Deck 7: Pediatric and Newborn Assessment

Question 1

While assessing a seven-year-old girl, the nurse notices a regular-irregular heartbeat. The nurse listens carefully and notes that the heart rate increases on inspiration and decreases on expiration. What is the most appropriate action for the nurse to take next?

A)Record the finding as normal.
B)Notify the physician.
C)Schedule an EKG.
D)Ask the mother if a murmur has been detected before.

Answer 1

Record the finding as normal.

Question 2

A nurse caring for a nine-year-old notices some swelling in the child's ankles. The nurse presses against the ankle bone for five seconds, then releases the pressure, noticing a markedly slow disappearance of the indentation. Based on these physical findings, the nurse would be most concerned with assessing:

A)Skin integrity, especially in the lower extremities.
B)Level of consciousness.
C)Urine output.
D)Range of motion and ankle mobility.

Answer 2

Urine output.

Question 3

A nurse working in the newborn nursery notes that an infant is having frequent episodes of apnea lasting 10 to15 seconds without any changes in color or decreases in heart rate. Which intervention would be the most appropriate?

A)Continue to observe the infant and call the physician if the apnea lasts longer than 20 seconds.
B)Suction the infant's mouth and nares.
C)Call the physician immediately.
D)Turn the infant on its right side.

Answer 3

Continue to observe the infant and call the physician if the apnea lasts longer than 20 seconds.

Question 4

A very concerned 14-year-old boy presents to the clinic because of an enlargement of his left breast. Except for the breast enlargement, the client's history and physical are normal. The most appropriate intervention for the nurse to implement next would be to inform the child that:

A)This is a normal finding in adolescent males and that the breast tissue generally regresses by the time of full sexual maturity.
B)His condition is related to a high-fat diet and that limiting fat intake usually will resolve the enlargement over a period of a couple of months.
C)A pediatric endocrine consult is being arranged.
D)The healthcare provider is arranging a surgical consult for him.

Question 5

While evaluating development of children, the nurse notes that the development of secondary sexual characteristics follows a typical pattern. Place the appearance of secondary sexual characteristics in the female in order of appearance from earliest to latest. Standard Text: Click and drag the options below to move them up or down.

A)Appearance of pubic hair
B)Menarche
C)Breast budding
D)Breast Tanner stage 5, areola strongly pigmented

Question 6

During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. Which finding would strongly suggest this disorder?

A)Asymmetric thigh and gluteal folds
B)Positive Babinski's reflex
C)A negative Moro reflex
D)Flat soles with prominent fat pads

Question 7

While assessing newborns, the nurse should differentiate normal findings from findings which require further evaluation and intervention. Which would be normal newborn findings? Standard Text: Select all that apply.

A)Swelling over the occiput that crosses suture lines
B)Tiny white papules located primarily on the nose and chin
C)Tiny red macules and pustules that come and go, primarily on the trunk and extremities
D)When the Moro reflex is elicited, the right arm extends and returns to the body.The left arm remains resting against the chest.
E)Greenish discoloration of skin over the entire body that is not removed by the initial bath

Question 8

The nurse is taking a health history from the family of a three-year-old child. Which statement or by the nurse would be most likely to establish rapport and elicit an accurate response from the family?

A)"Tell me about the concerns that brought you to the clinic today."
B)"Does any member of your family have a history of asthma, heart disease, or diabetes?"
C)"Hello, I would like to talk with you and get some information about you and your child."
D)"You will need to fill out these forms; make sure that the information is as complete as possible."

Question 9

The nurse is caring for an infant diagnosed with "failure to thrive." The nurse observes the physician taking blood pressures in all four extremities and recognizes that the physician suspects which congenital cardiac defect?

A)Tetralogy of Fallot
B)Ventricular septal defect
C)Pulmonary atresia
D)Coarctation of the aorta

Question 10

The nurse is assessing a newborn while the new parents watch. The nurse uses an ophthalmoscope to examine the back of the eye (the retina) and notes a positive red reflex. The nurse would explain to the parents that the red reflex indicates:

A)The absence of congenital cataracts.
B)The presence of intraocular hemorrhage.
C)The optic nerve has been traumatized during delivery.
D)Presence of amblyopia.

Question 11

A seven-year-old presents to the clinic with an exacerbation of asthma symptoms. On physical exam, the nurse would expect which of the following findings? Standard Text: Select all that apply.

A)Increased tactile fremitus
B)Decreased vocal resonance
C)Bronchophony
D)Decreased tactile fremitus
E)Wheezing

Question 12

While inspecting a five-year-old child's ears with an otoscope, the nurse notes that the right membrane is red and there is an absence of light reflex. In view of these findings, which vital sign parameter would most concern the nurse?

A)Heart rate
B)Temperature
C)Blood pressure
D)Respirations

Question 13

The nurse wants to do a quick evaluation of a one-month-old infant's hearing. Which assessment will provide the best information?

A)Examining the ear canal with an otoscope
B)Using a vibrating tuning fork placed against the child's skull
C)Using tympanometry
D)Using a noisemaker in the infant's presence to evaluate the child's response

Question 14

While assessing a 10-month-old African American infant, the nurse notices that the sclerae have a yellowish tint. Which organ system would the nurse suspect as having an ongoing disease process?

A)Genitourinary
B)Cardiac
C)Gastrointestinal
D)Respiratory

Question 15

Put the following nursing assessments of a toddler in the best order for the nurse to proceed (from first assessment to last assessment). Standard Text: Click and drag the options below to move them up or down.

A)Auscultation of chest
B)Examination of eyes, ears, and throat
C)Palpation of abdomen
D)General appearance

Question 16

To accurately access blood pressure on a child, the nurse would select a cuff:

A)By the cuff label-infant, child, adult.
B)That covers 2/3 of the upper arm with a bladder that wraps around at least 80% of the circumference of the arm.
C)Based on availability as the size of the cuff will not influence the blood pressure.
D)That extends up to 50 % of the upper arm and the bladder covers 1/4 of the circumference of the arm.

Question 17

The nurse is completing a physical examination of a four-year-old child. The best position in which to place the child for assessment of the genitalia would be:

A)Supine, with legs at a 50-degree angle.
B)Right side-lying.
C)In prone position, with knees drawn up under the body.
D)Frog-leg position.

Question 18

The nurse is assessing a new admission to the newborn nursery. Which physical findings suggest the infant was preterm? Standard Text: Select all that apply.

A)The ear pinna quickly returns to original position after being bent manually.
B)The infant's resting position is tightly flexed.
C)Labia widely separated with clitoris prominent.
D)Breast area barely perceptible with flat areola, no bud.
E)Sole creases do not extend the length of the foot.

Question 19

The policy of the pediatric clinic is that head circumferences are performed at each visit, if appropriate. The nurse should plan to check head circumferences on which of the children being seen today? Standard Text: Select all that apply.

A)One-month-old child who is coming for his first well-child visit
B)Two-month-old child with failure to thrive
C)Nine-month-old child with otitis media
D)18-month-old well-child visit for a child with Down's syndrome