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OB/PEDS REVIEW > Practice Q's > Flashcards

Practice Q's Flashcards

1
Q

A woman at 39 weeks of gestation with a history of preeclampsia is admitted to the labor and birth unit. She suddenly experiences increased contraction frequency of every 1 to 2 minutes, dark red vaginal bleeding, and a tense, painful abdomen. Which clinical change does the nurse anticipate?

  • Eclamptic Seizure
  • Rupture of the uterus
  • Placenta Previa
  • Placental Abruption
A

Placental Abruption

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2
Q

Which statement best describes chronic hypertension?

  • Chronic hypertension is defined as hypertension that begins during pregnancy and lasts for the duration of the pregnancy
  • Chronic hypertension is considered severe when the systolic BP is higher than 140 mmHg or the diastolic BP is higher than 90 mmHg
  • Chronic hypertension is general hypertension plus proteinuria
  • Chronic hypertension can occur independently of or simultaneously with preeclampsia
A

Chronic hypertension can occur independently of or simultaneously with preeclampsia

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3
Q

Which client exhibits the greatest number of risk factors associated with the development of preeclampsia?

  • 30-year-old obese Caucasian with her third pregnancy
  • 41-year-old Caucasian primigravida
  • 19-year-old African American who is pregnant with twins
  • 25-year-old African American whose pregnancy is the result of donor insemination
A

19-year-old African American who is pregnant with twins

AA ethnicity, younger in age, multiple pregnancy

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4
Q

Which neonatal complications are associated with hypertension in the mother?

  • Intrauterine growth restriction (IUGR) and prematurity
  • Seizures and cerebral hemorrhage
  • Hepatic or renal dysfunction
  • Placental abruption and DIC
A

Intrauterine growth restriction (IUGR) and prematurity

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5
Q

The nurse has evaluated a client with preeclampsia by assessing deep tendon reflexes (DTRs). The result is a grade of 3+. Which DTR response most accurately describes this score?

  • Sluggish or diminished
  • Brisk, hyperactive, with intermittent or transient clonus
  • Active or expected response
  • More brisk than expected, slightly hyperactive
A

More brisk than expected, slightly hyperactive

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6
Q

The client being cared for has severe preeclampsia and is receiving a magnesium sulfate infusion. Which new finding would give the nurse cause for concern?

  • Sleepy, sedated affect
  • Respiratory rate of 10 breaths per minute
  • Deep tendon reflexes (DTRs) of 2+
  • Absent ankle clonus
A

Respiratory rate of 10 breaths per minute

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7
Q

A 26-year-old pregnant woman, gravida 2, para 1-0-0-1, is 28 weeks pregnant when she experiences bright red, painless vaginal bleeding. On her arrival at the hospital, which diagnostic procedure will the client most likely have performed?

  • Amniocentesis for fetal lung maturity
  • Transvaginal ultrasound for placental location
  • Contraction stress test (CST)
  • Internal fetal monitoring
A

Transvaginal ultrasound for placental location

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8
Q

A woman arrives for evaluation of signs and symptoms that include a missed period, adnexal fullness, tenderness, and dark red vaginal bleeding. On examination, the nurse notices an ecchymotic blueness around the woman’s umbilicus. What does this finding indicate?

  • Normal integumentary changes associated with pregnancy
  • Turner sign associated with appendicitis
  • Cullen sign associated with a ruptured ectopic pregnancy
  • Chadwick sign associated with early pregnancy
A

Cullen sign associated with a ruptured ectopic pregnancy

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9
Q

A woman who is 30 weeks of gestation arrives at the hospital with bleeding. Which differential diagnosis would not be applicable for this client?

  • Placenta previa
  • Abruption placentae
  • Spontaneous abortion
  • Cord insertion
A

Spontaneous abortion

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10
Q

Which maternal condition always necessitates delivery by cesarean birth?

  • Marginal placenta previa
  • Complete placenta previa
  • Ectopic pregnancy
  • Eclampsia
A

Complete placenta previa

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11
Q

What is the highest priority nursing intervention when admitting a pregnant woman who has experienced a bleeding episode in late pregnancy?

  • Assessing fetal heart rate (FHR) and maternal vital signs
  • Performing a venipuncture for hemoglobin and hematocrit levels
  • Placing clean disposable pads to collect any drainage
  • Monitoring uterine contractions
A

Assessing fetal heart rate (FHR) and maternal vital signs

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12
Q

A 32-year-old primigravida is admitted with a diagnosis of ectopic pregnancy. Which information assists the nurse in developing the plan of care?

  • Bed rest and analgesics are the recommended treatment
  • She will be unable to conceive in the future
  • A D&C will be performed to remove the products of conceptions
  • Hemorrhage is the primary concern
A

Hemorrhage is the primary concern

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13
Q

Screening at 24 weeks of gestation reveals that a pregnant woman is experiencing gestational diabetes mellitus (GDM). In planning her care, the nurse and the client mutually agree that an expected outcome is to prevent injury to the fetus because of GDM. This fetus is at the greatest risk for which condition?

  • Macrosomia
  • Congenital anomalies of the CNS
  • Preterm birth
  • Low birth weight
A

Macrosomia

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14
Q

To manage her diabetes appropriately and to ensure a good fetal outcome, how would the pregnant woman with diabetes alter her diet?

  • Eat six small equal meals per day
  • Reduce the carbohydrates in her diet
  • Eat her meals and snacks on a fixed schedule
  • Increase her consumption of protein
A

Eat her meals and snacks on a fixed schedule

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15
Q

During a prenatal visit, the nurse is explaining dietary management to a woman diagnosed with pre-gestational diabetes. Which statement by the client reassures the nurse that teaching has been effective?

  • I will need to eat 600 more calories per day because I am pregnant
  • I can continue with the same diet as before pregnancy as long as it is well balances
  • Diet and insulin needs change during pregnancy
  • I will plan my diet based on the results of uterine glucose testing
A

Diet and insulin needs change during pregnancy

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16
Q

A woman arrives at the clinic for a pregnancy test. The first day of her LMP was September 10, 2014. Her expected date of birth (EDB) is __________.

A

June 17, 2015

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17
Q

A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this client’s total recommended weight gain during pregnancy?

  • 20 kg (44 lb)
  • 16 kg (35 lb)
  • 12.5 kg (27.5 lb)
  • 10 kg (22 lb)
A

12.5 kg (27.5 lb)

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18
Q

While assessing the vital signs of a pregnant woman in her third trimester, the client reports feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?

  • Have the patient stand up, and then retake her BP
  • Have the patient sit down, and then hold her arm in a dependent position
  • Have the patient lie supine for 5 minutes, and then recheck her BP on both arms
  • Have the patient turn to her left side, and then recheck her BP in 5 minutes
A

Have the patient turn to her left side, and then recheck her BP in 5 minutes

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19
Q

Which sign of a potential complication is the most important for the nurse to share with the client?

  • Constipation
  • Alteration in the pattern of fetal movement
  • Heart palpitations
  • Edema in the ankles and feet at the end of the day
A

Alteration in the pattern of fetal movement

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20
Q

A pregnant client tells her nurse that she is worried about the blotchy, brownish coloring over her cheeks, nose, and forehead. The nurse can reassure her that this is a normal condition related to hormonal changes. What is the correct term for this integumentary finding?

  • Melasma
  • Linea nigra
  • Striae gravidarum
  • Palmar erythema
A

Melasma (cholasma)

Usually fades after birth

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21
Q

A client arrives for her initial prenatal examination. This is her first child. She asks the nurse, “How does my baby get air inside my uterus?” What is the correct response by the nurse?

  • The baby’s lungs work in utero to exchange oxygen and carbon dioxide
  • The baby absorbs oxygen from your blood system
  • the placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream
  • The placenta delivers oxygen-rich blood through the umbilical artery to the baby’s abdomen
A

The placenta provides oxygen to the baby and excretes carbon dioxide into your bloodstream

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22
Q

Which minerals and vitamins are usually recommended as a supplement in a pregnant client’s diet?

  • Fat-soluble vitamins A + D
  • Water-soluble vitamins C + B6
  • Iron + folate
  • Calcium + zinc
A

Iron and folate

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23
Q

The nurse has received a report regarding a client in labor. The woman’s last vaginal examination was recorded as 3 cm, 30%, and –2. What is the nurse’s interpretation of this assessment?

  • Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm above the ischial spines
  • Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines
  • Cervix is effaced 3 cm and dilated 30%; the presenting part is 2 cm below the ischial spines
  • Cevix is dilated 3 cm and effaced 30%; the presenting part is 2 cm below the ischial spines
A

Cervix is dilated 3 cm and effaced 30%; the presenting part is 2 cm above the ischial spines

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24
Q

When assessing the fetus using Leopold’s maneuvers, the nurse feels a round, firm, and movable fetal part in the fundal portion of the uterus and a long, smooth surface in the mother’s right side close to midline. What is the position of the fetus?

  • ROA
  • LSP
  • RSA
  • LOA
A

RSA

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25
Q

What is the most likely cause for early decelerations in the fetal heart rate (FHR) pattern?

  • Altered fetal cerebral blood flow
  • Umbilical cord compression
  • Uteroplacental insufficiency
  • Spontaneous rupture of membranes
A

Altered fetal cerebral blood flow

VEAL CHOP BABY

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26
Q

Which clinical finding or intervention might be considered the rationale for fetal tachycardia to occur?

  • Maternal fever
  • Umbilical cord prolapse
  • Regional anesthesia
  • Magnesium sulfate administration
A

Maternal fever

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27
Q

While evaluating an external monitor tracing of a woman in active labor, the nurse notes that the fetal heart rate (FHR) for five sequential contractions begins to decelerate late in the contraction, with the nadir of the decelerations occurring after the peak of the contraction. What is the nurse’s first priority?

  • Change the woman’s position
  • Notify the HCP
  • Assist with amnioinfusion
  • Insert a scalp electrode
A

Change the woman’s position

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28
Q

What is the most likely cause for variable fetal heart rate (FHR) decelerations?

  • Altered fetal cerebral blood flow
  • Umbilical cord compression
  • Uteroplacental insufficiency
  • Fetal hypoxemia
A

Umbilical cord compression

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29
Q

During labor a fetus displays an average fetal heart rate (FHR) of 135 beats per minute over a 10-minute period. Which statement best describes the status of this fetus?

  • Bradycardia
  • Normal baseline heart rate
  • Tachycardia
  • Hypoxia
A

Normal baseline heart rate

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30
Q

How does the nurse document a non-stress test (NST) during which two or more fetal heart rate (FHR) accelerations of 15 beats per minute or more occur with fetal movement in a 20-minute period?

  • Nonreactive
  • Positive
  • Negative
  • Reactive
A

Reactive

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31
Q

A woman gave birth to a healthy infant boy 5 days ago. What type of lochia does the nurse expect to find when evaluating this client?

  • Lochia rubra
  • Lochia sangra
  • Lochia alba
  • Lochia serosa
A

Lochia serosa

Blood, serum, leukocytes + tissue debris

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32
Q

A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath three times daily, and a stool softener. Which information regarding the client’s condition is most closely correlated with these orders?

  • Woman is gravid 2, para 2
  • Woman has a vacuum-assisted birth
  • Woman received epidural anesthesia
  • Woman has an episiotomy
A

Woman has an episiotomy

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33
Q

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. Which guidance should the nurse provide to the client at this time?

  • Run warm water on her breasts during a shower
  • Apply ice to the breasts for comfort
  • Express small amounts of milk from the breasts to relieve the pressure
  • Wear a loose-fitting bra to prevent nipple irritation
A

Apply ice to the breasts for comfort

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34
Q

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely saturated a perineal pad within 15 minutes. What is the nurse’s highest priority?

  • Beginning an IV infusion of Ringer’s lactate solution
  • Assessing the woman’s vital signs
  • Calling the woman’s primary health care provider
  • Massaging the woman’s fundus
A

Massaging the woman’s fundus

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35
Q

An African-American woman noticed some bruises on her newborn daughter’s buttocks. The client asks the nurse what causes these. How would the nurse best explain this integumentary finding to the client?

  • Lanugo
  • Vascular nevus
  • Nevus flames
  • Mongolian spot
A

Mongolian spot

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36
Q

A first-time father is changing the diaper of his 1-day-old daughter. He asks the nurse, “What is this brown, sticky stuff in her diaper?” What is the nurse’s best response?

  • That’s meconium, which is your baby’s first stool. It’s normal
  • That’s transitional stool
  • That means your baby is bleeding internally
  • Oh, don’t worry about that. It’s okay
A

That’s meconium, which is your baby’s firs stool. It’s normal

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37
Q

A client is warm and asks for a fan in her room for her comfort. The nurse enters the room to assess the mother and her infant and finds the infant unwrapped in his crib with the fan blowing over him on high. The nurse instructs the mother that the fan should not be directed toward the newborn and that the newborn should be wrapped in a blanket. The mother asks why. How would the nurse respond?

  • Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and should prevent cool air from blowing on him.
  • Your baby may lose heat by conduction, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and should prevent cool air from blowing on him
  • Your baby may lose heat by evaporation, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and should prevent cool air from blowing on him.
  • Your baby will easily get cold stressed and needs to be bundled up at all time
A

Your baby may lose heat by convection, which means that he will lose heat from his body to the cooler ambient air. You should keep him wrapped and should prevent cool air from blowing on him

38
Q

While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a C with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a which positive reflex.

  • tonic neck
  • Glabellar (myerson)
  • Babinski
  • Moro
A

Moro

39
Q

An infant boy was delivered minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. When should the Apgar assessment be performed?

  • Only if the newborn is in obvious distress
  • Once by the obstetrician, just about
  • At least twice, 1 min and 5 mins after birth
  • Every 15 mins during the newborn’s first hour after birth
A

At least twice, 1 minute and 5 minute after birth

40
Q

The nurse is preparing to administer a hepatitis B virus (HBV) vaccine to a newborn. Which intervention by the nurse is correct?

  • Obtaining a syringe with a 25-gauge, 5/8 inch needle for medication administration
  • confirming that the newborn’s mother has been infected with the HBV
  • Assessing the dorsogluteal muscle as the preferred site for injection
  • Confirming that the newborn is at least 24 hrs old
A

Obtaining a syringe with a 25-gauge, 5/8 inch needle for medication administration

41
Q

At 1 minute after birth a nurse assesses an infant and notes a heart rate of 80 beats per minute, some flexion of extremities, a weak cry, grimacing, and a pink body but blue extremities. Which Apgar score does the nurse calculate based upon these observations and signs?

  • 4
  • 5
  • 6
  • 7
A

5

42
Q

A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization, the infant is weighed, and the birth weight is 4550 g (9 lb, 6 oz). What is the nurse’s first priority?

  • Leave the infant in the room w the mother
  • Immediately take the infant to the nursery
  • Perform a gestational age assessment to determine whether the infant is large for gestational age
  • Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia
A

Frequently monitor blood glucose levels, and closely observe the infant for signs of hypoglycemia

43
Q

~ Starting Peds Material ~

A

:’ )

44
Q

Which predisposes the adolescent to feel an increased need for sleep?

  • An inadequate diet
  • Rapid physical growth
  • Decreased activity that contributes to a feeling of fatigue
  • The lack of ambition typical of this age group
A

Rapid physical growth

45
Q

Place in order the sequence of maturational changes for girls. Begin with the first change seen, sequencing to the last change.

a. Growth of pubic hair
b. Rapid increase in height and weight
c. Breast changes
d. Menstruation
e. Appearance of axillary hair

  • A, B, C, D, E
  • C, B, E, A, D
  • C, B, A, E, D
  • B, E, A, C, D
A

C, B, A, E, D

Breast changes
Rapid increase in height and weight
Growth of pubic hair
Appearance of axillary hair
Menstruation
46
Q

Which describes the cognitive abilities of school-age children? (Select all that apply.)

  • Have developed the ability to reason abstractly
  • Are capable of scientific reasoning and formal logic
  • Developed the ability to understand relational terms and concepts
  • Have a mastery of the concept of conservation
  • Have a steady reduction in egocentricity
A

Developed the ability to understand relational terms and concepts

Have a mastery of the concept of conservation

Have a steady reduction in egocentricity

47
Q

When teaching injury prevention during the school-age years, which would the nurse include?

  • promote the fear of strangers
  • basic rules of water safety
  • avoidance of microwave cooking
  • emphasize the negative aspects of competitive sports
A

Basic rules of water safety

48
Q

Which would the nurse expect of a healthy 3-year-old child?

  • Jump rope
  • Ride a two-wheel bike
  • Skip on alternate feet
  • Balance on one foot for a few seconds
A

Balance on one foot for a few seconds

49
Q

According to Piaget, which describes magical thinking common in preschool age children?

  • Events have cause and effect
  • God is like an imaginary friend
  • Thoughts are all-powerful
  • If the skin is broken, the child’s insides will come out
A

Thoughts are all-powerful

50
Q

Which play is most typical of the preschool period?

  • solitary
  • parallel
  • associative
  • team
A

Associative

= group play in a similar or identical activities but without rigid organization or rules

51
Q

Preschoolers’ fears can best be dealt with by which intervention?

  • Actively involving them in finding practical methods to deal with the frightening experience
  • Forcing them to confront the scary object or experience in the presence of their parents
  • Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are
  • Ridiculing their fears so that they understand there is no need to be afraid
A

Actively involving them in finding practical methods to deal with the frightening experience

52
Q

Which factor predisposes toddlers to frequent infections?

  • respirations are abdominal
  • pulse and RR are slower than those in infancy
  • defense mechanisms are less efficient than those during infancy
  • Short, straight internal ear canal and large lymph tissue
A

Short, straight internal ear canal and large lymph tissue

53
Q

Which is descriptive of a toddler’s cognitive development at age 20 months?

  • Searches for an object only if he or she sees it being hidden
  • realizes that out of sight is not out of reach
  • puts objects into a container but cannot take them out
  • Understands the passage of time, such as just a minute + in an hour
A

Realizes that out of sight is not out of reach

54
Q

Which characteristic best describes the gross motor skills of a 24-month-old child?

  • Skips and can hop in place on one foot
  • Rides tricycle and broad jumps
  • Jumps with both feet and stands on one foot momentarily
  • Walks up and down stairs and runs with a wide stance
A

walks up and down stairs + runs with a wide stance

55
Q

Which is the leading cause of death during the toddler period?

  • unintentional injuries
  • infectious diseases
  • congenital disorders
  • childhood diseases
A

Unintentional injuries

56
Q

The nurse recommends to parents that peanuts are not a good snack food for toddlers. Which is the nurse’s rationale for this action?

  • low in nutritive value
  • high in sodium
  • cannot be entirely digested
  • can be easily aspirated
A

Can be easily aspirated

57
Q

A nurse is assessing a 12-month-old infant. Which statement best describes the infant’s physical development a nurse would expect to find?

  • Anterior fontanel close by age 6 - 10 months
  • Binocularity is well established by age 8 months
  • Birth weight triples by 1 year
  • Maternal iron stores persist during the first 12 months of life
A

Birth weight triples by 1 year old

58
Q

At which age can most infants sit steadily unsupported?

  • 4 months
  • 6 months
  • 8 months
  • 10 months
A

8 months

59
Q

The nurse would teach parents that which age is safe to give infants whole milk instead of commercial infant formula?

  • 6 months
  • 9 months
  • 12 months
  • 18 months
A

12 months

60
Q

In terms of gross motor development, which would the nurse expect a 5-month-old infant to do? (Select all that apply.)

  • Roll from abdomen to back
  • Put feet in mouth when supine
  • Roll from back to abdomen
  • Sit erect without support
  • Move from prone to sitting position
  • Adjust posture to reach object
A

Roll from abdomen to back

Put feet in mouth when supine

61
Q

Which is an important consideration for the nurse who is communicating directly to a young child?

  • Speak loudly, clearly, + directly
  • Use transition objects, such as a doll
  • Approach rapidly with a broad smile
  • Initiate contact with the child when the parent is not present
A

Use transition objects, such as a doll

62
Q

A nurse is performing an otoscopic exam on a school-age child. Which direction would the nurse pull the pinna for a child this age?

  • Up + back
  • Down + back
  • Straight back
  • Straight up
A

Up and back

63
Q

Which type of croup is always considered a medical emergency?

  • Epiglottitis
  • Laryngitis
  • Spasmodic croup
  • Laryngotracheobronchitis (LTB)
A

Epiglottitis

64
Q

The nurse is caring for a 5-year-old child who is scheduled for a tonsillectomy. Which action should the nurse include in the child’s postoperative care plan? (Select all that apply.)

  • Notify the surgeon if the child swallows frequently
  • Apply a heat collar to the child for pain relief
  • Place the child on the abdomen until fully awake
  • Prepare for oral liquids immediately following procedure
  • Encourage the child to cough frequently
A

Notify the surgeon if the child swallows frequently

Place the child on the abdomen until fully awake

65
Q

Parents have understood teaching about prevention of childhood otitis media if they make which statement? (Select all that apply.)

  • We will avoid secondhand smoke
  • Breast feeding will be discontinued after 4 months of age
  • We will place the child flat right after feedings
  • A conjugate vaccine may be administered
  • We will administer medications as prescribed
A

We will avoid secondhand smoke

A conjugate vaccine may be administered

We will administer medications as prescribed

66
Q

Pancreatic enzymes are administered to the child with cystic fibrosis (CF). What nursing considerations should be included?

  • Do not administer pancreatic enzymes if the child is receiving ABX
  • Decrease dose of pancreatic enzymes if the child is having frequent, bulky stools
  • Administer pancreatic enzymes between meals if at all possible
  • Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal
A

Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of the meal

67
Q

The nurse is talking to the parents of a child with pediculosis capitis. Which would the nurse include when explaining how to manage pediculosis capitis?

  • You will need to cut the hair shorter if infestation and nits are severe
  • You can distinguish viable from nonviable nits, and remove all nonviable ones
  • You can wash all nits out of hair with a regular shampoo
  • You will need to remove nits with an extra-fine-tooth comb or tweezers
A

You will need to remove nits with an extra fine tooth comb or tweezers

68
Q

Using the CDC vaccine chart answer the following question.

A nurse is preparing to administer a vaccine to a 4-year-old child. Which of the following vaccines should the nurse administer?

  • Haemophilus influenza type B (HIB)
  • Hepatitis B (HepB)
  • Varicella (VAR)
  • Meningococcal (MCV4)
A

Varicella (VAR)

69
Q

Which defect results in increased pulmonary blood flow?

  • Pulmonic stenosis
  • Tricuspid atresia
  • Atrial Septal defect
  • Transposition of the great arteries
A

Atrial septal defect (ASD)

70
Q

A 6-month-old infant is receiving digoxin (Lanoxin). The nurse would notify the practitioner and withhold the medication if the apical pulse is less than _______

  • 60
  • 70
  • 90-110
  • 110-120
A

90 - 110

71
Q

The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity?

  • Seizures
  • Vomiting
  • Bradypnea
  • Tachycardia
A

Vomiting

72
Q

The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with cardiomyopathy. Which signs and symptoms would the nurse include? (Select all that apply.)

  • Warm flushed extremities
  • Poor feeding
  • Rapid weight gain
  • Tachypnea
  • Abnormally slow pulse rate
A

Poor feeding

Rapid weight gain

Tachypnea

73
Q

When caring for the child with Kawasaki disease, the nurse would know which information?

  • A child’s fever is usually responsive to ABX within 48 hrs
  • The principal area of involvement is joints
  • The child is very docile through the illness
  • Therapeutic management includes administration of gamma globulin and salicylates (aspirin)
A

Therapeutic management includes administration of gamma globulin and salicylates (aspirin)

74
Q

Which is the expected outcome from surgical closure of the ductus arteriosus?

  • Stops the loss of unoxygenated blood to systemic circulation
  • Decreases the edema in legs and feet
  • Increases the oxygenation of blood
  • Prevents the return of oxygenated blood to the lungs
A

Prevents the return of oxygenated blood to the lungs

75
Q

A child with diabetes mellitus presents to the clinic with a sore throat, cough, low-grade fever and a blood glucose level of 245 mg/dl. The nurse instructs the parent to do which of the following during the illness?

  • Decrease fluid intake during convalescence
  • Check BG levels every 30 minutes
  • Provide high calorie snacks every few hours
  • Urine testing for ketones every 3 hrs
A

Urine testing for ketones every 3 hrs

76
Q

The parents of a child who has just been diagnosed with type 1 diabetes asks about exercise. Which would the nurse explain about exercise in type 1 diabetes?

  • Exercise will increase BG
  • Exercise should be restricted
  • Extra snacks are needed before exercise
  • Extra insulin is required during exercise
A

Extra snacks are needed before exercise

77
Q

The nurse is implementing care for a school-age child admitted to the pediatric intensive care in diabetic ketoacidosis (DKA). Which prescribed intervention would the nurse implement first?

  • Begin 0.9% saline solution intravenously as prescribed
  • Administer regular insulin intravenously as prescribed
  • Place child on a cardiac monitor
  • Place child on a pulse oximetry monitor
A

Begin 0.9% saline solution intravenously as prescribed

78
Q

Most cases of acute glomerulonephritis are associated with which of the following?

  • Urinary tract infection
  • Streptococcal infection
  • Renal vascular disorders
  • Structural anomalies of genitourinary tract
A

Streptococcal infection

79
Q

Which clinical manifestations would the nurse expect to assess in a child admitted with nephrotic syndrome? (Select all that apply.)

  • Weight loss
  • Facial edema
  • Cloudy smoky brown-colored urine
  • Fatigue
  • Frothy-appearing urine
A

Facial edema

Fatigue

Frothy-appearing urine

80
Q

Which is instituted for the therapeutic management of minimal change nephrotic syndrome?

  • Corticosteroids
  • Antihypertensive agents
  • Long-term diuretics
  • Increased fluids to promote diuresis
A

Corticosteroids

81
Q

A 10-year-old sustained a fracture in the epiphyseal plate of her right fibula from a fall. When discussing this injury with her parents, the nurse would consider which statement?

  • Healing is usually delated in this type of fractures
  • Growth can be affected by this type of fracture
  • This is an unusual fracture in young children
  • This type of fracture is inconsistent with a fall
A

Growth can be affected by this type of fracture

82
Q

The nurse is conducting teaching to parents of a 7-year-old child who fractured an arm and is being discharged with a cast. Which instruction would be included in the teaching?

  • Swelling of the fingers is to be expected to the next 48 hours
  • Immobilize the shoulder to decrease pain in the arm
  • Allows the affected limb to hang down for 1 hour each day
  • Elevate casted arm when resting and when sitting up
A

Elevate casted arm when resting and when sitting up

83
Q

The nurse is preparing an adolescent with scoliosis for a spinal surgical instrumentation placement procedure. Which consideration would the nurse include?

  • A chest tube and urinary catheter may be required
  • Ambulation will not be allowed for up to 3 months
  • Surgery eliminates the need for casting and bracing
  • Discomfort can be controlled with nonpharmacologic methods
A

A chest tube and urinary catheter may be required

84
Q

Which clinical manifestations would the nurse prepare to assess if bacterial meningitis is confirmed? (Select all that apply.)

  • Headache
  • Photophobia
  • Bulging anterior fontanel
  • Seizures
  • Poor muscle tone
A

Headache

Photophobia

Seizures

85
Q

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?

  • Posturing
  • Vital signs
  • Focal neurologic signs
  • Level of consciousness
A

Level of consciousness

86
Q

Which condition in a child would alert a nurse for increased fluid requirements?

  • Fever
  • Mechanical ventilation
  • Congestive heart failure
  • Increased intracranial pressure (ICP)
A

Fever

87
Q

Which type of dehydration is defined as “dehydration that occurs in conditions in which electrolyte and water deficits are present in approximately balanced proportion”?

  • Isotonic
  • Hypotonic
  • Hypertonic
  • All types
A

Isotonic

88
Q

Which therapeutic management treatment is implemented for children with Hirschsprung disease?

  • Daily enemas
  • Low-fiber diet
  • Permanent colostomy
  • Surgical removal of the aganglionic colon
A

Surgical removal of the aganglionic colon

89
Q

When caring for a child with probable appendicitis, the nurse would be alert to recognize that which condition or symptom is a sign of perforation?

  • Bradycardia
  • Anorexia
  • Sudden relief from pain
  • Decreased abdominal distention
A

Sudden relief from pain

90
Q

An infant is brought to the emergency department with dehydration. Which physical assessment finding does the nurse expect?

  • Puffy appearance
  • Bradycardia
  • Poor skin turgor
  • Brisk capillary refill
A

Poor skin turgor

OB/PEDS REVIEW (1 decks)

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