Kaplan Focused Review Pediatrics A PDF

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Kaplan Focused Review – Pediatrics A 1. A toddler client accidently drinks some drain cleaner and is brough to the emergency department. Which piece of equipment is MOST essential for the nurse when catting for this client? a. Intubation tray i. An intubation tray is the most essential piece of equipment for the nurse to have on hand. Because drain cleaner is a caustic substance, there is potential for massive swelling, which would compromise respirations. An intubation tray should be immediately available so that the toddler’s airway is protected. 2. The nurse performs a home care visit for a child client diagnosed with cystic fibrosis. The nurse intervenes if which finding is observed? a. The child takes the pancreatic enzymes one hour after eating. i. Enzymes should be taken at the beginning of a meal, with a snack, or within 30 min of eating. One hour is too long after eating. Chewing or crushing beads destroys the enteric coating. 3. An infant client is diagnosed with a cyanotic congenital heart defect (CCHD). The nurse knows a cyanotic congenital heart defect is associated with which symptom as reported by the parent? a. Poor feeding with no or very poor weight gain i. Reports of poor feeding, difficulty feeding, and poor weight gain or no weight gain are symptoms that occur in infants with congenital heart defects usually seen on the wellbaby check following birth. There are respiratory related symptoms such as cyanosis, tachypnea, labored breathing, pulmonary edema, and sternal retractions. Circulatory related symptoms are tachycardia, heart murmur, weak femoral pulses, or shock. The infant can also demonstrate lethargy, hepatomegaly, and failure to thrive. 4. The nurse provides teaching to an adolescent client and parent about the brace the adolescent will wear to correct a scoliosis deformity. Which statement made by the parent indicates teaching is successful? a. The brace should be worn 23 hours a day i. The brace should be worm 23 hours per day. The nurse should assess the home environment for safety hazards and teach the client how to prevent falls by using handrails and avoiding slippery surfaces. 5. A client delivers a healthy 8-lb, 2-oz infant. The client mentions to the nurse that the baby’s “soft spot” bulges out when the baby cries. Which statement made by the nurse is MOST appropriate? a. The anterior fontanel will normally bulge out when the baby coughs or cries. i. The fontanels should feel flat, firm, and well demarcated when the baby is at rest. Coughing or crying may cause the anterior fontanel to bulge. 6. During a well child check-up for a 6-month-old client, the parent reports the client received the first DTaP at two-months of age, and has received no other vaccinations. Which action by the nurse is MOST appropriate? a. Give the second DTaP. i. By the age of 6 months, the child should be ready for the third immunization. When the schedule has been interrupted, it Is appropriate to simple continue with the schedule. The child is due for the second DTaP vaccination. 7. The nurse instructs a 10-year-old client about how to collect a 24-hour urine specimen at home using a clean, empty jar. Which size jar does the nurse recommend that the client use for the collection? a. A 48-ounce jar. i. The expected amount of urine output for a 10-year-old child is about 1200 mL. Since 30 mL equals 1 ounce, 1200 mL equals 40 ounces, a 48-ounce jar would be best to hold 40 ounces of urine.

Kaplan Focused Review – Pediatrics A 8. The nurse know DTaP vaccine protects against which diseases? a. Diphtheria, tetanus, pertussis i. DTaP refers to the combination of Diphtheria, Tetanus, and Pertussis vaccines. 9. A toddler client diagnosed with autism is admitted to the pediatric unit with a tracheostomy after swallowing a small toy. The unlicensed assistive personal (UAP) reports to the nurse that the child does not maintain eye contact. Which response by the nurse is BEST? a. The inability to maintain eye contact is a characteristic of autism. i. This response offers the staff member an explanation about the lack of eye contact. While in the hospital, parents should be encouraged to stay with the child. The plan of care should include decreased stimulation, as physical contact may upset the child with autism, and the nurse should establish trust. 10. A school-age client is admitted to the hospital with a diagnosis of idiopathic hypopituitarism. Which clinical manifestation is the nurse MOST likely to observe? a. Short stature i. Pediatric clients with idiopathic hypopituitarism characteristically have short stature and slow growth. Children typically fall off the growth curve in height and may have weight gain that is out of proportion to height. 11. The nurse observes a child client walk up and down steps. The nurse notes the child has a steady gait and can use short sentences. The nurse estimates the child’s age to be how many months? a. 24 months i. The 24-month-old child goes up and down stairs alone, runs well with a wide stance, builds a tower of six to seven blocks, and has a vocabulary of about 300 words. 12. The nurse in a pediatric clinic is doing health record audits and notices that a preschool client is on a delayed immunization schedule per the parents request. The client is 5 years old, and it has been 3 weeks since the initial administration of the measles, mumps, and rubella (MMR) vaccine. Which is the best response by the nurse? a. Call the parents and explain that the child will need to be seen in the next week to receive the second dose of the MMR vaccine to keep on the schedule. i. According to the CDC, the MMR vaccine requires a 4 week time period between the first and second doses. 13. The nurse teaches a parent how to care for a child with impetigo. The nurse knows the greatest danger associated with an impetigo infection is the risk of which complication? a. Developing glomerulonephritis. i. Impetigo can be caused by beta hemolytic streptococcus, the same organism responsible for glomerulonephritis. The antibodies formed in the body during the streptococcal infection can damage the glomeruli. 14. The nurse in the emergency department (ED)) provides care for a toddler client with a fever. The parents report the toddler has received regular adult acetaminophen 325mg every 4 hours for the past four days. Which medication does the nurse have available for the treatment of acetaminophen overdose? a. Acetylcysteine i. Acetylcysteine (acetadote/mucomyst) is given as an antidote following an acetaminophen overdose. This toddler received more than the recommended dose of 10-15 mg/kg/dose not to exceed 4 doses in 24 hours. The acetaminophen has been excessive and absorbed into the blood stream over 4 days and is near or at toxic levels for this toddler

Kaplan Focused Review – Pediatrics A 15. A child client diagnosed with attention deficit hyperactive disorder (ADHD) is receiving methylphenidate. The nurse knows that methylphenidate is prescribed for this client for which effect? a. Central Nervous System Stimulant i. Pharmacological therapy is useful in the management of ADHD. CNS stimulants improve concentration and adaptive behavior. CNS stimulants include methylphenidate, atomoxetine, modafinil, armodafinil and the amphetamines. Adverse effects include depersonalization, dizziness, facial tics, headaches, insomnia, increased blood pressure, and irritability. 16. Which intervention does the nurse recognize as MOST important to promote maximum mobility in infants? a. Provide a safe play area. i. Be aware of safety concerns for the infant, including aspirating foreign objects, poisoning, burns, and falls from infant seats, high chairs, walkers, and swings. 17. To prevent disturbed parent-child interactions, the nurse completes which action? a. Discusses with the parents any problems or fears about child rearing they may have. i. It is important that parents become active listeners, become actively involved in their child’s education, and look at things from the child’s point of view. 18. The nurse provides care for a newborn client diagnosed with dysplasia. The nurse expects which method of treatment to be used for the client? a. Pavlik harness i. A Pavlik harness is used to treat hip dysplasia in a newborn client to stabilize and keep the hip joint in proper alignment. During the early newborn period, a Pavlik harness is applied to hold the hips in wide abduction. A undershirt is placed on the client under the chest straps. Knee socks are placed on the client under the foot and leg pieces. The parents are taught to check for skin breakdown 2-3 times per day, avoid lotions and powders, and place the diaper under straps. If the treatment does not achieve the correct hip placement in a few months, then surgery is indicated and a postoperative spica hip bandage or body cast is applied. 19. A preschool-age client comes to the clinic for a routine exam. The parent reports the child likes to jump and club, questions everything, and is often observed interacting with an ‘Imaginary” best friend. The nurse advises the parent to take which action? a. Allow the child to engage in imaginary play i. Having imaginary friends is a normal and common occurrence for preschool-age children. By the time the child reaches school-age, the child outgrows the imaginary friend. 20. A newborn client is diagnosed with hemophilia A. Neither parent has the disease. Which statement CORRECTLY describes the hemophilia trait? a. It is an X-linked recessive trait found primary in males i. The trait very rarely shows itself in females, since the second sex chromosome is also an X. Females would need to have the trait linked to both chromosomes in order to show the disease. Since the second sex chromosome in males is a Y, males will show the disease. A female who has the trait linked to one X chromosome and not the other is considered a carrier.

Kaplan Focused Review – Pediatrics A 21. A toddler client has nausea, vomiting, and diarrhea. Which implementation is BEST for the nurse to use to maintain an adequate fluid intake? a. Offer oral rehydration solution (ORS) to re-hydrate. i. Oral rehydration solutions contain sodium, potassium, chloride, citrate, and glucose, the amount given is determined by the degree of dehydration and child’s weight. If the child is vomiting, give a small amount of oral rehydration solution at frequent intervals. 22. A parent brings a newborn client to the health care providers office. The newborn is vomiting, has abdominal distention, and is diagnosed with pyloric stenosis. Which characteristic of the newborn’s emesis does the nurse expect? a. Projectile and forceful i. An infant with pyloric stenosis will present with projectile vomiting and abdominal distention. Other symptoms include weight loss, constipation, dehydration, and visible peristaltic waves 23. The home care nurse visits a child client diagnosed at birth with phenylketonuria. The nurse assesses the client s intake for the previous week. The nurse is most concerned if the parent makes which statement? a. My child favorite lunch is a peanut butter and jelly sandwich i. Peanut butter is not allowed on a diet because of high protein. The child can have a jelly sandwich made with low-protein bread, but no peanut butter. 24. The nurse observes a preschool-age client playing with several other children of about the same age. The nurse identifies which play activity as the one in as the one in which the child is MOST likely to engage? a. Imitating the actions of the nurse or HCP i. Preschool-age children are involved in imitative play will play house, play “doctor” or pretend to be engaged in the occupational role of the adults around them. 25. A school-age child client is diagnosed with tonic-clonic seizure disorder. The home health nurse intervenes if which finding is observed? a. The parent takes the child’s temperature using an oral electronic thermometer i. Seizures can occur without warning. It is dangerous to have a thermometer in the mouth because the child may start seizing 26. Which guideline is appropriate for the nurse to give a parent concerning the normal developmental of a young school-age child? a. The child’s periods of shyness should be tolerated. i. A young school-age child may become shy at time because of experiencing a conflict regarding independence from the parent. In order to allow the child to become independent, the parent should allow these episodes of shyness 27. The school nurse assesses children enrolled in a kindergarten class. The nurse is MOST concerned if which fining is observed? a. A child walks down stairs by placing both feet on one step. i. A child at this stage of developmental should be able to walk down stairs using alternating feet. This indicates a delay. 28. The nurse plans care for n infant client diagnosed with a myelomeningocele. Which principle of nursing care is MOST important to apply when caring for this infant? a. Asepsis i. Myelomonocyte is a birth defect of the spine and spinal cord. Infection around the area may cause meningitis and damage to the brain. Asepsis is extremely important to prevent the spread of infx to the infants CNS. 29. A child client is admitted with chronic lead poisoning. Which symptoms does the nurse expect to see?

Kaplan Focused Review – Pediatrics A a. Anemia, seizure, and learning disabilities i. Anorexia, nausea, vomiting, excess salvation, lead lines on the gums, ABD pain, muscle cramps, kidney failure, encephalopathy, and pain in the joints are symptoms of chronic lead poisoning. Tx includes removal of the child from the lead source. If the lead level is very high tx will include chelation. 30. The nurse performs assessments in the well-baby clinic. The nurse identifies which finding as an early warning sign of cerebral palsy (CP)? a. The 4 month-old infant lacks head control i. The earliest indication of CP is delayed gross motor development. Signs included stiff or rigid arms or legs, arching back, and floppy or limp body posture....