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Pediatric Final Exam Graded A (This Exam Consists of Frequently
Tested Questions and Answers)
Which approach is best for administering oral medication to a young child?
- "Would you please take your medicine now, David?"
- "Look how good Johnny takes his medication. Can you do that too, David"
- "You must take your medication now if you want to get better."
- "It's time for the medicine, David. Would you like water juice after it?” - Correct answer Correct answer: 4 Rationale: Allowing a young child autonomy, providing praise for cooperation, and providing a good-tasting liquid or a frozen treat following administration of a medication are all techniques that encourage compliance. Page reference: Page 501-
The preferred site for an intramuscular injection in small infant is:
- Dorsolateral
- ventrogluteal
- vastus lateralis
- deltoid - Correct answer Correct answer: 3 Rationale: IM injections are given into the vastus lateralis muscle of the thigh in all infants. The site is free of major nerves and blood vessels. Page reference: Page 503
The physician orders 10 mg of Demerol for an infant after surgery. If the label reads 50 mg/ml, the nurse would administer
- 2.0 mL
- 0.8 mL
- 0.5 mL
- 0.2 mL - Correct answer Correct answer: 4 Rationale: Page reference: Page 509 Box 22-
Which of the following medication can be crushed when administered to a pediatric patient?
- Potassium chloride (Sol-K" capsule
- Colace gel tablets (Docusate)
- Ditropan XL tablets (oxybutynin)
- Simethicone tablet - Correct answer Correct answer: 4 Rationale: Most pediatric medications are available in liquid, suspension, or chewable tablets. Only scored tablets should be divided. Extended-release tablets and medication in capsule form, such as Ditropan XL (oxybutynin) and potassium chloride (Sol-K), should not be chewed or crushed. Gel tablets, such as Colace (docusate sodium) should not be cut or dissolved. Page reference: Page 501
The mother and grandmother of a child are at the bedside, rubbing the skin of a child when the nurse enters the room, the visitors a startled and drop the item they were rubbing against the child's skin. The nurse picks up the item and recognizes it as a penny. The best response of the nurse is to?
- ask, "What on earth are you doing to that child with this penny?"
- Give a penny back to mother leave the room to give them their privacy.
- Tell them that they could hurt the child with the penny and there are many germs on coins.
- Return the paint to the mother an open dialogue about the practices are using. - Correct answer Correct answer: 4 Rationale: Cultural practices need to be considered, and an open dialogue about these practices will help the health care team to understand the reasoning behind them. As long as patient safety is not compromised, the caregivers should allow these practices to take place. Communication should reflect a nonjudgmental attitude on the part of the caretaker. If the cultural practice compromises safety or is against hospital policy, the health care provider should educate the patient and family members as to why the practice should not take place in the hospital setting. Page reference: Page 490 (See also Chapter 24 Page 575.)
What is the most effective position for the nurse to place a toddler in to administer medications?
Semi-sitting position on a nurse's lap Sitting in a high chair Semi-Fowler's in a crib Standing after providing an explanation - Correct answer Semi-sitting position on a nurse's lap Toddlers are usually going to resist and this will allow for the most effective method to administer medications.REF: Page 501
A child on the pediatric unit has an order for a 24-hour urine specimen. Six hours after initiating the specimen collection the parents inform nursing staff that the child was incontinent. What instruction does the nurse provide to the parents at this time?
Lost specimens necessitate restarting the test. The specimen can now be sent to the laboratory. They should continue collecting the child's urine. The child will now require a straight catheterization to obtain urine. - Correct answer Lost specimens necessitate restarting the test. At times a 24-hour urine specimen may be requested to determine the rate of urine production and measure the excretion of specific chemicals from the body. The nurses on each shift must closely supervise this test to maintain its accuracy, because lost specimens necessitate restarting the test.REF: Page 497
Children may be uncooperative, so extra time must be allowed. Resistance is higher with toddlers, so nurses must plan for this. Elixirs and chewable tablets are preferred for Preschoolers. The nurse should not leave medications with an adolescent to take at a later time. The nurse should always be the professional who gives the injection. This should not be delegated to the parents.REF: Page 511
How often should the nurse assess the IV line of a pediatric patient?
Every hour Every 2hours Every 4 hours Every shift - Correct answer Every hour IV medications can cause phlebitis, and the nurse must observe the child's IV site hourly for reddened areas or signs of inflammation. Infiltration is a risk for children who are active, and the site should be observed hourly because infants cannot communicate the burning or pain that may accompany infiltration. The nurse should monitor the rate of the IV flow, refill the burettes hourly, observe the condition of the IV site, identify the responses of the child, and document findings.REF: Page 505
What is the most significant reason for obtaining an accurate weight on a child in the hospital?
Plots their growth on the growth chart Helps determine dose of medication Allows for accurate nutrition orders Helps identify growth disorders - Correct answer Helps determine dose of medication The most significant reason for obtaining a weight is for calculating medications. The other ones are accurate reasons that nurses obtain weights, but the most significant reason is to allow for accurate dosing of medication. If the pharmacy doesn't have an accurate weight, then the medications can't be ordered accurately.REF: Page 507
Puberty starts in girls with breast development. True or false - Correct answer False; puberty is easily recognized in girls by menarche.
A fear that is unique to 5-year olds is a fear of bodily harm. True or False - Correct answer False, the fear of bodily harm, particularly the loss of body parts, is unique to 3- year olds
The pincer grasp is the accurate and coordinated opposition of index finger and thumb of the same hand. True or False - Correct answer True
Pretension is the ability to grasp objects between all fingers of one hand and the opposing thumb of the same hand. True or False - Correct answer True
What activity would the nurse choose to meet Erikson's developmental task of industry when caring for a 7-year old? - Correct answer Completing a 50-piece jigsaw puzzle
A mother calls the pediatricians office because her infant is "colicky". What is the most helpful measure the nurse can suggest to the mother - Correct answer Rock the fussy infant slowly and gently
The nurse is assessing development in a 9-month old infant. What would the nurse expect to observe? - Correct answer Creeping along the floor
The nurse observes a 10-month old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed? - Correct answer the pincer grasp
What instruction would the nurse include when planning anticipatory guidance for parents of a toddler? - Correct answer Limit-setting should include praise
What is the most appropriate toy for the nurse to select for a normal 2-year old child - Correct answer Dump truck, toys that can be pushed or pulled?
What would be an expected finding when assessing language development in a 2-year old? - Correct answer Use of two-word sentences
The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." What is the most appropriate response by the nurse?
- Correct answer How much milk does she drink in a day? Milk should be limited to 24 ounces a day, too few solid foods can lead to dietary deficiencies of iron.
A 16-month old child is attending a well-child visit at a pediatric clinic. Which assessment would indicate the biggest cause for concern? - Correct answer Does not walk independently
What is an example of associative play? - Correct answer Two children playing in a sand box, one building a wall and the other digging a hole
What should the nurse keep in mind when planning to teach a class on nutrition to fourth grade students? - Correct answer School-age children think logically and concretely
What can the nurse suggest as a good dietary source of zinc for an adolescent who is a vegetarian? - Correct answer Nuts
The nurse is documenting the pediatrician’s assessment of a male patient. When assessing Tanners stages of genital development she notes skin on the scrotum has reddened and changed texture. What stage of development will the nurse document? - Correct answer Stage 2
Principles for managing soft tissue injuries include range of motion exercises, ice, compression, and elevation. True or False - Correct answer False, RICE =. Rest, ice, compression, elevate
Amputation is generally recommended treatment for Ewing's sarcoma. True or False - Correct answer False, Amputation is not generally recommended for Ewing's sarcoma because the tumor is sensitive to radiation and chemotherapy
It is the primary nursing responsibility to visualize the throat to help confirm diagnosis i of epiglottis. True or false - Correct answer False; it is a primary nursing responsibility to be sure there is a tracheotomy set at the bedside before any examination of the throat is attempted
A sweat chloride test is the test of choice for diagnosis cystic fibrosis. True or False - Correct answer True
The prevention of preterm births is the best way to prevent bronchopulmonary dysplasia. True or False - Correct answer True
A chronic case of child abuse is most likely non-intentional. True or False - Correct answer True
All parents have the potential to be abusive to a child. True or False - Correct answer True
Opisthotonos is the voluntary arching of the back and flexion of the neck. True or False
One of the most common causes of death in a child with muscular dystrophy is cardiac failure. True or False - Correct answer True
What is the best way for the nurse to communicate with a 10-year old child who has a hearing impairment? - Correct answer Face the child and speak clearly in short sentences
What would the nurse include in teaching when preparing to teach parents about air travel instructions to prevent barotrauma in infants? - Correct answer Letting the infant nurse during descent
What might the nurse explain as a common treatment for amblyopia? - Correct answer Patching the good eye to force the brain to use the affect eye
A child is diagnosed with no paralytic strabismus. How will this disorder most likely be corrected? - Correct answer Corrective lenses
What assessment does the school nurse recognize as the cardinal sign of hyphae? - Correct answer A dark-red spot in the anterior chamber
The nurse urges the mother of a 6-month old to get her child inoculated with hemophilic influenza type B. What does this immunization protect against? - Correct answer Bacterial meningitis
A child is admitted to the hospital because she had a seizure. Her parents report that for the past few weeks she has had headaches, with vomiting, that are worse in the morning. What does the nurse suspect? - Correct answer Brain tumor
What does the nurse explain to parents of a child with febrile seizures? - Correct answer They occur when the temperature rises quickly
A parent reports that her child has begun to do poorly at school and experiences episodes where he appears to be staring into space. Of which type of seizure is this behavior a characteristic? - Correct answer Absence
A child diagnosed with epilepsy had a generalized tonic-clinic seizure that lasted 90 seconds. What would the nurse expect to assess after a generalized tonic-clinic seizure? - Correct answer Sleepiness
What would the nurse include hen creating a teaching plan that includes the long-term administration of phenytoin (Dilantin)? - Correct answer Gums should be massaged regularly to prevent hyperplasia
The nurse observes a child's position is supine with his arms and legs rigid with the arms and wrists flexed inward toward the chest. The feet are plantar flexed. Ho does the nurse identify this posture? - Correct answer Decorticate
The nurse is caring for a 3-year old with a head injury. Which assessment would lead the nurse to report the probability of increasing intracranial pressure (ICP) - Correct answer Increase in blood pressure with an attendant decrease in pulse
What would the nurse consider an abnormal finding on a musculoskeletal assessment of a 4-year old child? - Correct answer Walks on toes
A pediatric nurse is assisting with the care of a child diagnosed with a fractured femur. What type of fracture would be the most likely to alert the nurse to the possibility of physical abuse? - Correct answer Spiral fracture
On entering the room of a child in Buck's traction, the nurse makes all of the following observations. Which observation requires a nursing intervention? - Correct answer Childs heels are placed firmly against the foot of the bed
What classic sign would the nurse, auscultation the breath sounds of a child hospitalized for an acute stomach attack, expect to find? - Correct answer Expiration wheezing
The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the flue loss through dyspnea. Which fluids are most appropriate? - Correct answer Room temperature water
The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder. What does this prevent? - Correct answer Candidiasis
What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients? - Correct answer Pancreatic enzymes
The nurse is planning to teach parents about preventing sudden infant death syndrome. What significant information would the nurse include? - Correct answer Placing facts on their backs or sides for sleep
______________ occurs when there is a change in the atmospheric pressure between the internal body systems and the surrounding environment. - Correct answer Barotrauma
The nurse records the finding of _____________ ______________ when the child with meningitis cries out in pain when his head is flexed toward his chest. - Correct answer Unchallenged rigidity
The child with Duchenne's muscular dystrophy must push on his legs and "walk up the leg" in order to rise to a standing position. The nurse recognizes this characteristic behavior as __________ maneuver - Correct answer Growers
The nurse reminds the adolescent boy with Ewing's sarcoma that he is prohibited from vigorous weight-Bearing activities during treatment with radiation to reduce the risk of a(n) ________________ fracture - Correct answer Pathological
What is the definition of athetoid seizures - Correct answer Involuntary purposeless movements that interfere with normal motion; involves damage to the cortex of the brain
What is the definition of spastic seizures - Correct answer Involves damage to the cortex of the brain; related to cerebra asphyxia
What is the definition of Ataxic seizures - Correct answer Uncoordinated movements and ataxia from a lesion in the cerebellum
What is the definition of mixed seizures - Correct answer usually a combo of spastic and athetoid?
What is a ligament that i torn or stretched away from the bone - Correct answer Sprain
What does genu Valgus mean? - Correct answer Knock-kneed
What is Genu Varum? - Correct answer Bowlegged
What is a microscopic tear to a muscle or tendon - Correct answer Strain
What is sexual abuse - Correct answer Involved an act that is performed on a child for the sexual gratification of the adult
What is physical abuse? - Correct answer the deliberate infliction of injury on a child
What is emotional neglect - Correct answer an intentional omission of verbal or behavioral actions that are necessary for the development of a healthy self-esteem?
What is physical neglect? - Correct answer the failure to provide for the basic physical needs of the child
What is emotional abuse? - Correct answer Intentional verbal acts that result in a destruction of self-esteem
What is clubbing - Correct answer Compensatory response indicating chronic lack of oxygen
What are alveoli - Correct answer Air sacs surrounded by capillaries for gas exchange
What is stridor? - Correct answer Harsh, high-pitched sound on inspiration
What is asthma - Correct answer Bronchospasm, mucosal edema, and secretion of and plugging of mucus contribute to narrowing of the airways
Atrial septal defect is the most common heart anomaly and is seen with a loud, harsh, murmur on exam. True or False - Correct answer False, Ventricular septal defect is the most common heart animal and is seen with a loud, harsh murmur on exam
Rheumatic fever involves the joints, heart, CNS, skin and subcutaneous tissue. True or False - Correct answer True
Erythema magnate consists of small red circles with red-colored margins, a pale center, and wavy lines appearing on the trunk and abdomen with rheumatic fever. True or False
The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" On what understanding is the nurse’s response based? - Correct answer Inflammation weakens blood vessels, leading to aneurysm.
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse - Correct answer Clamp off blood and keep line open with normal saline
What important focus of nursing care for the dying child and the family should the nurse implement? - Correct answer Families should be made aware that hearing is the last sense to stop functioning before death
Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action? - Correct answer Allow 1 ounce of glucose water at frequent intervals
What is the treatment of choice for a child with intussusception? - Correct answer A barium enema
A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid base imbalance old the nurses expect to occur from this persistent vomiting? - Correct answer Alkalosis
The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise? - Correct answer An oral rehydrating solution, such as pedialyte
Why are infants more vulnerable to fluid and electrolyte imbalances than adults? - Correct answer A greater percentage of body water in infants is extra cellular
what would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive? - Correct answer be limp like a rag doll
which nursing interventions will be implemented for the mother of a 10-month old infant with nonorganic failure to thrive? - Correct answer teaching the mother about the developmental milestones to expect in the next few months
the nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include? - Correct answer use a sterile applicator to swab the medication on the oral mucosa
what instruction will the nurse give to parents about preventing the spread and reinfection of pinworms? - Correct answer keep children's nails short
a child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage? - Correct answer N-acetylcysteine
Which statement made by a parent alerts the nurse to the need for additional education about poison prevention? - Correct answer "I keep a bottle of syrup of ipecac handy"
intussusception - Correct answer slipping of one part of the intestine into another part just below it
Mackle’s diverticulum - Correct answer occurs when a small blind pouch forms if the vitelline duct fails to disappear completely
Pyloric stenosis - Correct answer projectile vomiting is the classic symptom for this disease
celiac disease - Correct answer with this disease stools are large, bulky, and frothy from undigested contents
coarctation of the aorta - Correct answer narrowing of the aortic arch or the descending aorta
patent ductus arteriosus - Correct answer failure of the ductus arteriosus to close
atrial septal defect - Correct answer opening between the left and the right atria
ventricular septal defect - Correct answer opening between the right and left ventricles
the patient has lost equal amounts of fluids and electrolytes - Correct answer isotonic
the child has lost more electrolytes than fluids - Correct answer hypotonic
the child has lost more fluids than electrolytes - Correct answer hypertonic
vasoocclusive sickle cell crisis - Correct answer most common type; obstruction of blood flow by cells
hyper hemolytic sickle cell crisis - Correct answer rapid rate of hemolysis is superimposed on an already severe process
aplastic crises - Correct answer bone marrow stops producing RBCs
Splenic sequestration - Correct answer large amounts go blood pool in liver and spleen
what is a complication of iron-deficiency anemia - Correct answer heart failure
which nursing action urinary output for a child with acute glomerulonephritis should expect urine to be? - Correct answer smoky brown
which nursing action would be avoided when caring for a child diagnosed with Wilms' tumor - Correct answer abdominal palpation
what is the most appropriate nursing response to an adolescent who asks what she can do about her acne? - Correct answer "get adequate rest and eat a well-balanced diet"
a common manifestation of an allergy in a neonate is? - Correct answer infantile eczema
all of the following skin conditions are considered contagious except a) impetigo b) staphylococcus aureus infection c) infantile eczema d) pediculosis - Correct answer infantile eczema
a topical ointment is prescribed for an infant with eczema. Which application strategy is key to maximizing its absorption? - Correct answer for the best absorption, apply ointment after bathing the child
Scabies are most strongly characterized by: - Correct answer intense itching
the "honeymoon period" after diagnosis of type 1 diabetes mellitus in the child may result in? - Correct answer parental denial of child need for lifetime insulin
a 5-year-old boy is admitted to the hospital with acute glomerulonephritis. In taking the child's history, what does the nurse recognize as the probable cause? - Correct answer a sore throat 2 weeks ago
what food does the nurse recommend the child with acute glomerulonephritis avoid to prevent hyperkalemia? - Correct answer bananas
what will the nurse caution the parents of a child who has had a nephrectomy that he will have to avoid? - Correct answer contact sports
The 6-year-old scheduled for an orchiopexy shyly asks the nurse, "what are they going to do to me 'down there'? what is the nurses best response? - Correct answer what do you think your doctor is going to do
the nurse is careful to apply only the prescribed amount of ointment to the skin of a 2- month old. How is infant skin different from adult skin? - Correct answer greater absorption
the nurse is documenting a description of a skin assessment. What term can be used for an elevated, fluid-filled blister? - Correct answer vesicle
what should the nurse suggest before a 17-year old girl starts a protocol of isotretinoin (Accutane) for her acne? - Correct answer get a prescription for oral contraceptives
which statement made by a parent indicates the need for further teaching about strategies to control itching for the infant with eczema? - Correct answer "wool is the best fabric for the infants clothing"
what should the nurse stress to the mother of a child with impetigo? - Correct answer small cuts and bites should be treated promptly
on the first day following a severe burn, the body's fluid reserves have left the circulating volume and entered the interstitial space, causing massive edema. What should the nurse monitor for very closely in the burn victim? - Correct answer reduced urine output
A child with diabetes is brought to the emergency department. He is flushed and drowsy, and his skin is dry. His father states that the child has been feeling progressively worse since the morning. What is this child most likely experiencing? - Correct answer Ketoacidosis
Which comment made by a school-age child indicates that he needs more teaching about diabetes mellitus and exercise? - Correct answer sometimes i skip my breakfast when i have a game in the morning
the nurse is preparing to administer a long-acting insulin. Which insulin is considered long acting - Correct answer glargine
What is the best immediate food choice for the nurse to give to a child having an insulin reaction - Correct answer orange juice
Tinea Corporis - Correct answer ringworm of the skin
tinea cruris - Correct answer jock itch
tinea pedis - Correct answer athletes foot
tinea capitis - Correct answer ringworm of the scalp
blistered, moist, pink, or red, painful described what level of burn - Correct answer partial thickness
tough, leathery, dry, painless to touch describes what level of burn - Correct answer full thickness
the use of opiates coupled with sharing needles puts the user at risk for HIV and hepatitis B. True or false - Correct answer True
the disease that causes a "slapped cheek" appearance is - Correct answer fifth disease
a parent asks the nurse when her younger child will get chickenpox now that the oldest child contracted the illness. The nurse would explain the incubation period for chickenpox is - Correct answer 2-3 weeks after home exposure to brother with varicella
the period that refers to the initial stage of a disease between the earliest symptoms and the appearance of the rash or fever is the - Correct answer prodromal period
what statement leads the nurse to determine that a child's parents understand information related to tick bites? - Correct answer "we will wear long pants and long- sleeved shirts in the woods"
the nurse is planning to administer immunizations at a well-child visit when a parent reports the 18-month old child is allergic eggs. Which vaccine would be contraindicated? - Correct answer influenza
which finding would lead the nurse to delay the administration of DTaP for an infant - Correct answer temperature of 40.5C (100.5F)
the mother of a newborn asked the nurse, "when will my baby get the hepatitis B vaccine?" When will the nurse explain the first dose of convex should be given to infants born to a hepatitis B positive mother? - Correct answer within 12 hr. after birth
An adolescent is taking tetracycline for a sexually transmitted disease. What would the nurse stress when providing instruction about his medication - Correct answer take the medication on an empty stomach
A nurse is planning to speak with a parent support group about childhood autism. What will the nurse include? - Correct answer no two word spontaneous phrases by 24 months
what is an appropriate nursing intervention for a hospitalized child who is autistic? - Correct answer organize care to provide as few disruptions to the routine as possible
A parent asks the nurse to describe what is meant by a learning disability. Which is the nurse's most helpful response? - Correct answer a child may have difficulty with perception, language, comprehension, or memory
the pediatric nurse listens to a 9-year-old child read to his 6-year old roommate. What action by the 9-year old leads the nurse to question possible dyslexia - Correct answer reads the word dog as god
which statement made by a parent of an adolescents with anorexia indicates an understanding of this condition? - Correct answer she seems to see herself as fat, even though her weight is below normal
what is the most appropriate classroom intervention for a child with attention deficit hyperactivity disorder (ADHD) for the school nurse to suggest - Correct answer divide work assignments into shorter periods with breaks in between
a 15-year old boy was previously active in a band and saved money to buy a special guitar. What would a nurse assess as an early sign of depression in this boy? - Correct answer he gives his guitar away and spends his time listening to music in his room
what would be the appropriate response to an adolescent who states, "this has been the worst day of my life" - Correct answer tell me about the worst day of your life"
The nurse tells the adolescents about substances that can lead to the use of stronger drugs. What is she describing? - Correct answer gateway drugs
an adolescent is brought to the emergency room after an automobile accident. When the nurse approaches the adolescent, he becomes combative. The nurse notes his speech is slurred and his hair is ataxic. What does the nurse suspect the adolescent has used? - Correct answer alcohol
when the nurse is collecting a nursing history, adolescent states that she has tried "ice" For what does the nurse recognize this as the street name for? - Correct answer meth
a 9-year old has been admitted to the hospital after "huffing" lighter fluid and is in a high euphoric state. For what should the nurse assess - Correct answer CNS depression
What role has the child of an alcoholic assumed if he tries to do everything perfectly - Correct answer super coper or savior
A mother is concerned because her adolescent son is always in trouble for fighting at school and always seems to be angry. She mentions that her husband drinks a bit. Which understanding will guide the nurse's response? - Correct answer The boy is only one member of the family affected by alcoholism, and all members should receive immediate intervention.
The nurse asks, "Do your parents drink every day?" The adolescent suddenly shouts, "I'm not going to talk about that! It's none of your business, anyway! Leave me alone!" How does the nurse interpret the adolescent's behavior? - Correct answer The adolescent is responding to the discrediting of his parents, which causes anxiety.
What is the difference between complementary therapy and alternative therapy? - Correct answer Complementary therapy is administered with conventional therapy.
