NUR 336 Peds exam 3 review questions Latest

NUR 336 Peds exam 3 review questions Latest Update 2024-2025 Actual Exam from Credible Sources with 180 Questions and Verified Correct Answers Golden Ticket to Guaranteed A+ Verified by Professor

A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated?

• Skin moist and flushed; mucous membranes dry
• Low specific gravity of urine; skin color pale
• Fontanels depressed; capillary refill greater than three seconds

4. High specific gravity of urine; moist mucous membranes - CORRECT ANSWER:

Answer: 3

Rationale: Two signs of severe dehydration are depressed fontanels and capillary refill time greater than three seconds. Moist, flushed skin; moist mucous membranes; and low specific gravity of urine are not signs of dehydration. Dry mucous membranes and pale skin color are signs of mild dehydration, not severe.

A 3-day-old preterm infant is diagnosed with necrotizing enterocolitis. The nurse plans care around the frequent radiographs. How frequently should the nurse anticipate that the radiology staff will bring the portable machine to the nursery?

• Every 6 hours
• Every 12 hours
• Every 24 hours
• Every 48 hours - CORRECT ANSWER: Answer: 1

Rationale 1: Radiographs are done every 6 hours to evaluate for perforation.

A child diagnosed with a mild traumatic brain injury is being sedated with a mild sedative so that pain and anxiety are minimized. Which nursing interventions are appropriate for this child?

Standard Text: Select all that apply. 1 / 4

• Place a continuous-pulse oximetry monitor on the child.
• Place the child in a room near the nurses station.
• Allow for several visitors to remain at the childs bedside.
• Use soft restraints if the child becomes confused.
• Use sedation around the clock to decrease agitation. - CORRECT ANSWER: Answer:

1,2 Rationale 1: When a child is sedated, respiratory status should be monitored with a pulse-oximetry machine. The child should be close to the nurses station so that frequent monitoring can be done. Several visitors at the bedside would increase the childs anxiety. Soft restraints may increase agitation. Sedation around the clock is not recommended due to the need to evaluate the neurologic system.

A child diagnosed with acute glomerulonephritis is in the playroom and experiences blurred vision and headache. Which action by the nurse is the most appropriate?

• Check the urine to see if hematuria has increased.
• Obtain a blood pressure on the child; notify the healthcare provider.
• Reassure the child, and encourage bed rest until the headache improves.
• Obtain serum electrolytes, and send a urinalysis to the lab. - CORRECT ANSWER:

Answer: 2

Rationale 1: Blurred vision and headache may be signs of encephalopathy, a

complication of acute glomerulonephritis. A blood pressure (BP) should be obtained and the healthcare provider notified. The healthcare provider may decide to order an antihypertensive to bring down the BP. This is a serious complication, and delay in treatment could mean lethargy and seizures. Therefore, the other options (checking urine for hematuria, encouraging bed rest, and obtaining serum electrolytes) do not directly address the potential problem of encephalopathy.

A child experienced a lacerated spleen in a motor vehicle accident. Which is the highest-priority nursing intervention on admission to the pediatric intensive care unit (PICU) following surgery?

• Observing for signs of hypovolemic shock
• Maintaining IV fluids
• Implementing strict bedrest 2 / 4

• Administering blood products as ordered - CORRECT ANSWER: Answer: 1

Rationale 1: The priority nursing intervention is observing for signs of hypovolemic shock due to bleeding from the lacerated spleen. The other interventions are appropriate but not the highest priority.

A child is admitted to the hospital for hypercalcemia and is placed on diuretic therapy.Which diuretic would the nurse expect to give?

• Hydrochlorothiazide (Aquazide)
• Spironolactone (Aldactone)
• Furosemide (Lasix)
• Mannitol (Osmitrol) - CORRECT ANSWER: Answer: 3

Rationale 1: Furosemide (Lasix) is the diuretic used to aid in excretion of calcium.Thiazide diuretics (hydrochlorothiazide) decrease calcium excretion and should not be given to the hypercalcemic client. Mannitol (Osmitrol) is a diuretic used to decrease cerebral edema and is not routinely used to aid in excretion of calcium. Spironolactone (Aldactone) is a potassium-sparing diuretic and would not be effective for excretion of calcium.

A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment?

• Hematuria, bacteriuria, weight gain
• Gross hematuria, albuminuria, fever
• Massive proteinuria, hypoalbuminemia, edema
• Hypertension, weight loss, proteinuria - CORRECT ANSWER: Answer: 3

Rationale 1: Nephrotic syndrome is an alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. It is characterized by massive proteinuria, hypoalbuminemia, and edema. While hematuria and hypertension may be present, they are not pronounced. Gross hematuria and hypertension are associated with glomerulonephritis. Bacteriuria and fever are associated with a urinary tract infection. Because of the edema, a weight gain, not a weight loss, would be seen.

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A child is being treated for dehydration with intravenous fluids. The child currently weighs 13 kg and is estimated to have lost 7 percent of the normal body weight. The nurse is double-checking the IV rate the practitioner has ordered. The formula the practitioner used was for maintenance fluids: 1000 mL for 10 kg of body weight plus 50 cc for every kg over 10 for 24 hours. Replacement fluid is the percentage of lost body weight 10 per kg of body weight. According to the calculation for maintenance plus replacement fluid, this childs hourly IV rate for 24 hours should be ____ mL. Round the answer to the nearest whole number. - CORRECT ANSWER: Answer: 86 Rationale: Maintenance need for 13 kg is 1000 + (50 3), or 1150 mL/24 hours. Add to this the replacement-fluid loss = 7 (percent of total body weight lost) 10 = 70 mL/kg/24 hours (70 13 = 910). 1150 + 910 = 2060 for 24 hours. 2060/24 = 86 mL per hour.

A child is diagnosed with epilepsy and is prescribed daily phenytoin (Dilantin). Which topic is most appropriate for the nurse to include in the discharge teaching?

• Increasing fluid intake
• Performing good dental hygiene
• Decreasing intake of vitamin D
• Taking the medication with milk - CORRECT ANSWER: Answer: 2

Rationale 1: Because phenytoin (Dilantin) can cause gingival hyperplasia, good dental hygiene should be encouraged. Fluid intake does not affect the drugs effectiveness, an adequate intake of vitamin D should be encouraged, and phenytoin (Dilantin) should not be taken with dairy products.

A child is prescribed hemodialysis for the treatment of kidney failure. When providing care for this child, what will the nurse monitor for during the assessment?

Standard Text: Select all that apply.

• Shock
• Hypotension
• Infections
• Migraines
• Fluid overload - CORRECT ANSWER: Answer: 1,2,3

Rationale 1: Rapid changes in fluid and electrolyte balance during hemodialysis may lead to shock and hypotension. Other complications to watch for are thromboses and

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