Question 1

Nurse Barbara is assigned in the pediatric unit. She is aware that the most reliable indicator of pain in a 2-year-old client is:

Accepted Answer

There are several indicators of pain in pediatric client but changes in behavior is the one that occurs most often. A change in vital signs doesn't always happen even if here's pain. Crying has more than one cause like fear or separation.

Question 2

A 3-month-old infant was brought back to the unit after a surgery for hypertrophic pyloric stenosis. The mother was very good in caring for the client but is reluctant with regard to feeding. Probably the mother is:

Accepted Answer

Past experiences with projectile vomiting are frightening. It is the responsibility of the nurse to explain that it will not happen again. No special nipple is needed in this situation.

Question 3

A mother of a toddler who recently diagnosed with diabetes type 1 asks the nurse why her child can't be given oral antidiabetics instead of insulin. The nurse would explain that oral medication would not work for the baby because they:

Accepted Answer

Oral antidiabetics stimulate the pancreatic beta cells to synthesize and release insulin; these functional beta cells are absent in children with type 1 diabetes so they rely on exogenous insulin.

Question 4

Erick, a school age child, was rushed at the emergency room due to lead poisoning. The nurse is aware that if Erick has high levels of lead in his blood, he could suffer from:

Accepted Answer

Too much lead in the blood blocks the formation of erythrocytes because it is very toxic to the biosynthesis of heme; this results to anemia. A child with plumbism experiences polyuria because of damage to proximal tubules that causes proteinuria, ketonuria, and glycosuria. Usually, CNS disturbances occurs not liver failure.

Question 5

A 7-year-old is admitted to the pediatric unit for acute asthma. Vital signs re RR of 56, BP of 98/75 and has shortness of breath. The nurse expects that the child's arterial blood gas level to indicate a:

Accepted Answer

A pH of 7.28 indicates hypoxia. The value is less than the expected range of 7.35 to 7.45. Hypoxia leads to hypercapnia that later leads to low pH level.

Question 6

During the morning rounds, a toddler client with autism starts to run and he head bangs in the all. What would be the best initial action of the nurse:

Accepted Answer

Children with autism needs protection from self-injury. Option D is permitted but do it if doesn't put the child in jeopardy. Options A and B is incorrect because the child has difficulty in following instructions especially if when out of control.

Question 7

A nurse is caring for a child with diarrhea due to salmonella infection. What order should be questioned by the nurse:

Accepted Answer

Kaopectate will keep the stool in the intestines longer which could allow the organism to infect the intestinal mucosa. This drug has adsorbent and demulcent effects.

Question 8

An infant had a surgery to correct imperforate anus. A colostomy was performed before having an Anoplasty. In what position should a nurse place the client?

Accepted Answer

Supine position with the head elevated is preferred to prevent pressure on the abdominal area. Buck's traction would put pressure and contamination by feces. Other options would put pressure on the abdominal area.

Question 9

A 5-month-old was diagnosed with intussusception. What assessment would be a priority to assist in confirming the diagnosis?

Accepted Answer

intussusception creates intestinal obstruction because the intestine "telescopes" and becomes trapped. Stools are red and currant jelly-like from the mixing of stoll with blood and mucus.

Question 10

A child possibly has pinworm infestation because he reported that he first felt:

Accepted Answer

With enterobiasis, the adult worm lays her eggs around the anal opening, producing an irritation and thus an itch.

Question 11

A nurse is aware that the concept that a developmentally disabled pediatric client could probably learn first is:

Accepted Answer

Small vs large is the concept that a developmentally disabled pediatric client could probably learn first. A child who is mentally disabled can learn concrete concepts faster compared to those which re-abstract in nature. Other options are abstract that could be learned at about 7-11 years of life

Question 12

A mother tells the nurse that she is very worried because her 2-year old child does not finish his meals. What should the nurse advise the mother:

Accepted Answer

If the child is hungry he/she would likely finish his meals. Therefore, the mother should be advised not to give snacks to the child. The child is a "busy toddler." He/she will not able to keep still for a long time.

Question 13

At the community center, the nurse leads an adolescent health information group, which often expands into other areas of discussion. She knows that these youths are trying to find out "who they are," and discussion often focuses on which directions they want to take in school and life, as well as in the peer relationships. According to Erikson, this stage is known as:

Accepted Answer

During this period, which lasts up to the age of 18-21 years, the individual develops a sense of "self." Peers have a major big influence over behavior, and the major decision is to determine a vocational goal.

Question 14

The twelve-year-old boy has fractured his arm because of a fall from his bike. After the injury has been casted, the nurse knows it is most important to perform all of the following assessments on the area distal to the injury except:

Accepted Answer

Skin integrity is less important. Capillary refill pulses, and skin temperature and color are indicative of intact circulation and absence of compartment syndrome. Skin integrity is less important.

Question 15

An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant?

Accepted Answer

A nurse caring for an infant with nonorganic failure to thrive should maintain a consistent, structured environment that provides interaction with the infant to promote growth and development. Encouraging the infant to hold a bottle would reinforce an uncaring feeding environment. The infant should receive social stimulation rather than be confined to bed rest. The number of caregivers should be minimized to promote consistency of care.

Question 16

A 5year-old child is receiving dextrose 5% in water and half-normal saline solution at 100 ml/hour. Which sign or symptom suggests excessive I.V. fluid intake:

Accepted Answer

Dyspnea and other signs of respiratory distress signify fluid volume excess (overload), which can occur quickly in a child as fluid shifts rapidly between the intracellular and extracellular compartments. Gastric distention may suggest excessive oral fluid intake or infection. Nausea and vomiting or an elevated temperature may indicate a fluid volume deficit.

Question 17

Gracie, the mother of a 3-month-old infant calls the clinic and states that her child has a diaper rash. What should the nurse advise?

Accepted Answer

Leaving the diaper off while the infant sleeps helps to promote air circulation to the area, improving the condition. Switching to cloth diapers isn't necessary; in fact, that may make the rash worse. Baby wipes contain alcohol, which may worsen the condition. Extra fluids won't make the rash better.

Question 18

Ada, tells the nurse that she wants to begin toilet training her 22-month-old child. The most important factor for the nurse to stress to the mother is:

Accepted Answer

If the child isn't developmentally ready, child and parent will become frustrated. Consistency is important once toilet training has already started.

Question 19

Nurse Bianca is providing cardiopulmonary resuscitation (CPR) to a child, age 4. the nurse should:

Accepted Answer

The nurse should use the heel of one hand and compress 1" to 1½ ". The nurse should use the heels of both hands clasped together and compress the sternum 1½ "to 2" for an adult. For a small child, two-person rescue may be inappropriate. For a child, the nurse should deliver 20 breaths/minute instead of 12.

Question 20

Nurse Tammy is administering total parental nutrition (TPN) through a peripheral I.V. line to a school-age child. What's the smallest amount of glucose that's considered safe and not caustic to small veins, while also providing adequate TPN?

Accepted Answer

The amount of glucose that's considered safe for peripheral veins while still providing adequate total parental nutrition is 10%. Any amount above 10% must be administered via central venous access.

Quiz 3: Pediatrics