PEDS EXAM 2 Practice Questions

from calia, idk if its from upperclassmen or chatgpt XD but it's pretty helpful tho

chronic hypoxemia

A pediatric client has a chronic respiratory condition resulting in prolonged hypoxemia. Which complication should the nurse monitor for as a result of chronic low oxygen levels?

A. Increased cognitive function

B. Impaired cognitive development

C. Increased muscle strength

D. Decreased metabolic demands

ANS: B

chronic hypoxemia can reduce oxygen delivery to the brain and may lead to impaired cognitive development, learning difficulties, and developmental delays.

foreign body aspiration

the nurse is teaching the parents of a toddler about preventing foreign body aspiration. which items should the nurse identify as common choking hazards? select all that apply.

A. Whole grapes

B. Hot dogs

C. Peanuts

D. Popcorn

E. Mashed potatoes

ANS: A,B,C,D

young children are at increased risk for aspiration of small, roung, hard, or chewy foods, including grapes, hot dogs, peanuts, popcorn, and nuts.

post-op tonsillectomy

the nurse is caring for a child immediately after a tonsillectomy. which intervention is appropriate?

A. Offer red-colored fluids

B. Encourage coughing every hour

C. Offer cool, clear fluids and ice chips as tolerated

D. Place the child in a supine position

ANS: C

(C) cool fluids and ice hips can help decrease discomfort and promote hydration

WRONG:

(A) AVOID red-colored fluids because they can make it difficult to identify flood.

(D) the child is genrally positioned SIDE-LYING OR PRONE while recovering from anesthesia to facilitate drainage and protect airway.

CORRECTION:

ice cream is not necessarily the best answer immediately post-op because dairy products can increase mucus and may cause nausea in some children. think cool, clear fluids/ice chips first.

epiglottitis pathology

a child presents with sudden high fever, drooling dysphagia, muffled voice, and is sitting upright leaning forward. which pathophysiologic process does the nurse recognize?

A. Inflammation and swelling of the epiglottis causing potential airway obstruction

B. Viral inflammation of the bronchioles causing wheezing

C. Inflammation of the trachea causing a barking cough

D. Narrowing of the bronchi caused by bronchospasm

ANS: A.

epiglottitis causes severe inflammation and edema of the epiglottis causing potential airway obstruction

Important distinction:

• epiglottitis → epiglottis swelling → drooling, dysphagia, muffled voice

• croup → larynx/trachea swelling → barking cough, stridor, hoarseness

RSV

a child is admitted with respiratory syncytial virus (RSV bronchiolitis. which infection-control intervention should the nurse implement?

A. Place the child in a room with a child who has influenza

B. Place the child in a private room or cohort with another child who has RSV

C. Use airborne precautions

D. Place the child in a positive-pressure room

ANS: B

RSV requires contact precautions. if a private room is unavailable, children with the same infection may be cohorted

asthma teaching

the nurse is teaching the parents of a child with asthma about preventing exacerbations. which statement by the parent indicates understanding?

A. “We should avoid known asthma triggers.”

B. “My child only needs medication when symptoms are severe.”

C. “Exercise should always be avoided.”

D. “We should stop the medication when my child feels better.”

ANS: A

identifying and avoiding triggers such as smoke, allergens, respiratory infections and environmental irritants can help prevent asthma exacerbations

inhaled medication of an 8-year-old

the nurse is teaching an 8-year-old child how to use a metered-dose inhaler (MDI). which device should the nurse recommend to improve medication delivery?

A. Nebulizer

B. Spacer

C. Oxygen mask

D. Nasal cannula

ANS: B

a spacer improves medication delivery from an MDI by allowing the child to inhale the medication more effectively and reducing medication deposition in the mouth.

cystic fibrosis

which finding would the nurse expect in a child with cystic fibrosis?

A. Thin respiratory secretions

B. Increased viscosity of mucus

C. Decreased sodium and chloride in sweat

D. Decreased risk for respiratory infections

ANS: B

Cf causes thick, sticky secretions that obstruct the respiratory and gastrointestinal systems.

pancreatic enzyme replacement

The nurse is teaching the parents of a child with cystic fibrosis about pancreatic enzyme replacement therapy. What is the primary purpose of these enzymes?

A. Prevent respiratory infections

B. Improve digestion and absorption of nutrients

C. Thin respiratory secretions

D. Increase insulin production

ANS: B

pancreatic insufficiency causes inadequate digestive enzymes. replacement enzymes help the child digest and absorb fats, proteins, and and carbohydrates.

vaccine for immunocompromised child

The nurse is reviewing immunizations for an immunocompromised child. Which vaccine should the nurse question?

A. Hib

B. Pneumococcal

C. DTaP

D. MMR

E. Inactivated influenza vaccine

ANS: D.

MMR is a live-attenuated vaccine and is generally contraindicated in significantly immunocompromised individuals.

you original choices: RSV, Hib, DTaP, pneumococcal, flu

if the flu option is specifically inactivated influenza, it can generally be given. RSV prevention is usually through monoclonal antibodies, not a routine live vaccine

live vaccines: rotavirus, MMR, varicella (chickenpox), live flu vaccine (spray)

digoxin toxicity

a child receiving digoxin develops nausea, vomiting, anorexia, headache, and mild confusion. which complication should the nurse suspect?

A. Hypoglycemia

B. Digoxin toxicity

C. Heart failure improvement

D. Dehydration

ANS: B

early manifestations of digoxin toxicity can include anorexia, nausea, vomiting, abdominal symptoms, headache, confusion, and visual disturbances. cardiac dysrhythmias as a major concern.

digoxin teaching

the nurse is teaching the parent of an infant receiving digoxin and furosemide. which statement indicates a need for further teaching?

A. “I will check my child's pulse before giving digoxin.”

B. “I will count the pulse for a full minute.”

C. “I will use the apical pulse to determine whether to give digoxin.”

D. “I will contact the provider if my child vomits repeatedly.”

ANS: none of the above — all are appropriate

So I would fix your original question. The incorrect statement should probably be:

“I will check my child's brachial pulse for 1 full minute before giving digoxin.”

Answer: This needs correction because an apical pulse is the appropriate pulse to assess before administering digoxin, e

specially in infants and children.

assessment findings

Which assessment findings should the nurse expect in a child experiencing heart failure? Select all that apply.

A. Tachycardia

B. Tachypnea

C. Pulmonary congestion

D. Poor feeding

E. Bradycardia

F. Increased oxygenation

ANS: A,B,C,D

pediatric heart failure commonly causes tachycardia, tachypnea, pulmonary congestion, fatigue, diaphoresis, poor feeding, and poor weight gain

correction: “increased BP” and “apnea” are not the best general answers for pediatric heart failure

feeding an infant with heart failure

a mother is feeding an infant with heart failure. The infant becomes tachypneic and dyspneic during feeding. what should the nurse do first?

A. Encourage the mother to continue feeding slowly

B. Stop the feeding and allow the infant to rest

C. Increase the amount of formula offered

D. Place the infant flat on the back

ANS:B

feeding is strenuous for infants with heart failure and increases oxygen demand. tachypnea (fast breathing) and dyspnea (shortness of breath) indicate the infant needs to stop feeding and rest.

kawasaki disease medications

a child is diagnosed with kawasaki disease. which medications should the nurse anticipate administering?

A. IV immune globulin and aspirin

B. Acetaminophen and furosemide

C. Heparin and warfarin

D. Albuterol and corticosteroids

ANS: A

treatment includes IVIG and Aspirin to decreasse inflammation and reduce the risk of coronary artery complications.

→ the “prostaglandin” medication you’re remembering is probably not part of routine treatment. Prostaglanding E1 is used for certain congenital heart defects to maintain ductal patency (e.g., TGA)

kawasaki diagnostic test

a child with Kawasaki disease is being evaluated for cardiac complication. which diagnostic test should the nurse anticipate?

A. Electroencephalogram

B. Echocardiogram

C. Colonoscopy

D. Pulmonary function test

ANS: B.

an echocardiogram is used to evaluate the coronary arteries and identify complications such as coronary artery aneurysm.

WRONG:

A: electronencephalogram = brain

C. colonoscopy = GI/colon

D. pulmonary function test = lungs

infant with UTI

A 6-month-old infant is being treated for a urinary tract infection (UTI). which teaching should the nurse include with the parents?

A. Begin toilet training immediately

B. Encourage adequate fluid intake and proper perineal hygiene

C. Limit fluids to prevent urinary frequency

D. Stop the antibiotic once symptoms disappear

ANS: B

infants cannot be toilet trained at 6 months. teaching should focus on hydration, completing antibiotics, and proper hygiene.

recurrent UTI

The nurse is assessing a child with recurrent urinary tract infections. Which finding would NOT be expected as a consequence of recurrent UTIs?

A. Renal scarring

B. Hypertension

C. Impaired renal function

D. Weight gain

ANS: D

recurrent UTIs can cause renal scarring and long-term renal complicatios, but weight gain is not a typical complication.

diagnostic finding - nephrotic syndrome

which laboratory finding would the nurse expect in a child with nephrotic syndrome?

A. Hypoalbuminemia

B. Hypercalcemia

C. Decreased proteinuria

D. Increased serum albumin

ANS: A

nephrotic syndrome causes significant protein loss in the urine, resulting in hypoalbuminemia, edema, and hyperlipidemia.

which statement by the parent of a school-age child indicates an understanding or nocturnal enuresis?

A. “My child wets the bed at night while sleeping.”

B. “My child urinates frequently because of a UTI.”

C. “My child has daytime urinary incontinence every day.”

D. “My child is unable to control bowel movements.”

ANS: A

nocturnal enuresis refers to involuntary urination during sleep in a child who is expected to have nightime bladder control.

dehydration from vomting

Which assessment finding would the nurse expect in a toddler experiencing dehydration from persistent vomiting?

A. Moist mucous membranes

B. Decreased urine output

C. Bounding pulse

D. Increased tears

ANS: B

signs of dehydration include dry mucous membranes, decreased urine output, poor skin turgor, tachycardia, lethargy, and absence of tears.

severely dehydrated child

a dehydrated child is minimally responsive with signs of hypovolemic shock. which intervention should the nurse anticipate first?

A. Oral rehydration solution

B. IV isotonic fluids

C. High-fiber diet

D. Fluid restriction

ANS: B

a child with severe dehydration and altered level of consciousness requires rapid IV fluid restriction, typically with an isotonic solution such as normal saline.

pediatric medication calculation

achild weighs 75 kg. the provider prescribes a medication at 25 mg/kg.day divided into 2 equal dose. the medication is available as 400 mg/5 mL. how many mL should the nurse administer per dose?

Step 1: Calculate daily dose

75 kg × 25 mg/kg/day = 1,875 mg/day

Step 2: Divide into 2 doses

1,875 ÷ 2 = 937.5 mg/dose

Step 3: Calculate

mL 400 mg = 5 mL

937.5 mg × 5 mL ÷ 400 mg = 11.72 mL

Answer: 11.7 mL per dose

minimal change nephrotic syndrome

which findings should the nurse expect in a child with minimal change nephrotic syndrome? select all that apply

A. Proteinuria

B. Hypoalbuminemia

C. Edema

D. Hyperlipidemia

E. Hematuria as the primary finding

ANS: A,B,C,D

nephrotic syndrome causes massive proteinuria → hypoalbuminemia → decreased oncotic pressure → edema, along with hyperlipidemia.

cleft lip and palate

A 1-month-old infant with a cleft lip and palate is admitted for evaluation. which problem should the nurse anticipate?

A. Difficulty sucking and feeding

B. Excessive weight gain

C. Increased ability to coordinate swallowing

D. Decreased risk of aspiration

ANS: A

a cleft lip and palate can interfere with the infant’s ability to create an effective seal and suck, increasing the risk for inadequate nutrition and aspiration.

post-op cleft lip/palate

the nurse is caring for an infant following cleft lip and palate repair. which interventions are appropriate? select all that apply:

A. Use elbow restraints as prescribed

B. Position the infant on the side as prescribed

C. Keep the surgical site clean

D. Allow the infant to rub the surgical site

E. Use a hard spoon to feed the infant

ANS: A,B,C

elbow restraints may prevent the infant from touching the surgical site. positioning and wound care help protect the repair.

tracheoesophageal fistula

The nurse is caring for a newborn with a suspected tracheoesophageal fistula. which intervention is the priority?

A. Begin oral feedings immediately

B. Maintain NPO status and prepare for further evaluation/treatment

C. Place the newborn flat after feeding

D. Encourage large-volume feedings

ANS: B

a newborn with suspected TEF is at high risk for aspiration. oral feeding should be witheld until the condition is evaluated and managed.

pyloric stenosis

which assessment finding is characteristic of hypertrophic pyloric stenosis in an infant?

A. Olive-shaped mass in the upper abdomen

B. Currant jelly stool

C. Bilious vomiting

D. Rigid, distended abdomen

ANS: A

pyloric stenosis causes projectile, non-bilious vomiting and may produce a palpable olive-shaped mass in the right upper quadrant/epigastric area.

intussusception

A child with suspected intussusception is waiting for an air enema. The child passes a normal-appearing brown stool. Which action should the nurse take?

A. Document that the intussusception has resolved

B. Notify the healthcare provider

C. Give the child oral fluids

D. Cancel the scheduled air enema

ANS: B

a normal stool does not rule out intussusception. the nurse should continue monitoring and notify the provider of the change in the child’s condition.

important: the classic currant jelly is a late finding, caused by blood and mucus from intestinal ischemia.

late finding of intussusception

the nurse is assessing a child with suspected intussusception, which finding is considered a late manifestation?

A. Intermittent abdominal pain

B. Vomiting

C. Sausage-shaped abdominal mass

D. Currant jelly stool

ANS: D

currant jelly stool indicates blood and mucus resulting from intestinal ischemia and is considered a later finding.

temporary colostomy

an 11-year-old child is scheduled for a temporary colostomy. which nursing intervention is most appropriate?

A. Avoid discussing the child's appearance

B. Encourage the child to express concerns about body image

C. Tell the child that the colostomy will not affect daily life

D. Limit the child's involvement in stoma care

ANS: B

school-age children and adolescents may have significant concerns about body image, peer acceptance, independence and social activities. emotional support and age-appropriate education are important.

Hirschsprung disease

a child is suspected of having Hirschsprung disease. which diagnostic test should the nurse anticipate?

A. upper GI series

B. Rectal biopsy

C. Abdominal ultrasound

D. Colonoscopy only

ANS: B

a rectal biopsy is the definitive diagnostic test for Hirschsprung disease because it identifies the absence of ganglion cells.