Peds Exam 1
Total Questions : 63
Showing 25 questions, Sign in for moreWhich immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis?
Explanation
a) Measles, mumps, rubella (MMR): Does not directly protect against epiglottitis.
b) Diphtheria, tetanus, pertussis (DTaP): While important for other diseases, does not directly prevent epiglottitis.
c) Hepatitis B: Provides immunity against hepatitis B, not epiglottitis.
d) Hemophilus influenzae type B (Hib): Protects against the bacteria responsible for epiglottitis.
A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to the pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is most appropriate?
Explanation
a) Constipation: Not typically a primary symptom of cystic fibrosis.
b) Meconium ileus: Digestive signs and symptoms of cystic fibrosis include foul-smelling, greasy stools, poor weight gain and growth, and intestinal blockage, particularly in newborns (meconium ileus)
c) Rectal prolapse: Can be related to cystic fibrosis but is not as specific as other symptoms.
d) Steatorrhea stools: Frequent fatty stools are symptoms of the disease but not specific to cystic fibrosis.
Which breath sounds indicate the infant is experiencing respiratory distress? (Select All That Apply: SATA)
Explanation
a) Eupnea: Normal breathing rate and pattern, not indicative of distress.
b) Apnea: Cessation of breathing, a sign of significant distress.
c) Tachypnea: Rapid breathing, often seen in respiratory distress.
d) Wheezing: High-pitched, musical sounds during expiration, suggesting airway obstruction.
e) Grunting: Heard during expiration, a sign of the body's attempt to keep air in the lungs, indicating distress.
f) Retractions: Visible sinking of tissues between ribs or at the sternum, indicating increased effort to breathe, a sign of distress.
An infant has had recurrent respiratory infections. The mother of the child expresses concern that the infant seems to be at increased risk for complications from respiratory infections in comparison with her older children. Which response by the nurse would be most appropriate?
Explanation
a) The younger child’s airways are smaller and more easily occluded: Children, especially infants, have smaller airways, making them more susceptible to blockage during infections.
b) You are incorrect in your assessment: This response dismisses the mother's concern without providing information.
c) Air passages are more likely to become blocked with mucus due to increased mucus production in young children: While increased mucus production can be a factor, the size of airways is a more critical consideration.
d) Infants are not able to breathe deeply: Not an accurate statement; infants have a different breathing pattern but can breathe adequately.
A 4-year-old girl is brought to the emergency department. She has a ‘frog-like’ croaking sound on inspiration, is agitated, and drooling. She insists on sitting upright. The nurse should do which of the following?
Explanation
a) Make her lie down and rest quietly: Inappropriate as the symptoms suggest potential airway obstruction.
b) Examine her oral pharynx and report to the physician: Important action, but immediate airway management is the priority.
c) Auscultate her lungs and prepare for placement in a warm mist tent: Less critical than ensuring an open airway.
d) Defer an oral assessment and be prepared to assist with a tracheostomy or intubation: The child's symptoms (stridor, agitation, drooling) indicate potential upper airway obstruction, and immediate readiness for airway intervention is essential.
A 3-year-old with bacterial pneumonia is crying and says it hurts when he coughs. The nurse would teach the child to do which of the following?
Explanation
a) Hug his teddy bear when he coughs: Splinting the chest while coughing can reduce discomfort.
b) Blow bubbles to prevent coughing episodes: Not effective for reducing cough-induced pain.
c) Take a sip of apple juice before coughing: Drinking before coughing may not significantly alleviate the discomfort.
d) Ask for codeine cough syrup when he coughs: Medication should be given based on medical advice and prescription, not as a self-request by a child.
A nurse delegates the task of neonatal vital sign assessment to a nurse technician. Which instruction will the nurse give to the technician prior to assigning care?
Explanation
a) Do not report any pause in respiration unless it's greater than 20 seconds: This instruction might delay the recognition of potential respiratory distress in a neonate.
b) Report any neonate with nasal flaring: While nasal flaring can be a sign of respiratory distress, it might not be the most critical parameter to report in this scenario.
c) Report any pause in respiration greater than 10 seconds: In neonatal care, shorter durations of apnea can be significant and should be reported promptly for evaluation.
d) Report any respiratory rate of 40 or greater: A higher respiratory rate alone might not be as critical as the presence of significant pauses in respiration in a neonate.
An anxious and irritable preschooler arrives in the ER, refusing to lie down to be examined. The child sits, leans forward in onto the hand, and drools saliva. The child is warm to the touch, is using accessory muscles to breath, and pale in color. The nurse should: Place in the correct order from highest to lowest priority (assume you can only do one at a time).
Explanation
1. Prepare for intubation
2. Notify the physician
3. Start an IV
4. Draw blood gasses
5. Take the child's vital signs
An adolescent was diagnosed with cystic fibrosis as an infant, at this time, the nurse anticipates that the adolescent will need additional teaching related to which of the following?
Explanation
a) Obtaining a sweat chloride test: Likely already part of routine monitoring for cystic fibrosis.
b) Reproductive ability: Adolescents with cystic fibrosis may need education regarding how their condition can affect fertility.
c) The effect of pancreatic enzymes on sex hormones: Not a commonly discussed aspect in cystic fibrosis care.
d) Increased need for weight reduction diet: Weight maintenance or specific diets to promote weight gain are more commonly addressed in cystic fibrosis care.
Which of the following are characteristics seen in bronchiolitis and RSV? (Select All That Apply . )
Explanation
a) Airway swelling: Seen in both bronchiolitis and RSV due to inflammation.
b) Barking cough: More commonly associated with croup, not typically a prominent feature in bronchiolitis or RSV.
c) Increased mucus: Both conditions involve increased mucus production.
d) Bronchospasm: Present in both bronchiolitis and RSV due to airway irritation.
e) Air trapping: Can occur in both conditions due to the airway obstruction and inflammation
You are caring for a 14-year-old patient in the ER following a motor vehicle accident. The patient is exhibiting moderate respiratory distress, with decreasing LOC and becoming hypotensive. On chest X:ray, there is air in the pleural space with tracheal deviation. You suspect which condition?
Explanation
a) Pulmonary constriction: Typically, not associated with tracheal deviation or air in the pleural space.
b) Smoke inhalation injury: Unlikely to cause tracheal deviation or air in the pleural space.
c) Pneumonia: Does not typically cause tracheal deviation or immediate hypotension.
d) Tension pneumothorax: Presents with air in the pleural space, tracheal deviation, respiratory distress, decreasing LOC, and can lead to hypotension due to compromised circulation.
A child has epistaxis while at school. Which intervention by the school nurse is appropriate?
Explanation
a) Immediately packing the nares with cotton with neo-synephrine: Packing the nose immediately is not usually recommended as a first aid measure and should be done by a healthcare professional.
b) Tilting the child’s head forward, squeezing below the nasal bone, and applying ice to the nose: Correct first aid for epistaxis involves tilting the head forward to prevent swallowing of blood, applying pressure below the nasal bone, and using ice to constrict blood vessels.
c) Tilting the child’s head back, squeezing the bridge of the nose, and applying a warm pack to the nose: Tilting the head back can cause blood to flow down the throat and potentially lead to swallowing or choking on blood.
d) Lying the child down and applying a warm pack: Lying down may increase the risk of swallowing blood and should be avoided during a nosebleed.
A nurse is caring for a younger child with otitis media. The parents ask the nurse why children seem to get otitis media frequently, but adults do not. Which statement about the physiological differences between young children and adults would the nurse provide?
Explanation
a) The eustachian tube is longer, wider, and more vertical in younger children: Inaccurate; a more vertical tube might be less prone to drainage issues.
b) The eustachian tube is longer, narrower, and more vertical in younger children: The opposite configuration of the pediatric eustachian tube.
c) The eustachian tube is shorter, wider, and more horizontal in younger children: The anatomy of the pediatric eustachian tube predisposes children to ear infections due to poor drainage and ventilation.
d) The eustachian tube is shorter, narrower, and more horizontal in younger children: Inaccurate; this configuration is less prone to issues related to otitis media.
A 14-year-old boy who has experienced frequent ear infections has recently been diagnosed with conductive hearing loss. Which of the following should the clinic nurse assess?
Explanation
a) Oropharynx: While important for general health, in conductive hearing loss, assessing the oropharynx might not directly correlate.
b) Language development: Relevant to assess in the context of hearing loss, but not the most immediate concern in this scenario.
c) Serosanguinous drainage: Typically associated with nasal or ear infections but may not directly relate to conductive hearing loss.
d) Cranial nerve function: Conductive hearing loss can be related to issues in the middle ear or ossicles, making cranial nerve function assessment pertinent to evaluate hearing loss mechanisms.
igns indicating vision impairment in a child (Select All That Apply: SATA):
Explanation
a) Frequent blinking: Can indicate vision strain or discomfort.
b) Imitation of facial expressions: Typically, not directly related to vision impairment.
c) Appropriate eye contact: Good eye contact might be present despite vision impairment.
d) Tilting the head to the side when someone whispers: Could indicate an attempt to better hear or see, potentially indicating vision or hearing issues.
e) Rubbing eyes: Could suggest eye discomfort or vision problems.
Expected symptoms in an infant with pyloric stenosis:
Explanation
a) Projectile vomiting: A hallmark symptom of pyloric stenosis due to the narrowing of the pyloric sphincter, leading to forceful and projectile vomiting.
b) Watery diarrhea: Not typically associated with pyloric stenosis.
c) Increased urine output: Unrelated to pyloric stenosis, urinary output might vary based on other factors.
d) Bloody stools: Typically not a primary symptom of pyloric stenosis, which primarily affects the passage of food from the stomach.
An infant born with an omphalocele defect is admitted to the intensive care nursery. Which instruction from the nurse manager to the unlicensed assistive personal is most appropriate?
Explanation
a) Prepare a warmer: Infants born with omphalocele defects require careful temperature regulation due to potential heat loss through the exposed abdominal contents. Using a warmer helps maintain the infant's body temperature.
b) Prepare a crib: While necessary for the infant, temperature regulation is a more immediate concern.
c) Prepare a feeding of formula: Feeding might be necessary but is not the most urgent need for an infant with an omphalocele.
d) Prepare the bilirubin light: Bilirubin lights are used for treating jaundice, which might not be an immediate concern for an infant with an omphalocele defect.
The nurse is teaching the parents of a child diagnosed with Hepatitis A about care and prevention of transmission. Which of the following statements by the parents indicate more education is needed?
Explanation
a) Handwashing is the most important factor in reducing the spread of the virus: Correct, hand hygiene is crucial in preventing the transmission of Hepatitis A.
b) We understand that early treatments with gamma-globulins can help our child: Correct, gamma-globulin treatment can offer passive immunity.
c) We will clean contaminated surfaces with bleach: Correct, using bleach is effective in disinfecting contaminated surfaces.
d) We should feed our child a high-fat diet: Hepatitis A does not require a high-fat diet. In fact, a low-fat diet is often recommended during the acute phase of the illness to reduce stress on the liver. This statement indicates a need for further education.
What is the cardinal sign a nurse would expect to observe with intussusception?
Explanation
a) Red, currant, jelly-like stools: This is a classic indication of intussusception due to the presence of blood and mucus in the stool, a result of intestinal obstruction and ischemia.
b) Absent bowel sounds: Can occur but are not specific to intussusception.
c) Hematemesis: Vomiting blood is not a characteristic sign of intussusception.
d) Bilious emesis: While indicative of gastrointestinal issues, it's not the cardinal sign of intussusception.
Which food choice is most appropriate for a child who had a tonsillectomy and is now awake and tolerating fluids?
Explanation
a) Cherry jello: Red or colored foods may be mistaken for bleeding post-tonsillectomy, so they are typically avoided initially.
b) Lemonade: Citrus or acidic beverages may irritate the throat post-surgery.
c) Mandarin oranges: Similarly, acidic fruits can cause irritation to the healing throat.
d) Applesauce: It's a smooth and non-irritating option that's commonly recommended post-tonsillectomy as it's gentle on the throat and easy to swallow.
A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia defect. Which equipment does the nurse ensure is prepared at the bedside?
Explanation
a) A large bore needle with Heimlich valve for needle aspiration: Not typically used in the management of diaphragmatic hernia.
b) A chest tube set up: While useful in other situations, it may not be the immediate priority in managing diaphragmatic hernia.
c) Intubation setup: Essential for respiratory support in newborns with diaphragmatic hernia, as it helps manage respiratory distress.
d) Appropriate self-inflating bag and correct mask size: Important for neonatal resuscitation but doesn’t specifically address the respiratory challenges associated with diaphragmatic hernia.
A newborn is diagnosed with Hirschsprung disease. Which clinical manifestations found on assessment support this newborn’s diagnosis?
Explanation
a) Acute diarrhea, dehydration: Not typically associated with Hirschsprung disease, which involves constipation.
b) Failure to pass meconium, abdominal distension: Characteristic signs of Hirschsprung disease due to the absence of ganglion cells in the distal colon, leading to constipation and distension.
c) Gelatinous stools, pain: Uncommon features of Hirschsprung disease.
d) Projectile vomiting, altered electrolytes: These symptoms are not typically seen in Hirschsprung disease; they might indicate other conditions affecting the gastrointestinal tract.
Chelation therapy is an effective treatment for which condition?
Explanation
a) Lead poisoning: Chelation therapy effectively removes heavy metals like lead from the body.
b) Pancreatic infections: Chelation therapy is not a standard treatment for pancreatic infections.
c) Hyperbilirubinemia: Phototherapy or other approaches are used for managing elevated bilirubin levels, not chelation therapy.
d) Aspirin ingestion: Management of aspirin ingestion typically involves supportive care or activated charcoal, not chelation therapy.
A newborn has a stomach capacity of how many mL’s by the end of the first month?
Explanation
a) 90 mL’s: This amount is larger than the typical stomach capacity of a newborn at the end of the first month.
b) 300 mL’s: Exceeds the normal stomach capacity of a newborn at the end of the first month.
c) 30 mL’s: By the end of the first month, a newborn's stomach capacity is around 30 mL's, gradually increasing over time.
d) 150 mL’s: This amount is larger than the normal stomach capacity of a newborn at the end of the first month.
An infant has been born with an esophageal atresia and tracheoesophageal fistula. What is the priority preoperative nursing diagnosis?
Explanation
a) Risk for aspiration related to regurgitation: With esophageal atresia and tracheoesophageal fistula, the risk of aspiration due to the abnormal connection between the trachea and esophagus is a significant concern. Preventing aspiration is a priority.
b) Acute pain related to esophageal defect: Pain might be present but managing the risk of aspiration is more immediate.
c) Ineffective tissue perfusion gastrointestinal related to decreased circulation: While important, preventing aspiration takes precedence.
d) Ineffective feeding pattern related to uncoordinated suck and swallow: A valid concern but not as critical as the risk of aspiration.
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