Question 1

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:

Accepted Answer

The nurse calculates for the intake of MES for this client is 975ml (2.2 lbs =1kg; 14.3lbs /2.2 lbs = 6.5 kg; 6.5 kg x 150 ml = 975 ml).

Question 2

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:

Accepted Answer

15 lbs is about 7 kg; at 40 ml/kg x 4 hours = 280 ml; at 50ml/kg x 4 hours = 350 ml; 330ml is within these parameters.

Question 3

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:

Accepted Answer

Elevation in body temperature or hyperpyrexia is a manifestation of acute aspirin toxicity. It leads to increase oxygen consumption and heat loss.

Question 4

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:

Accepted Answer

T o correct the sodium deficit and metabolic acidosis, the client needs Sodium Lactate. Sodium Lactate is converted to sodium bicarbonate. Saline intensifies acidosis. Potassium will only be given once kidney function was restored.

Question 5

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

Accepted Answer

Extremities need to be restrained as infants use them to dislodge the needle. Pupillary reaction and assessing at the occiput do not relate to scalp vein and IV therapy.

Question 6

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:

Accepted Answer

The therapy causes diuresis therefore the infant should be monitored for excessive fluid loss. Options B and C are related to fluid gain. Any changes in vital signs are not indicative of impending seizure.

Question 7

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:

Accepted Answer

Croup often begins at night and may be preceded by several days of upper respiratory infection symptoms. Croup is characterized by a sudden onset of a harsh, brassy cough, sore throat, and inspiratory stridor. Symptoms usually worsen at night and are better in the day. Croup usually is accompanied by a low-grade fever.

Question 8

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:

Accepted Answer

In the acute stage, the child has a fever, conjunctival hyperemia, red throat, swollen hands, rash, and enlargement of the cervical lymph nodes. In the subacute stage, cracking lips and fissures, desquamation of the skin on the tips of the fingers and toes, joint pain, cardiac manifestations, and thrombocytosis occur. In the convalescent stage, the child appears normal, but signs of inflammation may be present.

Question 9

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:

Accepted Answer

The child with intussusception typically has severe abdominal pain that is crampy and intermittent, causing the child to draw in the knees to the chest. Vomiting may be present but is not projectile. Bright red blood and mucus are passed through the rectum and commonly are described as currant jelly-like stools. Watery diarrhea and ribbon-like stools are not manifestations of this disorder.

Question 10

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

Accepted Answer

A nurse will monitor blood urea nitrogen level. Renal function is monitored closely during the administration of Chelation therapy because the medications are excreted via the kidneys. Although it is important to monitor the red blood cell count for the presence of anemia in a child with lead poisoning, this laboratory result is not specific to chelation therapy. Options A and D are unrelated to the administration of chelation therapy.

Question 11

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:

Accepted Answer

Pediatric client with acute glomerulonephritis are oliguric, therefore Potassium rich food should be avoided to prevent cardiac dysryhthmia associated with hypokalemia.

Question 12

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:

Accepted Answer

It allows the child to take full 1-ounce cup of fluid without long waits; a full cup, though it is small cup creates an illusion that he is receiving more. A child can't tolerate long hours of waiting for a fluid.

Question 13

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:

Accepted Answer

This position prevents incisional contact with the mattress. This is also the best position for infants who are not able to turn.

Question 14

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:

Accepted Answer

Signs and symptoms of Rubella include Koplik's spots and rash accompanied by coryza.

Question 15

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:

Accepted Answer

The lesions will not be disturbed if you pat them. Also, calamine lotion is an effective drying agent.

Question 16

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

Accepted Answer

Chicken pox is no longer communicable once the vesicles have dried. It is because dried vesicles do not harbor the virus.

Question 17

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

Accepted Answer

Touching the infant while in pain will make him feel secured. This is the best for a distressed infant. Feeding doesn't always comfort an infant.

Question 18

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:

Accepted Answer

This is a sign of increased intracranial pressure; which is caused by the fluid accumulation associated with hydrocephalus.

Question 19

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:

Accepted Answer

This is an honest response which forms the basis for the rest of the teaching, it will be more complex as parents progress in understanding the disorder. The disorder is not caused by a bacteria or a genetic disorder.

Question 20

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:

Accepted Answer

Findings are common to lead poisoning or Plumbism attributable to the deposition of lead at the gum lines and in between teeth.

Quiz 3: Pediatrics