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Pediatrics Exam 4

Total questions: 78

Worksheet time: 56mins

Name
Class
Date
1.

Signs and Symptoms of Heart Disease in Kids

a)

Failure to Thrive

b)

Developmental Disabilities (Down Syndrome/Trisomy 21)

c)

Clubbing in Fingers d/hypoxia and cyanosis

d)

Brain getting oxygen

e)

Waddling Gait

2.

Signs and Symptoms in Respiratory/Cardiac for Heart Disease

a)

Barrel Chest / Wide pulse pressure

b)

Shallow respirations/Respiratory Distress

c)

Peripheral Edema/Cold Hand s or feet

d)

Pale/Mottled/Gray Skin

e)

Cyanosis in first 24 hours of life

3.

What are some Genetic Risk Factors for CHD?

a)

Trisomy 21

b)

Kawasaki Disease

c)

Rheumatic Fever

d)

Turner Syndrome

e)

Congenital Abnormalities

4.

Obstructive Disorders for CHD?

a)

Coarctation of the Aorta

b)

TOF

c)

Aortic stenosis

d)

Pulmonary Atresia

e)

Pulmonary Stenosis

5.

Signs and symptoms of PDA?

a)

Cyanosis

b)

Weight Gain

c)

Washing Machine Sound/Diuresis/Poor feeding/ SOB/ Wet lung sounds

d)

Weight Loss

e)

Wet lung sounds

6.

Treatment for PDA? Wanting to Close?

a)

Cluster Periods

b)

Coil Embolization and Ligation

c)

Nifedipine/Digoxin

d)

Do not Cluster Care

e)

Indomethacin, Ibuprofen, NSAIDs

Every 4-6 Hr to make sure it closes

7.

Echocardiogram shows what for ASD?

(a)  

8.

What is VSD?

a)

Hole between left and right atrium

b)

Hole between left and right ventricle

c)

Right to left shunt. Pressure in the right ventricle will go to the left.

d)

Left to right shunt. Pressure in left ventricle will go to the right.

e)

Increased pulmonary blood flow

9.

A patient comes in with a sudden marked increase in cyanosis and dizziness (Tet Spell). What is our nursing intervention?

a)

Have the patient squat. If they are not old enough: Put the infant knees to chest.

b)

Administer Prostaglandin E1

c)

Raise the head of bed

d)

Increase fluids

10.

A patient has TOF, what should the nurse educate the parents about?

a)

Feed every 3 hours

b)

Knees should be drawn to chest to calm the infant

c)

Prepare for multiple surgeries/Blalock taussig procedure

d)

Do not cluster care/ Prostaglandin E1

e)

Cluster care / Prostaglandin E1/ HOB elevated

11.

Diagnosis and testing for Tricuspid Atresia?

a)

Echocardiogram

b)

EKG

c)

Chest XRAY

d)

Cardiac Catheterization

e)

Urinalysis

12.

Treatment for Hypoplastic Left Heart Syndrome?

a)

Prostaglandin E1 Drip To keep the PDA open

b)

Cardiac Catheretization/

c)

Digoxin/Diuretics

Life long follow up with cardiologist

d)

Tx for Ineffective Endocarditis: Antibiotics Prophylactically before surgery and dental work

e)

Several surgeries/ Open Heart Surgery/ Risk for infection/ Pain medications/ Feeds

13.

A patient has a high fever unresponsive to medication, lasting more than 5 days , strawberry tongue, and red swollen hands and feet, enlarged lymph nodes and scarlet fever rash Everything Red. What could be the potential diagnosis?

(a)  

14.

What is the treatment for hypoplastic left heart syndrome?

a)

Surgical transplantation Norwood procedure

b)

Prostaglandin E1 infusion

c)

Blalock Tuessigs procedure

d)

Cardiac Catheterization

15.

Signs and Symptoms of Coarctation of the Aorta

a)

Bp high in upper extremities/ JVD

b)

BP lower in lower extremities

c)

Shortness of breath/ headache/hypertension

d)

Increased femoral pulses/ Weight loss

e)

Decreased femoral pulses/ Weight gain/ Poor feedings

16.

Post op Cardiac Catheterization Interventions?

a)

I&O/ Pulses/ Hold pressure on site

b)

Have the patient move freely with semi fowlers

c)

have the patient flat

d)

Keep extremities straight for 4-6 hours

e)

Yellow/green drainage is okay

17.

What are the types of shock?

a)

Cardiogenic

b)

Hypervolemic

c)

Hypovolemic

d)

Septic

18.

A patient comes in with damage to the heart muscle resulting in failure to pump. What kind of shock is this? Decrease in cardiac output related to heart damage?

a)

Cardiogenic

b)

Hypovolemic

c)

Anaphylactic

d)

Septic

19.

What are some diuretics?

a)

Spironolactone (aldactone)

b)

Nifedipine

c)

Furosemide

d)

Hydrochlorothizaide

e)

Bumetanide

20.

What should a nurse do prior to administering Digoxin?

a)

Peripheral pulses

b)

Take apical for 1 full minute

c)

Double doses if missed a dose

d)

Administer 1 hour before meals and 2 hours after meals

e)

Assess for bradycardia (Digoxin toxicity)

21.

A patient has Kawasaki Disease. What should the nurse give for treatment?

a)

IV gamma globulin for ten days (Cardiac Protectant)

b)

IV gamma globulin for 5 days

c)

Aspirin High-Dose (To treat clots/redness)

d)

Antiplatelet therapy for 6-8 weeks

22.

What are my interventions for a patient with rheumatic heart disease?

a)

ASO Titer Test

b)

Administer antibiotics

c)

Cardiac Catheterization

d)

Diuretics

23.

Education for patient for TOF?

a)

Teach family to keep calm infant/ Support the family

b)

Continuous procedures/ Maintain Pyloric Intake

c)

Consistently following up with cardiologist every 6mo-1 year

d)

Supine position

24.

Post Hematoma?

a)

Hold pressure on the site

b)

Outline the hematoma if it gets bigger

c)

Increase fluids

d)

Prostaglandin E1

25.

Assessment Priorities for Rheumatic Heart Disease?

a)

Cardiac Assessment For valvular issues

b)

Digoxin Administration

c)

Auscultate Heart Sounds

d)

Bowel Sounds

26.

What position for a patient experiencing shock?

a)

Trendelenburg

b)

Prone

c)

Semi Fowlers

d)

HOB 30 degrees

27.

T/F about Furosemide (Lasix)

a)

Loop diuretic

b)

Give foods low in potassium

c)

Give foods high in potassium

d)

It is ototoxic

e)

Report signs of SOB due to Steven Johnsons Syndrome

28.

Signs and Symptoms of Digoxin Toxicity?

a)

Visual Disturbances

b)

Bradycardia

c)

Tachycardia

d)

Nausea/Vomiting

29.

Techniques to calm a baby during assessment?

a)

Nonnutritive Sucking to relief anxiety, decreases pain, provides comfort

b)

Administer medications

c)

Swaddling, skin-to-skin bonding

d)

prone position

e)

Supine position

30.

What is the treatment for Acute Gastroenteritis?

a)

Dehydration/Vomiting

PO Trial medication (for IV fluids)

b)

Monitor I&O

c)

Anti diarhheals that can lead to obstruction

d)

Bolus 20mL / kG

e)

Zofran For vomiting

31.

Signs and Symptoms of Dehydration

a)

Dark urine, little to no tears, dry mouth

b)

Dry diapers for the last 8-12 hours

c)

Sunken Fontanels

d)

Tachycardia/ Hypotension

e)

Bradycardia/Hypertension

32.

Nursing Interventions for Dehydration

a)

Clear diet and advance to formula

b)

Administer Prostaglandin E1

c)

IV hydration/ Supportive care

d)

Assess hydration status

33.

If patient has vomiting with diarrhea what should we administer?

a)

IV fluids

b)

zofran

c)

PO medication

d)

Oral Hydration

34.

If a patient has diarrhea what should we administer?

a)

IV hydration

b)

PO Hydration

c)

Breastfeeding

d)

NG Tube feeding

35.

Interventions for Dehydration

a)

Daily Weights

b)

IV Fluids

c)

Digoxin

d)

Increase fiber intake

36.

Education about Constipation/Functional Constipation?

a)

Increase fiber (veggies/fluids)

b)

Administer MiraLax (Polyethylene Glycol 3350)

c)

Involve the patient in meal prepping/ pictures

d)

Just talk to the parents not the child

37.

Administration for MiraLax?

a)

Starts at 17g in 8oz water twice/once daily

b)

If patient is no longer constipated, still administer full administration

c)

Take medication in the morning

d)

Take medication at night

38.

What is the diagnosis/labs for celiac disease?

a)

Endoscopy/Small intestine Biopsy (Do not restrict diet until after diagnosis)

b)

Echocardiogram

c)

Chest Xray

d)

Iga Decrase

e)

Iga Increase

39.

Interdisciplinary Referrals for Celiac Disease?

a)

Dietician/Nutritionist

b)

Cardiologist

c)

gastroenterologist

d)

Support group

e)

Physical Therapy

40.

Assessment for Appendicitis?

a)

Pain in periumbilical area, lower right quadrant

b)

Mcburnery's point pain,

c)

Inspection, Auscultation, Percussion, Palpate

d)

Auscultate, percuss, inspect, palpate

e)

Get ultrasound

41.

Signs and Symptoms of perforated ruptured appendicitis?

a)

Sudden relief of pain

b)

Ill looking child

c)

Yellow/green discharge

d)

Pain that does not get relieved

42.

Treatment for Appendicitis?

a)

Surgery, NPO , IV Fluids

b)

Antibiotics, Pain Control

c)

Digoxin

d)

diuretics

e)

trendelburg position

43.

Where does GERD happen?

a)

Lower esophageal sphincter

b)

Upper esophageal sphincter

c)

Small intestines

d)

Larger intestines

44.

Education for parents of child with GERD?

a)

Monitor weight closely, small frequent feedings, frequent burping, keep baby upright

b)

Priority: Sandifer's Syndrome: Sudden arching of head/neck trunk/ improves reflux

c)

Administer PPI 30min before breakfast/lunch/dinner

d)

High fiber diet

45.

Signs and Symptoms for Pyloric Stenosis?

a)

Projectile vomiting due to pyloric muscle hardening/ FTT

b)

No blood in vomiting

c)

Weight gain

d)

Weight loss

e)

Always hungry

46.

Diagnosis for Pyloric Stenosis?

a)

Palpation of the pyloric mass (olive sign)

b)

Ultrasound for pyloric thickening

c)

Echocardiogram

d)

EKG

47.

Treatment for Pyloric Stenosis?

a)

EKG

b)

Cardiac Catheterization

c)

Surgery: Pyloromyotomy to loosen the muscle

d)

NPO- NG for decompression

e)

Pedialyte , Monitor weighs

48.

Priority Assessment for Volvulus?

a)

Occurs in the first year, monitor for child if crying in pain

b)

Occurs in the first 6 months, Monitor for child if they are crying in pain

c)

Supine

d)

Abdominal distention, vomiting, tachycardia, tachypnea

49.

Potential Complications for Volvulus?

a)

Stool will be under the abdominal cavity

b)

Increase in blood flow

c)

Blood flow will be cut off

d)

Necrosis/Gangrene

e)

Perforation of the intestine/ stool over the abdominal cavity

50.

Education to parents for a child with Volvulus?

a)

Post Op Care: Assess for openings/infection/drainage/fever

b)

Encourage holding and rocking the patient/explain the procedure

c)

Digoxin

d)

Diuretics

e)

Beta Blockers

51.

Discharge teaching for a patient with Volvulus?

a)

Decrease Fiber

b)

Signs & Symptoms of Infection- Call the doctor

c)

Check the stool

d)

Have the patient in supine posistion

52.

When to notify the physician after correction of the volvulus?

a)

N/V

b)

Swollen/tender belly

c)

When bowel sounds are heart

d)

Fever and Chills

e)

Blood in stool

53.

Signs and Symptoms of Hirschsprungs Disease?

a)

Failure to pass meconium in the first 24 horus

b)

No more bowel movement for more than 3 days

c)

No bowel movement for more than a week

d)

Chronic Constipation/Ribbon like watery stools

e)

Bacteria in the stool, weight gain

54.

Signs and symptoms of Biliary Atresia?

a)

Liver Function Test (AST,ALT,Bilirubin) Increased

b)

Enlarged liver, jaundice

c)

Protruding abdomen

d)

Dark Urine, Light colored stools

e)

Light/clear urine, brown colored stools

55.

Care immediately after Gastroschisis

a)

Surgery: Silo "gravity will pull it down"

b)

Keep silo dry for first 24 hours

c)

Keep Silo moist with saline/nonadherent dressing

d)

Administer Antibiotics

e)

Administer Diuretics

56.

Referral for Cleft lip/Cleft Palate? TOP 3

a)

Lactation specialist

b)

Oral surgeons

c)

Speech therapist

d)

Psychologist

e)

Pediatrician

57.

Nursing Interventions for Post op for cleft lip/cleft palate?

a)

Keep incision moist/ intact/ and clean

b)

Keep incision dry/clean/intact

c)

NPO-Soft rubber nipple on side of the mouth and direct flow away from incision site

d)

Suction the airway

e)

Apply "no-no" to prevent scratching/pulling

58.

What is Voiding Cystourethrogram? (Know the anatomy of the Renal System)

a)

Kidney , ureter, bladder, sphincter, urethra

b)

heart, brain, lungs

c)

Muscles, abdomen, small intestine

d)

Large intestine, nose, pharynx

59.

Risk Factors for UTI?

a)

E.Coli

b)

Wiping front to back

c)

2-6 (Toddlers to preschoolers)

d)

Tight Clothing, bubble baths

e)

Changing diapers Frequently

60.

Signs and Symptoms for UTI?

a)

Fever above 100.9 (38.3)

b)

Vomiting, abdominal pain, flank pain

c)

Increased frequency/Dysuria

d)

Hyperthermia/Hypothermia

e)

Fever above 100.4

61.

Diagnosis for UTI?

a)

UA Sterile

b)

Urine Culture

c)

UA Clean

d)

Ultrasound

62.

Steps for Clean Catch UA?

a)

Clean with first wipe, pee a little in toilet, then pee in cup

b)

Clean with first wipe, pee in the cup

c)

Take the pee from the toilet

d)

Put on sterile gloves, pee in the cup

63.

Urine Culture is what? There is no such thing as a sterile diaper

a)

Clean Catch

b)

Sterile

c)

Straight cath

d)

Just pee in the cup

64.

What is the treatment for a UTI?

a)

Antibiotics (Ceftriaxone/Cefotaxime)

b)

IV Bolus to flush system

c)

Pain medication

d)

Diuretics/CCB

e)

NG Tube for decompression

65.

What are some preventions for a UTI?

a)

Wiping front to back

b)

Proper hand hygiene

c)

NO bubble baths/or scents

d)

Wear Clean Cotton Underwear

e)

Wiping back to front

66.

Treatment for Glomerulonephritis?

a)

Antibiotics (Cefotraxime/Ceftriaxone)/ Antihypertensives/Hemodialysis

b)

Increase in salt/Hemodyalisis

c)

Give Potassium

d)

Put patient in supine posistion

67.

How do we know if treatment for glomerulonephritis effective?

a)

Increase in urine

b)

Decrease in urine

c)

Weight loss

d)

Weight gain

68.

Signs and Symptoms of Nephrotic Syndrome?

a)

Edema (eyes , scrotum/ascities,pretibial)

b)

Weight loss

c)

Weight gain

d)

Foamy/Frothy dark urine/Proteinuria

e)

Tachycardia/Hypoalbuminia

69.

Potential Complications for Nephrotic Syndrome?

a)

Thromboembolism

b)

AKI

c)

Infection

d)

Decrease LOC

e)

Chest pain

70.

Signs and Symptoms of Thromboembolism?

a)

Respiratory Distress : Pulmonary embolism

b)

Neurological Issues: If travels to brain

c)

Shortness of breath: When travels to the heart

d)

Ability to speak in full sentences

e)

Gi Issues: Due to abdominal pain

71.

Nursing Interventions for Nephrotic Syndrome?

a)

Skin Integrity/Skin Breakdown every 2 hours

b)

Bolus / Oxygen/ corticosteroids/albumin

c)

Change pulse ox sites/antibiotics

d)

Wrap the patient in excessive tape

e)

Turn patient every 4 hours

72.

Treatment for vesicoureteral Reflux? (VUR)

a)

Grade 1-5 : The higher the grade the more severe

b)

It gets better over time, does not require surgery unless grade IV/V

c)

Grade 1-5: The lower the grade the more sever

d)

Your child will not grow out of this problem, surgery is needed

e)

The higher the grade, may require continuous prophylactic antibiotics (cetriaxone,cefotaxime, amoxicillin)

73.

Signs and Symptoms of AKI?

a)

Edema

b)

Anemia

c)

Anuria/Oliguria

d)

Hypotension

e)

Hypertension

74.

Treatment for AKI?

a)

Dialysis

b)

Increase IV Fluids

c)

Monitor their labs

d)

May require kidney transplants

75.

Treatment for Hemolytic Uremic Syndrome?

a)

Analgesics (Acetaminophen, morphine, oxycodone)

b)

NSAIDs

c)

Hemodialysis

d)

Seizure medications (lorazepam,fosphenytoin)

e)

Obtain consents / Blood transfusions

76.

Signs and Symptoms of Henoch Schonlein Purpura?

a)

Palpable Purpura

b)

Flank pain/GI bleeds

c)

Joint pain/Edema

d)

Colicky abdominal pain (emergent intusseception)

e)

Dysuria

77.

How will we diagnose Henoch-Schonlein Purpura

a)

Renal Biopsy: Shows IgA

b)

CBC for anemia

c)

Abdominal Ultrasound

d)

Urinalysis

e)

CT Scan

78.

Treatment for Fluid Volume Overload?

a)

Furosemide

b)

Metonalzaone

c)

Spironolactone

d)

Dimetane

e)

Nifedepine

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