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PEDS Unit 3 > PM Exam III > Flashcards

PM Exam III Flashcards

1
Q

The nurse is caring for a 6 yr old child hospitalized with a head injury following a car accident. The father yells from the child’s room that the child will not wake from sleep. The nurse assesses the child, who now has a respiratory rate of 6. What is the nurses’s most appropriate next action?

  1. Push the code blue button and prepare for resuscitation of the child.
  2. Go to the nurse’s station to make an immediate call to the physician
  3. Clear the patient’s bed as a precaution for seizure activity
  4. Tell the father to keep calling the child’s name loudly while the nurse goes to look for help
A

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2
Q

When providing education for teh family of a child with a new diagnosis of typical febrile seizures, what should the nurse include in the teaching plan?

  1. The child should recover fully and is not at greater risk for developing epilepsy
  2. the child is at greater risk for cognitive and developmental disabilities
  3. The child is very likely to develop a seizure disorder later in life
  4. The parents should use cool baths to control fevers such as this in the future
A

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3
Q

A 10 yr old child with hemophilia has slipped on the ice and bumped their knee. Which of the following medications can the nurse expect to prepare for the child?

  1. An intramuscular injection of iron
  2. An intravenous infusion of acetaminophen
  3. An intravenous infusion of Factor VIII
  4. A subcutaneous injection of deferoxamine
A

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4
Q

A 13 yr old girl is being evaluated for bracing to correct her scoliosis. What should the nurse anticipate as the primary concern for this patient?

  1. Selecting suitable exercise
  2. Appearance
  3. The discomfort of the brace
  4. Developing a rash under the brace
A

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5
Q

The nurse caring for a child newly diagnosed with Legg-Calve-Perthes Disease is asked by the parents to describe the diagnosis. The best response by the nurse is:

  1. LCP is a disease that progresses through several stages that begins with a lack of good blood flow to the head of the femur causing damage and ends with the child losing the ability to walk
  2. LCP is a disease that causes damage to the bones
  3. LCP is a disease that causes pain and limping but will heal after long-term antibiotics
  4. LCP is a disease that progresses through several stages that begins with a lack of good blood flow to the head of the femur causing damage and ends with the healing of the femoral head
A

4

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6
Q

A child with cerebral palsy is seen in the clinic for worsening muscle spasticity. The nurse can expect that the child will be prescribed a trial of what medication to help reduce the chance of the child developing contractures?

  1. Cyclobenzeprine
  2. NSAIDS
  3. Diazapam
  4. Baclofen
A

4

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7
Q

A teenager comes to the hematology clinic with a diagnosis of hemarthrosis of the elbow. Which of the following statements should the nurse include when providing educaiton to the patient?

  1. Playing sports like ice hockey will help you get stronger
  2. Factor XIII is a great way to decrease the pain and inflammation
  3. You can use ice and acetaminophen to decrease the pain
  4. Your mom and dad should watch what you eat since obesitiy will complicate your disease
A

2

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8
Q

The nurse is providing anticipatory guidance to the parents of a baby who just started crawling. The nurse is concerned about possible lead poisoning, so asks:

  1. What year was your apartment building built?
  2. Has your child had a cough recently?
  3. Does your child play on the climbing structures at the park?
  4. Do you keep your vitamins and medication sin a locked cabinet?
A

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9
Q

Even children who do not contract the virus are at increased risk of which of the following during the COVID-19 pandemic (select all that apply)

  1. Child abuse
  2. Contracting seasonal flu
  3. Anxiety
  4. Hunger or food insecurity
  5. Falling behind in their education
A

1, 3, 4, 5

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10
Q

Match the diagnosis to its unique characteristic.

Measles 1. Bull’s eye rash

Tetanus 2. Muscle rigidity

Diptheria 3. Barking cough

Pertussis 4. Koplik spots

Tick bite 5. Gray membrane across back of mouth

Petechiae. 6. Non-blanchable red spots

A

Measles, 4

Tetanus, 2

Diptheria, 5

Pertussis, 3

Tick bite, 1

Petechiae, 6

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11
Q

A nurse is out shopping with her family and notices a toddler that she suspects of having retinoblastoma. The nurse has probably noticed that the child has:

  1. An awkward gait
  2. Swollen cervical lymph nodes
  3. Bruising around the eye socket
  4. Leukocoria
A

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12
Q

All of the following statments by a teenager with osteosarcoma of the femur indicate understanding of diagnosis and treatment, except:

  1. A phantom pain is something some patients experience after treatment
  2. My cancer was discovered on x-ray when the doctor saw a Codman Triangle
  3. I have to think about whether to choose amputation or a limb salvage procedure as part of my treatment
  4. The nurse is assessing my respiratory status because the lungs are a place where my cancer might metastasize
A

2

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13
Q

Following the administration of a measles mumps rubella (MMR) vaccine, the nurse should make a priority assessment for which of the following client manifestations?

  1. Pain
  2. Anxiety
  3. Vomiting
  4. Wheezing
A

4

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14
Q

The public health nurse (PHN) working with the mother of a 10 month old infant receives a call from the mother who says that the infant has been febrile for two days, excessively irritable with high-pitched crying spells, and has not been feeding well. The mother is concerned now because the child is suddenly difficult to arouse and has reddish spots on the body. What is the appropriate action by the PHN?

  1. Tell the mother to hang up and call 911
  2. Instruct the mother to take the child to the emergency room by car
  3. Make a home visit to assess the infant
  4. Tell the mother to bring the infant to the clinic
A

1

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15
Q

Which assessment finding is the earliest sign of a decrease in the level of consciousness in a pediatric patient?

  1. Decreasing blood pressure
  2. Absent reflexes
  3. Decerebrate postering
  4. Irritability
A

4

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16
Q

An 8 yr old with leukemia is receiving chemo. The child is refusing to eat. Which of the following should the nurse do first?

  1. Look in the patient’s mouth
  2. Give ondansetron IV
  3. Insert an NG tube for feedings
  4. Give BMX swish and swallow
A

1

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17
Q

The mother of a child with hemophilia asks the nurse, “How did my son acquire this disease?” Which statement by the nurse would be the best response?

  1. Hemophilia is an idiopathic disorder and there is no telling who may be born with it
  2. Hemophilia is an x-linked disorder passed from mother to child if the mother carries the trait
  3. Hemophilia is a y-linked disorder passed from father to child if the father carries the trait
  4. Children will only inherit hemophila if both parents are carriers of the trait
A

2

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18
Q

As a part of anticipatory guidance for parents of young children, the nurse teaches them that _____ should be avoided for children who have a fever, as it increases the risk for the child to develop _____.

  1. acetaminophen, febrile seizures
  2. antivirals, a secondary infection
  3. aspirin, meningitis
  4. aspirin, Reye syndrome
A

4

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19
Q

The student nurse is taking care of a child with a femur fracture who will have an open reduction the following day. The student knows that a goal of traction before surgery is:

  1. Reduce the risk of muscle spasm
  2. Keep the child from moving
  3. Prevent compartment syndrome
  4. Reduce the risk of pressure ulcer while the child is immobilized
A

1

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20
Q

The nurse is caring for a preschooler with a tunneled central venous access device (Broviac). Which assessment finding should be of greatest concern?

  1. The parents use clean hands to assist with dressing changes
  2. Smooth-edged clamps are kept at the bedside
  3. The catheter line is coiled under a secure dressing
  4. The line is flushed with heparine once a day
A

1

21
Q

The nurse is teaching the parents of a child newly diagnosed with brain tumor. Which of the following parental statements indicate the nurse’s teaching has been effective?

  1. If we would have brought our child in earlier, we wouldn’t be goning through this right now.
  2. I will need to watch my child for signs of increased intracranial pressure
  3. If my child’s brain tumor is surgically removed, he won’t have to have chemo or radiation
  4. We are planning to attend a multi-school holiday carnival after this chemo treatment to give your child something positive to look forward to
A

2

22
Q

Which is most descriptive of the pathophysiology of leukemia?

  1. The unrestricted proliferation of immature white blood cells occurs
  2. Abnormal hemoglobin causes damage to RBCs
  3. The first stage of the coagulation process is abnormally stiumulated
  4. Thrombocytopenia occurs
A

1

23
Q

The parent of a healthy 9 month old child asks the nurse what immunications the child should have at the next well-child visit. The nurses best response is:

  1. I’m not sure which ones your child should have. My professor didn’t make me memorize this
  2. I will review your child’s medical recors and compare that to the current CDC guidlines to determine which vaccines are recommended for your child at this time
  3. Your child should have the MMR, Varicella and the Hep B vaccines
  4. Which vaccines did your child already have?
A

2

24
Q

A 5yr old with history of hydrocephalus is hospitalized in the PICU with an externalized ventricular drain (EVD). The child becomes fussy and complains of a headdache. What is the priority nursing action?

  1. Call the physician
  2. Administer a dose of acetaminophen as ordered
  3. Perform a neurological assessment
  4. Place the child in a supine position
A

3

25
Q

The nurse is educating the mother of a preschooler with iron deficiecy anemia. The nurse knows the family needs additional information when they state:

  1. I will keep my child’s supplemental iron on the kitchen counter so we don’t forget to give it to her each day
  2. I will give my child her supplemental iron with vitamin C rich foods, like oranges
  3. I will limit my child’s milk intake before meals so that she will not be too full to eat the iron rich foods I offer
  4. Iron helps my child’s body make healthy red blood cells with hemoglobin
A

1

26
Q

Prior to surgery for a myelomeningocele, the nurse should place teh baby in which position?

  1. Supine
  2. Prone
  3. Trendelenberg
  4. Right side
A

2

27
Q

The nurse is caring for a teenager following an above the knee amputation for osteosarcoma. Which assessment finding should the nurse find most concerning?

  1. The teenager discusses the surgery with a best friend
  2. The teenager cries when discussing what it will be like without the leg
  3. The teenager looks at the stump and wound while the bandages are being changed
  4. The teenager keeps the leg under the covers with the covers tightly clutched to the chest
A

4

28
Q

The nurse discusses long-term care with the parents of a child who has a ventriculoperitoneal shunt. Which topic should be a priority component of the teaching plan?

  1. Shunt malfunction or infection requires immediate treatment
  2. Wearing head protection is essential until the child reaches adulthood
  3. Most childhood activities will need to be modified
  4. Intellectual impairment is to be expected with this condition
A

1

29
Q

A parent asks the nurse caring for a child with terminal illness not to share information about life-expectancy with the child. The best response by the nurse is:

  1. Your child deserves the truthh so you have to tell her now
  2. Why would you want to lie to your child
  3. I won’t We don’t want your child to feel sad or worried
  4. Lets talk a little more about what your child may or may not already understand about her illness
A

4

30
Q

The parents of a 9yr old with moderatley severe hemophilia ask the nurse about sports activities that would be appropriate for their child. Based on an understanding of hemophilia, the nurse should suggest which of the following activities?

  1. Ice skating
  2. Swimming
  3. Horseback riding
  4. Jogging
A

2

31
Q

A 4yr old is hospitalized with suspected Wilms tumor. Pre-operatively, which of the following nursing actions is contraindicated in the care of this child?

  1. Monitor blood pressure every 4hrs
  2. Monitor strict intake and output
  3. Palpate abdomen for distention and tenderness every shift
  4. Prepare parents for post-operative appearance of the child
A

3

32
Q

The nurse completes an assessment of a 5yr old with a new cast for fractured radius. Which of the following assessments is most concerning?

  1. The child states, “my hand feels asleep”
  2. Edema in the fingers that decreases with elevation
  3. The skin around the cast is warm
  4. Capillary refill time is less than 3 secons
A

1

33
Q

A nurse is caring for a 3yr old hospitalized with a head injury following a fall from a tree. The child has been fatigued but with a Glasgow Coma Sclae (GCS) score of 15 for the past shift. A family member suddenly yells from the room that the child will not wake from sleep. The nurse confirms that the child is obtunded and has a respiratory rate of 6. What is the appropriate action by the nurse now?

  1. Push the code blue button and call for staff assistance
  2. Go to the nurses’s station to make an immediate call to the physician
  3. Tell the family member to keep calling the child’s name loudly
  4. Clear the patient’s bed as a precaution for pending seizure activity
A

1

34
Q

According to the video, Vaccine: Calling the Shots, the measles outbreak that happened in NYC in 2013 occured mainly because:

  1. The decline in vaccinations in the population caused a loss of heard immunity
  2. People in NYC do not wash their hands enough
  3. An infected person traveled to the city from the UK
  4. New varients which were resistant to the vaccines available at the time spread amongst vaccinated and not vaccinated people
A

3

35
Q

A 10 yr old child with sickle cell anemia who has been receiving regular blood transfusions is started on deferoxamine therapy. What would be the most appropriate explanation by the nurse about the purpose of this medication?

  1. It prolongs the life of RBCs and prevents their breakdown by the spleen
  2. It boosts white blood cell production to fight infection
  3. It prevents iron from being depositited in the tissues and allows it to be excreted
  4. It helps the bown marrow produce more RBC
A

3

36
Q

Chemo affects rapidly growing cells which can lead to problems like (Select All That Apply):

  1. Cognitive changes
  2. Infection
  3. Mucosal ulcers
  4. Hair loss
  5. Anemia
  6. Edema
A

2, 3, 4, 5

above is because of pancytoemia of chemo

google says 1, 3 and 5 can be caused by chemo

37
Q

The nurse is teaching the parents of a 5yr old with ALL about home care. Which of the following statements, by the parents, indicates the need for further teaching?

  1. The Broviac is for infusing meds and drawing labs
  2. All physicians are well trained in the care of ALL since it is the most common pediatric oncology diagnosis
  3. After induction, we will take the family to Disneyland for some distraction
  4. We should loop the catheter when securing it to the site
A

3

ALL physicians are not well trained in A.L.L.

A pt should avoid crowds for fear of exposure to infectious diseases - so NO fucking Disney!

38
Q

The most important care at home for an infant with osteogenesis imperfecta is:

  1. Pain control
  2. Traction care
  3. Support of the trunk and extremities when moving
  4. Post-op spinal surgery care
A

3

39
Q

A caregiver tells the nurse, “I heard that kids can get seizures from vaccines.” The nurse understands the concern, and provides the caregiver with the best information by stating:

  1. You don’t need to worry about that. I’m sure your child will be fine
  2. Some children have low fevers after immunizations because the body is learning how to fight off that particular disease. Children who are predisposed to febrile seizures can have one at that time, but they are rare and not typically harmful to the child
  3. Some children do have seizures. It is your choice to vaccinate your child or not
  4. Seizures are a concern, but having measles is worse. You need to immunize your child
A

2

40
Q

The nurse is caring for a 16yr old child immobilized after spinal fusion surgery. The nurses’s care for this patient will focus on all of the following, except:

  1. Pain contro
  2. Skin integrity
  3. Neurovascular assessments
  4. Maintaining traction
A

4

41
Q

A child weighting 20kg is admitted to the pediatric ward with a diagnosis of sickle cell crisis. Which IV infusion rate would be most appropriate for this patient?

  1. 94 mL/hr
  2. 160 mL/hr
  3. 82 mL/hr
  4. 63 mL/hr
A

First 10kg = 100 mL*10 = 1000mL

Second 10kg = 50 mL*10 = 500mL

1000+500=1500 mL

Per hour = 1500/24=62.5 mL/hr

Round to 63

42
Q

The nurse devises a teaching plan for toddler with a new diagnosis of aplastic anemia. Which of teh following is the most important concept to teach for health maintenance?

  1. Excercise is important to gain strength around the joints
  2. Get 8hrs of sleep at night and take naps during the day
  3. Avoid exposure to others with acute infection
  4. Eat iron-rich foods before drinking milk
A

3

43
Q

The first 6-12 hrs after a soft tissue injury is very important to control swelling and promote healing. Nurses often give out the advice to families to use the RICE method for treatement, which stands for:

  1. Rest, Ice, Compression, Elevation
  2. Reallly Intense Crying = Exhaustion
  3. Relax, Immobilize, Cryotherapy, Excederin
  4. Raise, Immobilize, Compression, Elevation
A

1

44
Q

A school age child is admitted in vaso-occlusive sickle cell crisis. The child’s care should include which of the following?

  1. Pain management and heparin administration
  2. Correction of acidosis
  3. Adequate hydration and pain management
  4. Adequate oxygenation and replacement of Factor VIII
A

3

45
Q

A 12 yr old is three days post-oop from a ventricular-peritoneal shunt revision. Neurological assessments have been normal. This morning, the nurse finds the patient vomiting and complaining of a severer headache and blurry vision. What should the nurses priority action be?

  1. Order a STAT CT scan
  2. Raise the HOB 30° and notify the physician
  3. Slow down the IV fluid infusion rate
  4. Give the child the ordered pain medication
A

2

46
Q

The nurse accompanies a 6yr old child to radiolgoy to x-ray the child’s humerus for potential fracture. The nurse remembers the Salter-Harris Classification of epiphyseal injuries and knows that the following type of fracture is most concerning:

  1. A fracture that occurs far from the epiphyseal plate
  2. A fracture that occurs above the epiphyseal plate
  3. A fracture that occurs below the epiphyseal plate
  4. A fracture that goes through the epiphyseal plate
A

4

47
Q

MATH

What is the formula to calculate fluid maintenance requirements for children?

A
  • First 10kg = 100 mL/kg
  • Second 10kg = 50 mL/kg
  • Over 20 kg = 20 mL/kg
48
Q

MATH

What are the daily and hourly fluid maintenance levels for a child weighing 22kg?

A
  • First 10kg = 100 mL*10 = 1000mL
  • Second 10kg = 50 mL*10 = 500mL
  • Extra 2 over 20 = 20 mL*2 = 40mL
  • 1000+500+40=1540 mL
  • Per hour = 1540/24=64 mL/hr

PEDS Unit 3 (9 decks)

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