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Peds Exam 3 and Final Questions with Answers Tested and Verified Updates, Exams of Pediatrics

Peds Exam 3 and Final Questions with Answers Tested and Verified Updates

Typology: Exams

2023/2024

Available from 07/22/2024

hesigrader002
hesigrader002 🇺🇸

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1 / 30

Peds Exam 3 and Final Questions with Answers Tested and

Verified Updates

1.What is spina bifida?: A birth defect in which a developing baby's spinal cord fails to develop properly. 2.which form of spina bifida is often only detected with tests?

  1. occulta
  2. meningocele
  3. hydrocephaly
  4. myelomeningocele: 1
  • meningocele is the most severe form and has lots of deficits this is just the sac and CSF
  • myeo is meningeal sac , csf and spinal cord 3.a school nurse is preparing to start the year and is informed that a child with spina bifida is starting this year which of the following actions is not correct
  1. know the signs and symptoms of hydro encephalitis
  2. prepare a foley cath for clean intermittent cath
  3. remove all strong magnets from the office and inform the student's teachers to keep strong magnets away
  4. inform the teacher to report any signs including personality change, irri- tability and declining school performance: 2
  • strong magnets may effect a VP shunt
  • these signs may be indicative that there is a blockage or infection of the shunt 4.what is cerebral palsy: the brain cant tell the muscles to move

2 / 30 5.how is the Glasgow coma scale different for younger children ?: verbal response is if they smile and coo motor response is are the movements spontaneous or not 6.a newborn comes in with bulging fontanel ,increased head circumference , and a high-pitched cry which of the following is not a good intervention

  1. low stimulus environment
  2. CT
  3. Lumbar puncture
  4. BMP: 3 a lumbar puncture is not a good intervention because it may lead to herniation 7.which of the following is not a common cause of ICP
  5. hypoxia
  6. meningitis
  7. acid-base imbalance
  8. TBI
  9. hypertension: 5
  • meningitis is the most common cause of altered LOC 8.A 5 year old presents with a widened pulse pressure a HR of 60 and irregular respirations. what is happening ?: Late sign of ICP (cushings triad ) 9.after a child hits their head how long will cerebral edema last if they have a TBI?
  1. 46 hours

3 / 30

  1. 24 hours
  2. 72 hours
  3. 96 hours: 3 10.a patient who is status post fall presents with the following symptoms lethargy , headache , unsteady gait , vomiting , slight increase in HR and RR , Glasgow's coma scale 14. The patient was diagnosed with a TBI which severity fits these symptoms?
  4. moderate
  5. mild
  6. severe
  7. normal: 2 11.a PT has been diagnosed with a moderate TBI. which of the following symptoms may indicate the TBI is progressing to severe?
  8. loss of consciousness
  9. amnesia
  10. pupillary changed
  11. stuporous: 3 12.what is crushing's triad indicative of?: resp or cardiac distress 13.a child has been diagnosed with a TBI. which of the following is an appropriate intervention? select all that apply 1.HOB 30 degrees
  12. lights on all the time
  13. hips flexed
  14. suction before oxygen

4 / 30

  1. watch for drainage from nose and ears: 1 and 5
  • you want to decrease stimuli
  • you dont wanna flex hips or head
  • never suction 14.which of the following is not true regarding concussions
  1. doesn't always includes loss of consciousness
  2. a CT is always done
  3. cognitive recovery can last up to 6 weeks
  4. .cognitive and physical rest are important: 2 a CT is only done when there is a LOC greater then 30 seconds or worsening symptoms 15.a parent is about to leave the emergency room after her child was diag- nosed with a concussion. which of the following statements requires further teaching?
  5. my child should be in a low stimulating environment for the next few days
  6. my child can only return to school once all symptoms are gone
  7. my doctor must clear my child before returning to sports
  8. for the next few days my child should just color and read: 2 the child can return when the symptoms are mild 16.a mom to be has just gotten tests that show their child has neural tube defects. which of the following indicates that the education was effective
  9. if eat lots of folic acid now it might reverse the defect
  10. my child is going to be disabled
  11. my child's bowel and bladder will be affected regardless of level of

5 / 30 the defect

  1. at least my child doesn't have allergies: 3 17.a child is born with myelomeningocele spina bifida the location is sacral . The surgery is scheduled for a few hours from now. which of the following pre - op interventions by the nurse is incorrect?
  2. cover the sac with a sterile moist dressing
  3. monitor for leakage and infection
  4. monitor neuro status
  5. supine position: 4 the patient should be prone to keep pressure off the sac 18.a child is post op of a spina bifida surgery. which of the following findings require immediate intervention? select all that apply
  6. a temp of 95.
  7. shrill cry
  8. clear drainage from wound
  9. resp of 56 5 pain response when supine: 1 , 2 , 3
  • 1 would indicate infection
  • 2 would indicate increased ICP
  • 3 CSF leakage 19.a child with spina bifida is being discharged and the student nurse is asked to give some instructions to the family. which of the following is appropriate to say?
  1. you will need to check the baby diapers every 4 hours to see if they

6 / 30 have voided if not you need to cath them

  1. you need to have sterile gloves and supplies to cath every time
  2. you need to give them a suppository every day at the same time
  3. foods like bananas and avocados are high in fiber so will help with bowel movements: 3
  • they will need to be cathed they cant pee on their own
  • at home parents do a clean cath
  • bananas and avocados have high amounts of latex in them which these kids are allergic to 20.a nurse is making a care plan and determines a child with spina bifida is at risk for all of the following except
  1. pressure injuries
  2. Failure to thrive
  3. delayed motor skills
  4. burns: 2 children are actually more at risk for obesity 21.What causes hydrocephalus?: csf production outweighs absorption 22.a child has a VP shunt which of the following is true
  5. it is temporary to drain the fluid then be removed
  6. the child can play sports
  7. seizure precautions in place
  8. there is no risk for infection: 3
  • this is permanent
  • the child should avoid any activities that may result in ICP
  • there is a big risk for infection

7 / 30 23.a child age 4 presents with poor head control , cant smile , cant sit , clenched fists and muscle rigidity. what is happening ?: spastic CP 24.a child is diagnosed with spastic CP and the nurse is planning care for them. Does the nurse determine that the child is at risk for all of the following except?

  1. obesity
  2. impaired mobility
  3. aspiration
  4. impaired skin integrity: 1 25.what does baclofen do ?: Muscle Relaxant 26.a patient on a baclofen pump is about to be discharged. which of the following statements requires further teaching?
  5. I will need to return to my primary every 1-3 months to refill my pump
  6. my pump will stay in for life
  7. sedation and hypotonic muscles mean to much baclofen
  8. abrupt withdrawal can cause seizures: 2
  • batterys run out every 5 years so they will need to be replaced 27.nurse is assessing a pt post MVA. which of the following symptoms would indicate increased ICP?
  1. brisk pupillary reaction
  2. increased sleeping
  3. tachycardia
  4. depressed fontanels: 2 28.a nurse is assessing an 11-month-old infant. which of the following symp- toms indicates a CNS infection?

8 / 30

  1. oliguria
  2. bulging fontanel
  3. negative Brudzinski's sign
  4. jaundice: 2 29.a child with increased ICP should be in what position?
  5. semi-fowlers
  6. high fowlers
  7. prone
  8. supine: 1 30.a nurse is teaching a new parent about essential vitamins and minerals for bone growth. which of the following statements is incorrect?
  9. calcium promotes bone density
  10. vitamin D promotes bone calcification
  11. vitamin A promotes bone formation
  12. vitamin C promotes growth at epiphyseal plate: 3 31.which type of fracture is most common in children ?: green stick 32.a child is diagnosed with congenital club foot. which of the statements made regarding treatment is true?
  13. new casts will be applied every month
  14. the brace will need to be worn 24 hours a day for 3 months
  15. the brace will need to be worn at bed time for 3 years
  16. after the brace my child will need surgery: 3
  • new casts are applied every 1-2 weeks
  • the brace is worn for 23 hours
  • the brace comes after the surgery

9 / 30 33.Subluxation vs. Dislocation: Subluxation = head partially out of socket Dislocation = head fully out of socket 34.which of the following can confirm diagnosis of developmental hip dyspla- sia

  1. Allis sign
  2. Ortolani maneuver
  3. Barlow maneuver
  4. x-ray: 4 the other are used as screening tools not ways to confirm diagnosis 35.why are kids prone to head injury ?: they have a large heavy head they play sports and they are clumsy 36.which of the following statements regarding DDH is true?
  5. uneven thigh folds in infants is a common sign
  6. screening only happens in infants
  7. most cases are life long
  8. a child under 3 months of age needs surgery: 1
  • screening happening in infants and again at age 1- 2
  • most cases resolve by 2 months of age
  • a child under 3 months needs a brace a child over 6 months would need surgery then a spica cast 37.when both thoracic and lumbar part of the spine are curved this is called what type of curve?
  1. C
  2. D
  3. L

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4. S: 4

38.a patient has uneven shoulders , prominent scapula with rib hump and uneven hips. what is likely happening ?: scoliosis 39.which of the following tests are used for screening for scoliosis?

  1. Ortolani's maneuver
  2. forward bend test
  3. allis sign
  4. morrows reflex: 2 40.a child has a mild curve to their back. which of the following interventions would be appropriate?
  5. exercises
  6. Boston brace
  7. spinal fusion
  8. nothing: 1 41.a child is to undergo spinal fusion surgery. which of the following state- ments by the family requires follow up
  9. my child should donate their own blood ahead of time in case of major blood loss
  10. my child will be on only Advil in the post op
  11. infection and blood clots are common complications
  12. my child will need help turning over during the post op period: 2 this pain is no joke they need the good stuff 42.which of the following interventions by the nurse is not effective during the post-op period of spinal fusion surgery.
  13. placing things close to the child

11 / 30

  1. neuro checks below the level of surgery
  2. maintain low stimulus environment, including limiting visitors
  3. log rolling the patient: 3 friends will be good distracting method
  4. a patient is about to be discharged following a spinal fusion surgery. which of the following statements requires further teaching
  5. I should wait a year to start sports
  6. i should make hospitals aware that i have a large amount of metal in my body
  7. thank god i wont have to wear that stupid brace again
  8. i will be fully recovered in about a year: 3 they will have to wear the brace after 6 weeks for some time until they 6 months 44.a patient has a positive growlers sign , delayed walking , enlarged muscles and trouble climbing stairs. what are these symptoms of ?: muscular dystrophy 45.which of the following are appropriate interventions for children with muscular dystrophy?
  9. prednisone treatments for life
  10. watch for moon face, weight gain with steroids
  11. physical therapy
  12. mechanical cough device
  13. contact precautions: 1 , 2 , 4 46.both parents of a child were found to have the sickle cell trait how likely is it the child will have sickle cell disease?
  14. 100%

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2. 75 %

3. 25%

4. 0%: 3

47.which of the following is false regarding sickle cell patho

  1. the blood cells have a lower affinity for oxygen
  2. the blood cells are always in a sickle shape

13 / 30

  1. the spleen is occluded from a young age
  2. the life expectancy is around 40-50: 2 the cells become sickle-shaped when there is less oxygen present which is triggers 48.which of the following is true regarding vaso-occlusive crisis
  3. can lead to tissue damage
  4. the hallmark sign is fatigue
  5. there is no way to predict it
  6. ice the effected area: 1
  • the hallmark sign is pain
  • triggers are often present
  • you always wanna use heat never ice 49.simple vs exchange transfusion: simple is just regular blood transfusion exchange is similar to dialysis but you get fresh blood instead of your old blood 50.which of the following is a risk factor for anemia select all that apply
  1. heavy menses
  2. race
  3. smoking
  4. IBD
  5. poor nutrition: 1 , 4 and 5 51.what is MCV ?: mean corpuscular volume ( size ) 52.what is MCH ?: mean corpuscular hemoglobin (weight )

14 / 30 53.what is MCHC ?: mean corpuscular hemoglobin concentration (color) 54.what is a reticulocyte ?: immature RBC 55.a patient age 2 has a low reticulocyte count , a hemoglobin of 9 and a hematocrit of 30 what is happening ?: anemia 56.a pt is diagnosed with anemia which of the following finding is consistent with this diagnosis? select all that apply

  1. total iron binding capacity is elevated
  2. reticulocyte count increased
  3. Hemoglobin decreased
  4. serum ferritin level is high
  5. MCV is low: 1 , 3 , 5
  • reticulocyte is low
  • serum ferritin level is low 57.which of the following assessment findings is consistent with anemia select all that apply
  1. bradycardia
  2. fatigue
  3. brittle fingernails
  4. increased weight
  5. pallor: 2 , 3 and 5 58.which of the following foods is not an iron-rich food
  6. peanut butter
  7. dried fruits
  8. egg whites

15 / 30

  1. red meats: 3
  • egg yolks are 59.a patient has been prescribed ferrous sulfate. which of the following teach- ing is correct. select all that apply
  1. give past the teeth , brush teeth after
  2. take with food and vitamin c
  3. dark tarry stool is a sign of a complication
  4. blood will need to be taken 2 times a year
  5. the hemoglobin should increase after 1 month of medication: 1 , 2 , 5
  • 1 is bc it stains teeth
  • 2 bc GI upset and absorption
  • 3 is not a complication it is actually expected
  • 4 blood will be drawn every 4 weeks
  • hemoglobin should increase by 2 g/ dl 60.which of the following statements regarding testing for sickle cell anemia is false
  1. screening is done at 2 months
  2. a HGB electrophoresis is the way to determine trait vs disease
  3. reticulocyte count is high
  4. bilirubin is high: 1 screening is done as a newborn 61.a 6-month-old is presenting pale, tired, tachycardic, SOB w exertion, jaun- dice, and pain. what are these clinical manifestations of ?: sickle cell

16 / 30 anemia this normally presents between the ages 6 month and toddler years 62.which of the following is not a trigger for a sickle cell crisis?

  1. fever
  2. medications
  3. infection
  4. physical exertion: 2 63.which of the following is not a acute life threating complication of sickle cell?
  5. splenic sequestration
  6. hematuria
  7. acute chest syndrome
  8. CVA
  9. aplastic crisis
  10. priapism: 2
  • 1 pt is now at increased risk of infection -3 looks like pneumonia common in very young child
  • 4 Transcranial doppler is done yearly to assess for this risk
  • 5 extreme anemia
  • 6 painful penile engorgement emergency if not resolved in 4 hours 64.a patient with sickle cell is at risk for all of the following except?
  1. activity intolerance
  2. pain
  3. fluid volume deficit
  4. cognitive delay: 4

17 / 30 65.a patient is having a vaso-occlusive episode. which of the following nurs- ing actions is not appropriate?

  1. admin o
  2. blood transfusion
  3. SCDs
  4. opioids and NSAIDs: 3 66.a 3 year old diagnosed with sickle cell has a medication regimen which of the following daily medications should be questioned
  5. Advil twice daily
  6. penicillin twice daily
  7. Hydroxyurea once daily
  8. prednisone once daily: 4 Advil can be given for pain antibiotics are prophylactically given until age 5 hydroxyurea is for children over 2 67.what does hydroxyurea do ?: increases fetal hemoglobin and reduces sickling 68.What is hemophilia?: deficiency of factor VIII 69.a patient presents with a prolonged APTT , normal platelet count and normal H and H. what might this indicate ?: hemophilia 70.a patient with hemophilia is admitted to the hospital with a fever. which of the following actions by a student nurse requires further teaching select all that apply

18 / 30

  1. Advil PO admin
  2. head to toe to check for any bleeding
  3. 3 Ivs started
  4. rectal temp taken
  5. Bp taken: 1 , 3 and 4
  • no nsaids
  • avoid excessive venipuncture
  • no rectal temps 71.a pt with hemophilia is having an episode of hemarthrosis due to an injury . which of the following actions requires further teaching? 1.apply heat to affected injury
  1. immobilize joint
  2. factor VIII
  3. hold pressure on site for 5 mins: 1. apply heat to affected injury 72.a parent of a child who has hemophilia is talking about their child. which of the following statements might require some follow up questions.
  4. justin just came in 1st in his swim meet
  5. we give justin the factor VIII through his central line at home
  6. justin after he broke his elbow last week has been using the RICE method
  7. justin loves bowling in his free time: 2 a central line has to much risk for infection 73.a 9 mo old presents with raw red, raised bumps that doesnt effect the skin folds. what is happening?: contact dermtitis: diaper rash

19 / 30 74.a child diagnosed with diaper rash hasn't gotten better after 3 days. what medication would you expect to be prescribed?

  1. penicillin
  2. nystatin
  3. prednisone
  4. cephalosporin: 2 if after 3 days diaper rash isnt cured by interventions then it is prob fungal 75.a pt diagnosed with sickle cell has a lot of complications. which of the following is not directly related to sickle cell
  5. one leg longer then the other
  6. swollen hands
  7. ulcers
  8. vomiting
  9. cirrhosis: 4 76.a mom comes in with a child who has a diaper rash says shes been doing the following interventions , which of the following requires intervention?
  10. barrier cream
  11. baby powder
  12. warm water and pat dry
  13. freq diaper changes: 2 77.What is eczema?: impaired lipid barrier of the skin 78.a child has dry rough cracked skin , some of the sores have crusted exudate. the child also has a peanut allergy and asthma. what is

20 / 30 happening ?: eczema 79.a mom is talking to a nurse and is expressing frustration because her child eczema is not going away. the nurse asks what interventions she uses , which intervention is not correct?

  1. trims fingernails
  2. applying Eucerin then steroid
  3. loose cotton clothing
  4. freq baths: 2 you want to put on steriod then emollient 80.what causes acne ?: increased sebum then obstruction then comedones and inflammation 81.which of the following nursing goals is not a priority goal with acne
  5. infection control
  6. reduce scarring
  7. suppress lesions
  8. minimize psych distress: 1 82.a child is diagnosed with moderate acne which of the following would not be an expected intervention
  9. tretinoin
  10. tetracycline
  11. accutane
  12. benzoyl peroxide: 3 Accutane is only used for severe acne 83.a child is prescribed medication for moderate acne. which teaching is

21 / 30 not needed

  1. avoid sun exposure
  2. this treatment may take up to 6 weeks to work
  3. no astringents
  4. you must be on two forms of birth control: 4 this is a teaching for Accutane 84.how long is the treatment regime for accutane?: 4-6 months 85.which of the following could be a cause of impetigo
  5. staph aureus
  6. herpes 3.: 86.muscular dystrophy patho: lack of dystrophin that leads to fat entering cells and muscles are floppy 87.which of the following labs would not be appropriate for muscular dystro- phy
  7. cbc
  8. muscle biopsy
  9. creatine kinase: 2 88.a child presents with honey-crusted vesicles around the mouth and their sibling presents with similar symptoms. which of the following is not an appropiate intervention
  10. mupirocin topically 3 times a day for 5 days
  11. send a child to school 24 hours after antibiotics started
  12. wiping the crust off with q tip
  13. not sharing anything: 3

22 / 30 89.what is the priority for serial casting with club feet

  1. skin integrity
  2. mobility
  3. perfusion
  4. safety: 3 90.which of the following is not a risk factor for thrush
  5. inhaled steriod
  6. daycare
  7. if mom has yeast infection
  8. antibiotics: 2 91.where do fungus thrive ?: warm moist environment 92.a child has white patches on the tongue that cant be removed. what is happening ?: thrush 93.a mom is treating a child for thrush and she is freaking out because her child swallowed some oral nystatin. what should you say
  9. omg we need to pump her stomach
  10. its good for her
  11. its ok no biggie
  12. nystatin is neurotoxic she will die: 3 94.a pt is diagnosed with tinea capitus which of the following is not an expected treatment?
  13. girseofulvin po for 8-12 weeks
  14. miconazole topical
  15. selenium sulfide shampoo for 2 to 3 weeks: 2
  • this is used for tinea corporis which is on the trunk

23 / 30 95.What is pediculosis capitis?: head lice 96.a pt is diagnosed with lice which of the following is not a good intervention

  1. use nix
  2. treat for 10 minutes no more
  3. shampoo 24 hours after treatment
  4. return to school after one nix treatment: 3
  • no shampoo or conditioner for 2 days after treatment 97.a child has scaly circular patches all over the trunk. what is happening ?: tinea corpis 98.How is impetigo spread?: contact 99.What is enuresis?: involuntary urination by a child over 5 2 times a week for 3 months
  1. which of the following statements regarding enuresis is true?
  2. primary is incotience after 6 months of control
  3. primary is associated with stress or uti
  4. primary is associated with maturational delay
  5. secondary is never dry at night: 3 primary is never dry at night and related to maturational delay secondary is related to an underlying problem
  6. which of the following is not a good intervention for enuresis?
  7. fluid restriction
  8. urine analysis
  9. therapy
  10. desmopressin

24 / 30

  1. food restriction: 5
  2. a child is 3 years old and is only growing 2 inches a year , their length and weight is under 3 percentile , increased abdominal fat , delayed teeth eruption . what is happening ?: hypopituitarism (growth hormone deficiency )
  3. What is somatotropin?: growth hormone
  4. What do LH and FSH do?: regulate production of gametes and reproductive hormones
  5. a child is suspected to have growth hormone deficiency. which of the following would be an approriate next step?
  6. x- ray of hand
  7. full body x-ray
  8. CT of brain
  9. MRI: 1
  10. a child has been confirmed to have growth hormone deficiency. which of the following is not a good treatment method.
  11. daily sub q injections of somatotropin at night
  12. evidence of epiphyseal closure start medications
  13. endocrinologist visit every 3 months
  14. stop meds when growing over 1 inch a year: 2 you should stop meds when epiphyseal plate closure
  15. What is precocious puberty?: the very early onset and rapid progression of puberty
  16. a patient is 5 years old and begins to develop secondary sex

25 / 30 character- istics. which of the following would not be an appropriate intervention?

  1. suppress androgen
  2. discuss sexuality
  3. admin of FSH
  4. monthly IM of leuprolide: 3
  5. what can happen if PKU is left untreated?
  6. liver failure
  7. kidney damage
  8. heart failure
  9. brain damage: 4
  10. a child has musty odor in urine , vomiting, irritability, hypertonia. what is happening ?: PKU
  11. a mom is being discharged from the hosp with a child with PKU which does not need more teaching
  12. My child should eat lots of protein to make up for the lack of phenylalanine
  13. my child will need serum levels drawn regularly and their levels should be between 2 and 6 3.. I cant breastfeed i can only use lofenalac formula 4.. my child can drink diet coke: 2
  • child shouldnt eat any protein
  • moms can breast feed but will need to modify diet
  • no aspartame
  1. what is acanthosis nigricans and what does it put a child at risk for ?: hyperpigmentation , puts child at risk for type 2 diabetes