pediatric 2

Questionary Week 2 Pediatrics

1. A 1 month old infant has received a diagnosis of phenylketonuria (PKU). Which

statements about PKU are true?

A. A low-phenylalanine diet is required.

B. Meat and dairy products should not be introduced to the diet.

C. Phenylketonuria is a self-limiting disease that resolves by adulthood.

D. Special infant formula is required.

E. Tyrosine should be removed from the diet.

2. The mother of a 6 year old child with cystic fibrosis (CF) has received instruction on the

use of pancreatic enzymes. Which statement made by the mother indicates a need for

further teaching?

A. “I need to monitor the total amount of this medication that I give to my child every day”.

B. “I should give this medication with or just before my child has a meal or snack”.

C. “It is okay for my child to chew this medication.”

D. “It is okay to open the capsule and sprinkle the medicine on a tablespoon of apple sauce”.

3. A nurse is reviewing the laboratory values for a 3-year-old client with nephrotic

syndrome. The nurse interprets the results to most clearly reflect which physiologic

process related to nephrotic syndrome?

Laboratory results:

Serum albumin 2.0 g/dL (20 g/L)

Serum total cholesterol 275 mg/dL (7.1 mmol/L)

Urinalysis protein 3+

A. Glomerular injury B. Hepatic impairment C. Inherited hypercholesterolemia D. Malnutrition

4. A parent brings a 6 month old child to the primary health care provider after the child abruptly started crying and grabbing intermittently at the abdomen. The client’s stool has

a red, currant jelly appearance. What intervention does the nurse anticipate?

A. Administer epoetin alfa (erythropoietin) B. Give air (pneumatic) enema C. Have the parent give 2 ounces of extra juice a day for constipation D. Perform hemoccult test on stool

5. Which pediatric presentation in the emergency department is a priority for nursing care? A. Client with an acute asthma exacerbation but no wheezing. B. Client with bronchiolitis with low-grade fever and wheezing. C. Client with runny nose with seal-like barking cough. D. Cystic fibrosis client with fever and yellow sputum.

6. A 1 year old child is brought to the emergency department for a severe sore throat and fever of 102.9 F (39.4 C). The nurse notes that the child is drooling with distressed

respirations and inspiratory stridor. What action should the nurse take first?

A. Assess and accurate temperature with a rectal thermometer. B. Directly examine the throat for the presence of exudates C. Obtain intravenous access for anticipated steroid administration. D. Position the child in tripod position on the parent’s lap.

7. A 12 month old infant is brought to the clinic for routine immunizations. Which conditions would cause the nurse to question administration? Select all that apply:

A. Flu shot and a history of anaphylactic. B. Haemophilus influenzae type b vaccine and local redness/swelling after last

immunization.

C. Hepatitis A vaccine and current “cold” with a temperature of 99 (37.2 C) D. Measles, mumps, rubella vaccine and exposure to chicken pox (varicella-zoster) recently. E. Pneumococcal vaccine and allergy to penicillin. F. Varicella-Zoster vaccine and diagnosed with leukemia

8. A 4 year old boy is diagnosed with Duchenne muscular dystrophy. Which nursing teaching is most appropriate for this child?

A. Increase intake of foods high in iron. B. Lift weights to strengthen weak muscles. C. Remove throw rugs. D. Take the muscle relaxant baclofen on time.

9. A mother brings a child to the emergency department with itching and the rash shown in the picture. The child continues to scratch the lesions. What action should the nurse take

first?

A. Administer antihistamine and closely crop the fingernails. B. Ask about the child’s vaccination status. C. Place a mask on the child. D. Place the child in positive airflow room.

10. A client admitted with sickle cell crisis has a hemoglobin level 9 g/L. The client reports severe pain in the back and leg joints. The nurse would anticipate which of the following?

Select all that apply:

A. Folic acid supplements. B. Foods high in iron. C. Ice packs to painful joints. D. Intravenous hydration. E. Intravenous morpine.

11. The following 4 clients are brought to the emergency department triage nurse. The client with which of these signs should be a priority to be seen for immediate care?

A. A 2 year old has sclera visible above the iris (sunset eyes) B. A 3 year old has a single transverse crease across the entire pam of the hand. C. A 6 month old breastfeed client had 8 wet diapers in the last 24 hours. D. A 9 month old client’s toes fan out and the big toe dorsiflexes when the foot sole is

stroked.

12. A child in the emergency department had a cast placed on the right arm for a nondisplaced fracture. The client is being discharged home with pain medications. Which

assessments by the parent indicates the additional teaching is required?

A. “A tingling or burning sensation within the first 24-48 hours is not a concern”. B. “An itching sensation under the cast for the first 24-48 hours is not a concern.” C. “I will call the doctor if pain is severe despite medications for the first 24 hours”. D. “My child should elevate the arm for the first 24-48 hours.”

13. What is the priority when caring for a 6 month old diagnosed with atopic dermatitis? A. Encouraging use of humidifier. B. Exploration of family feelings. C. Instruction regarding hypoallergic diet. D. Prevention of scratching.

14. A nurse is assessing a newborn with an infection due to Candida Albicans. Which assessment data support this diagnosis?

A. Diffuse skin rash that resembles flea bites. B. Small, white cysts on the hard palate. C. Vesicles on the skin surrounding the lips. D. White, adherent patches on the tongue and palate.

15. The parent of a 21 day old male infant reports that the infant is “throwing up a lot”. Which assessments should the nurse make to help determine if pyloric stenosis is an

issue? Select all that apply:

A. Assess the parent’s feeding technique. B. Check for family history of gluten enteropathy. C. Check for history of physiological hyperbilirubinemia. D. Check if the vomiting is projectile. E. Compare current weight to birth weight.

16. A school nurse is educating the parent of a young client with pediculosis capitis. Which statement by the parent indicates understanding of the teaching?

A. “I will launder recently worn clothing, sheets, and towels in hot water”. B. “I will make sure all eating utensils are placed in the dishwasher”. C. “I will spray the house with insecticide to control this problem”. D. “I will throw away stuffed animals and toys that can not be washed”.

17. A nurse is caring for a child with acute glomerulonephritis. Frequent monitoring/assessment of which of the following is a priority?

A. Blood pressure B. Hematuria C. Intake and output D. Peripheral edema

18. Which is a management concern for a male teenage client with cystic fibrosis? Select all that apply:

A. Diabetes insipidus. B. Frequent respiratory infections. C. Infertility D. Obesity E. Vitamin A Deficiency

19. A parent had brought her 6 month old to the clinic for routine immunizations. The nurse administers which of the following to the client:

A. Hep B B. IPV C. MMR D. PCV E. VZV

20. A nurse is performing an assessment of a 12 month old infant. Which findings would the nurse expect? Select all that apply:

A. Approaches strangers with ease. B. Eruption of 2 teeth. C. Equal head and chest circumference. D. Places a raisin in a small bottle. E. Sits from a standing position.

21. A nurse is discussing the fine motor abilities of a 10 month old infant with the infant’s parent. Which are developmentally appropriate skills for an infant on this age? Select all

that apply:

A. Grasps a small doll by the arm B. Stacks 3 wooden blocks C. Transfers small objects from hand to hand D. Turns single pages in a book E. Uses a basic pincer grasp

22. A nurse in a pediatric clinic is performing a physical examination of a 30 month old child. Which finding requires further evaluation?

A. Bladder and bowel control achieved B. Chest circumference is greater than abdominal circumference C. Current weight is 6 times greater than birth weight D. Head circumference increased by 1 in (2.5 cm) in the past year.

23. A nurse in the clinic is talking with a parent about the onset of puberty in boys. What is the first sign of pubertal change that occurs?

A. Appearance of upper lip hair. B. Increase in height C. Presence of axillary hair D. Testicular enlargement

24. The parent of a 7 month old reports that the child has been crying and vomiting with a distended belly for the past 4 hours. The infant is now lying quietly in the parent’s arms

with a pulse of 200/min and respirations of 60/min. Which of the following components

of SBAR (situation, background, assessment, recommendation/read-back)

communication is most important for the nurse to report to the health care provider?

A. Client has been ill for approximately 4 hours. B. Client has improved from apparent earlier distress. C. Client is now lethargic with abnormal vital signs D. Does the healthcare provider want to order a laxative?

25. A nurse on a pediatric unit is admitting a school-aged child with suspected Reye syndrome. Which information obtained during the history taking is most consistent with

this condition?

A. No history of varicella vaccine administration B. Recent exposure to bats C. Recent influenza infection D. Recent use of acetaminophen for fever

26. A nurse is caring for a school-age client who has fever, somnolence, and a skin rash from suspected meningococcal meningitis. Which interventions should be included in the plan

of care?

A. Allow the client to self-position for comfort

B. Have the client wear a mask for the first 24 hours C. Keep the client on NPO status D. Minimize the environmental stimuli E. Place the client in a negative airflow room

27. An nurse is caring for a 3 month old infant who has bacterial meningitis. Which clinical findings support this diagnosis? Select all that apply:

A. Depressed anterior fontanelle B. Frequent seizures C. High-pitched cry D. Poor feeding E. Presence of Babinski sign F. Vomiting

28. A child is scheduled to have an electroencephalogram (EEG). Which statement by the parent indicates understanding of the teaching?

A. “I will et my child drink cocoa as usual the morning of the procedure”. B. “I will wash my child’s hair using shampoo the morning of the procedure”. C. “My child may have scalp tenderness where the electrodes were applied”. D. “My child will not remember the procedure”.

29. The nurse in a clinic is caring for an 8 month old with a new diagnosis of bronchiolitis due to respiratory syncytial virus (RSV). Which instructions can the nurse anticipate

reviewing with the parent?

A. Administering a cough suppressant and antihistamine. B. Prophylactic treatment of family members C. Temporary cessation of breastfeeding D. Use of saline drops and a bulb syringe to suction nares

30. The school nurse assesses an 8 year old with a history of asthma. The nurse notes mild wheezing and coughing. Which action should the nurse perform first?

A. Assess the client’s peak expiratory flow. B. Call the health care provider (HCP) C. Educate the client about avoiding triggers D. Notify the client parents

31. A newborn has a large myelomeningocele. What nursing intervention is priority? A. Assess the anus for muscle tone B. Cover the area with sterile, moist dressing C. Measure the occipital frontal circumference D. Place the newborn supine with the head of the bed elevated

32. An adolescent client with a sore throat is diagnosed with infectious mononucleosis. Which comment by the caregiver would alert the nurse that additional instruction is

necessary?

A. “I need to go to the pharmacy to pick up an antibiotic prescription”. B. “It is acceptable for my child to have ibuprofen for discomfort or fever”. C. “My child will be on bed rest with few activities for the next 2 weeks”. D. “Participation in soccer practice will not be allowed for the next month”.

33. The home health nurse is visiting an infant who recently had surgery to repair tetralogy of Fallot. The nurse should teach the parents to report which findings indicative of heart

failure to the health care provider (HCP)? Select all that apply:

A. Cool extremities. B. Increase in appetite C. Puffiness around the eyes D. Reduction in number of wet diapers E. Weight loss

34. A 6 month old is admitted with bacterial meningitis. Which action is the priority of care? A. Administering antibiotics. B. Avoiding environmental stimuli C. Initiating seizure precautions D. Measuring head circumference

35. The nurse is caring for a child who had a tonsillectomy and adenoidectomy. Which are appropriate nursing actions? Select all that apply:

A. Apply an ice collar to the child’s neck B. Encourage the child to drink cold liquids through a straw C. Notify the HCP if the child’s throat is white or has an odor D. Teach the parents to administer acetaminophen for analgesia E. Teach the parents to be aware of frequent, increased swallowing