Study Questions: Med Surg Pediatric

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A child is ordered to have ibuprofen 140 mg PO. The child weighs 30.6 pounds. The safe dose of ibuprofen is 10 mg/kg. Ibuprofen is available as 100mg/5ml/. The nurse then:

a.) calculates this as a safe dosage, draws up 7ml of ibuprofen and administers it to the child.

b.) the nurse calculates that this is not a safe dose and calls the physician

c.) calculates this as a safe dosage, draws up 1.4ml of ibuprofen and administers it to the child.

d.) the nurse doesn't calculate the safe dosage because physicians do not make mistakes

a.) calculates this as a safe dosage, draws up 7ml of ibuprofen and administers it to the child.

A nine year old with severe factor VIII deficiency falls, injures an elbow and is brought to the ER. The nurser should prepare for which of the following?

a.) a placental transfusion

b.) an IM injection of factor VIII

c.) an IV infusion of factor VIII

d.) a transmission of packed red blood cells

c.) an IV infusion of factor VIII

Tetralogy of Fallot involves all of the following defects except:

a.) VSD

b.) overriding aorta

c.) patent ductus arteriosis

d.) right ventricular hypertrophy

e.) pulmonary valce stenosis

c.) patent ductus arteriosis

Parents are told by the genetic counselor that they have a 1 to 4 probability of having a second child with cystic fibrosis. They already have one child who is affected. The parents state their risk is lower now than when they had the previous child. What should the nurse tell the parents about the 1 to 4 probability?

a.) They will not have another child with cystic fibrosis until their fifth child

b.) each pregnancy is an independent event

c.) the probability of having another child with cystic fibrosis is twice as likely as it was when they had their first child

d.) the probability of having a child that is healthy is twice as likely with this pregnancy

b.) each pregnancy is an independent event

A myelomeningocele contains:

a.) Meninges, spinal fluid and nerves

b.) spina bifida occulta

c.) proteinurea and an elevated BUN and creatine

d.) meninges

a.) Meninges, spinal fluid and nerves

In a pediatric patient which of the following measurements is not considered when assessing for the risk of systemic inflammatory response syndrome a.k.a. SIRS?

a.) Oxygen saturation

b.) core body temperature

c.) tachycardia

d.) WBC count

e.) tachypnea

a.) Oxygen saturation

All of the following are risk factors of sudden infant death syndrome a.k.a. SIDS except:

a.) maternal smoking

b.) firm crib mattresses

c.) cosleeping/bed sharing with the infant d.) prone position for sleeping

b.) firm crib mattresses

The nurse is teaching about congenital club foot in infants. The nurse evaluates the teaching at successful when the parent states that club foot is best treated when? a.) After walking as established

b.) immediately after diagnosis with serial casting

c.) the child is old enough to have minimal surgical risks

d.) at age 1 to 2 with serial casting

b.) immediately after diagnosis with serial casting

what position would best relieve the child experiencing a cyonontic (tet) spell?

a.) bending at the waist as far as possible

b.) ankles to ears

c.) knee to chest

d.) hands to heart

c.) knee to chest

A 12 month old child weighed 3.7 kg at birth. What should the N421 nursing student expect the weight to be now?

a.) 11.1 kg

b.) 7.4 kg

c.) 15.7 kg

d.) 12.5 kg

a.) 11.1 kg

A 10 year old child who has been diagnosed with hydrocephalus at age 1 year had a ventriculoperitoneal (VP) shunt placed at the time of diagnosis. She is now complaining of a headache, nausea and blurry vision. The parents ask the nurse what they should do. Select the nurses's response:

a.) You should bring her to the emergency department as these may be symptoms of a shunt malfunction

b.) it is common for children to have the symptoms give her a few days and see if she improves

c.) you're probably worrying that she's having a problem with her shunt that is very unlikely since it has been working for 9 years

d.) give acetamiophen and see if her symptoms improve if they do not improve bring her to the pediatric clinic

a.) You should bring her to the emergency department as these may be symptoms of a shunt malfunction

The parent of a 15 month old with iron deficiency anemia tells the nurse that her child is currently taking an iron supplement. Which statement by the mother should be of concern to the nurse?

a.) I gave the iron supplements two hours before breakfast

b.) I give the iron supplements with an oral syringe towards the back of the cheek

c.) I gave the iron supplement at the same time each morning

d.) I gave the iron supplements with a bottle of whole milk in the morning

d.) I gave the iron supplements with a bottle of whole milk in the morning

The nurse is using the FLACC scale to write the pain level in a nine-month-old what is the nurses best response to fathers question about what the FLACC scale is?

a.) It estimates a child's level of pain utilizing behavioral and physical assessments

b.) estimates the child's level pain utilizing a numerical scale from 0 to 10

c.) it estimates a child's level pain based on parents perception

d.) it estimates a child's level of pain utilizing vital sign formation

a.) It estimates a child's level of pain utilizing behavioral and physical assessments

Parents of a 3 month old ask the nurse when they can begin giving their baby foods other than formula. The nurses's best response is:

a.) at 4 months, you can begin to give your baby rice cereal

b.) at 4 months you can begin to alternate rice cereal with pureed fruits and vegetables

c.) At four months you can begin to give your baby puréed fruits

d.) at four months you can begin to give your baby pureed vegetables

a.) at 4 months, you can begin to give your baby rice cereal

The intrauterine environment can have a profound and permanent effect on the developing fetus. Teratogens can cause birth defects. All the following are examples of teratogen except?

a.) Alcohol

b.) radiation

c.) measles

d.) folic acid

e.) Dilantin

d.) folic acid

The primary risk factor for the development of cerebral palsy is?

a.) Birth at 37 weeks gestation

b.) low birth weight

c.) maternal age

d.) high birthweight

b.) low birth weight

Therapeutic management for children with CP includes all, EXCEPT:

a.) Educational opportunities adapted to the child's needs and capabilities

b.) socialization experience with other children

c.) avoidance of all medication since they may increase spasticity

d.) local motion communication and maximize independence in activities of daily living

c.) avoidance of all medication since they may increase spasticity

What should the nurse administer to provide quick relief to a child with asthma who is coughing, wheezing, and having difficulty catching her breath?

a.) Nebulize coolmist

b.) Flovent

c.) prednisone

d.) albuterol

d.) albuterol

Which of the following is not a serious complication of Kawasaki disease?

a.) Coronary artery aneuysm

b.) Coronary stenosis

c.) Coronary thrombosis

d.) Hypocoagulability

d.) Hypocoagulability

The nurse who is caring for a child with Kawasaki disease has a USF capstone nursing student working with her. She asks the student, "What medications are used to treat Kawasaki disease?" That nurse is impressed when the student responds:

a.) Immunoglobulin G and aspirin

b.) Immunoglobulin E and heparin

c.) Immunoglobulin G and ACE inhibitors

d.) Immunoglobulin E and ibuprofen

a.) Immunoglobulin G and aspirin

The parent of a child with hemophillia is asking the nurse what caused the hemophillia. The nurse's best answer is based on the knowledge of this about hemophillia.

a.) It is an X linked recessive disorder

b.) it is an X linked dominant disorder

c.) it is an autosomal recessive disorder

d.) it is an autosomal dominant disorder

a.) It is an X linked recessive disorder

The parents of a newborn wants to know what the newbporn screening tests do. What is the nurses best response?

a.) Parenst are able to choose which disease to screen for

b.) They screen for congenital diseases that insurance companies cover

c.) they screen for PKU, hypothyroidism, HgbS and Galactosemia

d.) They screen for PKU, hyperthyrodisim, Hgb F and galactosemia

c.) they screen for PKU, hypothyroidism, HgbS and Galactosemia

Nurse is caring for a child diagnosed with thalassemia who is receiving the first chelation therapy. What information should the nurse teach the parent regarding therapy?

a.) It prevents further sickling of the RBC

b.) it eliminates excessive iron

c.) it provides an iron supplement

d.) it decreases the risk of bleeding

b.) it eliminates excessive iron

A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. What information about this medication should the nurse explain to the parents?

a.) It is given to reduce nausea and vomiting

b.) it helps decrease pain in the bone marrow

c.) it is used to make the chemotherapy more effective

d.) it helps reduce the uric acid level that tends to rise due to cell destruction

d.) it helps reduce the uric acid level that tends to rise due to cell destruction

Parent of a four-year-old brings her child to the pediatric clinic for a distended area on there right flank. After complete examination a diagnosis of Wilms tumor is a suspected. Which of the following is most important we doing a physical examination on this child?

a.) Assess the urine for the presence of blood

b.) monitor vital signs especially blood pressure

c.) obtain an accurate height and weight

d.) avoid palpation of the abdomen

d.) avoid palpation of the abdomen

Which of the following is the most common opportunistic infection in children infected with HIV?

a.) Meningitis

b.) encephalitis

c.) pneumocystic carini pneumonia

d.) CMB

c.) pneumocystic carini pneumonia

The parent of a child diagnosed with strep throat ask the nurse what the treatment will likely be. The nurses best response is?

a.) your child will be sent home on bed rest and ibuprofen and should recover in a few days.

b.) Your child will need to be admitted for seven days of IV antibiotics

c.) your child will need to have their tonsils removed to prevent further strep infections

d.) your child will need penicillin for 10 days even though she should feel better in a few days

d.) your child will need penicillin for 10 days even though she should feel better in a few days

A six month old is brought to the emergency department. His HR is 198. The infants anterior fontanelle is sunken. Capillary refill is greater than three seconds. The peripheral pulses are absent. The nurse notes that the infant does not cry when the IV is inserted. The nurse obtains a fingerstick blood sugar of 94. Which were the nurse expect to do immediately?

a.) Offer the child oral rehydration solution

b.) make a plan to reevaluate the child in 30 minutes

c.) administer at 20 mL/KG bolus of D10W

d.) administer a 20 mL/KG bolus of normal saline

d.) administer a 20 mL/KG bolus of normal saline

A child recently diagnosed with a seizure disorder is being evaluated for anticonvulsant medication therapy. The child will likely be placed on what type of regimen?

a.) On rectal gel to be administered in the vent of a seizure

b.) 3 oral anti-convulsant medication to stop all seizure activity

c.) 1 oral anti-convulsant medication to observe effectiveness and minimize side effects

d.) a combination of oral and intervenous anti-convulsant medications to ensure compliance

c.) 1 oral anti-convulsant medication to observe effectiveness and minimize side effects

In Hirchsprung disease, the N421 student knows that:

a.) There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention

b.) there is excessive peristalsis throughout the intestine resulting in abdominal distension

c.) the excess amount of ganglion cells there is an obstruction in the small intestine

d.) one loop of the bowel telescopes into the other

a.) There is a lack of peristalsis in the large intestine and an accumulation of bowel contents, leading to abdominal distention due to the absence of ganglion cells.

And gastroesophageal reflux disease which of the following is not recommended?

a.) H2 antagonist must be used as part of the therapy

b.) place the infant and prone position after feeding to decrease the risk of aspiration

c.) Nisson Fundoplication is done with all other measures fail

d.) encourage the parents to hold the infant upright for 30 minutes after feeding

b.) place the infant and prone position after feeding to decrease the risk of aspiration

The nurse is caring for a five-year-old who has just returned from having an appendectomy. On the faces scale she rates her pain 10 out of 10. What is the optimal pharmacological way to manage pain?

a.) IV morphine as needed

b.) IM morphine as needed

c.) morphine administered through a PCA pump

d.) liquid Tylenol as needed

a.) IV morphine as needed

Nurse is caring for a four month old who has just had her cleft lip repaired. Select the best position for the child in the immediate post surgical.

a.) Supine with elbow restraints

b.) right side laying with left arm elbow restraints

c.) prone with elbow restraints

d.) left side lying with right arm elbow restraint

a.) Supine with elbow restraints

Signs that a 7 month old may have meningitis include:

a.) Fever, irritability and a bulging anterior fontanelle

b.) fever, irritability and a sunken anterior fontanelle

c.) hypothermia, unresponsiveness a bulging anterior fontanelle

d.) hypertension bradycardia and a bulging posterior fontanelle

a.) Fever, irritability and a bulging anterior fontanelle

A newborn begins to choke, cough and become cyanotic when beginning to feed. The nurse suspects:

a.) Esophageal atresia

b.) pyloric stenosis

c.) intasusseption

d.) malrotation and volvulous

a.) Esophageal atresia

The nurse is caring for a newborn diagnosed with tracheo-esophageal fistula who is scheduled for surgery. Which should the nurse expect to do in the pre-operative.

a.) Have the mother feed the infant slowly but stop all feeds four hours before surgery

b.) administer IV fluids and antibiotics

c.) place the infant on 100% oxygen via non-rebreather mask

d.) keep the child in a monitor crib and allow the parents to visit

b.) administer IV fluids and antibiotics

The USF nursing student is caring for an eight week old being evaluated for pyloric stenosis. Which statement by the parent would be typical for a child with this diagnosis?

a.) The baby tends to have a very forceful vomiting episode almost immediately after feeding

b.) the baby is very fussy eater and does not want to eat

c.) the baby is never hungry

d.) the baby tends to have a very forceful vomiting episode about five hours after eating

a.) The baby tends to have a very forceful vomiting episode almost immediately after feeding

5 they were become silent and more education is needed about necrotizing anterior colitis in a staff in-service when one of the non-USF alum nurses say?

a.) When signs of sepsis appear the infant will likely deteriorate quickly

b.) these babies have distended abdomen's because of the gas producing bacteria that colonize in the intestine

c.) bloody diarrhea may be an indication of an NEC an infant

d.) encourage the mother to pump her milk for the feedings helps prevent any bloody diarrhea

d.) encourage the mother to pump her milk for the feedings helps prevent any bloody diarrhea

The nurse is caring for a four year old who weighs 15 kg. At the end of a 10 hour. The nurse notes the urine output to be 175 mL. What action does the nurse take?

a.) Record the child urine output in the chart

b.) encourage the child to increase oral intake to increase your an output

c.) administers isotonic fluid intravenously to help with three hydration

d.) Notifies the physician because the urine output is too low

d.) Notifies the physician because the urine output is too low

What is the most important piece of information that the nurse must ask a parent of a child experiencing an asthma exacerbation?

a.) How old is your child when he was diagnosed with asthma

b.) when was your child last admitted for asthma

c.) when and what was your child's last dose of medication

d.) what are your child's asthma triggers

c.) when and what was your child's last dose of medication

The clinical manifestations of nephrotic syndrome are due to?

a.) Obstruction of the capillaries of the glomeruli

b.) instability of the BUN and creatinine levels

c.) the increased permeability of the glomeruli which allows a large amount of proteins to pass into the urine

d.) thrombocytopenia

c.) the increased permeability of the glomeruli which allows a large amount of proteins to pass into the urine

A child with hemolytic uremic syndrome is very pale and lethargic. Blood analysis indicates severe anemia and the child has not had any urine output in 24 hours. The nurse expect what will be part of the treatment plan?

a.) Observation for the next 48 hours

b.) initiation of dialysis

c.) checking throat cultures

d.) monitoring urine output

b.) initiation of dialysis

What causes the symptoms in testicular torsion?

a.) Swelling of the scrotal sac leads to testicular displacement

b.) unmanaged undescended testes cause testicular displacement

c.) micro thrombi formation in the vessels of the spermatic cord causes interruption of the blood supply

d.) twisting of the spermatic cord interrupts the blood supply

d.) twisting of the spermatic cord interrupts the blood supply

The best urine specimen for an eight-month-old suspected of having a UTI is?

a.) From a straight catheter that is inserted and immediately removed wants to specimen is obtained

b.) from a 24 hour urine collection

c.) from a Foley catheter that was inserted at least six hours prior to the specimen collection

d.) from squeeze in cotton balls that were placed in the diaper

a.) From a straight catheter that is inserted and immediately removed wants to specimen is obtained

A second grade student with a seizure disorder has been having episodes during which he drops his pencil and simply appears to be daydreaming. This is most likely a?

a.) Partial seizure

b.) generalized seizure

c.) simple seizure

d.) absence seizure

d.) absence seizure

All of the following are signifant problems premature birth except?

a.) Jaundice

b.) hyperthermia

c.) glucose instability

d.) intraventricular hemorrhage

b.) hyperthermia

Guillain-Barre syndrome is best described as?

a.) An ascending paralysis of unknown cause

b.) a descending paralysis of unknown cause

c.) a complication of a vaso-occlusive episode

d.) an autosomal dominant disorder

a.) An ascending paralysis of unknown cause

The Pavlik this is used to treat?

a.) Scoliosis

b.) leg calves Perthes disease

c.) developmental dysplasia of the hip

d.) skipped capital femoral epiphysis

c.) developmental dysplasia of the hip

What is an early sign of respiratory distress in a four month old?

a.) Grunting

b.) bradycardia

c.) hypotension

d.) tachypnea

d.) tachypnea

Slipped Capital Femoral Epiphysis (SCFE) the:

a.) The femoral head is excessively abducted

b.) capital femoral epiphysis remains in the acetabulum but the femoral neck slips, deforming the femoral head and stretching blood vessels to the epiphysis

c.) the acetabulum slips away from the femoral head

d.) the femoral head slips out of the acetabulum

b.) capital femoral epiphysis remains in the acetabulum but the femoral neck slips, deforming the femoral head and stretching blood vessels to the epiphysis

A 13-year-old boy with type two diabetes mellitus asked the nurse why do I need to have this hemoglobin A1 C test. The nurses best response is based on which of the following?

a.) To determine how balanced a child's diet has been over an extended time

b.) determine how controlled the child blood sugar has been over an extended time

c.) to make sure the child's blood ketone level is normal

d.) to make sure the child is not anemic

b.) determine how controlled the child blood sugar has been over an extended time

In order to give informed consent a person must?

a.) Meet the legal requirements of giving consent

b.) know the risks benefits and alternatives of the procedure/treatment

c.) received the information needed to make an intelligent decision

d.) all of the above

d.) all of the above

A parent brings her child to the triage desk in the emergency department. The child is four years old has inspiratory and expiratory wheezes with super sternal retractions and nasal flaring. Which triage category is a proper assignment for the child?

1= resuscitation

2 = emergent

3= urgent

4= non-urgent

a.) Urgent

b.) resuscitation

c.) non-urgent

d.) emergent

d.) emergent

Which is best described as the in ability of the heart to pump in adequate amount of oxygenated blood to the systemic circulation?

a.) Systemic venous congestion

b.) congenital heart defect

c.) pulmonary congestion

d.) heart failure

d.) heart failure

Eight year old with type one diabetes mellitus complaining of a headache and dizziness and is visibly perspiring. Which of the following should the nurse do first?

a.) Administer rapid acting insulin such as Humalog

b.) administer glucagon intramuscularly

c.) offer the child 8 ounces of orange juice

d.) offer the child 8 ounces of water

c.) offer the child 8 ounces of orange juice

It's a 24 hour fluid requirement for a child weighing 22 kg?

a.) 1540

b.) 2000

c.) 1200

d.) 1860

This type of burn involves the entire epidermis and varying degrees of this dermal layer. These wounds are painful, moist, red and blistered. These burns often heal with extensive scarring. Which type of burn does this statement describe?

a.) full thickness (third degree burn)

b.) partial thickness (second degree) burn

c.) inhalation burn

d.) superficial (first degree) burns

b.) partial thickness (second degree) burn

All of the following are manifestations of Anorexia nervosa except:

a.) severe weight loss

b.) sinus tachycardia

c.) hypotension

d.) hyperthermia

d.) hyperthermia

Which statement is true of shaken baby syndrome?

a.) There may be absense of external signs of injury

b.) Shaken babies usually have signs of external injury

c.) shaken babies usually do not have retinal hemorrhage

d.) shaken babies usually do not have signs of a subdural hematoma

a.) There may be absense of external signs of injury

In which type of play do children discuss and plan activities while dividing the labor for purposes of accomplishing an end such as making something or obtaining a goal?

a.) parallel play

b.) solitary play

c.) cooperative play

d.) associative play

c.) cooperative play

Which child would benefit most from having pressure equalizing (PE) tubes placed?

a.) a 3 year old whose siblings has had six ear infections

b.) a 7 year ld who has had two ear infections in the last 12 months

c.) a 2 year old who has had previous ear infections

d.) a 2 month old who has had one ear infection

c.) a 2 year old who has had previous ear infections

A child fell off his bike and hit his head on the street. The child is currently awake but the mother states that he "passed out" for approx. 2 min. The mother appears highly anxious and is very tearful. The child was not wearing a helmet. Which is the priority for the triage nurse to ask at this time?

a.) why wasnt he wearing a helmet? this could have been prevented?

b.) was anyone else injured?

c.) did he vomit, have a seizure or display any unusual behavior when he woke up?

d.) tell me more about the accident

c.) did he vomit, have a seizure or display any unusual behavior when he woke up?

a 2 1/2 year old is bought to the ED with a fever, barky cough, stridor and hoarseness. Which should the nurse prepare for?

a.) A tracheaostomy set at the bedside

b.) informing the parents about a tonsillectomy

c.) respiratory treatment of racemic epinephrine

d.) immediate IV placement

c.) respiratory treatment of racemic epinephrine

Which information will be most helpful in teaching parents about the primary prevention of foreign body aspiration?

a.) therapeutic management of foreign body aspiration

b.) risks associated with foreign body aspirations and why foreign body aspiration is a terrible idea

c.) most common objects that toddlers aspirate and how to use a paper towel roll to measure for them

d.) signs and symptoms of foreign body aspiration and how to assess for them

c.) most common objects that toddlers aspirate and how to use a paper towel roll to measure for them

The respiratory syncytial virus (RSV) is often associated with:

a.) cystic fibrosis

b.) bronchiolitis

c.) asthma

d.) chronic pulmonary disease

b.) bronchiolitis

An apparent life-threatening event (ALTE) includes all the following except:

a.) a change in color (pallor, cyanosis)

b.) change in muscle tone

c.) a period of apnea

d.) a macule- papule rash across the chest that spread to the face and limbs

d.) a macule- papule rash across the chest that spread to the face and limbs

Which of the following is not a red flag for Non accidental trauma (NAT)?

a.) the injury is inconsistent with the explanation of how it occurred

b.) anterior fractures in a child who is walking

c.) any posterior rib fracture

d.) multiple fractures at various stages of healing

b.) anterior fractures in a child who is walking

In child with sickle cell disease:

a.) pancreatic function is often lost before age 6 years

b.) hemoglobin F replaced with hemoglobin S in the newborn period

c.) daily prophylactic antibiotic therapy is begun when the child enters kindergarten

d.) the risk of dehydration is low due to altered renal function

b.) hemoglobin F replaced with hemoglobin S in the newborn period