Question 1

Which of the following nursing diagnosis would the nurse identify as the priority for a 4-month-old infant with heart failure and congenital heart disease:

Accepted Answer

An infant with congenital heart disease and congestive heart failure tires very easily, leading to a priority nursing diagnosis of Activity Intolerance. Nursing care needs to focus on allowing the infant to have frequent rest periods. Infants with congenital heart disease and congestive heart failure are not necessarily at risk for more infections than other infants. Impaired Mobility usually is not a problem because an infant with congenital heart disease usually exhibits normal physical mobility. Ineffective Health Maintenance usually is not a problem because these infants still need regular and routine health check-ups

Question 2

When developing a plan of care that includes interventions aimed at preventing complications of a low platelet count in a child with leukemia, which of the following is most appropriate:

Accepted Answer

The use of a stool softener would assist in preventing damage to the rectal mucosa due to hard stool, thereby decreasing the chances of rectal bleeding. Placing the child in protective isolation would be appropriate for the child if the neutrophil count was low. The use of heparin is contraindicated in situations in which there is a possibility of increased bleeding due to low platelets. Avoiding raw vegetables or fruits would be indicated if the child's neutrophil count were low.

Question 3

A mother brings her 18-month-old child to the clinic because the child "eats ashes, crayons, and paper." Which of the following information would be most important to obtain first about this toddler?

Accepted Answer

It is important to determine if the child is experiencing any change in the home environment that could cause anxiety that is relieved through oral gratification. A craving to eat nonfood substances is known Aspica.

Question 4

Which of the following interventions would be included in the plan of care for a child with juvenile rheumatoid arthritis to reduce joint pain in the morning just after arising?

Accepted Answer

Sleeping in a sleeping bag keeps the joints warm, therefore more flexible. Thus, joint pain in the morning would be lessened. Increasing bedtime pain medications may help the child sleep but will not decrease early morning stiffness. The child's joints should be kept in an extended position during sleep to maintain function. Lack of sleep such as from awakening the child at night for exercises is a stressor that can lead to exacerbation of juvenile rheumatoid arthritis.

Question 5

After the nurse instructs the parents of a 5-month-old infant about the purpose of the Denver Developmental Screening Test (DDST), which of the following statements by the parents about what the test measures would indicate that the teaching was effective:

Accepted Answer

DDST measures a child's social, language, and fine and gross motor skills by testing abilities that usually occur at a given age. The DDST is not designed to measure intelligence or emotional development nor does it necessarily predict future development.

Question 6

After teaching the parents of an 18-month-old child who has undergone cleft palate repair how to use elbow restraints, which of the following statements by the parents indicates effective teaching:

Accepted Answer

Elbow restraints help to keep the child from placing fingers or any other object in the mouth that would cause injury to the operative site. The restraints are worn at all times except when they are removed to check the skin. Because of the risk for skin breakdown, the restraints are removed periodically during the day to assess the child's underlying skin. It is advisable to remove only one restraint at a time while keeping hold of the child's hand on the unrestrained side.

Question 7

When determining the effectiveness of teaching a child's mother about sickle cell disease, which of the following statements by the mother indicates the need for additional teaching:

Accepted Answer

"He's going to be playing on a soccer team when he's feeling better" definitely indicated the need of additional teaching. Physical and emotional stress can precipitate a sickle cell crisis. Physical exercise such as running involved in soccer would increase the child's risk for a crisis. Thus, the mother needs additional instructions about this area.

Question 8

After the nurse has taught the parents of a 5-year-old boy who has leukemia how to talk with their child about death and dying, which of the following would indicate that the parents have age-appropriate expectations about their child's reaction to his impending death:

Accepted Answer

A 5-year-old child is in the preoperational stage of cognitive development and thinks of death as temporary. Also, for a child this age, thinking about behavior often is believed to be magical; thus, the child may think that his behavior can cause death. Generally, children under 3 years of age are unable to differentiate death from temporary separation and are unable to understand what is happening.

Question 9

The mother of a 16-month-old child who is coughing and having trouble breathing calls the clinic to ask advice because she suspects that her child has croup. Which of the following instructions would be most appropriate?

Accepted Answer

For a child with croup who is coughing and having difficulty breathing, the child should be taken into the shower where hot water is running to make the bathroom steamy. Steam helps to loosen secretion and relieve some of the respiratory distress. Giving acetaminophen is helpful but will not ease difficult breathing. Giving over-the-counter cough syrup is inappropriate because the underlying problem is airway inflammation and subsequent mucus accumulation and bronchoconstriction. Getting the child to take as much fluid as possible is important but it will not be effective in easing difficult breathing.

Question 10

Which of the following reflects the child's level of moral development when a 2 1/2-year-old child states that the nurse is "a bad girl" after she administers an injection:

Accepted Answer

Children between ages 1 and 3 are at the Preconventional/punishment-obedience stage and determine the goodness or badness of an action in terms of its consequences.

Question 11

When managing an abused child, the nurse should be aware that this child is most likely to do which of the following:

Accepted Answer

Because abused children see violence as an expected way of coping with life, they tend to develop aggressive behaviors toward other children. Many abused children fail to do well in school and are unable to compensate for their abused status. Many abused children have difficulty in establishing relationships, and those that are formed are usually superficial. Even though many abused children use attention-seeking behaviors toward their teachers, they are usually not seeking assistance, just attention.

Question 12

A mother is upset because her 8-year-old daughter developed a right breast mass. She asks the nurse what she should do. The nurse bases her response on knowing that the breast mass is most likely due to which of the following:

Accepted Answer

The onset of puberty may start as early as age 8, with development possibly beginning unilaterally. Gynecomastia is the development of breast tissue in males. Precocious pseudo puberty is a precocity that develops with no early secretion of gonadotropin. Precocious thelarche occurs before the onset of the pubertal period, which can start as young as age 8

Question 13

Which of the following maternal deficiencies is associated with the development of Neural Tube Defects?

Accepted Answer

Deficiency of the vitamin folic acid has been associated with Neural Tube Defects (NTD). There is no relationship between the amino acids, ascorbic acid or valproic acid and NTDs.

Question 14

Baby James weighs 6.2 lbs at birth, after 3 days he weighs 5% less than 6.2 lbs. The nurse is aware that the weight loss is a result of:

Accepted Answer

The intake of milk is gradual and small, at the same time, there is a loss of extracellular fluid primarily in the form of stool and urine.

Question 15

A school age child is admitted with cancer. The doctor ordered Fentanyl (lollipop) if there is a breakthrough pain. During the teaching on how to use the lollipop, the nurse should state that the client should:

Accepted Answer

A Fentanyl lozenge or lollipop is absorbed through the buccal mucosa. When pain is relieved, it should be removed and kept until needed again. Remember that there's no specific time to suck on the lozenge

Question 16

A 9-year-old child is attending a new school in Manitoba. Her teachers assess her behavior over 6 months and then reported it to the school nurse. The nurse suspects that the child shows behaviors related to ADHD. This adaptation would include:

Accepted Answer

Maladaptive behavior for at least 6 months duration characterized by inattention, impulsiveness, and over activity are the criteria for attention deficit hyperactivity disorder.

Question 17

A 6-year old child is admitted at the hospital with a diagnosis of Celiac disease. The nurse is taking health history and expects to find signs like:

Accepted Answer

Muscle wasting and abdominal distention are signs of malnutrition which is present in a child with celiac disease. Other sign is diarrhea, specifically steatorrhea, due to atrophy of the intestinal villi that result to watery stools, malabsorption of nutrients and malnutrition.

Question 18

A 4-year old child with cerebral palsy is admitted for a surgery. At the time of admission, the nurse should have told the mother that:

Accepted Answer

The therapy program that was utilized at home will be incorporated in the plan of care at the hospital in order to maintain continuity. The client needs to socialize and interact. Parents are encouraged to actively participate in caring for the chills. Diet is regular and should be appropriate for the age.

Question 19

A pediatric client is evaluated for a surgery in order to correct Strabismus. During history taking, the nurse learns that the parents had their child examined when they first noticed:

Accepted Answer

The classic sign of Strabismus is squinting. It occurs because of the misalignment of the yes.

Question 20

Immunization is very important to prevent certain disease. Daniel, a 5 and a half month-old infant should already receive:

Accepted Answer

Schedule is 3 doses of DTaP at 2 month intervals starting at 2 months of age. Fourth dose of IPV should be given at 4-6 years old. MMR vaccine is given at 12-15 months of age. First booster of DTP is at 15-18 months of age.

Quiz 3: Pediatrics