Peds Exam 3 1- A 5 y.o male diagnosed with mild dehydration should be given Oral Rehydration Solution (ORS) by the nurse or parent with which of the following rehydration therapy?(Mild ORS, 50 Ml/Kg within 4 hrs, Moderate 100 ml/Kg within 4 hr, Severe 40 mL/kg/hr IV until pulse and states of consciousness return to norm; then 50-100 mL/kg ) 50 ml/kg/ 4 hrs 2- The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included?-Assess for signs of increased intracranial pressure 3- A child with pyloric stenosis is having excessive vomiting. Which of the following is a potential complication?-Metabolic alkalosis 4- A 2-year-old is brought the peds ER following a generalized tonic clonic seizure that lasted 2 minutes. It terminated without any treatment. Her temperature was measured as 39.5°C. She has a two-day history of feeling unwell. She has never had such a seizure before. What is the most appropriate management plan for this child? (Select all that apply) -Reassure parents, discharge home and safety teaching -Child will probably be discharged home with anti-pyretic medication 5- A newborn female infant in the NICU has signs of ambiguous genitalia, and hyponatremia.Which of the following is the infant's likely diagnosis?-Congenital Adrenal Hyperplasia 6- A young girl has just injured her ankle at school. After notifying the child's parents and applying ice to the area, what is the next most appropriate action by school nurse?-Elevate the extremity to reduce edema formation 7- A child with a fracture of the humerus has a long arm cast. Which of the following signs are assessed to determine tissue ischemia or compartment syndrome?-Pulselessness 8- The nurse is assessing an infant with intussusception. Which of the following clinical findings should the nurse expect? (Select all that apply) -Stool mixed with blood and mucus -Palpable sausage shaped abdominal mass -Acute abdominal pain 9- The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching?
- “I should gently massage the skin under the straps once a day to stimulate
circulation." 10- In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information?-Have siblings examined for VUR 11- What statement is true concerning osteogenesis imperfecta (OI)?-Disease characterized by fractures and bone deformity 12- Which of the following conditions has the clinical manifestation of Exophthalmos (protruding eyeballs)?-Hyperthyroidism 13- A 12 yr old child is admitted to the PICU in acute renal failure (ARF). The nurse prepares to administer which of the following medication to rapidly provoke of urine?-Mannitol (osmitrol)/Furosemide (Lasix) or both PEDS EXAMs /Test bank for Wong's Nursing Care of Infants and Children 11th Edition by Hockenberry | Study Guide 1 / 4
14- The nurse is assisting with application of a synthetic cast on a child with a fractured humerus.What is an advantages of a synthetic cast over a plaster of Paris cast?-Lightweight, and less bulky/Drying time is faster/permits regular clothing to be worn/can be cleaned with small amount of soap and water 15- An adolescent with diabetes is admitted to the ER for treatment of hyperglycemia and pneumonia. What are clinical manifestations of diabetic hyperglycemia?-Increased appetite, fatigue, thirst/frequent urination(Polyuria, Polyphagia, Polydipsia) 16- A child with juvenile idiopathic arthritis (JIA) is started on a non-steroidal anti-inflammatory drug (NSAID). What nursing consideration should be included?-Check for abdominal pain and bloody stools 17- A 5 year old male is diagnosed with diarrhea and mild dehydration. Which of the following Oral Rehydration Solution (ORS) should be given by the nurse or parent to replace the stool losses?(Mild/Moderate/Severe all same 150-250 ml each stool, Infant 10ml/kg) -150-250 ml each stool (MILD) 18- Which of the following urine tests would be considered abnormal?(Norm 1.001-1.035) -Specific gravity 1.040 19- After a pyloromyotomy, a week old infant is prescribed feedings of 1 to 2 oz of Pedialyte every 3 hours then advance to breastmilk as tolerated postoperatively. The nurse should advance the feeding if which occurs?-The infant is taking the Pedialyte without vomiting or distention 20- Children with steroid induced Cushing syndrome should receive their medication at which of the
following times to lessen the Cushingoid features? Give the drug:
-Early in the morning upon awakening 21- Alport Syndrome is a X linked hereditary disease characterized by which of the following? (Select all that apply)(Hematuria, high-frequency deafness, ocular disorders, chronic renal failure, & proteinuria) -High tone sensorineural deafness -Chronic kidney disease -Ocular disorders 22- What statement is an advantage of peritoneal dialysis compared with hemodialysis?-It is easy to learn and can be done at home 23- A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. Which of the following is the most appropriate nursing action related to feeding Jason?-Stabilize his jaw with caregiver's hand to facilitate swallowing 24- A 10 yr old child is admitted with a hx of Crohn disease. The child's plan of care should include a diet that has which of the following component?-Increased calories/(Increased protein) 25- A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?-Skin and stoma care 26- A nurse is teaching clients in an outpatient facility about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to
expect a peak effect 2 to 4 hr after administration:
-Short acting Regular 2 / 4
27- Which of the following medications the nurse may need to administer for the initial management of children in presumed status epilepticcus?-Diazepam 28- The health care provider has prescribed sulfasalazine (Azulfidine) 5 mg/kg PO per dose twice a day for a child with juvenile arthritis. The child weighs 55 lb. The nurse is preparing to administer the 0900 dose. Calculate the dose the nurse should administer in milligrams -125 mg 29- 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 30- Which of the following parameters would the nurse monitor to evaluate the initial effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)?-Vomiting 31- At which of the following ages is recommendation made by the American Academy of Pediatrics (AAP), for pre-adolescent and adolescent males to be screened for Scoliosis? (female 10-12)
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32- The pediatric nurse is assessing the vital signs of a 5-year-old with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe?-Soft, subcutaneous lipomas 33- A 3 yr old is admitted to the peds unit with minimal change nephrotic syndrome. What clinical manifestations are usually seen with this diagnosis?-Massive proteinuria, hypoalbuminemia, and edema 34- A 4 yr old is seen in the peds ER, and the nurse suspects Diabetic ketoacidosis (DKA). What are characteristics of DKA? (Select all that apply) -Dehydration -Tachypnea -Acidosis -Electrolyte imbalance 35- The pediatric version of the Glasgow Coma Scale is used on a 3 year old male after falling from a tree in his back yard. A score of 15 on his chart is associated with?-Unaltered level of consciousness 36- 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 37- A 15 year-old male presents to his provider with a three-month history of a right hip pain. On examination of the hip, there is reduced range of motion in flexion and abduction with associated pain and a limp. You note the patient has a BMI of 27. What is the most likely diagnosis?-Slipped Capital femoral epiphysis 38- A 3 year old child has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this infant's fracture is how long?-4-5 weeks 39- A 12-year old boy, is brought to the peds ER after falling off a trampoline and hitting his head.His mother tells you that his arms started to twitch for a few seconds, but he did not lose consciousness. Which of the following best describes this event?A Myoclonic seizure 3 / 4
40- A 2 yr old female has been diagnosed with Celiac Disease. Which of the following foods should the peds nurse educate the parents to avoid giving this child? (Select all that apply) (Ans. Wheat, Barley, Rye, Oat) -Wheat/ Oat/Rye 41- A 4 week old infant has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this infant’s fracture is how long?-2-3 weeks 42- A 13 y.o male has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this adolescent’s fracture is how long?8-12 weeks 43- The nurse is preparing to admit a 7-year-old child with Crohn disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.)
Ans: (Weight loss is Severe, Pain is common, Diarrhea is moderate to severe)
-Pain is common -Diarrhea moderate to severe 44- A 10yr old child is seen in the peds clinic with watery for 2 days followed by bloody diarrhea. The Pediatric Nurse suspects the causative pathogen for this child's diarrhea is which of the following?-E-Coli 45- 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?(Spica cast at 7 months/Pavlik 6 months and under) -Gently massage skin under the straps once a day to stimulate circulation 46- Which of the following conditions is Intranasal desmopressin acetate (DDAVP) used to treat?-Diabetes insipidus (DI) (Drug of choice—DDAVP, Nasal spray or IM or SQ administration, Requires treatment for life) 47- A 6 yr old seen in the pediatric renal clinic was observed by the nurse with the following symptoms before labs or any diagnostics were done: Periorbital edema, hypertension, decreased urinary output and tea colored urine/(smoky urine). Relative to the symptoms, the nurse knows the child needs to be evaluated for the possibility of which disease process?-Acute Glomerulonephritis (Caused by untreated strep) 48- A 2-year-old child has simple constipation and is brought to the clinic for evaluation. The
therapeutic plan initially includes:
-Dietary modification 49- What is a common clinical manifestation of juvenile hypothyroidism?Ans:(Decelerated growth, Constipation, Sleepiness, Myxedematous skin changes/dry skin/sparse hair/periorbital edema) -Sleepiness 50- A peds nurses taking the history of a child hospitalized with Reye syndrome. Which of the following is a common occurrence seen in patients with Reye Syndrome?-Fatty Liver 51- The nurse is assessing a 4 year old boy in the pediatric clinic. Which behaviors by the client would concern the nurse for possible Duchenne muscular dystrophy? (Select that apply) Ans: (Waddling gait, frequent falls, Gower sign, Lordosis, Enlarged muscles, especially thighs and upper -Frequent trips and falls at home -Has disproportionately large calves, and a waddling gait -Demonstrates the Gower sign (Places hands on thighs to push up to stand)
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