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Pediatrics Test 3: Multiple Choice Questions and Answers, Exams of Nursing

Mercy College of Health Sciences (MCHS)Nursing

A series of multiple choice questions and answers covering various topics in pediatrics, including pyloric stenosis, congestive heart failure, parallel play, diabetes, congenital heart defects, kawasaki disease, sickle cell crisis, ulcerative colitis, hypothyroidism, cystic fibrosis, diabetes insipidus, sudden infant death syndrome (sids), and postpartum hemorrhage. It provides a valuable resource for students and professionals seeking to test their knowledge and understanding of these important pediatric concepts.

Typology: Exams

2023/2024

Uploaded on 09/09/2024

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OB/Peds Test 3
(Proctorio)
1. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical
manifestation would indicate pyloric stenosis?
-Abdominal rigidity and pain on palpation
-Rounded abdomen and hypoactive bowel sounds
-Visible peristalsis and weight loss
-Distention of lower abdomen and constipation
2. Which intervention should be included in the plan of care for an infant with the nursing
diagnosis of excess fluid volume related to congestive heart failure?
- Weigh the infant every day on the same scale at the same time
-Notify the physician when weight gain exceeds more than 20 g/day.
-Put the infant in a car seat to minimize movement
-Administer digoxin as ordered by the physician
3. The nurse observes some children in the playroom. Which play situation exhibits the
characteristics of parallel play?
-Kimberly and Amanda sharing clay to each make things.
- Brian playing with his truck next to Kristina playing with her truck.
-Adam playing a board game with Kyle, Steve, and Erich
-Danielle playing with a music box on her mother’s lap
4. A parent asks the nurse why self-monitoring of blood glucose is being recommended for
her child with diabetes. The nurse should base the explanation on what information?
-It is a less expensive method of testing.
-It is not as accurate as laboratory testing
-Children need to learn to manage their diabetes .
-The parents are better able to manage the disease
5. The nurse assessing a premature newborn infant auscultates a continuous machinery-like
murmur. This finding is associated with which congenital heart defect?
-Pulmonary stenosis
- Patent ductus arteriosus
-Ventricular septal defect
-Coarctation of the aorta
6. Which factor is most important in predisposing toddlers to frequent infections such as
otitis media, tonsilitis, and upper respiratory tract infections?
-Respirations are abdominal
-Pulse and respiratory rates are slower than those in infancy
-Defense mechanisms are less efficient than those during infancy
-The presence of short, straight internal ear/throat structures and large tonsil/adenoid
lymph tissue .
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Download Pediatrics Test 3: Multiple Choice Questions and Answers and more Exams Nursing in PDF only on Docsity!

OB/Peds Test 3 (Proctorio)

  1. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? -Abdominal rigidity and pain on palpation -Rounded abdomen and hypoactive bowel sounds -Visible peristalsis and weight loss -Distention of lower abdomen and constipation
  2. Which intervention should be included in the plan of care for an infant with the nursing diagnosis of excess fluid volume related to congestive heart failure?
    • Weigh the infant every day on the same scale at the same time -Notify the physician when weight gain exceeds more than 20 g/day. -Put the infant in a car seat to minimize movement -Administer digoxin as ordered by the physician
  3. The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play? -Kimberly and Amanda sharing clay to each make things.
    • Brian playing with his truck next to Kristina playing with her truck. -Adam playing a board game with Kyle, Steve, and Erich -Danielle playing with a music box on her mother’s lap
  4. A parent asks the nurse why self-monitoring of blood glucose is being recommended for her child with diabetes. The nurse should base the explanation on what information? -It is a less expensive method of testing. -It is not as accurate as laboratory testing -Children need to learn to manage their diabetes. -The parents are better able to manage the disease
  5. The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect? -Pulmonary stenosis
    • Patent ductus arteriosus -Ventricular septal defect -Coarctation of the aorta
  6. Which factor is most important in predisposing toddlers to frequent infections such as otitis media, tonsilitis, and upper respiratory tract infections? -Respirations are abdominal -Pulse and respiratory rates are slower than those in infancy -Defense mechanisms are less efficient than those during infancy -The presence of short, straight internal ear/throat structures and large tonsil/adenoid lymph tissue.
  1. During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is? -a normal finding -an abnormal finding; the child needs referral to an ophthalmologist -a sign of a possible visual defect; the child needs vision screening -a sign of small hemorrhages, which usually resolve spontaneously
  2. What should a nurse advise the parents of a child with type 1 diabetes mellitus who is not eating as a result of a minor illness? -Give the child half his regular morning dose of insulin
    • Substitute simple carbohydrates or calorie-containing liquids for solid foods -Give the child plenty of unsweetened, clear liquids to prevent dehydration -Take the child directly to the emergency department
  3. Parents of a school-age child with hemophilia as the nurse, “which sports are recommended for children with hemophilia?” Which sport should the nurse recommend? -Soccer -Swimming -Basketball -Football
  4. The nurse is performing an assessment on a child and notes the presence of Koplik’s spots. In which communicable disease are Koplik’s spots present? -Rubella
    • Measles (rubeola) -Chickenpox (Varicella) -Exanthema subitem (roseola)
  5. A nurse providing care to a child diagnosed with chronic otitis media with effusion (OME) will assess for which sign/symptom? -Fever as high as 40 degree Celsius (104 degree F) -Severe pain in the ear -Nausea and vomiting
    • A feeling of fullness in the ear
  6. It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently to monitor for what increased risk? -Cough -Osteoporosis
    • Slowed growth -Cushing’s syndrome
  7. The nurse is assessing a child with acute epiglottitis. Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition? -Inspiratory stridor -Complete obstruction

-Therapeutic management includes administration of gamma globulin and aspirin

  1. A school-age child is admitted in vaso-occlusive sickle cell crisis. The child’s care should include which intervention? (SATA) -Correction of acidosis -Adequate hydration -Pain Management -Administration of heparin -Replacement of factor VIII
  2. The nurse is meeting a 5 year-old child for the first time and would like the child to cooperate during a dressing change. The nurse decides to do a simple magic trick using gauze. This should be interpreted as: -inappropriate, because of child’s age.
    • a way to establish rapport -too distracting, when cooperation is important -acceptable, if there is adequate time
  3. What should the nurse stress in a teaching plan for the mother of an 11-year-old diagnosed with ulcerative colitis? -Preventing the spread of illness to others -Nutritional guidance and preventing constipation -Teaching daily use of enemas
    • Coping with stress and avoiding triggers
  4. A child is diagnosed with juvenile hypothyroidism. The nurse should expect to assess which symptoms associated with hypothyroidism? SATA -Weight loss
    • Sleepiness or Fatigue -Diarrhea
    • Puffiness around the eyes
    • Limited hair growth
  5. Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? -Bronchoscopy -Serum calcium -Urine creatinine
    • Sweat chloride test
  7. The nurse is caring for a child with suspected diabetes insipidus. Which clinical manifestation would be observable? -Oliguria -Glycosuria -Nausea and vomiting

-Polydipsia

  1. Which data would be included in a health history? SATA -Review of systems -Physical assessment
    • Sexual history -Height, Weight, BMI data
    • Diet and nutritional intake
    • Family medical history
  2. What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)? -Explain how SIDS could have been predicted and prevented -Interview parents in depth concerning the circumstances surrounding the infant’s death -Discourage parents from making a last visit with the infant
    • Make a follow-up home visit to parents as soon as possible after the infant’s death
  3. A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9 lb. 7 ounce boy after augmentation of labor with Pitocin. She punts on her call light and asks for her nurse right away, stating, “I’m bleeding a lot.” The most likely cause of after birth hemorrhage in this woman is: -retained placental fragments -unrepaired vaginal lacerations -uterine atony -puerperal infection
  4. Because a full bladder prevents the uterus from contracting normally, nurses intervene to help the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing the nurse could try is: -pouring water from a squeeze bottle over the woman’s perineum -placing oil of peppermint in a bedpan under the woman -asking the physician to prescribe analgesics -inserting a sterile catheter
  5. As relates to rubella and Rh issues, nurses should be aware that: -breastfeeding mothers cannot be vaccinated with the live attenuated rubella virus.
    • women should be warned that the rubella vaccination is teratogenic, and that they must avoid pregnancy for 1 month after vaccination. -Rh immune globulin is safely administered intravenously because it cannot harm a nursing infant -Rh immune globulin boosts the immune system and thereby enhances the effectiveness of vaccinations
  6. PPH may be sudden and result in rapid blood loss. The nurse must be alert to the symptoms of hemorrhage and hypovolemic shock and be prepared to act quickly to minimize blood loss. Astute assessment of circulatory status can be done with

-Vitamin K prevents the synthesis of prothrombin in the liver and must be given by injection -Bacteria that synthesize vitamin K are not present in the newborn’s intestinal tract. -The supply of vitamin K is inadequate for at least 3 to 4 months, and the newborn must be supplement

  1. A macrosomic infant is born after a difficult forceps-assisted delivery. After stabilization the infant is weight and the birth weight is 4550g (9lbs, 6 ounces). The nurse’s most appropriate action is to: -leave the infant in the room with the mother -take the infant immediately to the nursery -perform a gestational age assessment to determine whether the infant is large for gestational age
    • monitor blood glucose levels frequently and observe closely for signs of hypoglycemia
  2. A premature infant with respiratory distress syndrome receives artificial surfactant. How would the nurse explain surfactant therapy to the parents?
    • “Surfactant improves the ability of your baby’s lungs to exchange oxygen and carbon dioxide” -“The drug keeps your baby from requiring to much sedation” -“Surfactant is used to reduce episodes of periodic apnea” -“Your baby needs this medication to fight a possible respiratory tract infection”
  3. Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are: -suffering from sleep or wakeful apnea -experiencing severe swings in blood pressure -trying to maintain a neutral thermal environment
    • breathing in a respiratory pattern common to premature infants.
  4. Human immunodeficiency virus (HIV) may be perinatally transmitted: -only in the third trimester from the maternal circulation -by a needlestick injury at birth from unsterile instruments -only through the ingestion of amniotic fluid
    • through the ingestion of breast milk from an infected mother
  5. Which infant would be more likely to have Rh incompatibility?
    • Infant of an Rh-negative mother and a father who is Rh positive and homozygous for the Rh factor. -Infant who is Rh negative and whose mother is Rh negative -Infant of an Rh-negative mother and a father who is Rh positive and heterozygous for the Rh factor. -Infant who is Rh positive and whose mother is Rh positive
  6. A woman is in her seventh month of pregnancy. She has been reporting nasal congestion and occasional epistaxis. The nurse suspects that:

-this is a normal respiratory change in pregnancy caused by elevated levels of estrogen. -this is an abnormal cardiovascular change, and the nosebleeds are an ominous sign. -the woman is a victim of domestic violence and is being hit in the face by her partner -the woman has been using cocaine intranasally

  1. The diagnosis of pregnancy is based on which positive signs of pregnancy? SATA
    • Identification of fetal heartbeat -Palpation of fetal outline
    • Visualization of the fetus
    • Verification of fetal movement -Positive hCG test
  2. A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours. On assessment the nurse finds the following vital signs: temperature 37.3 C, pulse rate of 88 beats/min, respiratory rate of 10 breaths/min, blood pressure (BP) of 148/90 mm Hg, absent deep tendon reflexes, and no ankle clonus. The patient complains, “I’m so thirsty and warm.” The nurse: -calls for a state magnesium sulfate level -administers oxygen
    • discontinues the magnesium sulfate infusion -prepares to administer hydralazine
  3. Magnesium sulfate is given to women with preeclampsia and eclampsia to: -Improve patellar reflexes and increase respiratory efficiency -shorten the duration of labor
    • prevent and treat convulsions -prevent a boggy uterus and lessen lochial flow
  4. After an emergency birth, the nurse encourages the woman to breastfeed her newborn. The primary purpose of this activity is to: -facilitate maternal-newborn interaction
    • stimulate the uterus to contract -prevent neonatal hypoglycemia -initiate the lactation cycle
  5. A laboring woman is lying in the supine position. The most appropriate nursing action at this time is to:
    • ask her to turn to one side -elevate her feet and legs -take her blood pressure -determine whether fetal tachycardia is present
  6. A pregnant woman experiencing nausea and vomiting should: -drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning -eat small, frequent meals (every 2 to 3 hours)

-I should hold the Kegel exercise contraction for 10 seconds and rest for 10 seconds between exercises. -I should only perform Kegel exercises in the sitting position -I will perform daily Kegel exercises during the last trimester of my pregnancy to achieve the best results

  1. When obtaining a reproductive health history from a female patient, the nurse should: -limit the time spent on exploration of intimate topics -avoid asking questions that may embarrass the patient -use only accepted medical terminology when referring to body parts and functions
    • explain the purpose for the questions asked and how the information will be used
  2. The nurse is calculating the estimated date of confinement (EDC) using Nagele’s rule for a client whose last menstrual period started on December 1. Which date is most accurate?
    • September 8 -August 1 -August 10 -September 3
  3. During a prenatal intake interview, the nurse is in the process of obtaining an initial assessment of a 21-year-old Hispanic patient with limited English proficiency. It is important for the nurse to: -use maternity jargon in order for the patient to become familiar with these terms -speak quickly and efficiently to expedite the visit -provide the patient with handouts
    • assess whether the patient understands the discussion
  4. A woman is 14 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is: -“you should have felt the baby move by now” -“Within the next month or so, you should start to feel fluttering sensations -“The baby is moving, however, you can’t feel it yet” -Some babies are quiet, and you don’t feel them move”
  5. The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse’s instructions if she states that a positive sign of pregnancy is:
    • a positive pregnancy test -fetal movement palpated by the nurse-midwife -Braxton Hicks contractions -quickening
  6. The most prevalent clinical manifestation of abruptio placentae (as opposed to placenta previa) is: -bleeding
    • intense abdominal pain

-uterine activity -cramping

  1. What is common sign of digoxin toxicity -Seizures
    • Vomiting -Bradypnea -Tachycardia
  2. What is the common side effect of corticosteroid therapy? -Fever -Hypertension -Weight loss
    • Increased appetite
  3. The nurse must check vital signs on a 2-year-old boy who is brought to the clinic for his 24-month checkup. Which criteria should the nurse use in determining the appropriate-size blood pressure cuff? SATA -The cuff is labeled “toddler”
    • The cuff bladder width is approximately 40% of the circumference of the upper arm -The cuff bladder length covers 80%4 to 100% of the circumference of the upper arm -The cuff bladder covers 50% to 66% of the length of the upper arm
  4. The nurse is caring for a 10-month-old infant diagnosed with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child’s care? SATA -Administer antibiotics -Administer cough syrup
    • Encourage infant to drink 8 ounces of formula every 4 hours -Institute cluster care to encourage adequate rest. -Place on noninvasive oxygen monitoring
  5. When palpating the child’s cervical lymph nodes, the nurse notes that they are tender, enlarged, and warm. The best explanation for this is: -some form of cancer -local scalp infection common in children -infection or inflammation distal to the site
    • infection or inflammation close to the site
  6. An 8-year-old girl tells the nurse that she has cancer because God is punishing her for “being bad.” She shares her concern that, if she dies, she will go to hell. How should the nurse interpret this belief?
    • It is a belief common at this age -It is a belief that forms the basis for most religions -The belief is suggestive of excessive family pressure -The statement suggest a failed attempt to develop a conscience
  1. A prescription for Methylergonovine 0.2 mg IM has been ordered for a client in stage three of labor who is experiencing a hemorrhage. Using the information from the medical chart below, why is the medication contraindicated for this patient? Patient-J.L. DOB- 4/2/ Allergies-Penicillin G-5 T-4 P-0 A-0 L- Vital Signs-T 98.6 F P128 R22 B/P 155/ Medication-Methyldoda 250mg PO Q8h
    • The medication is contraindicated due to the client’s blood pressure -The medication is contraindicated due to the multigravity of the client -The medication is contraindicated due to the client’s drug allergy -The medication is contraindicated due to the client’s heart rate
  2. Please match the developmental milestone in the infant to the correct age: 2 months 9 months (can sit in highchair with back, ) (need to match) 6 months 4 months (pincer gras, begins to smile, can sit in highchair with back straight, beginning signs of tooth eruption, Moro reflex disappears, Grasp reflex absent)
  3. The first does of the immunization for Measles, mumps, and rubella (MMR) is given at the age of _________while the first dose of the immunization for Haemophilus influenzae type B (Hib) is given at the age of ( ). (couldn’t find)
  4. A 2-year-old girl brought to the pediatric ED after 5 days of diarrhea. Today, child’s parent estimates she has had six to eight episodes of watery diarrhea and only two wet diapers. She has a decreased appetite, but has been drinking well, including milk, water, and juice. Two other household members had diarrheal illnesses last week. There is no report of vomiting, fever, or changes to the diet. The triage nurse documents the following medical history and assessment findings: -Client is crying tears and resisting examination -Eyes appear sunken -Buccal mucosa dry (This is part 1 of a case study & I didn’t mark) -reduced skin turgor -Capillary refill approximately 3-4 seconds Vital Signs: -Temperature of 98.3 F -Heart rate 156 beats per minute -Respiratory rate 30 breaths per minute -Pulse oximetry 99% on room air

Please identify assessment findings that require immediate follow up: ___________Client is crying tears and resisting examination (choose) Eyes appear sunken (choose) Buccal mucosa dry (Part 2) (choose) Reduced skin turgor

  1. A 9 year old often comes to the school nurse complaining of stomach pains. The teacher says that the child has lately been somewhat aggressive and stubborn in the classroom. What should the school nurse recognize as the possible trigger for these behaviors?
    • Signs of stress -Development delay -A physical problem causing emotional stress -Lack of adjustment to the school environment