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Pearson for Peds—Exam 3
1. The nurse is teaching an adolescent client who is preparing for a long-distance running event about
eating for competition. The nurse explains that which type of meal is most appropriate before the
competition?
Pancakes with fresh strawberries, orange juice, wheat toast, and fresh melon slices
Explanation:
A meal of sausage, eggs, and gravy is high in fat and protein. The diet before competition should be high
in complex carbohydrates and low in fat and protein. Pancakes, toast and sources of fruit reflect the best
selections to meet this dietary balance. Fortified yogurt and a protein bar are high in protein but low in
carbohydrate. A cheese omelet and bacon are high in fat.
2. A client recovering from Guillain-Barré syndrome is admitted to the rehabilitation unit for general
rehabilitative care. Which method should the nurse anticipate to be used to provide for this client's
nutritional needs?
Oral intake sufficient to maintain positive nitrogen balance
3. The nurse identifies which of the following clients may be at risk for protein deficiency?
A client who has been hospitalized for a gastrointestinal (GI) infection
4. Which nutritional intervention would be of most assistance to a client who has recently experienced a
cerebrovascular accident (CVA)?
Use thickening agents to minimize the risk of aspiration and monitor the client closely during
all feedings.
5. The nurse notes that a client with gastroesophageal reflux disease (GERD) is prescribed a bland diet.
Which food should the nurse remove from the client's meal tray?
Coffee with cream
R: A bland diet consists of foods that do not irritate the gastrointestinal tract and reduce gastric acid stimulation.
These foods include caffeine-containing beverages such as coffee. The nurse should remove the coffee from the
client's meal tray. An egg-white omelet is high in protein and will not increase symptoms of GERD. Dry toast will
not aggravate symptoms of GERD. Skim milk is low in fat so it is helpful for a client with GERD.
6. The nurse has formulated a nursing diagnosis of ineffective family processes related to hospitalization
of a child with a potentially fatal condition for the family of a child who sustained a brain injury during an
automobile accident. Which nursing intervention would have the highest priority?
Encourage family to ask questions and express feelings.
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7. A 4-year-old child is being evaluated for hydrocephalus. The nurse notes which of the following as an
early sign of hydrocephalus in this child?
Bulging fontanels
Early morning headache
Shrill, high-pitched cry
Rapid enlargement of the head
Explanation: All of the above are symptoms of increased ICP or hydrocephalus. Head enlargement and bulging
fontanels would not be seen in the child after closure of the sutures (12 to 18 months). Shrill, high-pitched cry is a
late-stage symptom of children. Headache and vomiting on arising would be an early symptom in an older child.
8. The family who has a child with the chronic health problem of spina bifida experiences "chronic
sorrow" throughout the child's life. The nurse can anticipate that this will be more prevalent at which
time?
The child reaches the age of a "developmental milestone" that the child cannot attain.
R: Planned hospitalizations are part of the treatment plan and are not as likely to evoke more prevalent feelings of
chronic sorrow. All families deal with stressors, and the family of a child with a chronic health problem is no
exception. Chronic sorrow is the emotional experience many families have in grieving the loss of the perfect child.
This grief is intensified at times of developmental crisis and traditional developmental milestones such as "first
steps," when the parent is reminded of what the child will not be able to do. Attaining a developmental milestone
is not as likely to intensify chronic sorrow as it is a positive event for the child and family. The birth of an infant
that is healthy is not likely to evoke more prevalent feelings of chronic sorrow.
9. A child with a myelomeningocele is started on a bowel management plan. The child’s mother
questions why this is being done. The nurse’s response will be based on the understanding that lack of:
Innervation to the anal sphincter predisposes the child to being incontinent
R: Most children with spina bifida cystica (myelomeningocele included) have the level of their defect at a point
that does affect the innervation to both the colon and anal sphincter. The result is constipation and incontinence.
Any lack of mobility increases the risk for constipation, and all children need a pattern of regular bowel
movements.
10. A 3-year-old child is admitted to the hospital unit with a diagnosis of viral meningitis. Which actions
should the nurse include in the child’s plan of care?
Select all that apply.
Administer acetaminophen for pain
Allow the child to assume a position of comfort
Monitor the child for seizures
Pearson for Peds—Exam 3
1. The nurse is teaching an adolescent client who is preparing for a long-distance running event about
eating for competition. The nurse explains that which type of meal is most appropriate before the
competition?
Pancakes with fresh strawberries, orange juice, wheat toast, and fresh melon slices
Explanation:
A meal of sausage, eggs, and gravy is high in fat and protein. The diet before competition should be high
in complex carbohydrates and low in fat and protein. Pancakes, toast and sources of fruit reflect the best
selections to meet this dietary balance. Fortified yogurt and a protein bar are high in protein but low in
carbohydrate. A cheese omelet and bacon are high in fat.
2. A client recovering from Guillain-Barré syndrome is admitted to the rehabilitation unit for general
rehabilitative care. Which method should the nurse anticipate to be used to provide for this client's
nutritional needs?
Oral intake sufficient to maintain positive nitrogen balance
3. The nurse identifies which of the following clients may be at risk for protein deficiency?
A client who has been hospitalized for a gastrointestinal (GI) infection
4. Which nutritional intervention would be of most assistance to a client who has recently experienced a
cerebrovascular accident (CVA)?
Use thickening agents to minimize the risk of aspiration and monitor the client closely during
all feedings.
5. The nurse notes that a client with gastroesophageal reflux disease (GERD) is prescribed a bland diet.
Which food should the nurse remove from the client's meal tray?
Coffee with cream
R: A bland diet consists of foods that do not irritate the gastrointestinal tract and reduce gastric acid stimulation.
These foods include caffeine-containing beverages such as coffee. The nurse should remove the coffee from the
client's meal tray. An egg-white omelet is high in protein and will not increase symptoms of GERD. Dry toast will
not aggravate symptoms of GERD. Skim milk is low in fat so it is helpful for a client with GERD.
6. The nurse has formulated a nursing diagnosis of ineffective family processes related to hospitalization
of a child with a potentially fatal condition for the family of a child who sustained a brain injury during an
automobile accident. Which nursing intervention would have the highest priority?
Encourage family to ask questions and express feelings.
, Page 2 of 10
7. A 4-year-old child is being evaluated for hydrocephalus. The nurse notes which of the following as an
early sign of hydrocephalus in this child?
Bulging fontanels
Early morning headache
Shrill, high-pitched cry
Rapid enlargement of the head
Explanation: All of the above are symptoms of increased ICP or hydrocephalus. Head enlargement and bulging
fontanels would not be seen in the child after closure of the sutures (12 to 18 months). Shrill, high-pitched cry is a
late-stage symptom of children. Headache and vomiting on arising would be an early symptom in an older child.
8. The family who has a child with the chronic health problem of spina bifida experiences "chronic
sorrow" throughout the child's life. The nurse can anticipate that this will be more prevalent at which
time?
The child reaches the age of a "developmental milestone" that the child cannot attain.
R: Planned hospitalizations are part of the treatment plan and are not as likely to evoke more prevalent feelings of
chronic sorrow. All families deal with stressors, and the family of a child with a chronic health problem is no
exception. Chronic sorrow is the emotional experience many families have in grieving the loss of the perfect child.
This grief is intensified at times of developmental crisis and traditional developmental milestones such as "first
steps," when the parent is reminded of what the child will not be able to do. Attaining a developmental milestone
is not as likely to intensify chronic sorrow as it is a positive event for the child and family. The birth of an infant
that is healthy is not likely to evoke more prevalent feelings of chronic sorrow.
9. A child with a myelomeningocele is started on a bowel management plan. The child’s mother
questions why this is being done. The nurse’s response will be based on the understanding that lack of:
Innervation to the anal sphincter predisposes the child to being incontinent
R: Most children with spina bifida cystica (myelomeningocele included) have the level of their defect at a point
that does affect the innervation to both the colon and anal sphincter. The result is constipation and incontinence.
Any lack of mobility increases the risk for constipation, and all children need a pattern of regular bowel
movements.
10. A 3-year-old child is admitted to the hospital unit with a diagnosis of viral meningitis. Which actions
should the nurse include in the child’s plan of care?
Select all that apply.
Administer acetaminophen for pain
Allow the child to assume a position of comfort
Monitor the child for seizures
