PEDS EXAM 1-4 QUESTIONS.

12PEDS EXAM 1-4 QUESTIONS. EXAM 1 1. A nurse is assessing language development in all the infants presenting at the doctor's office for well-child visits. At which age range would the nurse expect a child to verbalize the words "dada" and "mama"? 9 and 12 months 2. During the toddler stage, ages 2-3 years, a child will gain approximately how many pounds per year? 3-5 3. Development that proceeds from the inside out is called by which of the following terms? proximodistal 4. Routine physical examinations on children include height, weight, vital signs, physical examination, vision and hearing screening, diet assessment, screening for alcohol and other drug use, and screening for which of the following? scoliosis 5. A mother tells you that her 4-year-old child has begun to have night waking and has started thumb sucking again. Otherwise the child seems very healthy. From this brief history, your immediate response is: “What changes have happened in your family or with your child?” 6. Using your knowledge of the Freudian stages of psychosexual development when caring for a child between the ages of 1 and 3 years, it would be most important for you to ask the caregivers about: d. rituals used for elimination 7. To look into the ear of a child younger than 3 years old, the nurse would position the ear by pulling the auricle: down and back 8. The very first sucking by an infant occurs because of: d. an accidental reflex of rooting 9. Piaget believed that interactions with the environment caused people to organize patterns of thought called: Schema 10. Which of the following statements best describes object permanence? The infant realizes an object continues to exist even when out of sight. 11. A mother asks which developmental milestones she can expect when her baby is 6 months old. Which response by the nurse is the most appropriate? Transfers objects from one hand to the other 12. While assessing the development of a 9-month-old infant, the nurse asks the mother if the child actively looks for toys when they are placed out of sight. Which developmental task is the nurse assessing this infant for? Object permanence 13. When working with school-aged children, the nurse should keep in mind that these children will increase their weight by how many pounds per year? 3-5 14. The nurse working on the pediatric unit checks the apical pulse of a school-aged child and finds a rate of 95 beats per minute while the child is lying in bed. The best action on the part of the nurse is to: Chart the apical pulse of 95 as it is in the normal range. 15. A nurse has instructed the parents of an infant to introduce solid foods one at a time, while carefully observing for signs of food allergies. Which of the following signs and symptoms may be suggestive of food allergies? Select all that apply. diarrhea abdominal pain rashes 16. According to Piaget, the concrete operations stage occurs in which of the following age ranges? 6 to 12 years 17. Cephalocaudal development proceeds in which direction? head downward 18. The nurse would expect to find which of the following resting respiratory rates in the normal newborn? 40 19. According to Erikson’s psychosocial theory of development, a child between ages 6 and 12 is going through which of the following stages? industry versus inferiority 20. In order to help an infant accomplish the basic task of infancy (according to Erikson’s stages of psychosocial development), caregivers must consistently do which of the following things? Meet need for comfort, security, predictability, food, and warmth. 21. The nurse is assessing an infant client during a health supervision visit. Which assessment findings are considered normal variations for this client? Select all that apply. Sucking pads in the mouth A rounded chest Hearing breath sounds over the entire chest 22. Which of these developmental milestones should the nurse expect to find in children who are between 2 and 3 years old? Select all that apply. Scribbles and draws on paper Kicks a ball Goes up and down stairs 23. According to Erikson, the psychosocial development of an infant is centered around the concept of: trust versus mistrust 24. The nurse is assessing a toddler of 18 months to see what skills the child has for dressing himself. The nurse expects to find that a toddler of this age can do which of the following tasks? remove his own shoes 25. When an infant is hospitalized, the nurse recognizes the importance of this infant mastering the first of Erikson’s eight life stages. He or she would most help the infant by instructing the caregivers: to spend as much time with the infant as possible 26. Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle while the other is stacking blocks. Which type of play are these children exhibiting? Parallel play 27. To assess the pinna position of the ears of a child, the nurse would draw an imaginary line from the outer canthus to the top of the ear. If the nurse finds that the ears are below the imaginary line, this means that: the finding is abnormal and may be a sign of renal anomalies or Down syndrome 28. If a baby is weaned too soon from formula or breast milk to cows milk, which of the following problems is most likely to develop? iron-deficiency anemia 29. According to Freud, toddlers are in which stage of development? anal 30. Which of the following methods of taking the temperature of a child is considered to be most accurate? rectal 31. The rooting reflex of an infant disappears at approximately how many months of age? 4 32. Toddlers age 1-2 years have which of the following visual acuities? 20/50 33. The most rapid growth period in a person’s life is during which of the following periods? infancy 34. Which of the following best describes the term parallel play? playing alongside, but not with, other children 35. The nurse will perform all invasive or uncomfortable procedures such as ear inspection at what point during the physical examination? last 36. The nurse notices a baby in the waiting room. The baby is sitting on the mother’s lap and picking up small cereal rings out of a bowl with a true pincer grasp and eating them unassisted. The nurse knows that this baby is at least how many months old? 8 to 10 37. From birth to 1 year of age, the infant is in which of the following stages, according to Freudian theory? oral 38. During the newborn examination, the nurse assesses the infant for signs of developmental dysplasia of the hip. A finding that would strongly indicate this disorder would be: asymmetric thigh and gluteal folds. 39. While teaching parents of a newborn about normal growth and development, which statement is most appropriate for the nurse to include in the session? Weight should triple by 1 year of age. 40. When obtaining a child’s past health history, the nurse would ask questions aimed at getting pertinent information, beginning with the: prenatal period 41. Based on a recommendation from the American Academy of Pediatrics, the nurse will advise the caregivers to do which of the following to help prevent sudden infant death syndrome? Have the baby sleep in a supine position. 42. The neonatal or newborn period of life is defined as the first: 28 days 43. Freud developed the theory that the source of psychic energy that drives human behavior is: the id, ego, and superego 44. Freud theorized that during the phallic stage, a child’s energy is focused on which of the following areas of the body? genitals 45. The nurse would instruct the mother of a baby under 28 days of age to contact the health care provider if the baby’s rectal temperature is at which of the following readings or higher? 37.9 degrees C (100.2 degrees F) 46. Which of the following best describes the ego, according to Freudian theory? the rational and controlling part of the personality 47. When you are the nurse taking the health history of a child, the historian is most likely going to be an adult. Which of the following questions would be the most important to ask before admitting or treating the child? “Who is the legal guardian?” 48. The nurse takes the temperature of a newborn and gets a reading of 37.7 degrees C (99.6 degrees F). The nurse interprets this temperature as: normal and proceeds to chart the temperature in the infant’s record 49. Head circumference is no longer measured in children when the child reaches which of the following age ranges? d. 24-36 50. According to child psychoanalyst Erik Erikson, newborns develop basic trust when: caregivers meet the needs of the newborn EXAM 2 1. The school nurse is working with teenaged parents and their babies in a high school program designed to keep these parents in school and to teach them how to care for their children. The nurse teaches the mothers to change diapers on: a washable surface that is disinfected after each use 2. The leading cause of pneumonia for schoolchildren is which of the following organisms? Mycoplasma pneumoniae 3. Erythema infectiosum, or fifth disease, has which of the following characteristics? intensely red “slapped cheeks” appearance 4. College-bound adolescents who will live in a dormitory or residence hall need to be advised most on the importance of vaccination against: meningococcal disease 5. The Epstein-Barr virus is responsible for which of the following? infectious mononucleosis 6. Group A beta-hemolytic streptococci cause which of the following diseases? scarlet fever 7. A father calls the school nurse and asks when his daughter, who has chickenpox, can return to school. The best reply by the nurse would be: when all lesions are crusted over 8. The transmission of tetanus to humans is when a skin wound comes in contact with: contaminated soil 9. Which of the following statements best defines the term child maltreatment? intentional injury of a child 10. Which of the following statements best defines the term physical abuse? bodily injury to a person that seems to have been inflicted by other than accidental means 11. Which of the following children are at greatest risk of abuse or neglect by the parents? premature infants 12. The nurse notices that a child has bright red bruises noted to the back and buttocks. The nurse estimates that these bruises are how old? less than 1 day 13. Which of the following statements best describes Munchausen syndrome by proxy? Caregivers make up signs and symptoms of disease or unnecessarily expose their child to harmful medical interventions and painful invasive procedures. 14. Which of the following best describes the reservoir, one of six factors in the chain of infection? living and nonliving places there pathogens can survive without multiplication 15. Which of the following best describes a vector? an animal or insect that carries the infectious organism from one host to another 16. The school nurse gets a call from a caregiver who is planning to send her child to summer camp, but recently heard there was a case of Rocky Mountain spotted fever at the camp the previous year. The mother asks, “What causes Rocky Mountain spotted fever?” The best answer by the nurse would be: the bite of an infected tick, which is carried by dogs and wild rodents 17. The nurse assessing a child with a respiratory problem finds stridor, which is best described by which of the following? a high-pitched sound noted on inspiration produced by an obstruction of the trachea or larynx 18. Examination of the throat of a child with acute epiglottis by depressing the tongue is: contraindicated due to the possibility of causing complete airway obstruction 19. Which of the following types of pneumonia would be treated with antibiotics? bacterial 20. Which of the following conditions is the leading cause of pediatric chronic illness? asthma 21. Which of the following represents the median life-expectancy of a child with cystic fibrosis? 40 + years 22. A 6-month-old infant presents to the clinic for routine immunizations. Prior to this visit, the infant has remained up-to-date with immunizations. The nurse anticipates the infant will need which of the following immunizations recommended at 6 months? Select all that apply. pneumococcal Haemophilus influenzae type b (Hib) diphtheria, tetanus, and pertussis (DTaP) 23. A child is admitted to the hospital with pneumonia. The child's oximetry reading is 88 percent upon admission to the pediatric floor. Which is the priority nursing intervention for this child? Begin oxygen per nasal cannula. 24. A child is admitted to the hospital with the diagnosis of laryngotracheobronchitis (LTB). Which nursing intervention is the priority for this child? Administer nebulized epinephrine and oral or IM dexamethasone. 25. A child is showing signs of acute respiratory distress. Which position will the nurse place this child? Upright 26. A school nurse is planning care for a school-age child recently diagnosed with asthma. Which items will the school nurse include in the plan of care at the school? Select all that apply. Conduct a support group for all children with asthma. Coordinate education of the child's teachers. Assess for symptoms of exercise-induced bronchospasm. Maintain a log of quick-relief medication administration. 27. Parents of a child admitted with respiratory distress are concerned because the child won't lie down and wants to sit in a chair leaning forward. Which response by the nurse is the most appropriate? "This position helps keep the airway open." 28. The nurse is teaching the parents of a newly diagnosed cystic fibrosis patient how to administer the pancreatic enzymes. How often will the nurse teach the parents to administer the enzymes? With all meals and snacks 29. A mother brings her 4-month-old infant in for a routine checkup and vaccinations. The mother reports that the infant was exposed to a brother who has the flu. The infant is afebrile. Which action by the nurse is most appropriate based on these assessment findings? Give the vaccinations as scheduled. 30. A parent brings her school-age child to the clinic because the child has a temperature of 100.2°F. The child remains active without other symptoms. Which statement by the nurse to the parents is most appropriate? "Unless the fever bothers the child, it is best to let the natural body defenses respond to the infection." 31. A parent reports that her school-age child, who has had all recommended immunizations, had a mild fever one week ago and now has bright red cheeks and a lacy red maculopapular rash on the trunk and arms. Which disease process does the nurse suspect based on the parent's description? Fifth disease (erythema infectiosum) 32. A school nurse is planning care for a school-age child recently diagnosed with asthma. Which items will the school nurse include in the plan of care at the school? Select all that apply. Coordinate education of the child's teachers. Maintain a log of quick-relief medication administration. Assess for symptoms of exercise-induced bronchospasm. Conduct a support group for all children with asthma. 33. Concerned parents call the school nurse because of changes in their 15-year-old adolescent's behavior. Which behavior would the nurse indicate as indicative of adolescent substance abuse? Receiving numerous detentions lately from teachers for sleeping in class 34. The nurse is conducting a health promotion class for adolescents. In counseling an adolescent about lifestyle choices, what should the adolescent eliminate in order to decrease the risk of the most preventable cause of adult death? Tobacco use 35. The nurse is providing care to a toddler-age child. Which assessment finding is indicative of abuse? Inconsistency of stories between caregivers 36. The nurse prepares the second diphtheria, tetanus toxoid, and acellular pertussis (DTaP) and second inactivated polio vaccine (IPV) immunization injections for an infant who is 4 months old. The nurse may also give which of immunizations during the same well-child- care appointment? Haemophilus influenza type B (HIB) 37. The pediatric nurse is working with a parent who is suspected of Münchausen Syndrome by Proxy. Which action by the nurse is the priority? Carefully document parent-child interactions. 38. The school nurse is planning a smoking-prevention program for middle school students. Which intervention is most likely to be effective in preventing middle school children from smoking? Having a local high school basketball star come to talk to the students about the importance of not smoking 39. The school nurse is implementing a program to decrease bullying. Which interventions are appropriate for the school nurse to implement? Select all that apply. Teach children to report behaviors Ensure adult supervision in the hallways Train teachers about the behaviors 40. While the nurse is conducting the history of a school-age child, the parents admit to owning firearms. Which safety measures are appropriate to include in the teaching plan for this family? Select all that apply. Using a gun lock on all firearms in the house Storing the guns and ammunition in separate places Keeping all the guns in a locked cabinet 41. A parent brings a toddler to the pediatric clinic. The nurse observes a number of bruises on the child in various stages of healing. The parent claims the toddler bruises easily. The best action on the part of the pediatrician and the nurse would be to: report this to child and family services and order a screening battery of bleeding and clotting blood work 42. Caregivers of a child with chickenpox tell the pediatric nurse that their child is not eating or drinking much because the child says the “sores in the mouth hurt.” The best advice by the nurse would be for the caregivers to try which one of the following actions and call back if it does not improve the intake of fluids? Offer gelatin and Popsicles. 43. The school nurse is advising students who are going on a weeklong field trip into a wooded area. The nurse would tell the students to: use DEET, wear light-colored long-sleeve top and pants, and inspect clothing and body daily 44. When an infant is in respiratory distress and having retractions, what causes the retractions? soft tissue surrounding the ribs and sternum are drawn inward during inspiration 45. Which of the following respiratory alterations is the same as nasopharyngitis? common cold 46. The nurse assessing a child with acute epiglottitis looks up the disorder as a review and is most likely to find which of the following classic symptoms associated with this disorder? respiratory distress, drooling, fever, agitation, and lethargy 47. The nurse is providing care to an infant who is diagnosed with bronchiolitis. Which of the following indicate the infant is experiencing respiratory distress? Select all that apply. Retractions Grunting Wheezing Tachypnea 48. A child is admitted with a diagnosis of localized Lyme disease. Which clinical manifestations would the nurse expect to find on the initial assessment of this client? Select all that apply. Fever Body aches Swollen lymph nodes 49. The nurse is teaching a group of mothers of infants about the benefits of immunization. Which immunization will the nurse teach to the mothers that can assist in preventing the life- threatening disease epiglottitis? Haemophilus influenzae type B (HIB) 50. The nurse is assessing a school-age client who experienced blunt force trauma to the chest when an airbag deployed following a motor vehicle crash. Which areas of assessment are essential for this client? Select all that apply. Auscultate the lungs for crackles, wheezes, decreased breath sounds. Note changes in voice quality or coughing. Monitor responsiveness and behavior. Monitor SpO 2. EXAM 3 1. Which of the following structural differences between children and adults predisposes children to middle ear infections? Children have shorter, more horizontal, and more flaccid eustachian tubes. 2. The nurse will advise the parents of a child who has a hearing loss that communication can best be enhanced by doing which of the following? Get the child’s attention and look into the child’s face at eye level. 3. At what age is binocularity established? 6 months 4. Which of the following definitions of visual impairment most emphasizes the clearness of vision at various distances (visual acuity) and is important to receiving accommodations and funding? legal-medical 5. The pediatric nurse working with newborns and infants will find which of the following types of newborns having a significantly increased incidence of ocular muscle weakness? very low birth weight 6. The school nurse observes a child who has strabismus. Which of the following is the most obvious sign of strabismus? a cross-eyed appearance 7. In assessing a child with strabismus, the nurse charts that the child has exotropia. This means that the nurse has found which of the following then assessing the eyes? One eye turns outward or away from the midline. 8. The nurse is talking with a parent of a child with strabismus. The nurse is talking about alternatives to surgery and explains that there is a correction for strabismus, which is an alternative to surgery, and it is successful in about 50% of clients. Which of the following substances is involved in this treatment? botulism toxin 9. What is the major cause of nasopharyngitis? Viruses 10. Heart size has a correlation that continues into adulthood. The heart is the size of the: fist 11. Which of the following terms describes the nurse’s finding that the angle between the nail and the nail bed of a child has been lost and the fingertips are wider and rounder? clubbing 12. Which of the following actions would the nurse take when finding an innocent murmur while listening to a child’s heart? Teach the family that this murmur needs no intervention. 13. While assessing a child the nurse finds hepatomegaly. The nurse is aware that this condition is most associated with which of the following? congestive heart failure 14. When assessing a child for any possible cardiac anomalies, the nurse takes the right arm blood pressure (BP) and the BP in one of the legs. She finds that the right arm BP is greater than that found in the child’s leg. The nurse reacts to these findings in which of the following ways? suspects the child may have coarctation of the aorta 15. Which of the following conditions is the most common cause of congestive heart failure in infants? congenital heart disease 16. The nurse is assessing an infant with congestive heart failure (CHF). Which of the following symptoms would the nurse most likely find in this infant? diaphoresis during feeding 17. Which of the following symptoms would the nurse most likely find in assessing a child with right ventricular failure? hepatomegaly, jugular venous distention, and peripheral edema 18. Which of the following medications is the primary diuretic used in children to treat volume overload? Furosemide (Lasix) 19. The three primary treatments for congestive heart failure are diuretics, afterload-reducing agents, and: inotropes 20. You are the nurse preparing to give a child a dose of digoxin. Before giving the digoxin, you would first check the apical pulse, and you would also be most interested in making sure which of the following levels were within normal? potassium levels 21. Which of the following heart defects increases pulmonary blood flow? patent ductus arteriosus 22. The nurse is caring for a premature infant who is receiving an infusion of a substance in an attempt to close a patent ductus arteriosus. The nurse will explain to the mother that this substance is: indomethacin, which inhibits the synthesis of prostaglandin, the substance that maintains the patency of the ductus arteriosus 23. The nurse is caring for a 2-week-old infant with a diagnosis of truncus arteriosus. The nurse is aware that surgical repair for truncus arteriosus is done at which of the following times? within the first 1-2 weeks of life 24. Children with defects with decreased pulmonary blood flow frequently have which of the following symptoms? hypoxia, cyanosis, polycythemia, erythrocytosis 25. Acute rheumatic fever follows which of the following health problems? an untreated or partially treated group A streptococcal pharyngitis 26. Which of the following are the main therapeutic interventions for Kawasaki disease in the first 10 days of the disease? intravenous immune globulin and aspirin 27. Which of the following is the initial symptom of hypertrophic pyloric stenosis? nonbilious vomiting starting between the 2nd and 8th week of life 28. During the newborn assessment, the nurse will examine the palate: by palpation with a gloved finger 29. In the period immediately after a baby has had surgery for cleft lip repair, the nurse will do which of the following things? Apply a Logan bow or a butterfly adhesive. 30. The mother of a newborn with esophageal atresia asks the nurse to explain this condition to her. The best response by the nurse would be to say that esophageal atresia is: characterized by incomplete formation of the esophagus so it ends before it gets to the stomach 31. In assessing a newborn, the nurse notices a large amount of fine, frothy bubbles of mucus in the mouth. Even then the nurse suctions the bubbles, they soon return. The baby has a rattling sound to the respirations and has a choking episode and becomes a little cyanotic. Which of the following conditions will the nurse suspect? esophageal atresia 32. Which of the following statements best describes intussusception? a condition in which one segment of the bowel telescopes into the lumen of an adjacent segment 33. The nurse assessing an infant for intussusception will look for three classic signs and symptoms: colicky intermittent abdominal pain, vomiting, and which kind of stool? currant-jelly-like stools 34. Hirschsprung’s disease (HD) involves which of the following problems? absence of parasympathetic ganglion cells in the large intestine 35. The nurse on the pediatric unit is assigned to an infant with gastroesophageal reflux. The infant has had episodes of pneumonia and is not gaining weight. The infant has not responded well to 6 weeks of medical management and is being considered for surgery. At the beginning of the shift, after receiving report on this infant, the nurse will first: assess respiratory status 36. The nurse is assessing a child admitted to the hospital for abdominal pain. Which of the following findings by the nurse would be typical of those seen in appendicitis? pain that was vague and somewhat localized to the periumbilical area and gradually migrated to the right lower quadrant 37. Which of the following factors determines stroke volume? preload, afterload, and contractility 38. You would expect to see hypokalemia in which of the following conditions? loss of gastric or intestinal fluids 39. A nurse is planning to teach school-age children about the common cold. Which information should the nurse include in the teaching session? Proper handwashing can prevent the spread of the infection. 40. An infant with tetralogy of Fallot is having a hypercyanotic episode ("tet" spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Select all that apply. Administer morphine and propranolol intravenously as ordered. Administer oxygen. Place the child in knee-chest position. 41. The family has just been informed by the healthcare provider that their newborn is diagnosed with a congenital heart defect, Tetralogy of Fallot (TOF). The family tells the nurse that the healthcare provider told them that TOF is comprised of several defects, and they ask the nurse what the defects are. What will the nurse tell the family? Select all that apply. Ventral septal defect Right ventricular hypertrophy Overriding aorta Pulmonary stenosis 42. The nurse suspects that an infant has a visual disorder caused by abnormal musculature. Which test will the nurse perform to detect this disorder? A cover/uncover test 43. Which of the following signs or symptoms is the earliest manifestation of bleeding in a child who has had a tonsillectomy? frequent swallowing 44. The nurse who is teaching parents about reducing risk factors for otitis media in children would mention which of the following as putting children most at risk for otitis media? secondhand smoke 45. Which of the following is the most common congenital heart defect? ventral septal defect 46. When the nurse assesses a newborn that has transposition of the great arteries (TGA), the nurse will most likely find which of the following signs or symptoms? normal size and weight and healthy appearance except for acute cyanosis that will not respond to oxygen 47. Which of the following conditions is the leading cause of acquired heart disease in children in developing countries? Acute Rheumatic Fever 48. The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? A high hemoglobin 49. The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child? Dry, swollen, fissured lips 50. The nurse is admitting an infant diagnosed with supraventricular tachycardia. Which intervention is the priority for this infant? Apply ice to the face. EXAM 4 1. Which of the following substances is the predominant component of extracellular fluid? saline 2. Regulation of homeostatic changes associated with fluids and electrolytes in infants and young children is much slower than in adults because of children’s: immature kidneys and buffering systems 3. Insensible water loss per unit of body weight is: higher in infants and children 4. You are the nurse calculating the minimum acceptable urine output per hour for an infant who weighs 5 kilograms (kg). Which of the following amounts in milliliters (mL) would you find to be acceptable? 5-10 5. The nurse coming on duty gets a laboratory report on an assigned child, and the serum sodium level is reported as 126 milliequivalents per liter (mEq/L). The nurse would expect this client with a 126 mEq/L sodium level to: be experiencing headache, muscle weakness, and abdominal cramps 6. When the nurse finds that a child has a sodium level of more than 145 milliequivalents per liter, the nurse would most expect to see: dry mucous membranes and thirst 7. You would expect to see hypokalemia in which of the following conditions? loss of gastric or intestinal fluids 8. The nurse is working with a child who has a drug overdose. Respirations are decreased and shallow. Arterial blood gases show the child’s pH is decreased and the pCO 2 is elevated. The nurse realizes that this child is in: respiratory acidosis 9. The nurse is assigned to an adolescent who is admitted with out-of-control diabetes. There are high levels of ketones in the urine. The child has Kussmaul’s respirations and is confused and somewhat lethargic. The nurse knows that this child is in: metabolic acidosis 10. One type of dehydration in children is isotonic dehydration, which occurs then: the loss of sodium and water are equal and the serum sodium level remains normal 11. The nurse is working with a child who has a diagnosis of gastroenteritis. The child becomes dehydrated, has serum sodium of 125 milliequivalents per liter, and goes into shock. After corrective measures to restore the child’s electrolyte balance and hydration status, the nurse realizes that this child had which of the following types of dehydration? hypotonic 12. Hypertonic dehydration occurs in which of the following conditions? then the vascular space loses more fluid than particles 13. Children with an internal hemorrhage such as bleeding into the thoracic or peritoneal cavity will have the same signs and symptoms of hypovolemic shock as a child with an external hemorrhage, except for one difference, which is: weight loss with external hemorrhage and no weight loss with internal hemorrhage 14. The nurse is assessing a 5-year-old child. In checking the heart rate, the nurse finds an increase of 25 beats then the child changes from a lying to a standing position. This increase in heart rate is indicative of: hypovolemia 15. Which of the following are the most common bacteria to infect the urinary tract? Escherichia coli 16. The nurse assessing a 6-year-old child who has a urinary tract infection will suspect pyelonephritis rather than cystitis then the child exhibits which of the following symptoms? fever greater than 38.3 degrees C (101 degrees F), chills, back pain, and appearing quite ill 17. The nurse is working on dietary interventions in a care plan for a child who has enuresis. Which of the following interventions would the nurse most likely include? Eliminate carbonated beverages, dairy products, citric foods, and caffeine. 18. Which of the following questions would be most important for the nurse to ask then assessing a child with enuresis? Is there a history of constipation or bowel movements that were large or painful? 19. Parents ask the nurse to explain what it means then the pediatrician says that their child’s vesicoureteral reflux is a grade I. Which of the following is the nurse’s best response to explain the significance of the grade? This grade of reflux is most likely to resolve spontaneously. 20. Which of the following best describes chordee, a condition that can be associated with hypospadias? downward curvature of the penis and an incomplete foreskin 21. Which of the following best describes the problem of cryptorchidism? failure of one or both of the testes to descend through the inguinal canal into the scrotum 22. Upon examining a child, the nurse found a bulge or swelling in the groin and suspected an inguinal hernia. Which of the following tests will the nurse use to verify that this is a hernia? “Strain or push down as if you were trying hard to pee or poop.” 23. You are the nurse assigned to care for a child with acute glomerulonephritis. After receiving report and doing an initial assessment, you check the lab reports. You would not be surprised to find which of the following signs and symptoms consistent with the diagnosis of acute glomerulonephritis? hematuria, dependent edema, elevated serum sodium, diminished glomerular filtration rate, proteinuria 24. The nurse is teaching a child and his family about medications for the child, who is getting dialysis. The nurse will teach the family which of the following? If urine output diminishes, call the health care provider prior to giving the medication. 25. Which of the following is most commonly the cause of growth hormone deficiency? idiopathic condition 26. After a child begins treatment for precocious puberty, the child’s growth will be monitored every few months. The areas monitored and evaluated will most likely include serum hormone levels and which one of the following areas? bone age 27. The nurse assessing the newborn will most often note which of the following signs in a child with congenital hypothyroidism? facial puffiness, swollen eyelids, enlarged tongue, low anterior hairline, flattened nasal bridge, and dull expression 28. Which of the following conditions most often causes primary acquired hypothyroidism? autoimmune chronic lymphocytic thyroiditis called Hashimoto’s thyroiditis 29. Which of the following is the most common cause of hyperthyroidism in the pediatric population? Grave’s disease 30. If not diagnosed at birth, a newborn with 21-hydroxylase (21-OH) deficiency and salt wasting will develop which of the following problems by days 10 to 14 of life? adrenal crisis 31. A 1-month-old client is admitted to the emergency room with severe diarrhea. Which assessment suggests the client is severely dehydrated? Fontanels depressed; capillary refill greater than three seconds 32. A child is admitted to the hospital unit with a diagnosis of minimal-change nephrotic syndrome (MCNS). Which clinical manifestations does the nurse anticipate when conducting the admission assessment? Massive proteinuria, hypoalbuminemia, edema 33. A nurse is planning care for a child with hyponatremia. The nurse, delegating care of this child to a new RN on the pediatric unit, cautions the new nurse to be especially alert for which condition in the child? Seizures 34. A pediatric client is diagnosed with type 1 diabetes. The nurse teaches the client the difference between insulin shock and diabetic hyperglycemia. The nurse evaluates that the client understands the teaching when the client states which characteristics of diabetic hyperglycemia? Thirst and flushed skin 35. A school-age client diagnosed with diabetes insipidus (DI) is admitted to the pediatric unit. Which laboratory value does the nurse anticipate for this client based on the diagnosis? Hypernatremia 36. An adolescent client diagnosed with Graves' disease is admitted to the hospital. Which clinical manifestations would the nurse expect on assessment? Tachycardia, fatigue, and heat intolerance 37. In the morning, a nurse receives a report on four pediatric clients who have some form of fluid-volume excess. Which client should the nurse assess first? A client with tachypnea and pulmonary congestion 38. Parents of an infant with slow weight gain ask the nurse if they can feed their baby a highly concentrated formula. Which response by the nurse is the most appropriate? "A higher-concentrated formula could lead to dehydration because of high sodium content; let's discuss other strategies." 39. The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration? Tachycardia 40. The nurse is providing care to a male infant who is diagnosed with hypospadias. Which clinical manifestation does the nurse anticipate when assessing this infant? A urethral meatus that is located on the ventral surface of the penis 41. Which symptoms are characteristic of a preschool-age client who is diagnosed with a urinary tract infection? Urgency, dysuria, low-grade fever 42. Which of the following methods is the most reliable method of diagnosing dehydration in children? weight loss 43. Classical symptoms of impending shock in a child who is dehydrated are: azotemia, rapid thready pulse, mottled skin, low blood pressure 44. The nurse is assigned to work with a child diagnosed with nephrotic syndrome. The nurse knows that this renal problem is characterized by massive proteinuria and hypoalbuminemia, which tells the nurse to assess for which of the following signs or symptoms? edema and hyperlipidemia 45. Which of the following are the clinical manifestations of hemolytic uremic syndrome? renal failure, thrombocytopenia, and anemia 46. The nurse is instructing a child and the child’s family about dietary needs while the child is undergoing dialysis treatments at home. The nurse will instruct the family to provide which of the following types of diet? low protein 47. A nurse is planning care for a child with hyperkalemia. Which clinical manifestation will the nurse plan to assessment this child for based on the diagnosis? Bradycardia 48. The recent dramatic increase in the incidence of type 2 diabetes has occurred mainly in which of the following groups? Select all that apply. overweight children culturally diverse populations NO MATH QUESTIONS. GOODLUCK!