pediatric nursing final review PDF

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PED FINAL REVIEW Final 75Qs and 112mins 60 multiple choice 10 select all apply 5 Math

1. A child has been admitted to the hospital with a blood lead level of 42 mcg/dl. What treatment should the nurse anticipate? – Initiation of chelation therapy 2. Which of the following is the most consistent and commonly used data for assessment of pain in infants? – behavioral 3. Select the vaccines usually given to children at 2 months of age according to the immunization schedule. – DTaP, RV, IPV, PCV, HIB 4. Which of the following concepts provides a rational approaching to decision making, that facilitates best practice in nursing care? – Evidence Based Practice 5. Which of the following chromosomal disorders seen in affected newborns cause significantly shortened life span? – Patau Syndrome 6. What assessing in a family, the nurse determines that the parents expect rules to followed rigidly and unquestioningly? This style of parenting is called. – Dictatorial /Authoritarian 7. Children may believe that they are responsible for their parent’s divorce and interpret the separation as punishment. At which age is this most likely to occur? – Age 4/ Preschool 8. The pediatric nurse is planning to educate and empower a family to use the information provide to build their competence. This preventive measure is referred to as. – Anticipatory guidance 9. Select the developmental milestone usually seen in children during the preschool stage (3-6 years). (Select all that apply) – Ride a tricycle, Child learns to run, jump, skip and hop, learns colors and shapes. 10. When interviewing a child and parent(s) at the beginning of a visit, it will be important for the nurse to follow which of the guiding principles? Select all that apply.  Include children in the interaction by asking them their name, age, and other information  Provide as much privacy as possible  Inform the family of the limits of confidentiality  Young children should be given play provision to keep them occupied during the parent-nurse interview

11. After the family, which has the greatest influence on providing continuity between generations? – School 12. The nurse is instructing the staff on measuring head circumference. Teaching by the nurse has been effective if the staff make which statement? Select all that apply.  The head circumference should be measure up to 24 months of age in children with an appropriate head size.  Measuring tapes should be made of paper or metal  For greatest accuracy, use devices marked with tenths of a centimeter because the percentile charts have only 0.5-cm increments.  The shape of the child's head can affect the accuracy of the measurement. 13. A 6-year-old male is diagnosed with a heart murmur that can be heard without the stethoscopes. The nursing student is aware that this occurs at which of the following grade? – VI (grade 6) 14. Select an initial assessment included in the Apgar scoring system? – Color, heart rate, reflexes, Muscle tone 15. The nurse is caring for an adolescent client receiving intravenous (IV) morphine for severe pain. The nurse observes a respiratory rate 9 and shallow, and the client cannot be aroused. What priority nursing action should the nurse take? – Administer naloxone 16. An 8-month-old infant is sitting contentedly on the mother’s lap. The nurse is preparing to perform a well-baby checkup. Which of the following steps should the nurse do first?  Auscultate heart and lung sounds 17. What is the leading cause of death during the toddler period? – unintentional injuries 18. The nurse is ready to perform a physical exam on a 9-month-old infant. Where should the nurse place the infant? – on the parent’s lap 19. The pediatric Nurse should begin screening for lead poisoning when a child reaches which age? – 18 months 20. The phenylketonuria blood screen test will be most reliable on a newborn if which of the following occurs initially? – Received breast milk or formula at least 24 hours before the test. 21. The nurse is caring for a patient who has chosen to breastfeed her infant. Which statement the nurse include when teaching the mother about breastfeeding problems that

may occur? – If mastitis continues breastfed while taking antibiotic and warm compress. 22. A child with acetaminophen (Tylenol) poisoning has been admitted to the emergency room. What antidote does the nurse anticipate being prescribed? – Mucomyst (Nacetylcysteine) 23. The nurse suspects that a child has ingested some type of poison. What clinical manifestation would e the most suggestive that the poison was corrosive product? – Edema of the lips, tongue, and pharynx. 24. The nurse is assessing breath sounds on a child. Which is an expected auscultated breath sound? – Bronchial 25. The nurse notes that a 12-month-old infant who weighed 6.5 lbs at birth now weighs 20.5 lbs. What is the nurse’s evaluation of the infant’s current weight? –Normal weight for age 26. The school nurse is explaining to older school children that obesity increase the risk for which disorders? – Hypertension, Altered glucose metabolism, Dyslipidemia 27. Statistically, how many children in the US experience mental health problems that affects their daily functioning? – 1 out of 5 children 28. The pediatric nursing student is educating a mother who plans to discontinue breastfeeding when the infant is 4 months old. The nurse student should advise her to include which foods in her infant’s diet? – Iron-rich formula only 29. One of the most common intestinal parasite pathogens in the United States acquired from a contaminated water source such as a lake or swimming pool is? – Giardia intestinalis 30. Which of the following is a heat generating source found in newborns, to assist the body with thermoregulation activity? – Brown Adipose Tissue 31. The parent of an 8,2 kg (18-lb) 9-month-old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what? – Rear facing the back seat 32. A 17-month-old child should be expected to be in which stage, according to Piaget? – Sensorimotor phase 33. The components of the FLACC scale include cry, leg movement, facial expression and activity. Choose the missing component from the following list. – Consolability 34. The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful? – Ask the child to draw a picture

35. A newborn’s assessment reveals a fused digit on the left hand. Which of the following terms is used to define fused digits of the hands or feet? – Syndactyly 36. Phenylketonuria is a genetic disease that results in the body’s inability to correctly metabolize which? – Phenylalanine 37. A parent brings a toddler, age 19 months, to the clinic for a regular check-up. What should the nurse expect to find when palpating the toddler’s fontanels? – By age 18 months, the anterior and posterior fontanels should be closed 38. Parents ask the nurse if there was something that should have been done during the pregnancy to prevent their child’s cleft lip. Which statement should the nurse give as a response? – The malformation occurs at 6wks of gestation with no known of prevention 39. What identified characteristics occur more frequently in parents who abuse their children? (select all that apply) – socially isolated, few supportive relationship, single parent families. 40. Which of the following reflexes usually disappear in a newborn around 3-4 months of age? (select all apply) – Rooting 41. A parent reports to the nurse that her child has inflamed conjunctivae of both eyes with purulent drainage and crusting of the eyelids, especially on awakening. These manifestations suggest. – Bacterial conjunctivitis. 42. Which concept reinforces the development of a sense of trust of an infant? – They can predict what is coming and their needs are consistently met. 43. The nurse reviewing the Healthy People 2020 leading indicators for a child health promotion program. Which are included in the leading health indicators? (select apply) – Decrease tobacco use, eating disorders, obesity, injury and violence, cancer. Increase access to health care. 44. By which age should the nurse expect that an infant will be able to pull to a standing position? 11-12 months 45. A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. The nurse should suspect. – shaking baby syndrome 46. The Apgar score of an infant 5 minutes after birth is 8. Which is the nurse’s best interpretation of this? – Adjustment of extrauterine life is adequate/normal.

47. What should a nursing intervention to promote parent-infant attachment include? – Explain normalcy of specific infant behaviors to parents. 48. Which of the following statement is true of X linked recessive inheritance? – affected males have symptoms of the disorder. 49. A parent requests info on her infant’s hearing. Which of the following should the nursey say is a clinical manifestation of hearing impairment in an infant less than 12 months old? – General indifference to sound 50. Select the parts of the fetal circulation of the pediatric heart in the correct order, as blood flows from the placenta to the fetus. – Placenta -umbilical vein – ductus venosus – inferior vena cava – R atrium. 51. A 10 yr old sustained a deep partial thickness 2nd degree burn on his left arm during a barbecue. What is the expected time of healing for this injury? – 3-4 weeks 52. A 2 month old seen in peds clinic has symptoms of tachypnea, retractions, anorexia, apneic spells, copious nasal secretions and wheezing. Which of the following on these symptoms best describes? – RSV Bronchiolitis 53. Which clinical finding may be present in an older child with Coarctation of the Aorta? – diminished pulses in the lower extremities 54. A nursing student is assessing the respiration of a young child. What is consider a normal respiratory rate in children age 1-3 years old? – 20-30 breaths per minute 55. A 4-year-old girl presents to the ER with her father, she is having difficulty breathing and leaning forwards with her arms propped on a chair. She also has nasal flaring; she is drooling, and you can hear a high-pitched noise on inspiration. Her temperature is 39.1 C. which of the following treatment should be administered immediately? – Securing the airways and supplemental oxygen. 56. A 15-year-old male referred to a cardiologist is diagnosed with infective Endocarditis. Which of the following symptoms are usually seen with this condition? (select all apply) – Painless bleeding areas on soles of feet. Painful nodes on pads of fingers. 57. What behavior seen in children should be addressed by the nurse who is providing care to a child with a chronic illness? – An adolescent who is becoming on dependent on family 58. An adolescent with diabetes is admitted to the ER for treatment of hyperglycemia and pneumonia. What are clinical manifestations of diabetic hyperglycemia? – Fruity acetone breath.

59. A 10-month-old females is diagnosed with Vesicoureteral Reflux. As a result of this diagnosis, the child is at risk for which of the following complications? – Hydronephrosis 60. Of the following nursing diagnosis, which would the nurse identify as a priority for the infant with tracheoesophageal fistula (TEF)? – Risk of injury related to increased potential for aspiration. 61. An appropriate nursing intervention when caring for an unconscious child would be which of the following? – Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema. 62. A pediatric nurse is caring for a newborn in the NICU with clinical manifestation of bulging fontanel and distended scalp veins and separated sutures. Which of the following diagnosis the symptoms suggest? – Hydrocephalus 63. A 4-year-old is seen in the ER with a fracture of the humerus. Which of the following P’s are assessed to determine the extent of the child’s injury? – pain and pulselessness 64. The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following interventions would be most appropriate? – Massage skin under the straps daily to stimulate circulation 65. The nurse is caring for a preschool child with a cast recently applied for a fracture tibia. Which assessment findings indicate possible compartment syndrome? (select all apply) – Tingling of extremity. Inability to move extremity. Severe pain not relieved by analgesics. 66. The nursing is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe? (select all apply) – Lack of bowel control. – Flaccid, partial paralysis of lower extremities. – Overflow incontinence with constant dribbling of urine. 67. An 19-month-old male is scheduled for surgery to reposition his undescended testes. What is this child’s diagnosis? – Cryptorchidism 68. What bone disorder of childhood is caused by an autosomal recessive defect in the synthesis of collagen? – Osteogenesis imperfecta 69. A child see in peds specialty clinic is diagnosed with Scoliosis. At which of the following degree of curvature will the child be fitted for bracing? – 25-45 70. A 4 yr. old female seen in peds clinical has urinary symptoms. What is the medical terminology for inflammation of the bladder? – cystitis

71. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? – Hirschsprung disease 72. The nurse is assisting a child with Celiac disease to select foods from a menu. What foods should the nurse suggest? – Corn on the cob with butter. 73. Select the “drug of choice” from the list below usually used in treatment of Nephrotic syndrome in children. – Prednisone. 74. What term describes invagination of one segment of bowel within another? – Intussusception 75. A 15-year-old boy on a bicycle has been hit by a car in front of the school. The initial nursing action by the school nurse should be? – Assesses airway, breathing, and circulation 76. What intervention should be beneficial in reducing the risk of Reye syndrome? – Avid giving aspirin to children after a suspected viral illness. 77. The nurse wants to provide 3-month-old infant with stimulation. What is the best toy for the nurse to provide? – Mobile with music box. 78. A school nurse decides to imitate a safety program for increasing the use of bicycle helmet. The program is an example of. – primary prevention. 79. When giving oral liquids from a syringe to an infant or child, which is the best procedure to use? – place the tip of the syringe into the pocket formed between the lower teeth and cheek. 80. A 14-month-old boy is hospitalized with dehydration. He is inconsolable, screaming, and rejecting your physical contact. What best describes the response? – Separation anxiety 81. When planning care for a 8-year-old boy with down syndrome. The nurse should. – Assess the child’s current developmental level and plan care accordingly. 82. What action should the school nurse takes for a child who has a hematoma (black eye) with no hemorrhage into the anterior chamber? – apply ice for the first 24 hr. 83. A 1-month-old infant is admitted to the hospital. The infant’s mother is 17 years old and single and lives with her parents. Who signs the informed consent for the 1-month-old infant? – The infant’s mother. 84. Which of the following therapy is usually ordered for patient with active TB as part of their medication management plan? – Directly Observed Therapy.

85. Which of the following age range of children qualify to be included in Early Intervention programs? – Birth – 3 86. A pediatric nurse is caring for a child who is terminally ill and expected to die. Which of the following procedures is usually no longer necessary during the terminal phase? – measure vital signs. 87. Which is the leading cause of death in infants younger than 1 year in the Untied State? – Congenital anomalies 88. What do mortality statistic describe? – The number of individuals who have died over a specific period. 89. Identify the age group of children per Erickson in the developmental stage of industry vs inferiority. – 6-12 90. A child is admitted to the hospital with an undiagnosed rash. The best initial nursing action of the pediatric nurse should be? – place child in contact precaution isolation. 91. Which statement best describes the use of the word family? – A group that is what an individual considers it to be. 92. The parents of a child diagnosed with an autosomal recessive condition consult the nurse, stating they want to have more children but are worried about subsequent children also inheriting the disease. Which information should the nurse provide to the parents? – Each child has a 1 in 4 risk of inheriting the disease. 93. At what age is it safe to give infants whole milk instead of commercial infant formula? – 12 months 94. What is the most common form of child maltreatment? – Child neglect. 95. Select the vaccines usually given to children at 2months old – DTap, IPV, PCV, HIB, RV 96. A newborn’s assessment reveals a fused digit on the left hand. Which of the following terms is used to define fused digits of the hands or feet? – Syndactaly. 97. The nurse is caring for a 3-year-old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction? A. Blood pressure trend is downward, and pulse is rapid and irregular. B. Right foot is cool to the touch and appears pale and blanched. C. Pulse distal to the femoral artery is weaker on the left foot than right foot. D. The pressure dressing at right femoral area is moist and oozing blood. Ans. B

98. Following a motor vehicle collision, a 3-year-old girl has a spica cast applied. Which toy is best for the nurse for this 3-year-old child? A. Duck the squeaks. B. Fashion doll and clothes. C. Set of cloth and hand puppets. D. Handheld video game. Ans. C 99. An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Which action should the nurse implement first? A. Administer morphine sulphate. B. Start IV fluids. C. Place the infant in a knee-chest position. D. Provide 100% oxygen by face mask. Ans. C 100. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respirations. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? A. Metabolic alkalosis. B. Respiratory acidosis. C. Respiratory alkalosis. D. Metabolic acidosis 1. Ans. D 5. A 7-year-old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? A. Gastric output of 100 mL in the last 8 hours. B. Shift intake of 640 mL IV fluids plus 30 mL PO ice chips. C. Serum potassium of 3.0 mg/dL. D. Serum pH of 7.45. Ans. C 6. The nurse is evaluating diet teaching for a client who has non tropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? A. Creamed corn. B. Pancakes. C. Rye crackers. D. Cooked oatmeal. Ans. A 7. During a well-baby check, the nurse hides a block under the baby’s blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing?

A. Separation anxiety. B. Associate play. C. Object prehension. D. Object permanence. Ans. D 8. The nurse is measuring the frontal occipital circumference (FOC) of a 3-months old infant, and notes that the FOC has increased 5 inches since birth and the child’s head appears large in relation to body size. Which action is most important for the nurse to take next? A. Measure the infant’s head-to-toe length. B. Palpate the anterior fontanel for tension and bulging. C. Observe the infant for sunken eyes. D. Plot the measurement on the infant’s growth chart. Ans. B 9. The nurse is preparing a 10-year-old with a lacerated for...