NURS 3444 PEDS EXAM2 NEWEST 2025 ACTUAL EXAM AND PRACTICE EXAM QUESTIONS& CORRECT ANSWERS, Exams of Nursing

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NURS 3444 PEDS EXAM2 NEWEST 2025

ACTUAL EXAM AND PRACTICE EXAM

QUESTIONS AND DETAILED CORRECT

ANSWERS | A+ STUDYGUIDE

A 5-year-old child weighs 18 kg. The child's urine output has been 175 mL for the past 12 hours. This indicates which of the following? Too little urine output Adequate urine output Excessive urine output It is impossible to calculate adequacy of urine output for a 5 - year-old child Correct Answer Adequate urine output Which is the most common virus causing diarrhea in children? e. coli rotavirus shigela epstein-barr Correct Answer rotavirus

The nurse is caring for an 18-month-old with rotavirus. Which of the following clinical manifestations would the nurse expect to observe? Severe abdominal cramping and bloody diarrhea Mild fever and vomiting followed by onset of watery stools Colicky abdominal pain and vomiting High fever, diarrhea, and lethargy Correct Answer Mild fever and vomiting followed by onset of watery stools Fentanyl and midazolam are given before debridement of a child's thermal wounds. These drugs are important to: minimize infection risk. decrease debridement needed. provide adequate pain relief. facilitate skin healing. Correct Answer provide adequate pain relief. The parents take A.P. home to treat her. Which statement by A.P.'s mother would help make A.P. the most comfortable during this treatment period?

A) "Here is the shampoo. Be sure to scrub your head for several minutes." B) "We can pretend you're at the beauty parlor! Lean back while I wash your hair." C) "I sure hope this works. I never thought this would happen!" D) "It might be best to go ahead and cut your hair. It will grow back quickly." Correct Answer B) "We can pretend you're at the beauty parlor! Lean back while I wash your hair." A.P.'s mother calls you to ask what complications may occur with the head lice infestation. Which answer is correct? A) "Head lice may transmit certain viral illnesses." B) "Head lice are not known to transmit disease." C) "Head lice are common carriers of impetigo." D) "It is common to have a ringworm infection after a case of head lice." Correct Answer A) "Head lice may transmit certain viral illnesses." While waiting for a physical exam from the physician, the mother of a 4-month-old female begins changing a soiled diaper. The nurse notes a reddened diaper area on the baby. Which of the following interventions would be most appropriate in this situation? A) Say nothing, as the mother appears comfortable with diaper care.

B) Ask the mother what care she provides to the diaper area during routine diaper changes. C) Report the red area to the physician. D) Give the mother a pamphlet on diaper rashes as she leaves the office. Correct Answer B) Ask the mother what care she provides to the diaper area during routine diaper changes. Descriptions of young people with anorexia nervosa (AN) often include which of the following? Impulsive Extroverted Perfectionist Low achieving Correct Answer Perfectionist Nutritional management of the child with Crohns disease includes a diet that has which of the following components? High fiber Increased protein Reduced calories Herbal supplements Correct Answer Increased protein

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. The therapeutic plan initially includes: bowel cleansing. dietary modification. structured toilet training. behavior modification. Correct Answer bowel cleansing. Calculate the hourly IV maintenance in ml for a 30lb child. Correct Answer Correct 49 Answer range +/- 2 (47 - 51) A 2-month-old infant with a fever and watery diarrhea for 3 days is brought to the pediatric clinic. What instruction would not be part of the nursing discharge teaching? Admit to the hospital for observation Provide frequent feedings Count number of diaper changes per day Call the office if the infant becomes lethargic Correct Answer Admit to the hospital for observation

The parent of a 2-year-old child asks you what precautionary measures can be taken at home to help prevent accidental poisonings. You know that the parent requires further instructions when he makes which of the following comments? "I will have the Poison Control Center phone number available at every phone." "I will lock up all medications, household cleaners, and other potentially poisonous substances." "I will check for poisonous houseplants and remove them from the home or place them out of my child's reach" "I will have syrup of ipecac available at home and administer it to my child if he swallows any type of poison." Correct Answer "I will have syrup of ipecac available at home and administer it to my child if he swallows any type of poison." Response Feedback: Options 1, 2, and 3 are all appropriate responses. Syrup of ipecac should only be administered for specific types of poisoning because its use is contraindicated for corrosive agents, hydrocarbons, and some oral medications. Therefore, the parent must call the Poison Control Center or 911 and receive instructions to administer the syrup of ipecac.

Which of the following most accurately describes bowel function in children born with an imperforate anus? Incontinence cannot be prevented. Enemas and laxatives are contraindicated. Some degree of fecal continence can usually be achieved. Colostomy is usually required during surgical repair of anus. Correct Answer Enemas and laxatives are contraindicated. When giving instructions to a parent whose child has scabies, the school nurse should include: treat all family members if symptoms develop. be prepared for symptoms to last 2 to 3 weeks. carefully treat only those areas where there is a rash. notify practitioner so an antibiotic can be prescribed. Correct Answer treat all family members if symptoms develop. ABG's: pH 7.28 PCO2 62 mm Hg HCO3- 23 mEq/L Respiratory acidosis Respiratory alkalosis

Metabolic acidosis Metabolic alkalosis Correct Answer Respiratory acidosis The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. Which of the following findings would the nurse expect to observe? Select all that apply. Scaphoid abdomen Mediastinal shift Inguinal swelling Moderate respiratory distress Loud, harsh murmur Correct Answer Scaphoid abdomen Mediastinal shift Moderate respiratory distress When performing a health screening on a 9-year-old male with mental retardation, you note that his weight is in the 98th percentile. When questioning the child and mother on his nutrition and exercise habits, the mother states that she does not allow her son to run and play because she is afraid he will be injured. Your teaching plan for the child and mother will be based on the fact that children with mental retardation:

Require a strict nutritional plan because they will not benefit from physical activities in the management of weight. Are unable to engage in exercise or play activities because of their lack of coordination. Have the same need for exercise and play as other children and it is beneficial to their health. Do not enjoy engaging in physical activities or participating in sports activities. Correct Answer Have the same need for exercise and play as other children and it is beneficial to their health. Response Feedback: Children with mental retardation need to exercise and play just as any other child does. Exercise and play is beneficial to the cardiovascular system, coordination, and weight control, as well as the promotion of socialization. Emphasize that activities should be appropriate to the child's physical and developmental maturity. A mother telephones the nurse at her child's primary health-care provider and states, "My child spilled my coffee on her arm. About one-half of the forearm is red, and there are 2 or 3 blisters that have developed. What should I do?" Which of the following is the best response for the nurse to give?

"Run cool water over the burned area and then call me back." "Apply ice to the blisters for ten minutes on and ten minutes off." "Proceed to the emergency department for a complete assessment." "Cover the burned area with petroleum jelly and sterile bandages." Correct Answer "Run cool water over the burned area and then call me back." An infant has been born with an esophageal atresia and tracheoesophageal fistula. What is a priority preoperative nursing diagnosis? Risk for Aspiration Related to Regurgitation. Acute Pain Related to Esophageal Defect. Ineffective Infant Feeding Pattern Related to Uncoordinated Suck and Swallow. Ineffective Tissue Perfusion: Gastrointestinal, Related to Decreased Circulation. Correct Answer Risk for Aspiration Related to Regurgitation. ABG's: pH 7.28 PCO2 62 mm Hg HCO3- 23 mEq/L Respiratory acidosis

Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Correct Answer Respiratory acidosis Physiologically, the child with a major burn compensates for fluid volume losses by which of the following mechanisms? Inhibition of aldosterone secretion. Hemoconcentration to reduce cardiac workload. Vasodilation of periphereal arterioles to increase perfusion. Fluid shift from interstitial space to intravascular space. Correct Answer Fluid shift from interstitial space to intravascular space. Match emergency treatments to type of poisoning: Question Correct Match Selected Match Hydrocarbons - (Gasoline) Intubate, gastric decontamination, prevent vomiting, decontaminate skin Salicytic acid (Aspirin)

Activated charcoal, gastric lavage, sodium bicarbonate, Vitamin K Corrosives (batteries, bleach) Dilute toxin with water to prevent further damage, airway maintenance, NPO, prevent vomiting, analgesics for pain Iron Induce vomiting, gastric lavage, chelation therapy Tylenol N-acetylcysteine (Mucomyst), activated charcoal A nurse instructs a parent of a preschooler to use the "five-a-day" rule for feeding the preschooler, a rule that relates to: Fruits and vegetables. Milk and milk products. Breads and cereals Chicken and at least two servings of red meat per week. Correct Answer Fruits and vegetables. Response Feedback: Five servings of fruits and vegetables each day are needed for toddlers and preschoolers to help boost the

immune system, provide regular bowel patterns, and promote healthy hair and nails. Whenever the parents of a 10-month-old leave their hospitalized child for short periods, he begins to cry and scream. The nurse explains that this behavior demonstrates that the child: Needs to remain with his parents at all times. Is experiencing discomfort. Is extremely spoiled. Is experiencing separation anxiety. Correct Answer Is experiencing separation anxiety. The nurse is educating a new mother of a child born with both a cleft lip and a cleft palate regarding formula feeding. Which of the following actions should the nurse include in her teaching session? Select all that apply. Instruct the mother to add rice cereal to the formula. Advise the mother to hold the baby in an upright position during feedings. Advise the mother to feed the baby slowly to allow the baby time to swallow and to rest.

Encourage the mother to cup feed her baby rather than to bottle feed. Correct Answer Advise the mother to hold the baby in an upright position during feedings. Advise the mother to feed the baby slowly to allow the baby time to swallow and to rest. A bottle-fed infant, age 3 months, is brought to the NP's office for a well-child visit. During the previous visit, the RN taught the parent about infant nutritional needs. Which statement by the parent during the current visit indicates effective teaching? "I started putting cereal in the bottle with formula because the baby kept spitting it out." "I'm giving the baby skim milk because he seemed to be getting so chunky and fat-free milk is good." "I started the baby on cereals and fruits because he wasn't sleeping through the night." "I'm giving the baby iron-fortified formula and a fluoride supplement because our water isn't fluoridated." Correct Answer "I'm giving the baby iron-fortified formula and a fluoride supplement because our water isn't fluoridated." A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet with the family. Which of the following may be tolerated the best?

Clear fluids Carbonated drinks Applesauce and milk Easily digested foods Correct Answer Easily digested foods A child with Hirschsprung's disease is being discharged after SOAVE-SWENSON-DUHAMEL.gif for colostomy closure. Which of these measures should the nurse include in the home care plan? Refer the parents to an enterostomal therapist for ostomy care. Teach parents how to perform weekly rectal irrigations. Teach parents signs and symptoms of infection. Teach parents PCA pain-control methods. Correct Answer Teach parents signs and symptoms of infection. Calculate the hourly IV maintenance in ml for a 30lb child. Correct Answer Correct 49 Answer range +/- 2 (47 - 51) Response Feedback: Child weighs 30 lb divided by kg conversion of 2.2 is 13.63kg

100 x 10 for 1st 10 kg of body weight = 1000 50 x 3.63 for 2nd 10 kg of body weight = 3.63 X 50 = 181. 5 1000 + 181.5 = 1181.5 ml/24 hr 1181.5/24 = 49. ABG's: pH 7.48 PCO2 39 mmHg HCO3 - 31mEq/L Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis Correct Answer Metabolic alkalosis A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. The nurse should explain that: this cannot be prevented. infants do not feel pain as adults do. this is not a good reason for refusing immunizations.

a topical anesthetic, EMLA, can be applied before injections are given. Correct Answer a topical anesthetic, EMLA, can be applied before injections are given. Which are the following are common findings in a child presenting with appendicitis? heartburn, difficulty swallowing, chronic cough vomiting occuring 30-60 mintues after eating, olive shaped mass in right upper quadrant, failure to gain weight and dehydration normal comfort interrupted by sudden episodes of acute pain, palpable, sauage-shaped mass in right upper quadrant, stools that are mixed with blood and mucus generalized abdominal pain that typically begins in the peri-umbilical area and localizes at McBurney's point Correct Answer generalized abdominal pain that typically begins in the peri-umbilical area and localizes at McBurney's point Calculate the hourly IV rate for a 34 lb child who is receiving IV fluid at 1 1/2 maintenance rate. Correct Answer Correct 79 Answer range +/- 2 (77 - 81) Clinical manifestations of sodium excess (hypernatremia) include which of the following?

Hyperreflexia Abdominal cramps Cardiac dysrhythmias Dry mucous membranes Correct Answer Dry mucous membranes Match GI bleeding chacteristics Rectal bleeding: Ulcerative colitis "Coffee grounds" emesis: Esophagus Melana: Meckel's diverticulum Currant jelly-like stools: Intussusception Pus and mucous diarrhea: Crohns Disease What does clubbing of nails indicate? Correct Answer Chronic respiratory illness.

Results from increased capillary growth as body attempts to supply more oxygen to distal body cells. What are the most common causes of illness and hospitalization in children? Correct Answer Respiratory disorders When is allergen-related respiratory disease most prevalent? Correct Answer Spring Variations in the Nose of an Infant: Correct Answer Preferential nose breathers until 4 weeks of age. Nares must be patent for breathing to be successful with feeding.

• Will only breathe through mouths when crying Small passages = easier for obstruction due to excess mucus Born with maxillary and ethmoid sinuses.
• Less apt to developing sinus infections because frontal and sphenoid sinuses develop from 6-8 years What happens to the upper respiratory mucus in infants? Correct Answer Newborns have very little mucus, which serves as a cleansing agent. This makes them more susceptible to infection. Throat of an Infant: Correct Answer Larger than adults.

Posterior displacement of tongue can lead to severe airway obstruction. Enlarged tonsillar and adenoidal tissue, which leads to increased incidence of airway obstruction. Trachea in Infants: Correct Answer Airway lumen is smaller in infants. Small reduction in diameter of airway will result in exponential increase in resistance to airflow, which leads to increased work of breathing. Cricoid cartilage is underdeveloped, which leads to laryngeal narrowing.

• Funnel shaped
• Larynx and glottis is higher in neck, which increases risk for aspiration into lower ariways Trachea in Teenagers: Correct Answer Larynx is cylindrical and uniform in width. What is congenital laryngomalacia? Correct Answer Resolves by 1 y/o because cartilage improves as larynx matures. Contributes to weaker upper airway structure --> may lead to greater collapse on inspiration

Characteristics of Congenital Laryngomalacia: Correct Answer Inspiratory stridor is present and intense. Suprasternal retractions are present, but no other signs of RDS. Crowing noise is heard with breathing. Intensified stridor will be sign of worsening condition and should be evaluated early. What can happen due to a child's highly compliant airway? Correct Answer Susceptible to dynamic collapse in presence of airway obstruction. Muscles supporting airway are less functional than in adults. Large amount of soft tissue surrounding trachea and mucous membranes lining airway are less securely attached.

• Increases risk for airway edema and obstruction What can result in tracheal collapse during inspiration? Correct Answer - Foreign body
• Croup
• Epiglottitis Where does the bifurcation of the trachea occur in children? Correct Answer The third thoracic vertebra in children.

This will increase risk for foreign material aspiration. Important difference when suctioning children and doing an endotracheal intubation. What do the bronchi and bronchioles in children look like? Correct Answer Narrower in diameter, which places them at risk for lower airway obstruction. Alveoli in Children: Correct Answer Developed at 24 weeks gestation. 150 million to 300 million alveoli (8 y/o). With preterm infants, smaller numbers of alveoli will place child at risk for hypoxemia and carbon dioxide retention. What does the chest function like in an infant? Correct Answer Chest walls are highly compliant (pliable) and fail to support lungs adequately. Functional residual capacity is reduced if respiratory effort is diminished. Lack of lung support makes tidal volume dependent upon movement of diaphragm.

• If impaired, intercostal muscles cannot lift chest wall and respiration is compromised

Metabolic Rate in Children: Correct Answer Higher in children. Oxygen Need for Children: Correct Answer Resting respiratory rate is faster and demand for oxygen is higher. Infants consume 6-8 liters per minute. Will develop hypoxemia more rapidly than adults. What is atopy? Correct Answer Genetic tendency toward asthma, allergic rhinitis, and atopic dermatitis. What inquiring about history of present illness for respiratory disorders, what should the nurse ask about? Correct Answer - Onset and progression

• Fever
• Nasal congestion
• Noisy breathing
• Cough
• Rapid respirations
• Work of breathing
• Second-hand smoke
• Environmental smoke exposure What is pallor? Correct Answer Pale appearance; peripheral vasoconstriction in effort to conserve oxygen for vital functions. Circumoral cyanosis: Correct Answer Blue tint around mouth --> may progress to central cyanosis

What is a true sign of hypoxia? Correct Answer Central cyanosis What is often the first sign of respiratory illness in infants? Correct Answer Tachypnea How does oxygen need and metabolic rate affect the hemoglobin saturation curve? Correct Answer Alkalosis and hypothermia (lower metabolic rate), hypocarbia, and anemia shift LEFT. Acidosis, hyperthermia, and hypercarbia will shift the curve RIGHT. When inspecting the nose and oral cavity, what should you look for? Correct Answer - Color of pharynx

• Presence of exudate
• Tonsil size
• Status and presence of lesions What is grunting? Correct Answer Occurs on expiration. Produced by premature glottis closure. Attempt to preserve or increase functional residual capacity. May occur with alveolar collapse (atelectasis), pneumonia, and pulmonary edema.

What is stridor? Correct Answer High-pitched, audible inspiratory noise. Sign of upper airway obstruction. What is paradoxical breathing? Correct Answer Seesaw. Chest falls on inspiration and rises on expiration. Lack of simultaneous chest and abdominal rise with inspiratory phase. How do you assess hydration status in infants? Correct Answer - Palpate fontanels

• Assess oral mucosa for color and moisture
• Note skin turgor, presence of tears, and urine output Is child with respiratory illness at risk for dehydration? Correct Answer Yes, due to soreness or mouth lesions. What does nasal congestion interfere with? Correct Answer Ability to suck effectively on breast or bottle. What does tachypnea and increased work of breathing interfere with? Correct Answer Ability to safely ingest fluids. Palpation for Respiratory: Correct Answer - Palpate sinuses of older child
• Assess for enlargement or tenderness of lymph nodes
• Documents fremitus (intensity of vibrations on lungs)