Worksheetspediatrics ch 27 and 28
Total questions: 65
Worksheet time: 35mins
Which finding in a newborn is suggestive of tracheoesophageal fistula?
Failure to pass meconium in 24 hours
Choking on the first feeding
Palpable mass in the sternal area
Visible peristalsis across abdomen
A child is brought to the pediatric clinic because he has been vomiting for the past 2 days. What acid-base imbalance would the nurse expect to occur from this persistent vomiting?
Hyperkalemia
Hypernatremia
Acidosis
Alkalosis
On the second day of hospitalization for a 3-month-old brought in for treatment for gastroenteritis, the nurse makes all of the assessments listed below. Which assessment finding indicates ineffectiveness of treatment?
Weight loss of 4 ounces
Dry mucous membranes
Decreased skin turgor
Depressed fontanelle
Why are rapid respirations a possible cause of dehydration?
They prevent the child from drinking.
They increase circulation, thus increasing urine production.
They cause evaporation of fluid on the mucous membranes.
They often lead to vomiting.
Which is the most appropriate intervention for a 3-month-old infant who has gastroesophageal reflux?
Position the infant in the crib on his or her abdomen, with the head elevated.
Administer medication as ordered to stimulate the pyloric sphincter.
Give thin rice cereal with formula before feeding solid foods.
Place the infant in an infant seat after feeding
The nurse is interviewing parents of an infant with pyloric stenosis. What would the nurse expect the parents to report?
Diarrhea
Projectile vomiting
Poor appetite
Constipation
A mother reports that her child has been scratching the anal area and complaining of itching. What does the nurse suspect based on this information?
Pinworms
Giardiasis
Ringworm
Roundworm
The nurse is teaching a parent about pyrvinium (Povan). What would be included in regard to potential side effects?
Diarrhea
Skin rash
Skin rash
Metallic taste
What instruction will the nurse give to parents about preventing the spread and reinfection of pinworms?
Keep childs nails short.
Dress child in loose-fitting underwear.
Clean the bathroom with bleach solution.
Clean the bathroom with bleach solution.
A mother reports that her 2-year-old child experiences constipation frequently. Which food would the nurse recommend to include in the childs diet?
Cooked vegetables
Pretzels
Whole-grain cereal
Yogurt
What description of a childs stool characteristic leads the nurse to suspect intussusception?
Currant jelly
Black and tarry
Green liquid
Greasy and foul-smelling
What is the treatment of choice for a child with intussusception?
A barium enema
Immediate surgery
IV fluids until the spasms subside
Gastric lavage
Parents ask the nurse how their infant developed a Meckels diverticulum. What condition, will the nurse explain, is present causing this diagnosis?
The yolk sac remains connected to the intestine.
There is inflammation of the ileocecal valve.
A pouch forms when the vitelline duct fails to disappear.
There is a weakness in the abdominal wall.
An infant is admitted to the hospital with severe isotonic dehydration. For what is this child at the highest risk?
Metabolic alkalosis
Hypocalcemia
Sepsis
Shock
A child is brought to the emergency department because he ingested an unknown quantity of acetaminophen (Tylenol). What does the nurse expect this child to receive following gastric lavage?
Activated charcoal
N-acetylcysteine
Vitamin K
Syrup of ipecac
The nurse is planning a parent education program about lead poisoning prevention. What will be included regarding primary sources of lead in the community?
Increased lead content of air
Use of aluminum cookware
Deteriorating paint in older buildings
Inhaling smog
A frightened mother calls the pediatricians office because her child swallowed dishwashing detergent. What is the most appropriate action?
Induce vomiting by giving the child syrup of ipecac.
Take the child to the local emergency department.
Give the child activated charcoal mixed with juice.
Give the child milk to soothe affected mucous membranes.
A child has been diagnosed with ascariasis (roundworm). Which statement made by her mother that may suggest a cause for her condition?
I've been airing out the house on these nice breezy days.
My child often goes out to the garden and pulls up a carrot to eat.
She runs barefoot so much I have to wash her feet at least twice a day.
We just remodeled our bathroom at home.
What does the nurse expect the appearance of the stools of a child with celiac disease to be?
Ribbon like
Hard, constipated
Bulky, frothy
Loose, foul-smelling
The nurse has reviewed dietary restrictions for celiac disease with concerned parents. Which grain will the nurse explain can be eaten with celiac disease?
Wheat
Oats
Barley
Rice
A 7-month-old infant is admitted to the hospital with a diagnosis of acute gastroenteritis. What will be the nursess priority goal of the infants care?
Prevent fluid and electrolyte imbalance.
Prevent nutritional deficiency
Prevent skin breakdown.
Prevent malabsorption.
The nurse is speaking to the parent of a 3-year-old child who has mild diarrhea. What dietary modification would the nurse advise?
Soft foods with rice, bananas, toast, and applesauce
Small amounts of clear fluids such as gelatin
An oral rehydrating solution, such as Pedialyte
Chicken soup because it is high in sodium
What would the nurse expect to find in a child admitted to the hospital for nonorganic failure to thrive?
Cry to be picked
Be limp like a rag doll
Be responsive to cuddling
Weigh in the 10th percentile for age
Which nursing interventions will be implemented for the mother of a 10-month-old infant with nonorganic failure to thrive?
Pointing out errors that the nurse observes when the mother is caring for the infant
Discussing negative characteristics of the infant with the mother
Having the nurse provide as much of the infants care as possible
Teaching the mother about the developmental milestones to expect in the next few months.
Which statement by a mother may indicate a cause of her sons vitamin C deficiency?
We get our fruits from homemade preserves.
We use milk from our own goats
We grow all our own vegetables
Were not big meat eaters.
The nurse is instructing a mother how to administer oral nystatin suspension prescribed to treat thrush. What will the nurse include?
Pour the prescribed amount into a nipple and have the infant suck the medication.
Squirt the prescribed dose into the back of the mouth and have the infant swallow
Give the medication mixed with a small amount of juice in a bottle
Use a sterile applicator to swab the medication on the oral mucosa.
Why are infants more vulnerable to fluid and electrolyte imbalances than adults?
They have a smaller surface area than adults in proportion to body weight.
Water needs and losses per kilogram are lower than those for adults.
A greater percentage of body water in infants is extracellular.
Infants have a lower metabolic turnover of water.
An infant is admitted to the hospital with severe dehydration. Laboratory results show pH 7.32, PaCO2 40, HCO3 21. How does the nurse interpret these values?
Metabolic acidosis
Metabolic alkalosis
Respiratory acidosis
Respiratory alkalosis
Following surgery for pyloric stenosis, an infant awoke from anesthesia hungry and crying. What is the most appropriate nursing action?
Delay feeding the child for 6 hours.
Offer regular formula thinned with water.
Give small amounts of regular formula thickened with cereal.
Allow 1 ounce of glucose water at frequent intervals.
The nurse is caring for an 18-pound child who has had one stool of diarrhea. The nurse knows that the child needs to consume how many milliliters of oral fluid to make up for the fluid loss?
18
36
64
81
Which statement made by a parent alerts the nurse to the need for additional education about poison prevention?
I keep the poison control center phone number easily accessible.
All medication is kept out of reach in a locked cabinet.
I keep a bottle of syrup of ipecac handy
Our garden is free from marigolds.
Which assessment would the nurse report to the physician immediately?
2-month-old with a urine output of 150 mL in 24 hours
3-year-old with a urine output of 650 mL in 24 hours
8-year-old with a urine output of over 1000 mL in 24 hours
14-year-old with a urine output of 800 mL in 24 hourse
What interventions will the nurse perform when feeding a child with pyloric stenosis? (Select all that apply.)
Give a formula thinned with water
Burp the infant before and during feeding.
Give the feeding slowly
Refeed if the infant vomits
Position infant on left side after feeding.
What assessment(s) would lead a nurse to suspect Hirschsprungs disease in a 1-month-old infant? (Select all that apply.)
Ribbon-like stools
Fever
failure to thrive
vomiting
diminished peristalsis
What sign(s) indicate(s) moderate dehydration? (Select all that apply.)
10 % weight loss
Dry mucous membranes
Normal anterior fontanel
Increased urinary output
Lethargy
The nurse, assessing an elevated erythrocyte sedimentation rate (ESR) for an infant with gastroenteritis, recognizes that this confirms the (a) process that is part of this disease.
The nurse is teaching the parents of a young child with iron deficiency anemia about nutrition. What food would the nurse emphasize as being a rich source of iron?
An egg white
Cream of wheat
A banana
A carrot
Which statement by a mother may indicate a cause for her 9-month-olds iron deficiency anemia?
Formula is so expensive. We switched to regular milk right away
She almost never drinks water
She doesnt really like peaches or pears, so we stick to bananas for fruit
I give her a piece of bread now and then. She likes to chew on it.
What will the nurse administer with ferrous sulfate drops when providing them to a child on the pediatric unit?
With milk
With Orange juice
With water
On a full stomach
What is the result of a deficiency of factor IX?
Thalassemia
Idiopathic thrombocytopenic purpura
Hemophilia A
Christmas disease
A 2-year-old child has been diagnosed with hemophilia A. What information should the nurse include in a teaching plan about home care?
If bleeding occurs, apply pressure, ice, elevate, and rest the extremity
Childrens aspirin in lowered doses may be given for joint discomfort.
A firm, dry toothbrush should be used to clean teeth at least twice a day.
Do not permit interactive play with other children.
What will the nurse teach the parents of a child with a low platelet count to avoid?
Ibuprofen
Aspirin
Caffiene
Prednisone
What should the nurse closely assess in a child receiving a transfusion?
Fever
Lethargy
Jaundice
Bradycardia
On admission, a child with leukemia has widespread purpura and a platelet count of 19,000/mm3. What is the priority nursing intervention?
Assessing neurological status
Inserting an intravenous line
Monitoring vital signs during platelet transfusions
Providing family education about how to prevent bleeding
An adolescent is diagnosed with Hodgkins disease. Lymph nodes on both sides of her diaphragm have been found to be involved, including cervical and inguinal nodes. Which disease stage is this?
I
II
III
IV
A 3-year-old child with sickle cell disease is admitted to the hospital in sickle cell crisis with severe abdominal pain. Which type of crisis is the child most likely experiencing?
Aplastic
Hyperhemolytic
Vaso-occlusive
Splenic sequestration
Which statement made by a parent indicates an understanding of health maintenance of a child with sickle cell disease?
I should give my child a daily iron supplement
It is important for my child to drink plenty of fluids
He needs to wear protective equipment if he plays contact sports.
He shouldnt receive any immunizations until he is older.
A newly married couple is seeking genetic counseling because they are both carriers of the sickle cell trait. How can the nurse best explain the childrens risk of inheriting this disease?
Every fourth child will have the disease; two others will be carriers.
All of their children will be carriers, just as they are.
Each child has a one in four chance of having the disease and a two in four chance of being a carrier
The risk levels of their children cannot be determined by this information.
A child with thalassemia major receives blood transfusions frequently. What is a complication of repeated blood transfusions?
Hemarthrosis
Hematuria
Hemoptysis
Hemosiderosis
A child has just been diagnosed with acute lymphoblastic leukemia. What is the result of an overproduction of immature white blood cells in the bone marrow?
Decreased T-cell production
Decreased hemoglobin
Increased blood clotting
Increased susceptibility to infection
The child receiving a transfusion complains of back pain and itching. What is the best initial action by the nurse?
Notify the charge nurse.
Disconnect intravenous lines immediately.
Give diphenhydramine (Benadryl).
Clamp off blood and keep line open with normal saline.
What would the nurse include in a teaching plan about mouth care of a child receiving chemotherapy?
Use commercial mouthwash.
Clean teeth with a soft toothbrush.
Avoid use of a Water-Pik.
Inspect the mouth weekly for ulcerations.
A 6-year-old with leukemia asks, Who will take care of me in heaven? What is the best response by the nurse?
Who do you think will take care of you?
Your grandparents and God will take care of you.
Your mom will know more about that than I do.
Why are you asking me that?
The nurse is dealing with a preschool-age child with a life-threatening illness. What should the nurse remember the childs concept of death is at this age?
That it is final
Only a fear of separation from her parents
That a person becomes alive again soon after death
An understanding based on simple logic
The nurse notes that a 4-year-old childs gums bleed easily and he has bruising and petechiae on his extremities. Which lab value is consistent with these symptoms?
Platelet count of 25,000/mm3
Hemoglobin level of 8 g/dL
Hematocrit level of 36%
Leukocyte count of 14,000/mm3
The nurse, caring for a child receiving chemotherapy, notes that the childs abdomen is firm and slightly distended. There is no record of a bowel movement for the last 2 days. What do these assessment findings suggest?
Peripheral neuropathy
Stomatitis
Myelosuppression
Hemorrhage
The nurse finds an adolescent with Hodgkins disease crying. The adolescent says, I am so scared. What is the most appropriate nursing response to this comment?
I understand how you must feel.
You shouldnt feel that way
Is this the strongest feeling youve had today?
Tell me whats got you scared
The nurse finds an adolescent with Hodgkins disease crying. The adolescent says, I am so scared. What is the most appropriate nursing response to this comment?
I understand how you must feel.
You shouldn't feel that way.
Is this the strongest feeling youve had today?
Tell me whats got you scared.
The most recent blood count for a child who received chemotherapy last week shows neutropenia. What is the priority nursing diagnosis for this child?
Risk for infection
Risk for hemorrhage
Altered skin integrity
Disturbance in body image
What important focus of nursing care for the dying child and the family should the nurse implement?
Nursing care should be organized to minimize contact with the child.
Adequate oral intake is crucial to the dying child.
Families should be made aware that hearing is the last sense to stop functioning before death
It is best for the family if the nursing staff provides all of the childs care.
The nurse is presenting information on the congentital disorder of hemophilia A. What fact will the nurse include?
It is seen in males and females equally
It is transmitted by symptom-free females.
It is a sex-linked dominant trait.
It is a defective gene located on the Y chromosome.
A child is diagnosed with iron deficiency anemia. What will the nurse explain can occur if this disorder goes untreated?
Hemorrhage
Heart failure
Infection
Pulmonary embolism
The nurse is caring for a child with a low platelet count. What skin assessments would alert the nurse to bleeding? (Select all that apply.)
Petichiae
Purpura
Ecchymosis
Hematoma
Lymphadenopathy
Why would the nurse urge the family of a dying 12-year-old boy to include his 8-year-old sister in care? (Select all that apply.)
She will feel less neglected by the parents
She can make amends for past hostilities to her brother
She will feel increased helplessness.
She can express her feelings through care.
She can experience being supportive of her parents and brother.
What should be included in the nursing care of a 12-year-old child receiving radiation therapy for Hodgkins disease? (Select all that apply.)
Application of sunblock
Appetite stimulation
Conservation of energy
Provision for expressions of anger
Preparation for premature sexual development
