Deck 3: Pediatrics

Question 1

Stuttering among pre-schoolers is:

A)a symptomatic delay in neural development
B)a common characteristic.
C)an indication of a speech problem.
D)a possible result of an emotional problem.

Answer 1

a common characteristic.

Question 2

A 5-week-old infant tightly grasps a little toy placed in his hands. The mother was impressed with this ability. The nurse on duty should explain that this is:

A)a behavior that is usually observed in an older infant.
B)a palmar grasp reflex that is expected at this age group.
C)an unusual behavior that needs further evaluation.
D)a pincer grasp reflex which will disappear in about 3-4 months of life.

Answer 2

a palmar grasp reflex that is expected at this age group.

Question 3

A primary school age boy was diagnosed with Myelogenous Leukemia. He is about to begin Chemotherapy and tells the nurse "I'm already 12 years old and I think I have the right to refuse the treatment". The nurse's most therapeutic response is:

A)"You are old enough. You're also old enough to understand that you need the Chemotherapy.
B)"You seem afraid. Let me talk to you about it".
C)Your father already gave his consent so we need to go on with the treatment".
D)Because you're under 18 years old, it means you don't have the capacity to refuse.

Answer 3

"You seem afraid. Let me talk to you about it".

Question 4

Jessica, a 29-year-old mother, tells the nurse that her youngest son who is just 7-months-old can already sit without any support. The nurse should tell the mother that this:

A)could be a developmental delay which needs further evaluation.
B)is an activity that shows the upper 10% of physical development.
C)is a developmental milestone that is just expected at his age.
D)is a behavior which indicates that he is going to walk in the next 3 months.

Question 5

A nurse teaches a mother of a 2-month-old infant to be sure that the floor is free of small objects when her child is crawling. The reason for this is that:

A)sharp objects can easily injure the infant's skin.
B)the infant could hide small objects making them harder to find.
C)the infant can easily pick up small objects
D)it is very hazardous for them to pick up things from the floor.

Question 6

What is the most appropriate toy that a nurse should give to a 12-week-old infant?

A)Colorful stuffed toy
B)Metallic mirror
C)Rattle
D)Balls made of safe plastic

Question 7

An infant who weighed 6 pounds at birth now weighs 12 pounds at 1 year. The nurse at the clinic recognizes that this infant:

A)has the expected weight at 1 year of age.
B)has probably been neglected
C)has low weight compared to what is expected.
D)has not been offered adequate nourishment

Question 8

A 2 year old boy was scheduled for an emergency surgery. It as noted that the mother is 16 year old and the father is 17 year old. The child's father and paternal grandfather, who care for the baby, are at the bedside. Informed consent should be signed by:

A)the 17 year old father
B)the 16 year old mother
C)Paternal grandfather
D)Surgeon and attending physician

Question 9

A 2 year old was brought to the pediatric clinic for a routine check up. When assessing the child's relationship with other children, the nurse would expect to observe.

A)cooperative play
B)team play
C)parallel play
D)initiative play

Question 10

Which of the following is the correct way of instilling eardrops among children below 3 years old:

A)Apply medicated ear wicks, then instill the eardrops
B)Cleanse the ear canal trough pulling the pinna outward
C)Pull the pinna up and back to straighten the ear canal
D)Pull the pinna down and back to straighten the ear canal

Question 11

When is the best time to do a corrective surgery for an infant with hypospadias:

A)Anytime during pre school age
B)72 hours after birth
C)Within few months after birth
D)6-18 months of age.

Question 12

A pre-schooler is being prepared for an ear surgery in an ambulatory care facility. When the child is called to go to the operating room, the nurse should:

A)Allow the child to walk from the unit.
B)Remove the child's toy.
C)Allow the parents to accompany the child until he is sedated.
D)Ask the parents to leave the room and wait outside.

Question 13

Measles vaccine should be given among infant between:

A)1 and 3 months
B)6 and 9 months
C)9 and 11 months
D)12 and 15 months

Question 14

A school age girl with rubella should be isolated from an unimmunized:

A)18 year old sister who has recently married.
B)4 year old child who lives next door.
C)14 year old brother who had rubella as a child.
D)21 year old brother living at home.

Question 15

Which of the following would a nurse expect to observe in a pediatric client who has a tentative diagnosis of Acute lymphocytic Leukemia:

A)Alopecia and swollen gums
B)Alopecia and Petechiae
C)Anorexia and Insomnia
D)Anorexia and Petechiae

Question 16

A nurse is aware that the most common site for bleeding to develop in a child with hemophilia is:

A)Gums
B)Stomach
C)Joints
D)Nose and ears

Question 17

One goal of therapy for sickle cell anemia is prevention of sickling phenomenon, which is responsible for the pathologic sequelae. Which of the following plan of care is directed toward the prevention of a crisis:

A)Giving iron-rich formula as nourishment.
B)Promoting oxygenation and hemodilution
C)Techniques in decreasing tissue oxygen requirements and maintaining hemoconcentration
D)Enforcing periods of bed rest to minimize energy expenditures.

Question 18

A father of a 16 year old who has sickle cell anemia tells a nurse that his family is scheduled to go camping this summer. He asks what activity would be appropriate for his child. The nurse would suggest:

A)Collecting logs to be use for campfire
B)Biking around the lake
C)Fresh water swimming
D)Motorboat ride around the lake.

Question 19

A nurse is aware that a child with AIDS is more prone to infection than an adult with AIDS because:

A)child with AIDS is exposed to more pathogen than an adult with AIDS.
B)the immune system of a child is incapable of producing antibodies.
C)the AIDS virus attacks child's immune systems through a different mechanisms
D)a child has fewer circulating antibodies resulting from a lack of previous exposure to pathogens.

Question 20

Victor, a 4 year old child, is at the clinic for a routine clinic visit. In assessing Victor's growth and development, the nurse is guided by principles of growth and development. Which is not included:

A)Different parts of the body grows at different rate
B)All individual follow standard growth rate
C)Rate and pattern of growth can be modified
D)All individuals follow cephalo-caudal and proximo-distal

Question 21

What type of play is most appropriate for a 6 year old child:

A)make believe
B)hide and seek
C)building blocks
D)peek-a-boo

Question 22

Which of the following information would indicate that a pre-school has normal growth and development:

A)Determines own sense self
B)Develops sense of whether he can trust the world
C)Has the ability to try new things
D)Learns basic skills within his culture

Question 23

Which of the following is true about Mongolian Spots?

A)Are linked to pathologic conditions
B)Are managed by tropical steroids
C)Disappears in about a year
D)Are indicative of parental abuse

Question 24

Signs of cold stress that the nurse must be alert when caring for a Newborn is:

A)Hypothermia
B)Increased Respirations
C)Shaking
D)Decreased activity level

Question 25

What would cause the closure of the Foramen ovale after the baby had been delivered?

A)Decreased blood flow
B)Shifting of pressures from right side to the left side of the heart
C)Increased in oxygen saturation
D)Increased PO2

Question 26

Failure of the Foramen Ovale to close will cause what Congenital Heart Disease?

A)Transposition of great arteries
B)Atrial Septal defect
C)Pulmunary Stenosis
D)Total anomalous Pulmunary Artery

Question 27

A mother brought her child to the clinic with nose bleeding. The nurse showed the mother the most appropriate position for the child which is:

A)low back rest
B)moderate back rest
C)Lying semi flat
D)Sitting up

Question 28

For acute otitis media, the treatment is prompt antibiotic therapy. Delayed treatment may result in complications of:

A)Eardrum Problems
B)Diabetes mellitus
C)Brain damage
D)Tonsillitis

Question 29

Which of the following statements would the nurse expect a 5-year old boy to say whose pet gerbil just died:

A)"He's just a bit dead"
B)"I'll be good from now own so I won't die like my gerbil"
C)"Did you hear the joke about…"
D)"Joker got him"

Question 30

When assessing the fluid and electrolyte balance in an infant, which of the following would be important to remember:

A)Infant has greater body surface area than adults
B)Infants have more intracellular water that adult do
C)The metabolic rate of an infant is slower than in adults
D)Infant can concentrate urine at an adult level

Question 31

A nurse must be aware that infants with heart failure require immediate scheduling of:

A)operations during childhood.
B)same medications as that of an adult.
C)different treatment as that of an adult.
D)meticulous heart surgery.

Question 32

A mother tells the nurse "the doctor said that my child has pulmonic stenosis. What does it mean?" The nurse's best response should be:

A)"What else did the doctor say about the disease"
B)"It means that the baby has a heart failure"
C)"Let me call your doctor so that your questions will be answered correctly"
D)"You seemed very concerned. Your baby has a great doctor anyway"

Question 33

An infant was diagnosed of Tetralogy of Fallot. The nurse assessed that the infant is underweight. What could be the reason behind this problem:

A)recurrent respiratory infections due to pulmonary hypertension.
B)Polycythemia brought by a decreased in the level of arterial PO2.
C)deficient caloric intake due to activity intolerance.
D)Cerebral changes due to cyanosis.

Question 34

An infant with tetralogy of fallot was admitted at the unit. Which of the following is indicative of physiologic adaptation of a client with tetralogy of fallot:

A)shallow and irregular respirations.
B)decrease platelet count
C)ecchymoses
D)digital clubbing

Question 35

Dietary restriction in a child who has Hemocystenuria will include which of the following amino acid:

A)Lysine
B)Methionine
C)Isolensine tryptophase
D)Valine

Question 36

Which of the following would be a diagnostic test for Phenylketonuria which uses fresh urine mixed with ferric chloride:

A)Guthrie Test
B)Phenestix test
C)Beutler's test
D)Coomb's test

Question 37

An inborn error of metabolism that causes premature destruction of RBC:

A)G6PD
B)Hemocystinuria
C)Phenylketonuria
D)Celiac Disease

Question 38

For a child with recurring nephrotic syndrome, which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care:

A)Muscle coordination
B)Sexual maturation
C)Intellectual development
D)Body image

Question 39

When assessing a newborn with cleft lip, the nurse would be alert which of the following will most likely be compromised:

A)Sucking ability
B)Respiratory status
C)Locomotion
D)GI function

Question 40

While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonate's urinary meatus appears to be located on the ventral surface of the penis. The physician is notified because the nurse would suspect which of the following:

A)Phimosis
B)Hydrocele
C)Epispadias
D)Hypospadias

Question 41

When assessing a newborn for developmental dysplasia of the hip, the nurse would expect to assess which of the following:

A)Symmetrical gluteal folds
B)Trendelemburg sign
C)Ortolani's sign
D)Characteristic limp

Question 42

Which of the following immunizations would the nurse expect to administer to a child who is HIV (+) and severely immunocompromised:

A)DTaP
B)Rotavirus
C)MMR
D)IPV

Question 43

A mother asks the nurse about Vitamin A supplementation. The best response is that giving Vitamin A starts when the infant reaches 6 months and the first dose is:

A)200,000 "IU"
B)100,000 "IU"
C)20,000 "IU"
D)10,000 "IU"

Question 44

Which of the following would require careful monitoring in the child with ADHD who is receiving Methylphenidate (Ritalin):

A)Dental health
B)Mouth dryness
C)Height and weight
D)Excessive appetite

Question 45

Which of the following statements by the family of a child with asthma indicates a need for additional teaching:

A)"We need to identify what things triggers his attacks"
B)"He is to use bronchodilator inhaler before steroid inhaler"
C)"We'll make sure he avoids exercise to prevent asthma attacks"
D)"he should increase his fluid intake regularly to thin secretions"

Question 46

A child was scheduled for a palliative surgery, which creates anastomosis of the subclavian artery to the pulmonary artery. This procedure is called:

A)Waterston-Cooley
B)Raskkind Procedure
C)Coronary artery bypass
D)Blalock-Tausig

Question 47

A client with tetralogy fallot will become cyanotic and dyspneic after crying. To relieve this clinical manifestation, the nurse should place the infant in what position?

A)Sitting position
B)Modified trendelenburg position
C)Knee chest position
D)Lateral Sim's position

Question 48

Which of the following would be an indicative of impending heart failure among infants:

A)notable increased in urinary output
B)shallow and grunting respirations
C)distended jugular vein
D)Dyspnea and tachycardia

Question 49

An infant with heart failure was fed and burped, after burping; he was repositioned in semi-fowler then had a bowel movement. Afterwards, the infant became diaphoretic and cyanotic. The nurse is aware that these were most likely caused by:

A)feeding
B)burping
C)changing of position
D)defecating

Question 50

What explanation would a nurse give to a parent of a pediatric client who will undergo a cardiac catheterization:

A)it will confirm if there is a pansystolic murmur.
B)it will establish the presence of heart muscle hypertrophy.
C)it will determine the degree of heart muscle problem
D)it will identify specific location of the defect.

Question 51

Michael, a toddler, was admitted at the hospital with a diagnosis of Wilm's tumor. The nurse should be aware that:

A)vigorous palpation of the mass must be avoided.
B)hypertension may occur at anytime of confinement.
C)respiratory problems should be expected and reported.
D)disease is communicable therefore the client must be isolated.

Question 52

Michael was diagnosed with Wilm's tumor and started on chemotherapy as treatment. The doctor ordered a Dactinomycin 0.015mg/kg slow IV push now. The nurse on duty should:

A)question the doctor's order to prevent over dosage.
B)administer the medicine and watch out for nausea and vomiting.
C)hold the medication until the doctor changed the dosage.
D)administer the medicine then give hydrocortisone 100 mg IV afterwards.

Question 53

Britney, a mother of a child who was diagnosed with Guillain-Barre syndrome, asks the nurse about the treatment plan for her child. The nurse is aware that:

A)therapies will lessen the severity of the illness and speed the recovery in most patients.
B)the child will be given loading dose of antibiotics.
C)surgical treatment will be discuss by the doctor once cardio-pulmonary clearance is done.
D)the child needs several blood transfusion to prevent shock.

Question 54

Olga is a 4 year old girl who was diagnosed with Trisomy 21. During the clinical check-up the nurse would expect to find:

A)gigantism
B)hydrocephalus
C)multiple-creased hand
D)protruding tongue

Question 55

A nurse is caring for a child who has Trisomy 13. During a morning rounds, the mother asks how her child acquired the syndrome. The nurse's response will be based from the fact that:

A)it is an inherited condition.
B)it is caused by microorganism.
C)it is a complication of previous exposure to streptococcus
D)it is a chromosomal anomaly.

Question 56

A mother of a child with heart failure questions the necessity of weighing the baby everyday. The nurse's best response should be guided by the fact that the daily weight is essential in determining:

A)fluid retention
B)nutritional status
C)dosage of medication
D)success of treatment

Question 57

The nurse scans the laboratory values of a pediatric client with rheumatic fever. Which data should be treated as insignificant:

A)positive antistreptolysin titer
B)positive C-reactive protein
C)elevated reticulocyte count
D)elevated ESR

Question 58

A pediatric client was returned to the unit after a heart surgery. Contraptions are: Left chest tube drainage attached to a bottle system; an IVF of D5 NSS at 32 gtts/min; and an NGT to gravity. The client was then attached to a cardiac monitor. What would be the priority nursing intervention:

A)obtain vital signs
B)check the identification bracelet
C)check the IVF level and flow rate
D)measure the drainage of both tubing.

Question 59

Included in the plan of care of a 7 year old client with diabetes is glucose monitoring. As a nurse, we must be aware that the most accurate way to evaluate the effectiveness of client and insulin therapy over time is the test that measures:

A)Serum protein levels
B)Urine ketones
C)Serum glucose level
D)Glycosylated Hemoglobin

Question 60

Channel is a 3 year old girl who has Thalassemia. She underwent several blood transfusion and folate intake as treatments. After 2 months, the doctor planned a therapy to remove too much iron in the blood. The nurse is aware that this therapy is called:

A)Chelation
B)Hemoglobin electrophoresis
C)Plasmapheresis
D)Cautery

Question 61

A Multi-Electrolyte Solution (MES) 150 ml/kg of body weight Q 24 hours is ordered for a pediatric client weighing 14.3 lbs. The nurse calculates for the intake of MES for this client is:

A)40 ml
B)2145 ml
C)975 ml
D)89 ml

Question 62

A 5-month-old infant, weighing 15 lbs, is admitted with a diagnosis of diarrhea with moderate dehydration. The doctor ordered oral rehydration therapy of 40-50 ml/kg of pedialyte over 4 hours. What would be the appropriate amount of fluid that the infant should ingest during the 4 hour period:

A)250 ml
B)330 ml
C)360 ml
D)400 ml

Question 63

Poisoning among toddlers is common because of the ingestion of different things like medicines that looks like candies. What would be the priority plan of care for a toddler who has ingested aspirin:

A)monitor BP
B)monitor Cardiac rate
C)monitor body temperature
D)monitor serum glucose level.

Question 64

An infant with Myelomeningocoele underwent a surgical repair. Suddenly, the client developed metabolic acidosis, notable decreased urinary output and diarrhea. The nurse at the unit anticipates that the doctor will order:

A)Hypertonic saline
B)Potassium chloride
C)Isotonic saline
D)Sodium Lactate

Question 65

What nursing action should be done in an infant who receives IVF via a scalp vein:

A)restrain the extremities when there's no one to see the child.
B)assess for signs of infiltration behind the occiput
C)assess the pupils every 1 hour for any untoward reaction.
D)explain to the parents that they cant hold the client while the IV therapy is ongoing.

Question 66

An IV solution of 10% glucose and mannitol are administered to an infant with Reye's syndrome. The client's vital signs should be monitored by the nurse to prevent the occurrence of:

A)hypovolemic shock
B)fluid volume excess
C)heart failure
D)seizure episodes.

Question 67

A student nurse is caring for a 4-year old child diagnosed with croup and the clinical instructor asks the student about the clinical manifestations associated with the illness. Which statement by the student indicates a need for further research:

A)cough is harsh and brassy
B)inspiratory stridor and a low-grad fever may be present
C)symptoms usually worsen at night and are better during the day
D)symptoms usually worsen during the day and are relieved during sleep

Question 68

A nurse is preparing for the admission of a child with a diagnosis of acute-stage Kawasaki disease. The nurse expects to note which clinical manifestation of the acute stage of the disease:

A)cracked lips
B)conjunctival hyperemia
C)desquamation of the skin
D)swollen joints

Question 69

A nurse is preparing to care for a child with a diagnosis of intussusception. The nurse reviews the child's record and expects to note which symptom of this disorder documented:

A)watery diarrhea
B)ribbon-like stools
C)profuse projectile vomiting
D)bright red blood and mucus in the stools

Question 70

A child is receiving succimer (Chemet) for the treatment of lead poisoning. A nurse monitors which of the following most important laboratory results:

A)SGOT and SGPT
B)blood urea nitrogen level
C)red blood cell count
D)serum albumin

Question 71

A 13-year-old client with acute glomerulonephritis asks the nurse about his diet. The nurse assigned said that he should eat foods which are low in:

A)Protein
B)Glucose
C)Potassium
D)Fat

Question 72

Fluid restriction of 800 ml in 24 hours was ordered for a 5-year-old child with acute glomerulonephritis. To best assist the client to cope with these limitations, the nurse should:

A)hold the fluids from 8am to 8pm
B)equally divide the intake per shift
C)allow fluid as desired until 800 ml is reached.
D)give fluids in 1-ounce calibrated cup throughout the waking hours.

Question 73

After a cleft lip repair, it is important to preserve the integrity of suture line. What is the best position for an infant who had this type of surgery:

A)side-lying
B)on his back
C)on his abdomen
D)mother's shoulder

Question 74

The nurse notes that a 10-month-old infant had a fever, runny nose, cough, and white spots in the mouth for almost 3 days. Rash started on his face and spread to the whole body. The nurse suspected a case of:

A)Rubella
B)Varicella
C)Herpes

Question 75

During a community visit, a mother asks the nurse on how to relieve the itch in a child with chicken pox. The nurse should suggest:

A)have the child wear mittens
B)pat the lesions with calamine lotion
C)use wet to dry saline dressing on the lesion
D)rub bacitracin ointment on the lesion

Question 76

During a home visit, a mother asks the nurse about the communicability of chicken pox. The nurse responds correctly by stating that it is:

A)communicable until the vesicles were dried.
B)communicable even when dry scabs remain.
C)not communicable once fever subsided.
D)not communicable while vesicles are reddish in color.

Question 77

How would a nurse soothe an infant who was hospitalized and appears to be in pain:

A)through feeding
B)playing a relaxing music
C)eliminating noise
D)holding the infant

Question 78

A clinical manifestation that a nurse would expect to observe during an assessment of a 4-week-old infant admitted to the unit with hydrocephalus is:

A)anterior fontanel is tense upon palpation.
B)head circumference is larger than that of his chest.
C)Poor muscle and or eye coordination
D)unable to support his head while in a prone position.

Question 79

Roy, a 12-month-old child, developed Reye Syndrome. His mother asks the nurse to define the illness. The nurse's best initial response must be that it is:

A)linked to genetic disorder.
B)an infection caused by bacteria
C)an idiopathic disorder
D)an illness primarily affecting the infant's brain.

Question 80

A school age girl was rushed to the Emergency room with symptoms of acute, crampy abdominal pain, fever, and impaired sensory perception. The nurse found a black line between his teeth and gums. The client needs further evaluation because findings are characteristics of:

A)Aspirin toxicity
B)Tetracycline exposure
C)Plumbism
D)Perthe's disease