Download peds exam 3 questions with Complete solution and more Exams Pediatrics in PDF only on Docsity!
1 / 58
peds exam 3 questions with Complete solution
1. The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is
most important to emphasize as the potential cause?
a. Poor hygiene
b. Constipation
c. Urinary stasis
d. Congenital anomalies: c. Urinary stasis
2. A girl, age 5 1/2 years, has been sent to the school nurse for urinary incon- tinence three
times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?
a. School phobia
b. Glomerulonephritis
c. Urinary tract infection (UTI)
d. Attention deficit hyperactivity disorder (ADHD): c. Urinary tract infection (UTI)
3. In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to
vesicoureteral reflux (VUR), the nurse should include which information?
a. Limit fluids to reduce reflux.
b. Give cranberry juice twice a day.
c. Have siblings examined for VUR.
2 / 58
d. Surgery is indicated to reverse scarring: c. Have siblings examined for VUR.
4. What measure of fluid balance status is most useful in a child with acute
glomerulonephritis?
a. Proteinuria
b. Daily weight
c. Specific gravity
d. Intake and output: b. Daily weight
5. The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood
pressure readings are being taken so often. What knowledge should influence the nurse's reply?
a. The antibiotic therapy contributes to labile blood pressure values.
b. Hypotension leading to sudden shock can develop at any time.
c. Acute hypertension is a concern that requires monitoring.
d. Blood pressure fluctuations indicate that the condition has become chron- ic.: c. Acute hypertension is a
concern that requires monitoring.
6. What laboratory finding, in conjunction with the presenting symptoms, indicates
minimal change nephrotic syndrome?
a. Low specific gravity
b. Decreased hemoglobin
c. Normal platelet count
4 / 58 the reason for the surgery if they tell the nurse this was done to do what?
a. "Prevent damage to the undescended testicle."
b. "Prevent urinary tract infections."
c. "Prevent prostate cancer."
d. "Prevent an inguinal hernia.": a. "Prevent damage to the undescended testicle."
11. A child is admitted with acute glomerulonephritis. What should the nurse expect
the urinalysis during this acute phase to show?
a. Bacteriuria and hematuria
b. Hematuria and proteinuria
c. Bacteriuria and increased specific gravity
d. Proteinuria and decreased specific gravity: b. Hematuria and proteinuria
12. The nurse is caring for a child with a urinary tract infection who is on intravenous
gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.)
a. Encourage fluids.
b. Monitor urinary output.
c. Monitor sodium serum levels.
d. Monitor potassium serum levels.
e. Monitor serum peak and trough levels: a. Encourage fluids.
5 / 58 b. Monitor urinary output. e. Monitor serum peak and trough levels
13. The nurse is caring for a child with a urinary tract infection who is on trimethoprim-
sulfamethoxazole (Bactrim). What side effects of this medica- tion should the nurse teach to the parents and the child? (Select all that apply.)
a. Rash
b. Urticaria
c. Pneumonitis
d. Renal toxicity
e. Photosensitivity: a. Rash
b. Urticaria e. Photosensitivity
14. The nurse is caring for a child with acute renal failure. What laboratory findings
should the nurse expect to find? (Select all that apply.)
a. Hyponatremia
b. Hyperkalemia
c. Metabolic alkalosis
d. Elevated blood urea nitrogen level
e. Decreased plasma creatinine level: a. Hyponatremia
7 / 58 d. Growth failure e. Blood in the urine
17. What dietary instructions should the nurse give to parents of a child in the oliguria
phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.)
a. High-fat
b. Low-protein
c. Encouragement of fluids
d. Moderate sodium restriction
e. Limit foods high in potassium: d. Moderate sodium restriction
e. Limit foods high in potassium
18. Parents of a child who will need hemodialysis ask the nurse, "What are the advantages
of a fistula over a graft or external access device for hemodialy- sis?" What response should the nurse give? (Select all that apply.)
a. It is ready to be used immediately.
b. There are fewer complications with a fistula.
c. There is less restriction of activity with a fistula.
d. It produces dilation and thickening of the superficial vessels.
e. The fistula does not require a needle insertion at each dialysis.: b. There are fewer complications with a
fistula.
c. There is less restriction of activity with a fistula.
8 / 58
d. It produces dilation and thickening of the superficial vessels.
19. What are signs and symptoms of a possible kidney transplant rejection in a child?
(Select all that apply.) a. Fever
b. Hypotension
c. Diminished urinary output
d. Decreased serum creatinine
e. Swelling and tenderness of graft area: a. Fever
c. Diminished urinary output
e. Swelling and tenderness of graft area
20. A toddler's mother calls the nurse because she thinks her son has swal- lowed a disc
type of battery. He has no signs of respiratory distress. The nurse's response should be based on which premise?
a. An emergency laparotomy is very likely.
b. The location needs to be confirmed by radiographic examination.
c. Surgery will be necessary if the battery has not passed in the stool in 48 hr.
d. Careful observation is essential because an ingested battery cannot be accurately detected: b. The
location needs to be confirmed by radiographic examination.
21. The mother of a child with cognitive impairment calls the nurse because her son has
been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the
10 / 58 what potential complication?
a. Hyperkalemia
b. Hyperchloremia
c. Metabolic acidosis
d. Metabolic alkalosi: d. Metabolic alkalosi
25. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN).
The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
a. Wean the infant from TPN the next day.
b. Stimulate adaptation of the small intestine.
c. Give additional nutrients that cannot be included in the TPN.
d. Provide parents with hope that the child is close to discharge.: b. Stimulate adaptation of the small
intestine.
26. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis
A. What information should the nurse include?
a. Advise bed rest until 1 week after the icteric phase.
b. Teach infection control measures to family members.
c.Inform the mother that the child cannot return to school until 3 weeks after onset of jaundice.
d. Reassure the mother that hepatitis A cannot be transmitted to other family members.: b. Teach
infection control measures to family members.
11 / 58
27. The nurse is caring for a neonate with a suspected tracheoesophageal fistula.
Which intervention should the nurse include in the plan of care?
a. Feed glucose water only.
b. Elevate the patient's head for feedings.
c. Raise the patient's head and give nothing by mouth.
d. Avoid suctioning unless the infant is cyanotic.: c. Raise the patient's head and give nothing by mouth.
28. What should preoperative care of a newborn with an anorectal malforma- tion include?
a. Frequent suctioning
b. Gastrointestinal decompression
c. Feedings with sterile water only
d. Supine position with head elevated: b. Gastrointestinal decompression
29. The parents of a newborn with an umbilical hernia ask about treatment options. The
nurse's response should be based on which knowledge?
a. Surgery is recommended as soon as possible.
b. The defect usually resolves spontaneously by 3 to 5 years of age.
c. Aggressive treatment is necessary to reduce its high mortality.
d. Taping the abdomen to flatten the protrusion is sometimes helpful.: b. The defect usually resolves
spontaneously by 3 to 5 years of age.
30. What should the nurse consider when providing support to a family whose infant has
13 / 58
a. The prognosis for full recovery is excellent.
b. Death usually occurs by 6 months of age.
c. One third requires a liver transplant.
d. Children with surgical correction live normal lives.: c. One third requires a liver transplant.
31. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed
any meconium stools. What disease should the nurse suspect?
a. Pyloric stenosis
b. Intussusception
c. Hirschsprung disease
d. Celiac disease: c. Hirschsprung disease
32. A 6-month-old infant with Hirschsprung disease is scheduled for a tempo- rary
colostomy. What should postoperative teaching to the parents include?
a. Dilating the stoma
b. Assessing bowel function
c. Limitation of physical activities
d. Measures to prevent prolapse of the rectum: b. Assessing bowel function
33. An infant is born with a gastroschisis. Care preoperatively should include which
priority intervention?
a. Prone position
14 / 58
b. Sterile water feedings
c. Monitoring serum laboratory electrolytes
d. Covering the defect with a sterile bowel bag: d. Covering the defect with a sterile bowel bag
34. The nurse is assisting a child with celiac disease to select foods from a menu. What
foods should the nurse suggest?
a. Hamburger on a bun
b. Spaghetti with meat sauce
c. Corn on the cob with butter
d. Peanut butter and crackers: c. Corn on the cob with butter
35. A child is being admitted to the hospital with acute gastroenteritis. The health care
provider prescribes an antiemetic. What antiemetic does the nurse anticipate being prescribed?
a. Ondansetron (Zofran)
b. Promethazine (Phenergan)
c. Metoclopramide (Reglan)
d. Dimenhydrinate (Dramamine): a. Ondansetron (Zofran)
36. The nurse should instruct parents to administer a daily proton pump in- hibitor
to their child with gastroesophageal reflux at which time?
a. Bedtime
16 / 58
c. Anorexia
d. Tender, distended abdomen
e. Hematemesis
f. Sudden acute abdominal pain: b. Passage of red, currant jelly-like stools
d. Tender, distended abdomen
f. Sudden acute abdominal pain
40. The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease
foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply.)
a. Citrus
b. Bananas
c. Spicy foods
d. Peppermint
e. Whole wheat bread: a. Citrus
c. Spicy foods
d. Peppermint
41. The nurse is preparing to admit a 6-year-old child with irritable bowel syn- drome (IBS).
What clinical manifestations should the nurse expect to observe? (Select all that apply.)
a. Flatulence
17 / 58
b. Constipation
c. No urge to defecate
d. Absence of abdominal pain
e. Feeling of incomplete evacuation of the bowel: a. Flatulence
b. Constipation
e. Feeling of incomplete evacuation of the bowel
42. The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical
manifestations should the nurse expect to observe? (Select all that apply.)
a. Steatorrhea
b. Polycythemia
c. Malnutrition
d. Melena stools
e. Foul-smelling stools: a. Steatorrhea
. Malnutrition e. Foul-smelling stools
43. The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical
manifestations should the nurse expect to observe? (Select all that apply.)
a. Fever
b. Vomiting
19 / 58
c. Failure to thrive
d. Excessive crying
e. Respiratory problems: a. Spitting up
c. Failure to thrive
d. Excessive crying
e. Respiratory problems
46. The nurse is preparing to admit a 7-year-old child with hepatitis B. What clinical
features of hepatitis B should the nurse recognize? (Select all that apply.)
a. The onset is rapid.
b. Rash is common.
c. Jaundice is present.
d. No carrier state exists.
e. The mode of transmission is principally by the parenteral route.: b. Rash is common.
c. Jaundice is present. e. The mode of transmission is principally by the parenteral route.
47. A child with hypopituitarism is being started on growth hormone (GH) therapy.
Nursing considerations should be based on which knowledge?
a. Therapy is most successful if it is started during adolescence.
b. Replacement therapy requires daily subcutaneous injections.
20 / 58
c. Hormonal supplementation will be required throughout child's lifetime.
d. Treatment is considered successful if children attain full stature by adoles- cence.: b. Replacement
therapy requires daily subcutaneous injections.
48. A child with growth hormone (GH) deficiency is receiving GH therapy. When is the best
time for the GH to be administered?
a. At bedtime
b. After meals
c. Before meals
d. After arising in morning: a. At bedtime
49. A child is receiving propylthiouracil for the treatment of hyperthyroidism (Graves
disease). The parents and child should be taught to recognize and report which sign or symptom immediately?
a. Fatigue
b. Weight loss
c. Fever, sore throat
d. Upper respiratory tract infection: c. Fever, sore throat
50. A child with hypoparathyroidism is receiving vitamin D therapy. The parents should be
advised to watch for which signs or symptoms of vitamin D toxicity?
a. Headache and seizures
b. Weakness and lassitude
