PEDIATRICS NURSING FINAL EXAM 2023 QUESTIONS WITH CORRECT ANSWERS A+ ASSUARED SUCCESS, Exams of Nursing

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Exam #1:

1. A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of: A. Down syndrome
2. Physiologic measurements in children's pain assessment are:
3. The nurse observes some children in the playroom. Which play situation exhibits the characteristics parallel play? C. Brian playing with his truck next to Kristina playing with her truck
4. Which action is contraindicated when a child with Down syndrome is hospitalized? B. Encourage parents to leave the child alone for extended periods of time.
5. An appropriate nursing intervention to minimize separation anxiety in a hospitalized toddler is to: C. Encourage parents to room in.
6. In which developmental stage is the child first able to localize pain and describe both the amount the intensity of the pain felt? A. Preschool stage
7. When should children with cognitive impairment be referred for stimulation and educational programs? C. As young as possible
8. A nurse is gathering a history on a school-age child admitted for a migraine headache. The child states, "I have been getting à migraine every 2 or 3 months for the last year." The nurse documents this as which type of pain? C. recurrent
9. When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is: D. Congenital heart disease.
10. The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child's parents begin to yell at the nurse about a variety of concerns. The nurse's best response is: D. “Being angry is only natural."

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11. When assessing pain in any child, the nurse should consider that:
12. Latasha, age 8 years, is being admitted to the hospital from the emergency department with an injection from falling off her bicycle. What will help her most in her adjustment to the hospital? A. Explain hospital schedules such as mealtimes.
13. The nurse wore gloves during a dressing change. When the gloves are removed, the nurse short? D. Wash hands thoroughly.
14. Frequent developmental assessments are important for which reason? D. Critical periods of development occur during childhood.
15. The major consideration when selecting toys for a child who is cognitively impaired is: D. safety
16. A child is playing in the playroom. The nurse needs to take a blood pressure on the child. Which is the appropriate procedure for obtaining the blood pressure? C. Ask the child to return to his or her room for the blood pressure, then escort the child back to the playroom.
17. Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs such as Cub Scouts that he might join. The nurse's recommendation should be based on knowing that: C. Children with Down syndrome have the same need for socialization as other children.
18. The head-to-tail direction of growth is referred to as: A. Cephalocaudal
19. A common parental reaction to a child with special needs is parental overprotection. Parental behavior suggestive of this includes: D. Giving inconsistent discipline.
20. Which "expected outcome" would be developmentally appropriate for a hospitalized 4- year-old child.? B. The child will independently ask for play materials or other personal needs.
21. Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by: B. Guilt and anger.
22. A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on the knowledge that routine developmental assessments during well-child visits are: A. The best method for early detection of cognitive disorders.

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23. When pain is assessed in an infant, it is inappropriate for the nurse to assess for: B. Localization of pain.
24. What represents the major stressor of hospitalization for children from middle infancy throughout the preschool years? A. Separation anxiety
25. An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? C. 21
26. The nurse is caring for a child receiving intravenous (IV) morphine for severe postoperative pain. There nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to: C. Administer naloxone (Narcan).
27. The nurse is providing support to parents at the time their child is diagnosed with chronic disability The nurse notices that the parents keep asking the same questions. The nurse should: B. Patiently continue to answer questions.
28. Which myth may interfere with the treatment of pain in infants and children? D. Children and infants are more susceptible to respiratory depression from narcotics.
29. What is probably the single most important influence on growth at all stages of development? A. Nutrition
30. When a preschool child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as: D. punishment
31. Which drug is usually the best choice for patient-controlled analgesia (PA) for a child in the immediate postoperative period? D. morphine
32. The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse's response should be based on knowledge that discipline is:
33. A nurse is preparing to complete an admission assessment on a 2-year-old child. The child is sitting on the parent's lap. Which technique should the nurse implement to complete the physical exam? C. Perform the exam while the child is on the parent's lap.
34. What medication is the most effective choice for treating pain associated with sickle cell crisis in a newly admitted 5-year-old child? D. morphine
35. The nurse caring for the child in pain understands that distraction: d. Must be developmentally appropriate to refocus attention.

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36. Which situation poses the greatest challenge to the nurse working with a child and family? C. Twenty-four-hour observation
37. A 2-year-old child has been returned to the nursing unit after an inguinal hernia repair. Which pain assessment tool should the nurse use to assess this child for the presence of pain? C. FLACC tool
38. Which intervention will encourage a sense of autonomy in a toddler with disabilities? C. Encouraging independence in as many areas as possible
39. Olivia, age 5 years, tells the nurse that she "needs a Band-Aid" where she had an injection. The best nursing action is to: B. apply a band-aid
40. The major cause of death for children older than 1 year is: A. Unintentional injuries.
41. The nurse is talking with the parent of a child newly diagnosed with a chronic illness. The parent is upset and tearful. The nurse asks, "With whom do you talk when something is worrying you?" This should be interpreted as: B. Part of assessing parent's available support system.
42. Approach behaviors are coping mechanisms that result in a family's movement toward adjustment and resolution of the crisis of having a child with a chronic illness or disability. What is considered an approach behavior in parents? B. Anticipate future problems and seek guidance and answers
43. The pediatric nurse understands that nonpharmacologic strategies for pain management: B. May reduce pain perception.
44. Lindsey, age 5 years, will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in à special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize that her disability was so severe. The best interpretation of this situation is that: : D. This is a normal anticipated time of parental stress.
45. Which assessment indicates to a nurse that a 2-year-old child is in need of pain medication? C. The child is lying rigidly in bed and not moving.

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51. The nurse is monitoring a patient for side effects associated with opioid analgesics. Which side effect should the nurse expect to monitor for (Select all that apply)? a. Sweating b. Pruritus c. Respiratory depression
52. An appropriate tool to assess pain in a 3-year-old child is the (Select all that apply): d. Oucher tool e. Faces pain rating scale
53. Which dietary recommendations should a nurse make to an adolescent patient to manage constant related to opioid analgesic administration (Select all that apply)? a. vegetables b. bran cereal e. chesses

Next exam: EXAM # 3 Pediatrics

Chapter 18,19, 20, 21 Chapters 18, 19 for Pediatrics Exam:( LEIFER 2015) Chapter 26 The Child with a Cardiovascular Disorder

1. What does the nurse explain that a ventricular septal defect will allow? Blood to shunt left to right, causing increased pulmonary flow and no cyanosis
2. Which assessment would lead the nurse to suspect that a newborn infant has a ventricular septal defect? A loud, harsh murmur with a systolic thrill
3. What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta? Blood pressure lower in the legs than in the arm
4. A father asks why his child with tetralogy of Fallot seems to favor a squatting position. What is the nurses best response? Squatting increases the return of venous blood back to the heart

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5. An infant is experiencing dyspnea related to patent ductus arteriosus (PDA). What does the nurse understand regarding why dyspnea occurs? Blood is circulated through the lungs again, causing pulmonary circulatory congestion
6. Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant? Withholding a dose if the apical heart rate is less than 100 beats/min
7. A child develops carditis from rheumatic fever. Which areas of the heart are affected by carditis? Heart muscle and the mitral valve
8. Which comment made by a parent of a 1-month-old would alert the nurse about the presence of a congenital heart defect? He tires out during feeding
9. The nurse is caring for a child with a diagnosis of Kawasaki disease. The child’s parent asks the nurse, how does Kawasaki disease affect my child’s heart and blood vessels? On what understanding is the nurse’s response based? Inflammation weakens blood vessels, leading to aneurysm
10. The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instruction? If the baby turns blue, I will hold him against my shoulder with his knees bent up toward his chest
11. The parent of a 1-year-old child with tetralogy of Fallot asks the nurse, why do my child’s fingertips look like that? On what understanding does the nurse base a response? Clubbing occurs as a result of chronic hypoxia
12. A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever? Painful, tender joints and carditis
13. An infant with congestive heart failure is receiving digoxin (Lanoxin). What does the nurse recognize as a sign of digoxin toxicity? vomiting
14. Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood? An atrial septal defect
15. A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates? Sydenham’s chorea

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16. How long should a 4-year-old child recovering from rheumatic fever need to receive monthly injections of penicillin G? 5 years
17. What is accurate about the characteristics of high-density lipoproteins (HDLs? They have little cholesterol
18. What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol? A fat intake reduction of 25-35% of total calorie
19. The nurse is planning a hypertension-prevention program. What should be the main focus of the nurse when presenting information? Patient education
20. A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate? Echocardiogram
21. How would the nurse caring for an infant with congestive heart failure (CHF) modify feeding techniques to adapt for the child’s weakness and fatigue? (Select all that apply.) a. Feeding more frequently with smaller feedings b. Using a soft nipple with enlarged holes c. Holding and cuddling the child during feeding e. Offering high-caloric formula
22. What are the four structural heart anomalies that make up the tetralogy of Fallot? (Select the four that apply.) a. Hypertrophied right ventricle b. Patent ductus arteriosus d. Narrowing of pulmonary artery e. Dextroposition of aorta
23. What assessment(s) in a child with tetralogy of Fallot would indicate the child is experiencing a paroxysmal hypercyanotic episode? (Select all that apply.) a. Spontaneous cyanosis b. Dyspnea c. Weakness e. syncope
24. Which congenital cardiac defect(s) cause(s) increased pulmonary blood flow? (Select all that apply.) a. Atrial septal defects (ASDs) d. Patent ductus arteriosus e. Ventricular septal defects (VSDs

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25. A 16-year-old patient is diagnosed with primary hypertension. What risk factors does the nurse mention when providing education on this diagnosis to the patient and his family? (Select all that apply.) a. Heredity b. Stress d. Obesity e. Poor diet

Chapter 25: The Child with a Respiratory Disorder

1. What will the nurse tell parents of a child with a positive throat culture for group A hemolytic streptococcus that the treatment is most likely to be? Oral penicillin for 10 days
2. Which initial intervention will the nurse suggest to the parents of a child experiencing laryngeal spasm? Take the child to the bathroom and turn on a hot shower.
3. The nurse would observe a child for frequent swallowing after a tonsillectomy and adenoidectomy (T&A). What might this indicate? Bleeding from the surgical site
4. What is the best choice for fluid replacement that the nurse can offer a child who has just had a tonsillectomy? A popsicle
5. When auscultating breath sounds of an infant with respiratory syncytial virus, which assessment would the nurse immediately report? Quiet chest from previous assessment of wheezing
6. What classic sign would the nurse, auscultating the breath sounds of a child hospitalized for an acute asthma attack, expect to find? Expiratory wheezing
7. What is the best intervention for the nurse caring for a child experiencing an acute asthma attack? Position the child with arms resting on the overbed table
8. What should the nurse explain to the parent of a child with exercise- induced asthma about when to inhale Cromolyn? Before exercise to prevent attack
9. The parents of a 3-month-old infant with cystic fibrosis (CF) want to know how their child got this disease, because no one in either of their families has CF.

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What is the nurses best response based on the understanding of CF? Both parents are carriers of the CF gen

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10. Which statement indicates that the child’s parents understand how to perform respiratory therapy? We give the aerosol followed by postural drainage before meal
11. What will the nurse teach the child with cystic fibrosis to take in order to facilitate digestion and absorption of nutrients? Pancreatic enzyme
12. How would the nurse advise a mother to clear the nostrils when her infant has a cold? Remove nasal secretions with a bulb syringe 13.The nurse offers a variety of fluids to a 5-year-old asthmatic child to compensate for the fluid loss through dyspnea. Which fluids are most appropriate? Room temperature water 14.The asthmatic child who has been taking theophylline complains of stomachache and tachycardia and is sweating profusely. What does the nurse recognize as the cause of these symptoms? Drug toxicity 15.The nurse is planning to teach parents about preventing sudden infant death syndrome (SIDS). What significant information would the nurse include? Placing infants on their backs or sides for sleep 16.An infant is hospitalized with RSV bronchiolitis. What is the priority nursing diagnosis? Ineffective breathing pattern related to airway inflammation and increased secretion 17.The nurse is caring for a toddler with acute laryngotracheobronchitis. Which assessment finding would indicate the child is experiencing increased respiratory obstruction? Restlessness 18.The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder. What does this prevent? Candidiasis 19.The nurse is caring for a 3-year-old who suffered a smoke inhalation injury. How long is this patient at the highest risk for pulmonary edema after exposure? 72 hours 20.Which is the most appropriate nursing action when planning care for a child with cystic fibrosis? Ensure high-protein, high-calorie diet 21.The first child of a couple is being treated for bronchopulmonary dysplasia (BPD). They ask how to prevent this from happening with the child they are currently expecting. What will the nurse explain as the best way to prevent BPD? Prevention of preterm birth

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22.The nurse describes the allergic salute as a cluster of what signs related to chronic allergy? (Select all that apply.) a. Mouth breathing b. Transverse nasal crease c. Dark circles under the eyes e. Reddened conjunctiva 23.The nurse would suggest the parents of an asthmatic child to encourage participation in which sport(s)? (Select all that apply.) a. Swimming b. Gymnastics c. Baseball 24.The nurse reports which assessments that suggest a meconium ileus in a newborn? (Select all that apply.) a. Abdominal distention b. Vomiting e. Absence of stool 25.What would the nurse teaching an asthmatic child the technique of pursed- lip breathing include? (Select all that apply.) a. Inhale deeply through nose with mouth closed. b. Make exhalation twice as long as inhalation. d. Exhale through mouth as if whistling. 26.A toddler must maintain bed rest for the diagnosis of pneumonia. What actions will the nurse implement? (Select all that apply.) b. Consider age. c. Assess developmental level. d. Implement light play activities. 27.The school nurse suspects a first-grade student has sinusitis. Which symptoms might lead the nurse to this suspicion? (Select all that apply.) a. Child reports tooth pain. c. Child reports, I have had a cold for 2 weeks. d. Nurse observes periorbital swelling. e. Halitosis is present 28.The nurse is caring for a 4-year-old child diagnosed with H. influenzae type B. Which signs and symptoms exhibited by the child would alert the nurse to suspect epiglottitis? (Select all that apply.) b. Restlessness c. Edematous epiglottis e. Drooling

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29.What will the nurse discourage when providing education to parents of a child with asthma? (Select all that apply.) a. Stuffed toys d. Basketball

Chapter 42: Cardiovascular Dysfunction (Perry Edition)

1. The nurse is assessing a child postcardiac catheterization. Which complication might the nurse anticipated? Cardiac arrhythmia
2. Jos is a 4-year-old child scheduled for a cardiac catheterization. Preoperative teaching should? Adapted to his level of development so that he can understand
3. The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. The most appropriate initial nursing action is to: Apply direct pressure above the catheterization site
4. Which defect results in increased pulmonary blood flow? Atrial septal defect
5. Which structural defects constitute tetralogy of Fallot? Pulmonic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
6. What is best described as the inability of the heart to pump an adequate amount of blood to the systemic circulation at normal filling pressures? Congestive heart failure
7. A clinical manifestation of the systemic venous congestion that can occur with congestive heart failure? Peripheral edema
8. A beneficial effect of administering digoxin (Lanoxin) is that is? Decreases edema
9. Which drug is an angiotensin-converting enzyme (ACE) inhibitor? Captopril (Capoten)
10. The nurse is evaluating a child who is taking digoxin for her cardiac condition. The nurse is cognizant that a common sign of digoxin toxicity is? vomiting

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11. The parents of a young child with congestive heart failure tell the nurse

that they are nervous about giving digoxin. The nurse’s response should be based on knowing that? Parents must learn specific, important guidelines for administration of digoxin

12. As part of the treatment for congestive heart failure, the child takes the

diuretic furosemide. As part teaching home care, the nurse encourages the family to give the child foods such as bananas, oranges, and leafy vegetables. These foods are recommended because they are high in potassium

13. An 8-month-old infant has a hyper cyanotic spell while blood is being drawn. The nurses First action should be to: Place the child in the knee-chest position
    14. The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes that a risk of cerebrovascular accidents (strokes) exists. An important objective to decrease this risk is: prevent dehydration .
    15. Parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. The nurses reply should be based on knowing that: The child needs opportunities to play with peer
    16. When preparing a school-age child and the family for heart surgery, the nurse should consider: Letting child hear the sounds of an electrocardiograph monitor
    17. Seventy-two hours after cardiac surgery, a young child has a temperature of 37. C (101 The nurse should: Report findings to physician
    18. An important nursing consideration when suctioning a young child who has had heart surgery is to? Administer supplemental oxygen before and after suctioning.
    19. The nurse is caring for a child after heart surgery. What should she or he do if evidence is found of cardiac tamponade? immediately report this to the physician
    20. An important nursing consideration when chest tubes will be removed from a child is to.? Administer analgesics before the procedure
    21. The most common causative agent of bacterial endocarditis is? Streptococcus viridians

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22. Which painful, tender, pea-sized nodules may appear on the pads of the fingers or toes in bacterial endocarditis? Oslers nodes
23. The primary nursing intervention necessary to prevent bacterial endocarditis is to: Counsel parents of high-risk children about prophylactic antibiotic
24. A common, serious complication of rheumatic fever is? Cardiac valve damage
25. A major clinical manifestation of rheumatic fever is? polyarthritis
26. When discussing hyperlipidemia with a group of adolescents, the nurse should explain that high levels of what substance are thought to protect against cardiovascular disease? High-density lipoproteins (HDLs)
27. The leading cause of death after heart transplantation is? rejection
28. When caring for the child with Kawasaki disease, the nurse should understand that? Therapeutic management includes administration of gamma globulin and aspirin
29. One of the most frequent causes of hypovolemic shock in children is? Blood loss
30. What type of shock is characterized by a hypersensitivity reaction causing massive vasodilation and capillary leaks, which may occur with drug or latex allergy? Anaphylactic shock
31. Which clinical changes occur as a result of septic shock? Increase cardiac output
32. A child is brought to the emergency department experiencing an anaphylactic reaction to a bee sting. While an airway is being established, what medication should the nurse prepare for immediate administration? Epinephrine
33. Which postoperative intervention should be questioned for a child after a cardiac catheterization? Keep the affected leg flexed and elevated
34. In which situation is there the greatest risk that a newborn infant will have a congenital heart defect (CHD)? Trisomy 21 detected on amniocentesis

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35. Which intervention should be included in the plan of care for an infant with the nursing diagnosis of Excess Fluid Volume related to congestive heart failure? Weigh the infant every day on the same scale at the same time
36. The nurse assessing a premature newborn infant auscultates a continuous machinery-like murmur. This finding is associated with which congenital heart defect? Patent ductus arteriosus
37. What is an expected assessment finding in a child with coarctation of the aorta? Disparity in blood pressure between the upper and lower extremities
38. A child with pulmonary atresia exhibits cyanosis with feeding. On reviewing this child’s laboratory values, the nurse is not surprised to notice which abnormality? Polycythemia
39. When assessing a child for possible congenital heart defects (CHDs), where should the nurse measure blood pressure? All four extremities
40. What is the nurses first action when planning to teach the parents of an infant with a congenital heart defect (CHD)? Assess the parents anxiety level and readiness to learn
41. For what reason might a newborn infant with a cardiac defect, such as coarctation of the aorta, that results in a right-to-left shunt receive prostaglandin E 1? To improve oxygenation
42. What is the appropriate priority nursing action for the infant with a CHD who has an increased respiratory rate, is sweating, and is not feeding well? Alert the physician
43. A nurse is teaching an adolescent about primary hypertension. The nurse knows that which of the following is correct? Primary hypertension may be treated with weight reduction
44. An adolescent being seen by the nurse practitioner for a sports physical is identified as having hypertension. On further testing, it is discovered the child has a cardiac abnormality. The initial treatment of secondary hypertension initially involve? Treating the underlying disease
45. The nurse is preparing an adolescent for discharge after a cardiac catheterization. Which statement by the adolescent would indicate a need for further teaching? I have to stay on strict bed rest for 3 day

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46. Surgical closure of the ductus arteriosus would? Prevent the return of oxygenated blood to the lungs
47. A nurse is teaching nursing students the physiology of congenital heart defects. Which defect results in decreased pulmonary blood flow? Tetralogy of Fallot
48. The nurse is talking to a parent of an infant with heart failure about feeding the infant. Which statement about feeding the child is correct? You may need to increase the caloric density of your infants formula
49. The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement? Administering penicillin
50. Which action by the school nurse is important in the prevention of rheumatic fever? Refer children with sore throats for throat culture
51. A preschool child is scheduled for an echocardiogram. Parents ask the nurse whether they can hold the child during the procedure. The nurse should answer with which response? Your child must lie quietly; sometimes a mild sedative is administered before the procedure
52. The nurse is caring for an infant with congestive heart disease (CHD). The nurse should plan which intervention to decrease cardiac demands? Organize nursing activities to allow for uninterrupted sleep
53. Nursing interventions for the child after a cardiac catheterization include which of the following (Select all that apply)
    • Assess the affected extremity for temperature and color
    • Maintain a patent peripheral intravenous catheter until discharge
54. Which clinical manifestations would the nurse expect to see as shock progresses in a child and becomes decompensated shock (Select all that apply)?
    • Cool extremities and decreased skin turgor
    • Confusion and somnolence
    • Tachypnea and poor capillary refill time

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55. A child has a total cholesterol level of 180 mg/dL. What dietary recommendations should the nurse make to the child and the child’s parents (Select all that apply)? ▪ Replace whole milk with 2% or 1% milk ▪ increase servings of fish ▪ Avoid excessive intake of fruit juice 56. A nurse is conducting discharge teaching to parents about the care of their infant after cardiac surgery. The nurse instructs the parents to notify the physician if what conditions occur (Select all that apply)?
    • Temperature above 37.7 C (100 F)
    • New, frequent coughing
    • Turning blue or bluer than normal 57. The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include (Select all that apply)?
    • Decreased urinary output
    • Sweating (inappropriate)
    • Fatigue

Chapter 40: Respiratory Dysfunction

1. Which statement best describes why children have fewer respiratory tract infections as they grow older? Repeated exposure to organisms causes increased immunity.
2. A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse recognizes that these symptoms are characteristic of which respiratory condition? Sinusitis
3. Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include: Avoiding use for more than 3 days.
4. When caring for an infant with an upper respiratory tract infection and elevated temperature, an appropriate nursing intervention is to: Give small amounts of favorite fluids frequently to prevent dehydration

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5. The parent of an infant with nasopharyngitis should be instructed to notify the health care professional if the Infant? Shows signs of an earache
6. It is generally recommended that a child with acute streptococcal pharyngitis can return to school? After taking antibiotics for 24 hours
7. A child is diagnosed with influenza, probably type A disease. Management includes: Amantadine hydrochloride to reduce symptoms
8. Chronic otitis media with effusion (OME) is differentiated from acute otitis media (AOM) because it is usually characterized by: A feeling of fullness in the ear
9. Which statement is characteristic of acute otitis media (AOM)? is treated with a broad range of antibiotics
10. An infant’s parents ask the nurse about preventing otitis media (OM). What should the nurse recommend? Avoid tobacco smoke
11. Which type of croup is always considered a medical emergency? Epiglottitis
12. The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. The nurses rationale for this action is primarily that? the mothers presence will reduce anxiety and ease the child’s respiratory effort

13. A school-age child has had an upper respiratory tract infection for several

days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. This is most suggestive of: Bronchitis

14. Skin testing for tuberculosis (the Mantoux test) is recommended?

Periodically for children who reside in high-prevalence region

15. The mother of a toddler yells to the nurse, Help! He is choking to death on his food. The nurse determines that lifesaving measures are necessary based on? Inability to speak
    16. The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include: Monitor pulse oximetry

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17. The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What is essential in this child’s care? Monitor arterial blood gases
18. Asthma in infants is usually triggered by? A viral infection
19. A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. This suggests? asthma
20. It is now recommended that children with asthma who are taking long-term inhaled steroids should be assessed frequently because they may develop? slowed growth.
21. b-Adrenergic agonists and methylxanthines are often prescribed for a child with an asthma attack. What is their action? Dilate the bronchioles
22. A parent whose two school-age children have asthma asks the nurse in what sports, if any, they can participate. The nurse should recommend? swimming
23. Which statement expresses accurately the genetic implications of cystic fibrosis (CF)? If it is present in a child, both parents are carriers of this defective gene
24. The earliest recognizable clinical manifestation of cystic fibrosis (CF) is: Meconium ileus
25. Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis? Sweat chloride test
26. A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (rhDNase). This drug? May cause voice alterations
27. Pancreatic enzymes are administered to the child with cystic fibrosis. Nursing considerations should Include? Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal
28. In providing nourishment for a child with cystic fibrosis (CF), which factor should the nurse keep in mind? Diet should be high in carbohydrates and protein
29. Cardiopulmonary resuscitation is begun on a toddler. Which pulse is usually palpated because it is the most central and accessible? carotid
30. Abdominal thrusts (the Heimlich maneuver) are recommended for airway obstruction in children older than: 1 year

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31. An appropriate nursing intervention when caring for a child with pneumonia is to? Encourage rest
32. The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? It has a harsh, barky cough
33. Which intervention for treating croup at home should be taught to parents? Take the child outside
34. Which information should the nurse teach workers at a day care center about respiratory syncytial virus (RSV)? Frequent hand washing can decrease the spread of the virus
35. Which vitamin supplements are necessary for children with cystic fibrosis? Vitamins A, D, E, and K
36. Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system? Mucus and edema obstruct small airway
37. A nurse is charting that a hospitalized child has labored breathing. Which describes labored breathing? dyspnea
38. Parents have understood teaching about prevention of childhood otitis media if they make which statement? We will be sure to keep immunizations up to date
39. An 18-month-old child is seen in the clinic with AOM. Trimethoprim-sulfamethoxazole (Bactrim) is prescribed. Which statement made by the parent indicates a correct understanding of the instructions? I should administer all the prescribed medication
40. The nurse is assessing a child with acute epiglottitis. Examining the childs throat by using a tongue depressor might precipitate which symptom or condition? Complete obstruction
41. Which consideration is the most important in managing tuberculosis (TB) in children? Pharmacotherapy
42. A nurse is conducting an in-service on asthma. Which statement is the most descriptive of bronchial asthma? There is heightened airway reactivity
43. A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? Before chest physiotherapy (CPT

CORRECT ANSWERS A+ ASSUARED SUCCESS

44. A nurse is interpreting the results of a tuberculin skin test (TST) on an adolescent who is human immunodeficiency virus (HIV) positive. Which induration size indicates a positive result for this child 48 to 72 hours after the test? 5mm
45. An infant has developed staphylococcal pneumonia. Nursing care of the child with pneumonia includes which of the following? (Select all that apply)
    • Cluster care to conserve energy
    • Administration of antibiotics
46. The nurse is caring for a 10-month-old infant with respiratory syncytial virus (RSV) bronchiolitis. Which interventions should be included in the child’s care (Select all that apply) ? - Encourage infant to drink 8 ounces of formula every 4 hour - Institute cluster care to encourage adequate rest. - Place on noninvasive oxygen monitoring
47. Which information should the nurse teach families about reducing exposure to pollens and dust (Select all that apply)?
    • Replace wall-to-wall carpeting with wood and tile floors.
    • Use an air conditioner.
    • Put dust-proof covers on pillows and mattresses

Nursing Care of the Child with an Alteration in Bowel

Elimination/Gastrointestinal Disorder.

****Chapter 41: Gastrointestinal Dysfunction (PERRY EDITION)

1. Nurses must be alert for increased fluid requirements when a child has?

fever

2. Which type of dehydration results from water loss in excess of

electrolyte loss? Hypertonic dehydration

CORRECT ANSWERS A+ ASSUARED SUCCESS

3. An infant is brought to the emergency department with poor skin

turgor, weight loss, lethargy, and tachycardia. This is suggestive of:

Dehydration.

4. Acute diarrhea is often caused by? Antibiotic therapy

5. The viral pathogen that frequently causes acute diarrhea in young

children is? Rotavirus

6. A parasite that causes acute diarrhea is? Giardia lamblia

7. A stool specimen from a child with diarrhea shows the presence

of neutrophils and red blood cells. This is most suggestive of

which condition? Bacterial gastroenteritis

8. 8.Therapeutic management of the child with acute diarrhea and

dehydration usually begins with? Oral rehydration solution

(ORS)

9. A young child is brought to the emergency department with severe

dehydration secondary to acute diarrhea and vomiting.

Therapeutic management of this child will begin with: Intravenous

fluids

10. Constipation has recently become a problem for a school-age girl. She is

healthy except for seasonal allergies, which are now being successfully treated

with antihistamines. The nurse should suspect that the constipation is most

likely caused by? Antihistamines.

11. A high-fiber food that the nurse could recommend for a child

with chronic constipation is? Popcorn

12. Therapeutic management of most children with Hirschsprungs

disease is primarily? Surgical removal of affected section of

bowel

13. A 3-year-old child with Hirschsprungs disease is hospitalized for surgery. A

temporary colostomy will be necessary. The nurse should recognize that

preparing this child psychologically is: Necessary because it will be an

adjustment

CORRECT ANSWERS A+ ASSUARED SUCCESS

14.The nurse is explaining to a parent how to care for a child with vomiting

associated with a viral illness. The nurse should include: Brushing teeth or

rinsing mouth after vomiting

15. A 4-month-old infant has gastroesophageal reflux disease

(GERD) but is thriving without other complications. What should the nurse

suggest to minimize reflux? Thicken formula with rice cereal

16. A histamine receptor antagonist such as cimetidine (Tagamet) or ranitidine (Zantac) is ordered for an infant with gastroesophageal reflux. The purpose of this is to? Reduce gastric acid production

17. Which clinical manifestation would most suggest acute appendicitis?

abdominal pain that is most intense at McBurneys point

18. When caring for a child with probable appendicitis, the nurse should

be alert to recognize that a sign of perforation is: Sudden relief from

pain

19. Which statement is most descriptive of Meckels diverticulum?

intestinal bleeding may be mild or profuse

20. What is characterized by a chronic inflammatory process that may

involve any part of the gastrointestinal GI) tract from mouth to

anus? Crohns disease

21. What is used to treat moderate-to-severe inflammatory bowel

disease? Corticosteroids

22. Bismuth subsalicylate, clarithromycin, and metronidazole are

prescribed for a child with a peptic ulcer? Eradicate Helicobacter pylori

.

23. Which statement best characterizes hepatitis A? Onset is usually

rapid and acute

CORRECT ANSWERS A+ ASSUARED SUCCESS

24. The best chance of survival for a child with cirrhosis is?

Liver transplantation.

25. The earliest clinical manifestation of biliary atresia is? jaundice

26. A newborn was admitted to the nursery with a complete bilateral cleft

lip and palate. The physician explained the plan of therapy and its

expected good results. However, the mother refuses to see or hold

her baby. Initial therapeutic approach to the mother should be to?

Encourage her to express her feelings

27. Caring for the newborn with a cleft lip and palate before surgical

repair includes: Providing satisfaction of sucking needs

28. The nurse is caring for an infant whose cleft lip was repaired.

Important aspects of this infants postoperative care include: Cleansing

of suture line, supine and side-lying positions, and arm restraint

29.The nurse is caring for a neonate with a suspected tracheoesophageal fistula. Nursing care should include: Elevating the head but giving nothing by mouth

30. Which type of hernia has an impaired blood supply to the herniated organ? Strangulated hernia
31. The nurse is caring for an infant with suspected pyloric stenosis. Which clinical manifestation would indicate pyloric stenosis? Visible peristalsis and weight loss
32. The nurse is caring for a boy with probable intussusception. He had diarrhea before admission but, while waiting for administration of air pressure to reduce the intussusception, he passes a normal brown stool. The most appropriate nursing action is to: Notify the practitioner

CORRECT ANSWERS A+ ASSUARED SUCCESS

33. An important nursing consideration in the care of a child with celiac disease is to: Refer to a nutritionist for detailed dietary instructions and education
34. An infant with short bowel syndrome will be discharged home on total parenteral nutrition (TPN) and gastrostomy feedings. Nursing care should include: Teaching the family signs of central venous catheter infection
35. For what clinical manifestation should a nurse be alert when suspecting a diagnosis of esophageal atresia? A nasogastric tube fails to pass at birth
36. What is the most important information to be included in the discharge planning for an infant with gastroesophageal reflux? Teach the parents how to do infant cardiopulmonary resuscitation (CPR)
37. What is the major focus of the therapeutic management for a child with lactose intolerance? Teaching dietary modifications
38. What food choice by the parent of a 2-year-old child with celiac disease indicates a need for further teaching? oatmeal
39. Which intervention should be included in the nurses plan of care for a 7-year-old child with encopresis who has cleared the initial impaction? Give the child a choice of beverage to mix with a laxative
40. Which description of a stool is characteristic of intussusception? Currant jelly stools
41. What should the nurse stress in a teaching plan for the mother of an 11-year-old boy with ulcerative colitis? Coping with stress and avoiding triggers 42.Careful hand washing before and after contact can prevent the spread of which condition in day care and school settings? Hepatitis A