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Summer Finals > More Peds Questions > Flashcards

More Peds Questions Flashcards

1
Q

What is a high-fiber food that the nurse should recommend for a child with chronic constipation?

a. White rice
b. Popcorn
c. Fruit juice
d. Ripe bananas

A

B

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2
Q

What statement best describes Hirschsprung disease?

a. The colon has an aganglionic segment.
b. It results in frequent evacuation of solids, liquid, and gas.
c. The neonate passes excessive amounts of meconium.
d. It results in excessive peristaltic movements within the gastrointestinal tract.

A

A

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3
Q

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?

a. It is unnecessary because of childs age.
b. It is essential because it will be an adjustment.
c. Preparation is not needed because the colostomy is temporary.
d. Preparation is important because the child needs to deal with negative body image.

A

B

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4
Q

A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?

a. Prevent spread of infection.
b. Monitor electrolyte balance.
c. Prevent abdominal distention.
d. Maintain accurate record of output.

A

C

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5
Q

What clinical manifestation should be the most suggestive of acute appendicitis?

a. Rebound tenderness
b. Bright red or dark red rectal bleeding
c. Abdominal pain that is relieved by eating
d. Colicky, cramping, abdominal pain around the umbilicus

A

D

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6
Q

When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

a. Anorexia
b. Bradycardia
c. Sudden relief from pain
d. Decreased abdominal distention

A

C

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7
Q

A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?

a. Hyperkalemia
b. Hyperchloremia
c. Metabolic acidosis
d. Metabolic alkalosis

A

D
Infants with excessive vomiting are prone to metabolic alkalosis from the loss of hydrogen ions. Potassium and chloride ions are lost with vomiting. Metabolic alkalosis, not acidosis, is likely.

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8
Q

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?

a. 60 beats/min
b. 90 beats/min
c. 100 beats/min
d. 120 beats/min

A

B

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9
Q

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge?

a. It is a safe, frequently used drug.
b. Parents lack the expertise necessary to administer digoxin.
c. It is difficult to either overmedicate or undermedicate with digoxin.
d. Parents need to learn specific, important guidelines for administration of digoxin.

A

D

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10
Q

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal?

a. Irritability when awake
b. Capillary refill of more than 5 seconds
c. Appropriate weight gain for age
d. Positioned in high Fowler position to maintain oxygen saturation at 90%

A

C

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11
Q

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?

a. Cyanosis
b. Heart failure
c. Decreased pulmonary blood flow
d. Bounding pulses in upper extremities

A

B

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12
Q

What blood flow pattern occurs in a ventricular septal defect?

a. Mixed blood flow
b. Increased pulmonary blood flow
c. Decreased pulmonary blood flow
d. Obstruction to blood flow from ventricles

A

B

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13
Q

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?

a. Hypoxemia
b. Right-to-left shunt of blood
c. Decreased workload on the left side of the heart
d. Pulmonary vascular congestion

A

D

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14
Q

What cardiovascular defect results in obstruction to blood flow?

a. Aortic stenosis
b. Tricuspid atresia
c. Atrial septal defect
d. Transposition of the great arteries

A

A

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15
Q

What physiologic defect is responsible for causing anemia?

a. Increased blood viscosity
b. Depressed hematopoietic system
c. Presence of abnormal hemoglobin
d. Decreased oxygen-carrying capacity of blood

A

D

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16
Q

YOU GOT THIS!

A

WAHOOOO

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17
Q

A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next?

a. Reduce environmental stimulation to prevent seizures.
b. Have the laboratory repeat the analysis with a new specimen.
c. Minimize energy expenditure to decrease cardiac workload.
d. Administer intravenous fluids to correct the dehydration.

A

C

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18
Q

A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason?

a. Allow her parents to come visit her.
b. Fight the infection that she now has.
c. Increase her energy so she will not be so tired.
d. Help her body stop bleeding by forming a clot (scab).

A

C

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19
Q

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what complication?

a. Air embolism
b. Allergic reaction
c. Hemolytic reaction
d. Circulatory overload

A

D

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20
Q

What explanation provides the rationale for why iron-deficiency anemia is common during
infancy?
a. Cows milk is a poor source of iron.
b. Iron cannot be stored during fetal development.
c. Fetal iron stores are depleted by 1 month of age.
d. Dietary iron cannot be started until 12 months of age.

A

A

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21
Q

What statement best describes iron deficiency anemia in infants?

a. It is caused by depression of the hematopoietic system.
b. Diagnosis is easily made because of the infants emaciated appearance.
c. It results from a decreased intake of milk and the premature addition of solid foods.
d. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.

A

D

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22
Q

What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations?

a. Give with meals.
b. Stop immediately if nausea and vomiting occur.
c. Adequate dosage will turn the stools a tarry green color.
d. Allow preparation to mix with saliva and bathe the teeth before swallowing.

A

C

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23
Q

What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin?

a. Aplastic anemia
b. Sickle cell anemia
c. Thalassemia major
d. Iron deficiency anemia

A

B

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24
Q

The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA?

a. SCA is not inherited.
b. All siblings will have SCA.
c. Each sibling has a 25% chance of having SCA.
d. There is a 50% chance of siblings having SCA.

A

C

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25
Q

The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration?

a. Decreased blood viscosity
b. Deficiency in coagulation
c. Increased red blood cell (RBC) destruction
d. Greater affinity for oxygen

A

C

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26
Q

A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The childs care should include which therapeutic interventions?

a. Hydration and pain management
b. Oxygenation and factor VIII replacement
c. Electrolyte replacement and administration of heparin
d. Correction of alkalosis and reduction of energy expenditure

A

A

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27
Q

A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse?

a. Administer 100% oxygen to relieve hypoxia.
b. Notify the practitioner because chest syndrome is suspected.
c. Infuse intravenous antibiotics as soon as cultures are obtained.
d. Give ordered pain medication to relieve symptoms of pain episode.

A

B

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28
Q

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxiaischemia cycle. What information should the nurse share with parents in a teaching plan?

a. Encourage drinking.
b. Keep accurate records of output.
c. Check for moist mucous membranes.
d. Monitor the concentration of the childs urine.

A

C

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29
Q

In which condition are all the formed elements of the blood simultaneously depressed?

a. Aplastic anemia
b. Sickle cell anemia
c. Thalassemia major
d. Iron deficiency anemia

A

A

30
Q

After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention?

a. Hydration
b. Oxygenation
c. Corticosteroids
d. Pain management

A

A

31
Q

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention?

a. Restrict oral fluids.
b. Institute strict isolation.
c. Use good hand-washing technique.
d. Give immunizations appropriate for age.

A

C

32
Q

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments?

a. Administer the chemotherapy between meals.
b. Give an antiemetic before chemotherapy begins.
c. Have the child bring favorite foods for snacks.
d. Keep the child NPO (nothing by mouth) until nausea and vomiting subside.

A

B

33
Q

A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try?

a. Relax any eating pressures.
b. Firmly insist that the child eat normally.
c. Serve foods that are either hot or cold.
d. Provide only liquids because chewing is painful.

A

A

34
Q

The nurse is caring for a child receiving chemotherapy for leukemia. The childs granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child?

a. Rinsing mouth with water
b. Daily toothbrushing and flossing
c. Lemon glycerin swabs for cleansing
d. Wiping teeth with moistened gauze or Toothettes

A

B

35
Q

What immunization should not be given to a child receiving chemotherapy for cancer?

a. Tetanus vaccine
b. Inactivated poliovirus vaccine
c. Diphtheria, pertussis, tetanus (DPT)
d. Measles, mumps, rubella (MMR)

A

D

36
Q

Urinary tract anomalies are frequently associated with what irregularities in fetal development?

a. Myelomeningocele
b. Cardiovascular anomalies
c. Malformed or low-set ears
d. Defects in lower extremities

A

C

37
Q

A girl, age 5 1/2 years, 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 what condition?

a. School phobia
b. Glomerulonephritis
c. Urinary tract infection (UTI)
d. Attention deficit hyperactivity disorder (ADHD)

A

C

38
Q

What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?

a. Infarction of renal vessels
b. Immune complex formation and glomerular deposition
c. Bacterial endotoxin deposition on and destruction of glomeruli
d. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation

A

B
After a streptococcal infection, antibodies are formed, and immune-complex reaction occurs. The immune complexes are trapped in the glomerular capillary loop. Infarction of renal vessels occurs in renal involvement in sickle cell disease. Bacterial endotoxin deposition on and destruction of glomeruli is not a mechanism for postinfectious glomerulonephritis.

39
Q

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss?

a. Poor appetite
b. Reduction of edema
c. Restriction to bed rest
d. Increased potassium intake

A

B

40
Q

What measure of fluid balance status is most useful in a child with acute glomerulonephritis?

a. Proteinuria
b. Daily weight
c. Specific gravity
d. Intake and output

A

B

41
Q

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply?

a. The antibiotic therapy contributes to labile blood pressure values.
b. Hypotension leading to sudden shock can develop at any time.
c. Acute hypertension is a concern that requires monitoring.
d. Blood pressure fluctuations indicate that the condition has become chronic.

A

C

42
Q

What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome?

a. Low specific gravity
b. Decreased hemoglobin
c. Normal platelet count
d. Reduced serum albumin

A

D

43
Q

What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)?

a. Reduce blood pressure.
b. Lower serum protein levels.
c. Minimize excretion of urinary protein.
d. Increase the ability of tissue to retain fluid.

A

C

44
Q

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child?

a. Stimulate appetite.
b. Detect evidence of edema.
c. Minimize risk of infection.
d. Promote adherence to the antibiotic regimen.

A

C

45
Q

The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need?

a. Consuming a regular diet
b. Increasing protein
c. Restricting fluids
d. Decreasing calories

A

C

46
Q

A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the childs prognosis is related to what factor?

a. Admission blood pressure
b. Creatinine clearance
c. Amount of protein in urine
d. Response to steroid therapy

A

D

47
Q

What condition is the most common cause of acute renal failure in children?

a. Pyelonephritis
b. Tubular destruction
c. Severe dehydration
d. Upper tract obstruction

A

C

48
Q

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children?

a. Low-pitched cry
b. Sunken fontanel
c. Diplopia, blurred vision
d. Increased blood pressure

A

C

49
Q

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child?

a. Suction the child frequently.
b. Turn the childs head side to side every hour.
c. Provide environmental stimulation.
d. Avoid activities that cause pain or crying.

A

D

50
Q

Intranasal administration of desmopressin acetate (DDAVP) is used to treat which condition?

a. Hypopituitarism
b. Diabetes insipidus (DI)
c. Syndrome of inappropriate antidiuretic hormone (SIADH)
d. Acute adrenocortical insufficiency

A

B

51
Q

What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency?

a. Type 1 diabetes
b. Type 2 diabetes
c. Gestational diabetes
d. Maturity-onset diabetes of the young (MODY)

A

A

52
Q

What statement is characteristic of type 1 diabetes mellitus?

a. Onset is usually gradual.
b. Ketoacidosis is infrequent.
c. Peak age incidence is 10 to 15 years.
d. Oral agents are available for treatment.

A

C

53
Q

What blood glucose measurement is most likely associated with diabetic ketoacidosis?

a. 185 mg/dl
b. 220 mg/dl
c. 280 mg/dl
d. 330 mg/dl

A

D

54
Q

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What effect does exercise have on a type 1 diabetic?

a. Exercise increases blood glucose.
b. Extra insulin is required during exercise.
c. Additional snacks are needed before exercise.
d. Excessive physical activity should be restricted.

A

C

55
Q

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid- releasing sugar should be followed by which dietary intervention?

a. Sports drink and fruit
b. Glucose tabs and protein
c. Glass of water and crackers
d. Milk and peanut butter on bread

A

D

56
Q

A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician?

a. Weigh on admission and daily.
b. Replace fluid volume deficit over 48 hours.
c. Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride.
d. Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus.

A

C

57
Q

What clinical manifestation occurs with hypoglycemia?

a. Lethargy
b. Confusion
c. Nausea and vomiting
d. Weakness and dizziness

A

D

58
Q

What finding is characteristic of fractures in children?

a. Fractures rarely occur at the growth plate site because it absorbs shock well.
b. Rapidity of healing is inversely related to the childs age.
c. Pliable bones of growing children are less porous than those of adults.
d. The periosteum of a childs bone is thinner, is weaker, and has less osteogenic potential compared d. to that of an adult.

A

B

59
Q

A 14-year-old is admitted to the emergency department with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture?

a. It will create difficulty because the child is left handed.
b. It will heal slowly because this is the weakest part of the bone.
c. This type of fracture requires different management to prevent bone growth complications.
d. This type of fracture necessitates complete immobilization of the shoulder for 4 to 6 weeks.

A

C

60
Q

The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign?

a. Petaling
b. Posturing
c. Paresthesia
d. Positioning

A

C

61
Q

What is the most common cause of cerebral palsy (CP)?

a. Central nervous system (CNS) diseases
b. Birth asphyxia
c. Cerebral trauma
d. Neonatal encephalopathy

A

D

62
Q

Spastic cerebral palsy (CP) is characterized by which clinical manifestations?

a. Athetosis, dystonic movements
b. Tremors, lack of active movement
c. Hypertonicity; poor control of posture, balance, and coordinated motion
d. Wide-based gait; poor performance of rapid, repetitive movements

A

C

63
Q

What type of cerebral palsy (CP) is the most common type?

a. Ataxic
b. Spastic
c. Dyskinetic
d. Mixed type

A

B

64
Q

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge?

a. Affected children have some degree of cognitive impairment.
b. Around 20% of affected children have normal intelligence.
c. About 45% of affected children have normal intelligence.
d. Cognitive impairment is expected if motor and sensory deficits are severe.

A

C

65
Q

Gingivitis is a common problem in children with cerebral palsy (CP). What preventive measure should be included in the plan of care?

a. High-carbohydrate diet
b. Meticulous dental hygiene
c. Minimum use of fluoride
d. Avoidance of medications that contribute to gingivitis

A

B

66
Q

What is a major goal of therapy for children with cerebral palsy (CP)?

a. Cure the underlying defect causing the disorder.
b. Reverse the degenerative processes that have occurred.
c. Prevent the spread to individuals in close contact with the child.
d. Recognize the disorder early and promote optimum development.

A

D

67
Q

The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching?

a. Patterning
b. Positions to reduce spasticity
c. Stretching exercises after meals
d. Topical analgesics for muscle spasms

A

B

68
Q

A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child?
a. Bottle or tube feed him a specialized formula until he gains sufficient weight.
b. Stabilize his jaw with caregivers hand (either from a front or side position) to facilitate
swallowing.
c. Place him in a well-supported, semireclining position.
d. Place him in a sitting position with his neck hyperextended to make use of gravity flow.

A

B

69
Q

An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurses response should be based on which knowledge?
a. Most activities such as Girl Scouts cannot be adapted for children with CP
b. After-school activities usually result in extreme fatigue for children with CP.
c. Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children
with CP .
d. Recreational activities often provide children with CP with opportunities for socialization and
recreation.

A

D

70
Q

The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training?

a. Children with dyskinetic CP have a wide-based gait and repetitive movements.
b. Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus.
c. Children with hemiplegia CP have mouth muscles and one lower limb affected.
d. Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria.

A

B

71
Q

The nurse should suspect a child has cerebral palsy (CP) if the parent says what?

a. My 6-month-old baby is rolling from back to prone now.
b. My 4-month-old doesnt lift his head when on his tummy.
c. My 8-month-old can sit without support.
d. My 10-month-old is not walking.

A

B

72
Q

The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what?

a. Playing pat-a-cake with the child
b. None so the child does not become overstimulated
c. Putting a colorful mobile with music on the bed
d. Giving the child a coloring book and crayons

A

C

Summer Finals (3 decks)

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