Pediatric GI, Endocrine/Metabolic, GU, Neuro, Cognitive/Behavioral Health, Heme/Onc Squarecap Questions

Question 1

The nurse would expect to see what clinical manifestations in the child diagnosed with Hirschsprung Disease?

A) History of bloody diarrhea, fever, and vomiting

B) Irritability, sever abdominal cramps, fecal soiling

C) Decreased hemoglobin, increased serum lipids, and positive stool for O&P

D) History of constipation, abdominal distension, passage of foul smelling, ribbonlike stools

Answer 1

D) History of constipation, abdominal distension, passage of foul smelling, ribbonlike stools

Question 2

You are caring for a 5 month old patient with crampy abdominal pain. Imaging reveals that the intestine has telescoped. What would you expect the diagnosis to be?

A) Intussusception

B) Pyloric Stenosis

C) Tracheoesophageal fistula

D) Hirschsprung Disease

Answer 2

A) Intussusception

Question 3

A common manifestation of inflammatory bowel diseases (IBD) in pediatric patients is:

A) growth failure

B) chronic constipation

C) obstruction

D) burning epigastric pain

Answer 3

A) growth failure

Question 4

You are caring for a 3 month old infant with GER. Which statement by the mother indicated that teaching was successful?

A) I will feed my baby every time she cries

B) I will lay her down flat after feeds to avoid fussiness

C) Spitting up is normal in infants my daughter’s age

D) I will give her zantac to help with the symptoms of GER

Answer 4

C) Spitting up is normal in infants my daughter’s age

Question 5

You are caring for a 2 month old that has been admitted due to being < 5% for her weight. You notice that his formula looks very watered down. Organic failure to thrive should be suspected

A) True

B) False

Answer 5

B) False

Question 6

Your 9-year old patient who is admitted for testing related to GHD (growth hormone deficiency) is upset because a volunteer gave her large blocks and a doll to play with in her room. What education will you provide to the volunteer about GHD and child development?

A) Tell the volunteer that the child will need to be in restraints

B) This is a normal reaction as many children with GHD also have conduct disorders

C) No education is need as this is an appropriate activity for the child

D) The patient may be small in stature but is not cognitively delayed

Answer 6

D) The patient may be small in stature but is not cognitively delayed

Question 7

Your 8-year-old male patient is having a diagnostic workup for precocious puberty. His medical history includes ear infections as an infant, meningitis when he was 5, and the flu when was 7. Which of these diagnoses could be a contributing factor?

A) ear infections

B) meningitis

C) Flu

D) none of the above

Answer 7

B) meningitis

Question 8

Your 6-year patient with a traumatic brain injury also has diabetes insipidus. Based on this information you know that he has which type of DI?

A) nephrogenic

B) neurogenic

C) hypothermic

D) hypovolemic

Answer 8

B) neurogenic

Question 9

The parent of your 11-year-old patient with SIADH is bringing her dinner. On the plate is fried chicken and green beans with butter. As the nurse, would you intervene and provide something else?

A) not immediately as children with SIADH will need to increase sodium

B) remove the tray and make sure the child is adhering to a clear liquid diet

C) Remove the tray as the child will to have enteral feeds through an naso-gastric tube

D) remove the tray as the child will need to have TPN

Answer 9

A) not immediately as children with SIADH will need to increase sodium

Question 10

A 13-year-old female client with hypothyroidism comes to your clinic for a follow-up visit. While her mother steps out to take a call, the patient confesses to you that she is being bullied at school on her appearance. Why might this be?

A) she is experiencing increased redness on her skin

B) she is experiencing an increase in weight

C) she is experiencing a severe amount of weight loss

D) she is experiencing an increased perspiration

Answer 10

B) she is experiencing an increase in weight

Question 11

You are providing stress reduction education to a family whose 14-year-old daughter has Graves disease. Why is it important to monitor this?

A) increased stress can lead to calcium disruption in children with Graves disease

B) increased stress can trigger a thyrotoxicosis event in children with Graves disease

C) increased stress can lead to increase G.I. disturbances in children with Graves disease

D) increased stress can lead to skeletal muscle changes in children with Graves disease

Answer 11

B) increased stress can trigger a thyrotoxicosis event in children with Graves disease

Question 12

Your 4-year-old with hypoparathyroidism has a serum CA level of 4.9 mg/dL. What orders and safety measures do you anticipate receiving from the physician?

A) no precautions are needed as this level is within normal range

B) suicide precautions

C) seizure precautions

D) bleeding precautions

Answer 12

C) seizure precautions

Question 13

You are straining urine for stones on your 9-year-old patient with hyperparathyroidism. A stone analysis will reveal what element?

A) Chloride

B) Calcium

C) Phosphorus

D) Sodium

Answer 13

B) Calcium

Question 14

Your 12-year-old patient is recovering from a severe asthma exacerbation and the physician has placed new orders to include: Albuterol inhaler 2 puffs BID, D/C IV fluids and IV Solu-medrol, regular diet, activity ad lib. Which order will you clarify with the physician in order to prevent the potential of Acute Adrenocortical insufficiency in this patient? Why?

A) Albuterol inhaler

B) D/C of IV fluids

C) regular diet

D) D/C of IV Solumedrol

Answer 14

D) D/C of IV Solumedrol

Question 15

The physician is ruling out pheochromocytoma in your 10-year-old patient. Which vital sign value will you be paying particular attention to while in your care?

A) temperature

B) blood pressure

C) oxygen saturation

D) heart rate

Answer 15

B) blood pressure

Question 16

Your 11-year-old patient is being seen in the clinic for Type 1 vs. Type 2 diabetes work-up. Her VS are T-98.4 po, HR 96, RR 22, BP 104/72, Height- in the top 75th percentile on the growth chart, weight- in the 25th percentile. Based on this data which type is more of a possibility?

A) Type 1

B) Type 2

C) more data is needed

Answer 16

A) Type 1

Question 17

You observe a nurse who is preparing to administer insulin to her patient with Type 1 diabetes. You notice she grabs a 1cc syringe and pulls an IM needle from the shelf. You intervene and explain what to the nurse?

A) injection insulin into muscle can lead to hypoglycemia

B) the nurse needed to use a 3cc syringe instead

C) the nurse should know that the patient’s condition is dependent on diet and exercise

D) the nurse should have grabbed a 14 gauge needle

Answer 17

A) injection insulin into muscle can lead to hypoglycemia

Question 18

You’ve just received a 15-year old patient in the Emergency Department for DKA. You anticipate orders from the intensivist to include…?

A) IV fluids

B) Start dextrose immediately

C) admit orders to the medical/surgical unit

D) stat CT scan

Answer 18

A) IV fluids

Question 19

What neurologic issue is a concern with Hypertonic dehydration?

A) Meningitis

B) Seizures

C) Infection

D) Encephalitis

Answer 19

B) Seizures

Question 20

In order to prevent the occurrence of a Urinary Tract Infection in a pre-school age girl, you provide education on wiping in which direction after voiding?

A) circular

B) back to front

C) front to back

D) side, side, center

Answer 20

C) front to back

Question 21

A potential cause of Acute Glomerulonephritis can be associated with this oral respiratory bacterial infection?

A) oral thrush

B) RSV

C) pharyngitis

D) croup

Answer 21

C) pharyngitis

Question 22

You are caring for a child with a history of Nephrotic Syndrome in the clinic. He is due for routine immunizations however the Pediatrician tells you to hold off giving the dose for now. This is most likely because the child may currently be on what type of medication?

A) blood thinners

B) antibiotics

C) loop diuretics

D) steroids

Answer 22

D) steroids

Question 23

Your patient in Acute Renal Failure or Kidney Injury will most likely have elevation of which two specific lab values?

Answer 23

BUN and Creatinine

Question 24

You are caring for an 8-year old in the hospital. On routine assessment during the night shift you find his bed linens and gown soaked in urine. Which type of Enuresis do you suspect?

A) primary

B) secondary

C) tertiary

D) none of the above

Answer 24

B) secondary

Question 25

A teenage male with corrected Cryptorchidism should be educated on the importance of doing this annually?

A) colorectal exams

B) breast exams

C) testicular exams

D) prostate exam

Answer 25

C) testicular exams

Question 26

A 16-year-old male is suffering from Testicular Torsion. Severe necrosis of this event can lead to what type of outcome/treatment?

A) necrosis/IV antibiotics

B) necrosis/debridement

C) necrosis/ orchiectomy

D) necrosis/ fasciotomy

Answer 26

C) necrosis/ orchiectomy

Question 27

Having to shake a child gently in order to arouse them is indicative of which Level of Consciousness?

A) lethargic

B) stupor

C) obtunded

D) coma

Answer 27

C) obtunded

Question 28

Posturing and papilledema are considered what signs in a patient with Increased Intracranial Pressure?

A) early signs

B) mild signs

C) moderate signs

D) late signs

Answer 28

D) late signs

Question 29

You are caring for a child who is showing signs of Seizure activity. The Pediatric Neurologist will refer the child and family for this standard diagnostic test?

A) Neural ultrasound

B) EKG

C) EEG

D) craniotomy with biopsy

Answer 29

C) EEG

Question 30

A child with Meningitis is experiencing pain behind his knee when you attempt to extend it during your assessment. This is indicative of what sign?

A) Homan’s sign

B) Kernig sign

C) Brudzinsky sign

D) Lateral neural sign

Answer 30

B) Kernig sign

Question 31

Neurological damage as a result of Reye’s Syndrome can be attributed to the ingestion of this medication?

A) Tylenol

B) Ibuprofen

C) Aspirin

D) Decadron

Answer 31

C) Aspirin

Question 32

In order to prevent musculoskeletal deconditioning in a patient with Guillain-Barre Syndrome, nursing care will include which measures

A) ensuring the child is being turned every two while on bedrest

B) ensuring the child is receiving their scheduled muscle relaxants on time

C) ensuring the child has a PT/OT consult ordered

D) ensuring the child’s dietary orders include red meat for at least 2 meals

Answer 32

C) ensuring the child has a PT/OT consult ordered

Question 33

An infant born with Spina Bifida is noted to have a myelomeningocele that is not intact. As a result, the priority concern for this patient is?

A) seizures

B) dehydration

C) infection

D) hypovolemic shock

Answer 33

C) infection

Question 34

You are caring for a patient with a Shunt malfunction. This is indicative of which type of neurological disorder?

A) Reye’s syndrome

B) hydrocephaly

C) otitis media

D) meningitis

Answer 34

B) hydrocephaly

Question 35

Your patient with Cerebral Palsy is admitted for a Baclofen pump site infection. Because the pump is not working, you anticipate seeing an increase in what symptom?

A) seizures

B) spasticity

C) fever

D) blood pressure

Answer 35

B) spasticity

Question 36

You receive a 10-year-old child in the emergency room with possible Traumatic Brain Injury. He is immediately sent to the CT room in order to assess for which types of damage? Select all that apply

A) intracranial bleeds

B) compression of cerebral tissue

C) infections

D) skull fractures

E) penetrating trauma

Answer 36

A) intracranial bleeds
B) compression of cerebral tissue
D) skull fractures
E) penetrating trauma

Question 37

You are on a pediatric rehab unit caring for a 12-year-old who suffered a Spinal Cord Injury. She is experiencing severe agitation, has an elevated BP, and is complaining of a crushing headache. This is indicative of what stress syndrome?

A) acute chest syndrome

B) autonomic dysreflexia

C) Graves disease

D) thyroid storm

Answer 37

B) autonomic dysreflexia

Question 38

You are working in the school health suite when a student comes in visibly shaking, has complaints of dizziness, and states that she can feel her heart beating very hard in her chest. You quickly assess she is experiencing this type of Anxiety disorder?

A) panic attack

B) agoraphobia

C) separation anxiety

D) shock

Answer 38

A) panic attack

Question 39

A teenager with a history of Depression confides in you that she is no longer interested in continuing with gymnastics, which she’s been involved with since she was in pre-school. You quickly recognize this as what symptom?

A) agoraphobia

B) bi-polar swing

C) anhedonia

D) lethargy

Answer 39

C) anhedonia

Question 40

A teenage male diagnosed with Bipolar Disorder is provided with sexual education information in hopes to prevent any unfavorable situations as a result of which phase of the disorder?

A) restrictive phase

B) neural phase

C) depressive phase

D) manic phase

Answer 40

D) manic phase

Question 41

A student comes to the school nurse office stating that she has had recurring thoughts of Suicide. What follow-up question would you want to ask her?

A) “do you want me to hold onto your belongings?”

B) “do you have a plan?”

C) “have you had anything to eat recently?”

D) “have you tried just smiling?”

Answer 41

B) “do you have a plan?”

Question 42

Priority measures for a child with Schizophrenia that is actively hallucinating should include?

A) placing the child a group therapy session with other children of the same age

B) offering the child a choice of activity to help calm her down

C) letting the child know that she will be disciplined if she acts out

D) ensuring safety

Answer 42

D) ensuring safety

Question 43

Effective treatment for a child diagnosed with Attention-Deficit Hyperactivity Disorder includes a combination of what two strategies?

A) mindfulness training and inpatient treatment

B) pharmacological and psychosocial therapy

C) strict discipline and pharmacological therapy

D) inpatient treatment center and pharmacological therapy

Answer 43

B) pharmacological and psychosocial therapy

Question 44

You are conducting an in-service at a local high school to parents about preventative measures on Substance Abuse. You’ll include strategies such as?

A) CRAFFT & CAGE questions

B) corporal punishment

C) including the parents

D) refrain from answering any of their questions

Answer 44

A) CRAFFT & CAGE questions

Question 45

A teenager with a history of an Eating Disorder comes to the school office for complaints of a headache. While talking to her you notice dental erosion of her lower front teeth. This assessment is indicative of the student doing what?

A) binging

B) purging

C) loss of appetite

D) laxative use

Answer 45

B) purging

Question 46

Children with an Autism Spectrum Disorder benefit from learning environments that are formatted in what way?

A) incorporate strict discipline

B) structured and predictable

C) unstructured and random levels

D) away from all family members

Answer 46

B) structured and predictable

Question 47

True or False: Learning disabilities are an indicator of IQ effort?

A) True

B) False

Answer 47

B) False

Question 48

Your patient who is just diagnosed with anemia presents with hepatosplenomegaly. Based on this symptom you determine the severity of this process to be moderate-severe?

A) True

B) False

Answer 48

A) True

Question 49

You are caring for a 2-month old infant with anemia and her lab work shows a hemoglobin of 6.2 g/dL. Is this cause for concern?

A) yes

B) no

C) more data is needed

Answer 49

A) yes

Question 50

You are in a pediatric clinic educating the mother of a 2-year old about the risks associated with Iron deficiency anemia for this age group. What reasoning do you include in your discussion?

A) Toddlers tend to be picky eaters

B) Toddlers are still allergic to iron rich foods

C) Toddlers lack the ability to synthesize iron

D) Toddlers metabolize iron a high rate

Answer 50

A) Toddlers tend to be picky eaters

Question 51

The mother of a 7 month old infant visits your clinic for a well-child checkup. On assessment she tells you that she has transitioned her child to regular milk. What concerns regarding iron deficiency anemia might you have for this child?

A) The child may have an allergic reaction

B) giving cow’s milk can decrease the absorption of of iron

C) the mother will have double the amount of cows milk in order for the child to receive the proper amount of iron

D) giving cow’s milk can increase iron deposits in neural tissue

Answer 51

B) giving cow’s milk can decrease the absorption of of iron

Question 52

You are working in a community clinic with a predominately large population of children who have sickle cell disease. In the waiting room are two vending machines that sell snacks and soda. Why would this a concern for specifically for the SCD population?

A) increased sugars and salt can lead to altered ventricular functioning in children with sickle cell disease

B) increased sugars and salt can lead to formation of a wide QRS complex in children with sickle cell disease

C) increased sugars and salt can lead to un-sickling of red blood cells

D) increased sugars and salt can lead to dehydration in children with sickle cell disease

Answer 52

D) increased sugars and salt can lead to dehydration in children with sickle cell disease

Question 53

Your 12-year old patient with sickle cell disease has been ordered chelation therapy to help get rid of iron accumulation in his body. What could be a potential cause of this excess?

A) The child may have received too much pain medication

B) The child’s lovenox levels may have increased

C) The child may have had a dietary change

D) The child may have had a multiple transfusions

Answer 53

D) The child may have had a multiple transfusions

Question 54

You are working in a pediatric hematology clinic and are providing education to parents about the importance of vaccinations. What particular vaccination can help with decreasing the incidence of ITP?

A) DTaP

B) MMR

C) Flu vaccine

D) Hepatitis B series

Answer 54

B) MMR

Question 55

You are caring for a patient with Acute Lymphocytic Leukemia. What symptom would you address first?

A) Mouth sores

B) Nausea

C) Fever

D) Hgb 9.0

Answer 55

C) Fever