PEDS Exam 4 Practice Questions

The home health nurse is visiting a 3-month-old infant who is diagnosed with congenital

hypothyroidism and is prescribed daily levothyroxine. Which should the nurse include in the infant's continued plan of care?

1. Stopping the medication as long as the child continues to grow

2. Preventing hypothermia with appropriate clothing

3. Changing formula because it is contraindicated with prescribed medication

4. Monitoring growth and development without any other prescribed interventions

2. Preventing hypothermia with appropriate clothing

The nurse is providing information to an adolescent newly diagnosed with diabetes. Which clinical manifestations of diabetic ketoacidosis (DKA) should the nurse include in the teaching session? Select all that apply.

1. Change in mental status

2. Tachycardia

3. Fruity breath odor

4. Rapid, shallow respirations

5. Abdominal pain

1, 3, 5

A child weighing 18.2 kg with a history of diabetes insipidus (DI) has been admitted to the hospital. Which healthcare provider prescription should the nurse question?

1. Stat electrolytes

2. Urine specific gravity with each void

3. DDAVP (desmopressin) PO

4. Restrict oral fluids to 500 mL every 24 hours

4. Restrict oral fluids to 500 mL every 24 hours

A 5-year-old child with a history of hypopituitarism presents with complaints of right hip and leg pain. Which prescribed medication for the diagnosis should the nurse identify as the cause for the current symptoms?

1. Daily growth hormone

2. Insulin before meals and bedtime

3. DDAVP (desmopressin) at bedtime

4. Cortisone injections

1. Daily growth hormone

Which clinical manifestations should the nurse anticipate when providing care to an

adolescent client who presents with untreated Graves disease?

1. Hyperglycemia, ketonuria, and glucosuria

2. Weight gain, hirsutism, and muscle weakness

3. Tachycardia, fatigue, and heat intolerance

4. Dehydration, metabolic acidosis, and hypertension

3. Tachycardia, fatigue, and heat intolerance

A hospitalized child has been diagnosed with SIADH (syndrome of inappropriate antidiuretic hormone), a complication of his meningitis. Which laboratory data should the nurse anticipate for this child?

1. Hyponatremia

2. Hypocalcemia

3. Hyperglycemia

4. Hypernatremia

1. Hyponatremia

The nurse is giving discharge instructions to the parents of a child whose adrenal glands have been removed due to a tumor. Which parental statement indicates the need for further education?

1. "I will call the doctor if my child has restlessness and confusion."

2. "If my child has any gastric irritation, I will give him antacids."

3. "If my child has vomiting and diarrhea, I will hold his hydrocortisone."

4. "I will give my child his hydrocortisone in the morning."

3. "If my child has vomiting and diarrhea, I will hold his hydrocortisone."

The nurse is caring for a child just admitted with diabetic ketoacidosis (DKA). Which

healthcare provider prescription should the nurse question?

1. Neurologic checks hourly

2. Insert urinary catheter and measure output hourly

3. NPH insulin IV at 0.1 unit/kg per hour

4. Stat serum electrolytes

3. NPH insulin IV at 0.1 unit/kg per hour

An adolescent presents in the emergency department (ED) with confusion. The healthcare provider suspects diabetic ketoacidosis (DKA). A stat serum glucose is done, and the result is 7l5 mg/dL. Which clinical manifestations does the nurse anticipate upon assessment for this client?

1. Tachycardia, dehydration, and abdominal pain

2. Sweating, photophobia, and tremors

3. Dry mucous membranes, blurred vision, and weakness

4. Dry skin, shallow rapid breathing, and dehydration

3. Dry mucous membranes, blurred vision, and weakness

Which teaching point should the nurse include when providing education to an adolescent client, who participates in soccer, regarding the plan of care for diabetes mellitus?

1. Decreased food intake

2. Increased doses of insulin

3. Increased food intake

4. Decreased doses of insulin

3. Increased food intake

Which action related to insulin administration should the nurse include in the teaching plan

for an adolescent client who has been newly diagnosed with diabetes mellitus to avoid the

development of lipoatrophy?

1. Rotating injection sites

2. Checking blood sugars at mealtime and bedtime

3. Using a sliding scale for additional coverage

4. Administration of insulin via insulin pump

1. Rotating injection sites

The nurse is teaching the caregiver of a child who is newly diagnosed with type 1 diabetes

mellitus how to minimize pain with insulin injections. Which interventions should the nurse include in the teaching session? Select all that apply.

1. Do not reuse needles.

2. Remove all bubbles from the syringe before injecting.

3. Have the child flex the muscle during injection.

4. Inject insulin when it is cold.

5. Do not change the direction of the needle during insertion or withdrawal.

1, 2, 5

Which food should the nurse remove from the food tray for a toddler-age client who is

diagnosed with syndrome of inappropriate antidiuretic hormone (SIADH)?

1. Oatmeal

2. Yogurt

3. Biscuit

4. Watermelon

4. Watermelon

Which sequela should the nurse include in the teaching session for a parent who does not believe in medication for the treatment of the newborn's hypothyroidism?

1. Heart disease

2. Mental retardation

3. Renal failure

4. Thyroid storm

2. Mental retardation

Which changes should the school nurse implement to decrease the risk for the development of type 2 diabetes mellitus for a population who is identified as being at risk? Select all that apply.

1. Increase the amount of daily physical activity.

2. Meet with all parents and explain the risk that is associated with obesity.

3. Test each child's urine monthly.

4. Teach the parents to avoid administering aspirin to their children.

5. Work with the cafeteria to decrease the amount of fat in the foods served.

1, 2, 5

Which assessment finding would cause the nurse to question whether a preschool-age boy, diagnosed with phenylketonuria shortly after birth, is following the prescribed dietary

restrictions?

1. The child's body has a musty odor.

2. This child is a blue-eyed blond.

3. The child appears sleepy and uninterested in the surroundings.

4. The child has a sunburn over his entire body.

1. The child's body has a musty odor.

The nurse is providing care to a newborn who is suspected of having Turner syndrome.

Which should the nurse assess the newborn for based on the current diagnosis?

1. Club foot (talipes equinovarus)

2. Congenital heart anomalies

3. Hyperbilirubinemia due to liver abnormalities

4. Diaphragmatic hernia

2. Congenital heart anomalies

Which prescription regarding an oral hydrocortisone for a toddler-age client diagnosed with congenital adrenal insufficiency should the nurse anticipate when the client is admitted to the hospital with pneumonia?

1. It will be discontinued.

2. It will be reduced.

3. It will be continued as previously prescribed.

4. It will be increased.

4. It will be increased.

Which type of nutrition should the nurse include when planning care for a newborn who is diagnosed with galactosemia?

1. Goat's milk formula

2. Breast milk

3. Cow's milk-based formula

4. Lactose-free formula

4. Lactose-free formula

The nurse is providing care to a newborn female who is born with ambiguous genitalia. The follow-up investigation discovers adrenogenital syndrome (also called congenital adrenal hyperplasia [CAH]). The parents question why the baby's genitalia looks more male than female. Which response by the nurse is accurate?

1. "The disorder caused your baby to be a hermaphrodite with both male and female sex

organs."

2. "The changes in the genitalia are due to increased androgens secondary to deficient

cortisol."

3. "The excessive cortisol caused the enlargement of the female tissue, creating a male

appearance."

4. "Your baby has only one sex chromosome resulting in an XO configuration.

2. "The changes in the genitalia are due to increased androgens secondary to deficient

cortisol."

Which pediatric client diagnoses would cause the nurse to include information related to

short stature? Select all that apply.

1. Hypothyroidism

2. Turner syndrome

3. Chronic renal failure

4. Cushing syndrome

5. Diabetes mellitus

1, 2, 3, 4

Which functions of the adrenal hormone aldosterone should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development

2. Increases sodium ion reabsorption

3. Stimulates secondary sexual characteristics

4. Increases potassium excretion by the kidneys

5. Activates the sympathetic nervous system

2, 4

Which functions of the adrenal androgens should the nurse include in a teaching session for a pediatric client diagnosed with alterations in adrenal function? Select all that apply.

1. Stimulates bone development

2. Increases sodium ion reabsorption

3. Stimulates secondary sexual characteristics

4. Increases potassium excretion by the kidneys

5. Activates the sympathetic nervous system

1, 3

Which diagnostic tests should the nurse include in the plan of care for a pediatric client who is at risk for short stature? Select all that apply.

1. Thyroid function studies

2. Adrenocorticotropic hormone (ACTH) and cortisol levels

3. Complete blood count

4. Blood culture

5. Urine creatinine

1, 2, 3, 5

Which assessment data for a pediatric client supports the diagnosis of familial or idiopathic central diabetes insipidus (DI)? Select all that apply.

1. Polyuria

2. Polydipsia

3. Nocturia

4. Enuresis

5. Constipation

3, 4, 5

The nurse is providing care to a pediatric client, diagnosed with inflammatory bowel

disease, who is prescribed daily prednisone. Which parental statement regarding

administration of this drug indicates correct understanding of the teaching provided by the nurse?

1. "I will administer this medication between meals."

2. "I will administer this medication at bedtime."

3. "I will administer this medication one hour before meals."

4. "I will administer this medication with meals."

4. "I will administer this medication with meals."

Which assessment data would cause the nurse to suspect that a 3-year-old child has

Hirschsprung disease?

1. Clay-colored stools and dark urine

2. History of early passage of meconium in the newborn period

3. History of chronic, progressive constipation and failure to gain weight

4. Continual bouts of foul-smelling diarrhea

3. History of chronic, progressive constipation and failure to gain weight

An adolescent client reports recurrent abdominal pain with diarrhea and bloody stools. Which type of inflammatory bowel disease does the nurse suspect based on these data?

1. Necrotizing enterocolitis (NEC)

2. Ulcerative colitis (UC)

3. Crohn disease

4. Appendicitis

2. Ulcerative colitis (UC)

The nurse is assessing abdominal girth for a pediatric client who presents with abdominal

distension. Which nursing action is appropriate?

1. Measuring the girth just below the umbilicus

2. Measuring the girth just below the sternum

3. Measuring the girth just above the pubic bone

4. Measuring the girth around the portion of the stomach

4. Measuring the girth around the portion of the stomach

Which is the priority nursing diagnosis when planning care for a newborn who is born with

esophageal atresia and tracheoesophageal fistula?

1. Ineffective Tissue Perfusion

2. Ineffective Infant Feeding Pattern

3. Acute Pain

4. Risk for Aspiration

4. Risk for Aspiration

A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?

1. Placing the newborn on a radiant warmer

2. Placing the newborn in an open crib

3. Preparing the newborn for phototherapy

4. Preparing the newborn for a bottlefeeding

1. Placing the newborn on a radiant warmer

The nurse is planning care for a school-age client who is postoperative for the surgical

removal of the appendix. In addition to pharmacologic pain management, which should the nurse include in the plan of care to address pain?

1. Applying a warm, moist pack every 4 hours

2. Applying EMLA cream to the incision site prior to ambulation

3. Applying a cold, moist pack every 2 hours

4. Applying a pillow against the abdomen to splint the incision site when coughing

4. Applying a pillow against the abdomen to splint the incision site when coughing

Which parental statement at the end of a teaching session by the nurse indicates correct understanding of colostomy stoma care for the infant client?

1. "We will change the colostomy bag with each wet diaper."

2. "We will expect a moderate amount of bleeding after cleansing the area around the

stoma."

3. "We will watch for skin irritation around the stoma."

4. "We will use adhesive enhancers when we change the bag."

3. "We will watch for skin irritation around the stoma."

A nurse is preparing for the delivery of a newborn with a known diaphragmatic hernia

defect. Which equipment should the nurse have on hand for the delivery?

1. Bag-valve-mask system

2. Sterile gauze and saline

3. Soft arm restraints

4. Endotracheal tube

4. Endotracheal tube

A child returns from exploratory surgery following a gunshot wound to the abdomen.

Which nursing intervention should be excluded for the plan of care?

1. Immediate initiation of oral feedings

2. Assessment of the surgical site

3. Administration of opioid narcotics for pain management

4. Visitation at the bedside

1. Immediate initiation of oral feedings

A neonate is born with a bilateral cleft lip that was not detected during the pregnancy. The

parents are distressed about the appearance of their infant. Which nursing actions are

appropriate to assist the parents to bond with their newborn? Select all that apply.

1. Calling the newborn by the chosen name

2. Keeping the newborn's lower face covered with the blanket

3. Smiling and talking to the newborn in the parents' presence

4. Showing the parents before and after pictures of other children with cleft lips

5. Discussing positive features of the baby

1, 3, 4, 5

The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?

1. Position the newborn in semi-Fowler position.

2. Allow the newborn to be taken to the mother's room for bonding.

3. Offer the newborn formula feeding instead of breastfeeding.

4. Wrap the newborn in blankets and place in a crib by the viewing window.

1. Position the newborn in semi-Fowler position.

A nasogastric tube to suction is ordered for a neonate diagnosed with a diaphragmatic

hernia. Which complication related to gastric drainage is the priority when planning care for this neonate?

1. Weight loss

2. Metabolic alkalosis

3. Dehydration

4. Hyperbilirubinemia

2. Metabolic alkalosis

Which statements, made by the adolescent following dietary teaching for Crohn disease,

indicate correct understanding of the content presented by the nurse? Select all that apply.

1. "I can promote solid stools by increasing fiber in my diet."

2. "Small, frequent meals are preferred over three meals a day."

3. "I should identify foods that cause distress and eliminate them from my diet."

4. "High-calorie dietary supplement shakes can help me to meet my nutritional

requirements."

5. "Socialization during my meal times is important even if my parents do not agree with

my food choices."

2, 3, 4

Which parental action, observed during a home care visit for an infant diagnosed with

gastroesophageal reflux, requires intervention by the nurse?

1. The infant's formula has rice cereal added.

2. The mother holds the infant in a high Fowler position while feeding.

3. After feeding, the infant is placed in a car seat.

4. The mother draws up the ranitidine (Zantac) in a syringe for oral administration.

3. After feeding, the infant is placed in a car seat.

Which is the priority nursing action when preparing a neonate born with a gastroschisis

defect for transport to a pediatric hospital for corrective surgery?

1. Covering the exposed intestines with sterile moist gauze

2. Wrapping the newborn warmly in two or three blankets

3. Providing a sterile water feeding to maintain hydration during transport

4. Allowing the parents of the newborn to see their child prior to transport

1. Covering the exposed intestines with sterile moist gauze

A toddler is admitted to the surgical unit for a planned closure of a temporary colostomy.

Which medical prescription should the nurse question?

1. Clear liquids today. NPO tomorrow

2. Type and cross-match for 1 unit of packed red blood cells.

3. Rectal temperatures every 4 hours

4. Start an intravenous line with D5NS at 20 mL per hour.

3. Rectal temperatures every 4 hours

Which gastrointestinal defects, often diagnosed shortly after birth, should the nurse include in the assessment process of all newborns? Select all that apply.

1. Pyloric stenosis

2. Biliary atresia

3. Hirschsprung disease

4. Umbilical hernia

5. Diaphragmatic hernia

3, 5

The nurse is providing care to a newborn client who presents in the pediatric clinic for a 2- week health maintenance visit. The parents of the newborn are concerned, as their baby has "gas all the time." Which responses from the nurse are appropriate? Select all that apply.

1. "Your baby has a relaxed lower esophageal sphincter, which is causing the gas."

2. "Your baby lacks the enzyme amylase, which is causing the gas."

3. "Your baby lacks the enzyme insulin, which is causing the gas."

4. "Your baby has an immature liver, which is causing the gas."

5. "Your baby lacks an enzyme that helps to digest fats, which is causing the gas."

2, 5

Which statements should the nurse include in a presentation related to the general function of the gastrointestinal (GI) system for parents of pediatric clients? Select all that apply.

1. "The GI tract is responsible for the ingestion and absorption of food."

2. "Newborns have smaller stomachs but increased peristalsis."

3. "All children require smaller, more frequent feedings."

4. "Infants lack certain digestive enzymes which increases the risk for regurgitation."

5. "By the second year of life a child is able to accommodate three meals each day."

1, 2, 5

Which are the leading causes of pediatric abdominal injuries for which the nurse should

provide client teaching during scheduled health maintenance visits? Select all that apply.

1. Motor vehicle crashes

2. Falls

3. Blunt trauma

4. Stabbing

5. Impalement

1, 2, 3

Which topics should the nurse include in discharge instructions related to enhanced safety for a pediatric client who experienced an abdominal injury after a biking accident? Select all that apply.

1. Use of hand signals

2. Age-appropriate use of child safety seats

3. Age-appropriate bicycles

4. Use of a helmet

5. Avoid assigning blame

1, 3, 4

Which factors in the maternal medical history should cause the nurse concern regarding the development of cleft lip or cleft palate during pregnancy? Select all that apply.

1. Cigarette smoking

2. Alcohol use

3. Excessive folate intake

4. Glucocorticoid use

5. Anticoagulant use

1, 2, 4

Which clinical manifestations should the nurse anticipate when assessing a child who has been admitted to the hospital unit with a diagnosis of minimal change nephrotic syndrome (MCNS)?

1. Massive proteinuria, hypoalbuminemia, and edema

2. Hematuria, bacteriuria, and weight gain

3. Urine specific gravity decreased and urinary output increased

4. Gross hematuria, albuminuria, and fever

1. Massive proteinuria, hypoalbuminemia, and edema

Which is the appropriate nursing intervention when providing care to a child, diagnosed

with nephrotic syndrome, who is edematous and on bed rest?

1. Monitor blood pressure every 30 minutes.

2. Reposition every 2 hours.

3. Limit visitors.

4. Encourage fluids.

2. Reposition every 2 hours.

Which urinalysis result should the nurse anticipate for a child who is admitted with acute glomerulonephritis?

1. Bacteriuria and increased specific gravity

2. Hematuria and proteinuria

3. Proteinuria and decreased specific gravity

4. Bacteriuria and hematuria

2. Hematuria and proteinuria

A preschool-age child is admitted to the hospital with acute postinfectious

glomerulonephritis (APIGN) and is admitted to the hospital. Which is the priority nursing

diagnosis for this child?

1. Risk for Injury related to hypertension.

2. Altered Growth and Development related to a chronic disease.

3. Risk for Infection related to hypertension.

4. Fluid Volume Excess related to decreased plasma filtration.

1. Risk for Injury related to hypertension.

Which laboratory tests should the nurse prepare to draw when admitting a pediatric client with possible obstructive uropathy? Select all that apply.

1. Platelet count

2. Blood urea nitrogen (BUN)

3. Partial thromboplastin time (PTT)

4. Blood culture

5. Creatinine

2, 5

Which clinical manifestations should the nurse anticipate upon assessment for a preschool- age child with a urinary tract infection (UTI)?

1. Headache, hematuria, and vertigo

2. Foul-smelling urine, elevated blood pressure (BP), and hematuria

3. Urgency, dysuria, and fever

4. Severe flank pain, nausea, and headache

3. Urgency, dysuria, and fever

The nurse is preparing medication instruction for a child who has undergone a kidney

transplant and is prescribed cyclosporine. The parents ask the nurse about the reason for the cyclosporine. Which rationale for this medication should the nurse include in the response?

1. Suppress rejection

2. Decrease pain

3. Improve circulation

4. Boost immunity

1. Suppress rejection

Which menu choices for a child who is diagnosed with renal failure and experiencing

hyperkalemia indicate the need for further instruction by the nurse?

1. Carrots and green, leafy vegetables

2. Spaghetti and meat sauce with breadsticks

3. Hamburger on a bun and cherry gelatin

4. Chips, cold cuts, and canned foods

1. Carrots and green, leafy vegetables

Which parental statement indicates understanding of the process involved with a kidney transplant for a child with renal failure?

1. "We are happy our child will not have to take any more medicine after the transplant."

2. "We understand our child will not be at risk anymore for catching colds from other

children at school."

3. "We will be glad we will not have to bring our child in to see the doctor again."

4. "We know it is important to see that our child takes prescribed medications after the

transplant."

4. "We know it is important to see that our child takes prescribed medications after the transplant."

Which complications should the nurse monitor for when providing care to a child who is having hemodialysis for the treatment of kidney failure? Select all that apply.

1. Migraines

2. Hypotension

3. Infections

4. Fluid overload

5. Shock

2, 3, 5

Which assessment finding would necessitate action by the nurse for a 10-month-old child

who is 4 hours postoperative for the placement of a urethral stent?

1. Bloody urine

2. One void since returning from surgery

3. Bladder spasms responding to pharmacologic intervention

4. Double diapering from the previous shift

2. One void since returning from surgery

Which risks of undescended testes should the nurse include in the teaching session for the

parents of a newborn diagnosed with this condition? Select all that apply.

1. Sperm production will be affected after puberty.

2. Abdominal testes are subject to injury.

3. Abdominal testes have a higher risk of developing cancer.

4. Hormonal production will be affected.

5. The testes are at greater risk of torsion.

1, 2, 3, 5

Which assessment finding, after the dialysate is drained during peritoneal dialysis for a

child experiencing acute renal failure, would warrant further action by the nurse?

1. The dialysate is clear on return.

2. The volume of drained dialysate is less than the volume infused.

3. The child is restless, wanting to get up and play.

4. The child's vital signs are basically the same as were noted on infusion.

2. The volume of drained dialysate is less than the volume infused.

Which instructions should be provided to the parents of a 4-year-old girl who has

experienced chronic urinary tract infections (UTIs) in the last 2 years? Select all that apply.

1. Wear only nylon underwear for better air flow.

2. Teach the child to wipe from front to back.

3. Encourage the child to take long baths by allowing the child bubbles and toys in the tub.

4. Encourage the child to drink additional fluids throughout the day.

5. Plan potty breaks every 2 hours throughout the day.

2, 4, 5

Which is the priority nursing intervention when caring for a neonate who is born with

bladder exstrophy?

1. Measuring intake and output

2. Inserting a Foley catheter

3. Covering the defect with sterile plastic wrap

4. Palpating the bladder mass to ensure urine is expelled

3. Covering the defect with sterile plastic wrap

Which clean-catch urinalysis finding should the nurse be most concerned for a child who is admitted to an urgent care center to rule out a urinary tract infection?

1. 2+ white blood cells

2. 1+ red blood cells

3. Urine appearance: cloudy

4. Specific gravity: 1009

4. Specific gravity: 1009

Which assessment questions should the nurse include in the psychosocial assessment to

determine the effects of chronic renal failure treatments on the growth and development of a school-age child? Select all that apply.

1. "How does it make you feel to have to follow a special diet?"

2. "Do you take your medications every day?"

3. "How does it make you feel to undergo dialysis treatments?"

4. "Do you attend school each day?"

5. "How does it make you feel when your parents come home late from work?"

1, 3

Which actions should the nurse implement when assessing the physical growth for a child who is diagnosed with chronic renal failure? Select all that apply.

1. Asking the child to step on the scale

2. Measuring the child's height

3. Measuring the child's head circumference

4. Using the Denver II with the child

5. Monitoring the child's blood pressure

1, 2, 3

Which nursing actions are appropriate to assess growth and development for an adolescent

client diagnosed with chronic renal failure? Select all that apply.

1. Using the Denver II during a health maintenance visit

2. Educating parents on normal milestones

3. Monitoring for delayed sexual maturation

4. Comparing blood pressure values from previous visit

5. Plotting height and weight measurements

1, 3, 5

Which nutritional interventions should the nurse include in the plan of care for a pediatric client who is receiving peritoneal dialysis in the treatment of chronic renal failure? Select all that apply.

1. Provide small, frequent meals.

2. Avoid battles over nutritional intake.

3. Administer supplements by tube feedings, if needed.

4. Implement hand hygiene frequently.

5. Perform daily catheter site care.

1, 2, 3

Which interventions should the nurse include in the plan of care for a pediatric client who is

receiving peritoneal dialysis in the treatment of chronic renal failure to prevent infection? Select all that apply.

1. Provide small, frequent meals.

2. Avoid battles over nutritional intake.

3. Administer supplements by tube feedings, if needed.

4. Implement hand hygiene frequently.

5. Perform daily catheter site care.

3, 4

The nurse is assessing a 4-year-old child with a possible alteration in mental health. Which

findings indicate a need for further investigation? Select all that apply.

1. Fails to make eye contact

2. Flinches when touched on the arm

3. History of limited prenatal care and precipitate delivery

4. Head circumference has not changed in over 1 year

5. Flat facial expressions

1, 2, 3, 5

Which factor, noted by the nurse during the pediatric health history portion of the

assessment process, would indicate the child is at risk for attention deficit/hyperactivity

disorder (ADHD)?

1. Measles, mumps, and rubella vaccine

2. Advanced parental age

3. Prenatal exposure to smoke

4. Immune response

3. Prenatal exposure to smoke

Which data, noted by the nurse during the physical assessment, would indicate the need to refer an adolescent client for further treatment due to possible depression? Select all that apply.

1. Agoraphobia

2. Somatic complaints

3. Focus on violence

4. Poor self-care

5. Poor school performance

3, 4, 5

Which statement from the parent of a child diagnosed with attention deficit/hyperactivity

disorder (ADHD) indicates the need for further education by the nurse?

1. "I will develop a reward system for desired behaviors."

2. "I will take my child to the physician every 3 months for a weight and height check."

3. "I will let him do his homework while he is watching his favorite television show."

4. "I will stick to the same routine each day after school."

3. "I will let him do his homework while he is watching his favorite television show."

A child diagnosed with autism spectrum disorder (ASD) is admitted to the hospital with

dehydration. Which should the nurse include in the plan of care for this child?

1. Discourage the parents from bringing favorite toys from home that might be lost.

2. Take the child on a tour of the pediatric unit.

3. Assign the child to a single-bed hospital room.

4. Take the child to the playroom for arts and crafts.

3. Assign the child to a single-bed hospital room.

The nurse is assessing a child with Down syndrome. Which illness should the nurse monitor for due to the increased risk for children with Down syndrome?

1. Rheumatic heart disease

2. Glomerulonephritis

3. Leukemia

4. Hepatitis

3. Leukemia

Which children should the nurse identify as exhibiting a delay in meeting developmental

milestones? Select all that apply.

1. An 18-month-old toddler who is unable to speak in sentences

2. A 2-year-old child who is unable to cut with scissors

3. A 2-year-old child who cannot recite her phone number

4. A 6-year-old child who is unable to sit still for a short story

5. A 5-year-old child who is unable to button his shirt

4, 5

The nurse is planning care for a school-age child diagnosed with separation anxiety

disorder. Which aspects of cognitive-behavior therapy (CBT) should the nurse include in

the teaching plan for the child's family? Select all that apply.

1. Self-talking

2. Relaxation

3. Hypnosis

4. Antidepressant medications

5. Recognition of feelings

1, 2, 5

Which information should the nurse include in the teaching plan for the parents of a child

who is diagnosed with autism spectrum disorder (ASD) as methods to increase the child's socialization?

1. Create a reward system when the child interacts with a person.

2. Punish the child when the child's social behaviors are inappropriate.

3. Use dolls to demonstrate appropriate social interactions to the child.

4. Enroll the child in a day care facility to encourage interaction with other children.

1. Create a reward system when the child interacts with a person.

Which child should the nurse refer for further assessment due to a probable diagnosis for

autism spectrum disorder (ASD)?

1. A 4-year-old girl who doesn't make eye contact with mother and resists the mother's

touch

2. A 3-year-old boy who joins one group of children, then moves to another group of

children without joining their activities

3. An 18-month-old child who walks around the area using the furniture to provide balance

4. A 6-year-old boy who chatters constantly to anyone who will listen

1. A 4-year-old girl who doesn't make eye contact with mother and resists the mother's

touch

Which activities should the nurse include in the plan of care for a child diagnosed with

attention deficit/hyperactivity disorder (ADHD) to improve behavior and learning? Select all that apply.

1. Asking the mother to seek a prescription for methylphenidate (Ritalin) for the child

2. Placing the child's desk at the back of the room to reduce distractions

3. Developing a consistent routine for the classroom

4. Limiting the decorations in the classroom

5. Determining areas where the child performs well and using these areas to promote self-

esteem

3, 4, 5

A school-age client presents to the pediatric clinic with a history of abdominal pain 3 to 4

mornings per week over the last 2 months. The mother states the child usually complains on school days and always seems to be better by afternoon. Which mental health disorder does the nurse suspect?

1. Separation anxiety

2. Depression

3. School phobia

4. Bipolar disorder

3. School phobia

Which nursing action assists in the diagnosis of mental health and cognitive disorders that

occur during childhood?

1. Monitoring vital signs

2. Administering prescribed medications

3. Conducting a developmental assessment

4. Documenting an accurate history and physical

3. Conducting a developmental assessment

The mother of a 22-month-old child states, "My child does not seem to be developing like my sister's daughter, who is the same age." Which screening test should the nurse plan to conduct based on the current data?

1. Magnetic resonance imaging (MRI) of the head

2. An electroencephalogram (EEG)

3. A Denver II

4. Chromosomal study

3. A Denver II

Which statements should the nurse include in the definition of mental health during a health

maintenance fair for pediatric clients? Select all that apply.

1. Mental health is the change in thought that occurs during childhood.

2. Mental health is foundational to a sense of personal well-being.

3. Mental health does not impact physical health.

4. Mental health involves successful engagement in activities.

5. Mental health changes over time.

2, 4

Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with autism spectrum disorder (ASD)? Select all that apply.

1. Arm flapping

2. Language delays

3. Ritualistic behavior

4. Impulsive behavior

5. Sleep disturbances

1, 2, 3

Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with attention deficit/ hyperactivity disorder (ADHD)? Select all that

apply.

1. Arm flapping

2. Language delays

3. Ritualistic behavior

4. Impulsive behavior

5. Sleep disturbances

4, 5

Which interventions should the nurse include in the plan of care for a child who is diagnosed with an intellectual disability? Select all that apply.

1. Providing emotional support to the family

2. Maintaining a safe environment for the client

3. Educating the family that maintenance of activities of daily living (ADL) is impossible

to achieve

4. Participating in the individualized education program (IEP) process

5. Recommending permanent institutionalization

1, 2, 4

Which items noted in a pediatric client's medical record indicate the child may be

experiencing a learning disability? Select all that apply.

1. Dyslexia

2. Dysphagia

3. Dyspraxia

4. Scoliosis

5. Hypotonia

1, 3

Which assessment finding for a 4-month-old infant would require further action by thenurse?

1. The posterior fontanel is open.

2. The infant has good head control when held upright.

3. The infant is able to roll only from abdomen to back.

4. The anterior fontanel is open and soft.

1. The posterior fontanel is open.

The nurse is providing care for a pediatric client in the emergency department (ED) with a diagnosis of decreased level of consciousness (LOC) secondary to increased intracranial pressure (ICP). Which healthcare provider order should the nurse question?

1. Passive range-of-motion exercises to promote hip flexion

2. Oxygen at 2 L nasal cannula to keep saturation above 95%

3. Hourly vital signs and neurologic checks

4. Elevate head of bed 30 degrees

1. Passive range-of-motion exercises to promote hip flexion

A 4-year-old client with intractable seizures has been on a ketogenic diet for the last 6 months, with a decrease in seizure activity. This child is now admitted to the pediatric unit with left-sided pain. Which possible complication to this diet does the nurse suspect?

1. Appendicitis

2. Bowel obstruction

3. Urinary tract infection

4. Kidney stones

4. Kidney stones

A child with a history of seizures arrives in the emergency department (ED) in status

epilepticus. Which is the priority nursing action?

1. Take vital signs.

2. Establish an intravenous line.

3. Perform rapid neurologic assessment.

4. Maintain patent airway.

4. Maintain patent airway.

The nurse is teaching a mother of a young child with a newly diagnosed seizure disorder. The child is prescribed valproic acid (Depakote) for control of seizures. Which parental statement indicates the need for further education?

1. "I will not use carbonated beverages to dilute his medication."

2. "I will give his medicine on an empty stomach so he will absorb it better."

3. "I will not let him chew his tablet."

4. "I will bring him to the physician's office for regular blood work to check bleeding

times.

2. "I will give his medicine on an empty stomach so he will absorb it better."

A young child admitted to the pediatric unit has fever, irritability, and vomiting with

suspected bacterial meningitis. Which cerebrospinal fluid (CSF) result should the nurse

anticipate based on these data?

1. Decreased protein count

2. Clear, straw-colored fluid

3. Positive for red blood cells (RBCs)

4. Decreased glucose level

4. Decreased glucose level

Which is the priority nursing diagnosis when planning care for a pediatric client who is diagnosed with bacterial meningitis?

1. Impaired Gas Exchange

2. Risk for Infection

3. Anxiety (parental)

4. Acute Pain

1. Impaired Gas Exchange

The nurse is caring for a 9-month-old infant who just returned from the postanesthesia care unit (PACU) after a shunt placement for hydrocephalus. Which healthcare provider prescription should the nurse question?

1. Vital signs and neurologic checks hourly

2. Small, frequent formula feedings

3. Elevate head of bed

4. Daily head circumference

3. Elevate head of bed

A neonate with a meningomyelocele is to have surgery in the morning. Which nursing action is appropriate for this neonate?

1. Applying a diaper to prevent contamination of sac

2. Positioning the newborn in a side-lying position

3. Encouraging the mother to hold the newborn because she will not be able to pick him up

after surgery

4. Positioning the newborn in a prone position

4. Positioning the newborn in a prone position

Which should the nurse include in the plan of care for a hospitalized school-age child with myelodysplasia? Select all that apply.

1. Implementing interventions for a client of normal intelligence

2. Using latex precautions when providing client care

3. Allowing the client to self-catheterize

4. Ensuring that the client has a low-fiber diet

5. Encouraging the client to shift positions hourly when in the wheelchair

1, 2, 3, 5

Which side effect should the nurse include in the parent teaching for a child who is

prescribed a baclofen pump for cerebral palsy?

1. Diarrhea

2. Hypertonia

3. Hypotonia

4. Restlessness

3. Hypotonia

A 9-month-old infant who is not sitting independently has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestations would the nurse expect to see in the baby?

1. Hypotonia and muscle instability

2. Hypertonia and persistence primitive reflexes

3. Tremors and exaggerated posturing

4. Hemiplegia and hypertonia

1. Hypotonia and muscle instability