized by: - CORRECT ANSWER hypertonicity and poor control of posture, balance, and coordinated motion. The parents of a child with cerebral palsy ask the nurse whether any drugs can decrease their childs spasticity. The nurses response should be based on which statement? - CORRECT ANSWER Implantation of a pump to deliver medication into the intrathecal space to decrease spasticity has recently become available. The nurse is preparing to admit a newborn with myelomeningocele to the neonatal intensive care nursery. Which describes this newborns defect? - CORRECT ANSWER Visible defect with an external saclike protrusion containing meninges, spinal fluid, and nerves The nurse is conducting a staff in-service on common problems associated with myelomeningocele. Which common problem is associated with this defect? - CORRECT ANSWER Hydrocephalus The nurse is teaching a group of nursing students about newborns born with the congenital defect of myelomeningocele. Which common problem is associated with this defect? - CORRECT ANSWER Neurogenic bladder The nurse is reviewing prenatal vitamin supplements with an expectant client. Which supplement should be included in the teaching? - CORRECT ANSWER Folic acid for all women of childbearing age How much folic acid is recommended for women of childbearing age? - CORRECT ANSWER 0.4mg
The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. The most appropriate way to position and feed this neonate is which position? - CORRECT ANSWER Prone, head turned to side, and nipple-fed The nurse is talking to a parent with a child who has a latex allergy. Which statement by the parent would indicate a correct understanding of the teaching? - CORRECT ANSWER My child should not eat bananas or kiwis. Latex allergy is suspected in a child with spina bifida. Appropriate nursing interventions include which action? - CORRECT ANSWER Avoid using any latex product. The nurse is admitting a child with Werdnig-Hoffmann disease (spinal muscular atrophy type 1). Which signs and symptoms are associated with this disease? - CORRECT ANSWER Progressive weakness and wasting of skeletal muscle Which clinical manifestations in an infant would be suggestive of spinal muscular atrophy (Werdnig-Hoffmann disease)? - CORRECT ANSWER Lying in the frog position A 4-year-old child has just been diagnosed with pseudohypertrophic (Duchenne) muscular dystrophy. The management plan should include which action? - CORRECT ANSWER Recommend genetic counseling. Therapeutic management of a child with tetanus includes the administration of: - CORRECT ANSWER tetanus immunoglobulin therapy. The nurse is conducting reflex testing on infants at a well-child clinic. Which reflex finding should be reported as abnormal and considered as a possible sign of cerebral palsy? - CORRECT ANSWER Extensor reflex at 7 months of age The nurse is caring for an infant with myelomeningocele scheduled for surgical closure in the morning. Which interventions should the nurse plan for the care of the myelomeningocele sac? - CORRECT ANSWER Covered with a sterile moist nonadherent dressing The nurse is admitting a school-age child with suspected Guillain-Barr syndrome (GBS). Which is a priority in the care for this child? - CORRECT ANSWER assessing respiratory efforts The nurse is caring for an intubated infant with botulism in the pediatric intensive care unit. Which health care provider prescriptions should the nurse clarify with the health care provider before implementing? - CORRECT ANSWER Administer gentamicin sulfate (Garamycin) 10 mg per intravenous piggyback every 12 hours. A home care nurse is caring for an adolescent with a T1 spinal cord injury. The adolescent suddenly becomes flushed, hypertensive, and diaphoretic. Which
