PEDIATRICS FINAL
Pediatrics Final EXAM
Exam August 3 2016 -AUGUST
Confidential 3 2016
Your Name: Your ID:
# of Questions: 100
Date and Time of Exam Creation: Thu, Jul 21, 2016 @ 16:51:07
Total Exam Points: 100.00
____________________________________________________________________________
Question #: 1
A 2-month-old male is brought to the pediatric clinic. The infant has had vomiting and diarrhea for 24 hours. The
infant's anterior fontanel is sunken. The child is irritable, and the nurse notes that the infant does not produce tears
when he cries. Which of the following tasks will help confirm the diagnosis of dehydration?
A. Urinalysis obtained by bagged specimen
B. Urinalysis obtained by sterile catheterization
✓C. Analysis of serum electrolytes
D. Analysis of cerebrospinal fluid
Rationale: The analysis of serum electrolytes offers the most information and assists with the diagnosis
dehydration.
____________________________________________________________________________
Question #: 2
An expectant mother asks the nurse if her new baby will likely have an umbilical hernia. The nurse bases the
response on which of the following?
A. Umbilical hernias occur more often in large infants.
B. Umbilical hernias occur more often in white infants than in African-American infants.
C. Umbilical hernias occur twice as often in male infants.
✓D. Umbilical hernias occur more often in premature infants.
Rationale: Umbilical hernia occurs commonly in preterm infants and much more frequently in African Americans
compared to Caucasians.
____________________________________________________________________________
Question #: 3
Identify the arrhythmia pictured below:
, ✓A. Ventricular tachycardia
B. Sinus tachycardia
C. Supraventricular tachycardia
D. Coarse ventricular fibrillation
____________________________________________________________________________
Question #: 4
Which of the following is true of a Wilms' tumor? Select all that apply.
A. It is also referred to as a neuroblastoma.
✓B. It occur most often between ages 2 and 3 years of age.
C. It is a slow-growing tumor.
✓D. Prognosis depends on staging and metastasis upon diagnosis.
✓E. The abdomen should not be palpated after initial assessment.
____________________________________________________________________________
Question #: 5
Based on the nurse's knowledge of Acute Lymphoblastic Leukemia (ALL), the prognosis is based on the:
✓A. initial white blood cell count, cytogenetic factors and extra medullary involvement.
B. race, gender and age at the time of diagnosis.
C. amount of time needed to initiate treatment.
D. allergy history of the child.
,Rationale: Prognosis is based on the white blood cell count (WBC) at diagnosis, the type of cytogenic factors, and
immunophenotype, the age at diagnosis, and the extent of extramedullary involvement.
____________________________________________________________________________
Question #: 6
A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. The parents ask why their
child is receiving this medication. What information about the medication should the nurse provide?
✓A. It decreases the production of uric acid.
B. It is used to make the chemotherapy work better.
C. It is given to reduce the nausea and vomiting associated with chemotherapy.
D. It helps reduce pain in the bone marrow.
Rationale: Allopurinol decreases production of uric acid. It is used to treat secondary hyperuricemia occurring
during leukemia or tumor treatment.
____________________________________________________________________________
Question #: 7
The nurse is assessing a 10-year-old child. The parents state the child has had several "accidents" over the last 4
months, which have not occurred since the child was 3-years-old. The nurse knows that this is referred to as which
of the following?
A. Primary enuresis
✓B. Secondary enuresis
C. Diurnal enuresis
D. Nocturnal enuresis
Rationale: Secondary enuresis: urinary in the child who previously demonstrated bladder control over a period of
at least 3 to 6 consecutive months
____________________________________________________________________________
Question #: 8
A hospitalized child is to receive 75mg of acetaminophen (Tylenol) for fever 101F (38.3C). If the acetaminophen
(Tylenol) is 80mg per 0.8mL, how much will the nurse administer?
✓A. 0.75 mL
B. 1.5 mL
C. 2.5 mL
, D. 3 mL
____________________________________________________________________________
Question #: 9
A 10-month-old with heart failure weighs 10 kg. Digoxin (Lanoxin) is prescribed as 10 mcg/kg/day to be given
every 12 hours. How much is given per dose?
✓A. 50 mcg.
B. 100 mcg.
C. 10 mcg.
D. 500 mcg.
____________________________________________________________________________
Question #: 10
Which of the following should the nurse include when completing discharge instructions for the parents of a 12-
month-old child diagnosed with Kawasaki disease (KD) and being discharged home?
A. Instruct parents to have the child receive measles vaccine as soon as possible if the child has not already
received it.
✓B. Take the child's temperature until the child has been afebrile for several days.
C. Check the child's blood pressure daily until the follow-up appointment.
D. Call the primary health care provider if the irritability lasts for more than 2 weeks.
Rationale: Avoid measles and varicella vaccines for 11 months after administration of high dose IVIG. Blood
pressure will not need to be monitor, but temperature will. Irritability may last for up to 2 months after initial
diagnosis.
____________________________________________________________________________
Question #: 11
The charge nurse is educating a nursing student about Acute Rheumatic Fever (ARF). Which of the following
statements if made by the nursing student would indicate that further teaching is necessary?
A. "Acute rheumatic fever is diagnosed using the modified Jones Criteria."
B. "If valvular disease is present, the client will need prophylactic antibiotics until age 40."
✓C. "If no valvular disease is present, the client will not need prophylactic antibiotics."
D. "Acute rheumatic fever is a delayed result of a group A streptococcal pharyngeal infection."
Rationale: Diagnosis of acute rheumatic fever is done using the modified Jones Criteria (two major, or 1 major and
Pediatrics Final EXAM
Exam August 3 2016 -AUGUST
Confidential 3 2016
Your Name: Your ID:
# of Questions: 100
Date and Time of Exam Creation: Thu, Jul 21, 2016 @ 16:51:07
Total Exam Points: 100.00
____________________________________________________________________________
Question #: 1
A 2-month-old male is brought to the pediatric clinic. The infant has had vomiting and diarrhea for 24 hours. The
infant's anterior fontanel is sunken. The child is irritable, and the nurse notes that the infant does not produce tears
when he cries. Which of the following tasks will help confirm the diagnosis of dehydration?
A. Urinalysis obtained by bagged specimen
B. Urinalysis obtained by sterile catheterization
✓C. Analysis of serum electrolytes
D. Analysis of cerebrospinal fluid
Rationale: The analysis of serum electrolytes offers the most information and assists with the diagnosis
dehydration.
____________________________________________________________________________
Question #: 2
An expectant mother asks the nurse if her new baby will likely have an umbilical hernia. The nurse bases the
response on which of the following?
A. Umbilical hernias occur more often in large infants.
B. Umbilical hernias occur more often in white infants than in African-American infants.
C. Umbilical hernias occur twice as often in male infants.
✓D. Umbilical hernias occur more often in premature infants.
Rationale: Umbilical hernia occurs commonly in preterm infants and much more frequently in African Americans
compared to Caucasians.
____________________________________________________________________________
Question #: 3
Identify the arrhythmia pictured below:
, ✓A. Ventricular tachycardia
B. Sinus tachycardia
C. Supraventricular tachycardia
D. Coarse ventricular fibrillation
____________________________________________________________________________
Question #: 4
Which of the following is true of a Wilms' tumor? Select all that apply.
A. It is also referred to as a neuroblastoma.
✓B. It occur most often between ages 2 and 3 years of age.
C. It is a slow-growing tumor.
✓D. Prognosis depends on staging and metastasis upon diagnosis.
✓E. The abdomen should not be palpated after initial assessment.
____________________________________________________________________________
Question #: 5
Based on the nurse's knowledge of Acute Lymphoblastic Leukemia (ALL), the prognosis is based on the:
✓A. initial white blood cell count, cytogenetic factors and extra medullary involvement.
B. race, gender and age at the time of diagnosis.
C. amount of time needed to initiate treatment.
D. allergy history of the child.
,Rationale: Prognosis is based on the white blood cell count (WBC) at diagnosis, the type of cytogenic factors, and
immunophenotype, the age at diagnosis, and the extent of extramedullary involvement.
____________________________________________________________________________
Question #: 6
A child diagnosed with leukemia is receiving allopurinol as part of the treatment plan. The parents ask why their
child is receiving this medication. What information about the medication should the nurse provide?
✓A. It decreases the production of uric acid.
B. It is used to make the chemotherapy work better.
C. It is given to reduce the nausea and vomiting associated with chemotherapy.
D. It helps reduce pain in the bone marrow.
Rationale: Allopurinol decreases production of uric acid. It is used to treat secondary hyperuricemia occurring
during leukemia or tumor treatment.
____________________________________________________________________________
Question #: 7
The nurse is assessing a 10-year-old child. The parents state the child has had several "accidents" over the last 4
months, which have not occurred since the child was 3-years-old. The nurse knows that this is referred to as which
of the following?
A. Primary enuresis
✓B. Secondary enuresis
C. Diurnal enuresis
D. Nocturnal enuresis
Rationale: Secondary enuresis: urinary in the child who previously demonstrated bladder control over a period of
at least 3 to 6 consecutive months
____________________________________________________________________________
Question #: 8
A hospitalized child is to receive 75mg of acetaminophen (Tylenol) for fever 101F (38.3C). If the acetaminophen
(Tylenol) is 80mg per 0.8mL, how much will the nurse administer?
✓A. 0.75 mL
B. 1.5 mL
C. 2.5 mL
, D. 3 mL
____________________________________________________________________________
Question #: 9
A 10-month-old with heart failure weighs 10 kg. Digoxin (Lanoxin) is prescribed as 10 mcg/kg/day to be given
every 12 hours. How much is given per dose?
✓A. 50 mcg.
B. 100 mcg.
C. 10 mcg.
D. 500 mcg.
____________________________________________________________________________
Question #: 10
Which of the following should the nurse include when completing discharge instructions for the parents of a 12-
month-old child diagnosed with Kawasaki disease (KD) and being discharged home?
A. Instruct parents to have the child receive measles vaccine as soon as possible if the child has not already
received it.
✓B. Take the child's temperature until the child has been afebrile for several days.
C. Check the child's blood pressure daily until the follow-up appointment.
D. Call the primary health care provider if the irritability lasts for more than 2 weeks.
Rationale: Avoid measles and varicella vaccines for 11 months after administration of high dose IVIG. Blood
pressure will not need to be monitor, but temperature will. Irritability may last for up to 2 months after initial
diagnosis.
____________________________________________________________________________
Question #: 11
The charge nurse is educating a nursing student about Acute Rheumatic Fever (ARF). Which of the following
statements if made by the nursing student would indicate that further teaching is necessary?
A. "Acute rheumatic fever is diagnosed using the modified Jones Criteria."
B. "If valvular disease is present, the client will need prophylactic antibiotics until age 40."
✓C. "If no valvular disease is present, the client will not need prophylactic antibiotics."
D. "Acute rheumatic fever is a delayed result of a group A streptococcal pharyngeal infection."
Rationale: Diagnosis of acute rheumatic fever is done using the modified Jones Criteria (two major, or 1 major and
