Peds Final Exam - Student Questions + Dosage
Calculations
Adolescence: A client's diagnosis of CF was made 13 years ago, and he has since been hospitalized
several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and
failure to thrive. Which nursing actions are most important initially?
A. Placing the client on bed rest and ordering a blood gas analysis
B. Ordering a high-calorie, high-protein, low-fat, vitamin-enriched diet and pancreatic granules
C. Applying an oximeter and initiating respiratory therapy
D. Inserting an I.V. line and initiating antibiotic therapy
C. Applying an oximeter and initiating respiratory therapy
Rationale:
A pulse oximetry is used for a variety of situations in which quick assessments of a child's respiratory
status are needed. Children who present with the following signs and symptoms will benefit from pulse
oximetry: increased work of breathing, wheezing, coughing and cyanosis.
School- age: A school-age child with CF asks the nurse what sports she can become involved in as she
becomes older. Which of the following activities would be appropriate for the nurse to suggest?
A. Swimming
B. Track
C. Baseball
D. Javelin throwing
A. Swimming
Rationale: The best answer is swimming because it coordinates breathing and movement of all muscle
groups and can be done on an individual basis or on a team. Track events, baseball and javelin throwing
usually are performed outdoors; the child would be breathing in large amounts of dust and dirt, which
would be irritating to her mucous membranes and pulmonary system. The activities that expose the
,child to dust and heat would play a role in placing the child at risk for an upper respiratory tract infection
and compromising her respiratory function.
Preschool: When developing a recreational therapy plan of care for a 3-year-old child hospitalized with
pneumonia and cystic fibrosis, which of the following toys would be appropriate?
A. 100 piece jigsaw puzzle
B. Child's favorite doll
C. Fuzzy stuffed animal
D. Scissors, paper, and paste
B. Child's favorite doll
Rationale:
The child's favorite doll is an appropriate choice for a toy. The doll provides support and is familiar to the
child. Although a 3-year-old may enjoy puzzles, a 100-piece jigsaw puzzle would be too complicated for
an ill 3-year-old child. Because of the child's lung and respiratory issues, a fuzzy stuffed animal would not
be an appropriate choice because of its potential as a reservoir for dust and bacteria, which could
possibly predispose the child to additional respiratory problems. Scissors, paper, and paste are not
appropriate for a 3-year-old unless the child is supervised closely.
Toddler: When developing the plan of care for a child with cystic fibrosis (CF) who is scheduled to receive
postural drainage, the nurse should anticipate performing postural drainage at which of the following
times?
A. After meals
B. Before meals
C. After rest periods
D. Before inhalation treatments
B. Before meals
, Rationale: Postural drainage for the CF patient is best before meals because the stomach is empty and
this will reduce the risk of vomiting.
Infant: A 9-month-old child with cystic fibrosis does not like taking pancreatic enzyme supplement with
meals and snacks. The mother does not like to force the child to take the supplement. The most
important reason for the child to take the pancreatic enzyme supplement with meals and snacks is:
A. The child will become dehydrated if the supplement is not taken with meals and snacks
B. The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates,
and proteins.
C. The child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear
D. The child will experience severe diarrhea if the supplement is not taken as prescribed
B. The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates,
and proteins.
Rationale: CF patients have pancreatic fibrosis, which causes blockage of the pancreatic ducts, thus
pancreatic enzymes cannot reach the duodenum. Thus, these enzymes must be added with their meals
to facilitate proper digestion and absorption of nutrients.
Infant: Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin should
include which of the following? Select all that apply
1. Give the medication at regular interval
2. Mix the medication with a small volume of breast milk or formula
3. Repeat the dose one time if the child vomits immediately after administration
4. Notify the primary care provider of poor feeding or vomiting
5. Make up any missed doses as soon as realized
6. Notify the primary care provider if more than 2 consecutive doses are missed
7. Keep medication in a safe place, preferably a locked cabinet
8. Induce vomiting if there is an accidental overdose
1. Give the medication at regular interval
Calculations
Adolescence: A client's diagnosis of CF was made 13 years ago, and he has since been hospitalized
several times. On the latest admission, the client has labored respirations, fatigue, malnutrition, and
failure to thrive. Which nursing actions are most important initially?
A. Placing the client on bed rest and ordering a blood gas analysis
B. Ordering a high-calorie, high-protein, low-fat, vitamin-enriched diet and pancreatic granules
C. Applying an oximeter and initiating respiratory therapy
D. Inserting an I.V. line and initiating antibiotic therapy
C. Applying an oximeter and initiating respiratory therapy
Rationale:
A pulse oximetry is used for a variety of situations in which quick assessments of a child's respiratory
status are needed. Children who present with the following signs and symptoms will benefit from pulse
oximetry: increased work of breathing, wheezing, coughing and cyanosis.
School- age: A school-age child with CF asks the nurse what sports she can become involved in as she
becomes older. Which of the following activities would be appropriate for the nurse to suggest?
A. Swimming
B. Track
C. Baseball
D. Javelin throwing
A. Swimming
Rationale: The best answer is swimming because it coordinates breathing and movement of all muscle
groups and can be done on an individual basis or on a team. Track events, baseball and javelin throwing
usually are performed outdoors; the child would be breathing in large amounts of dust and dirt, which
would be irritating to her mucous membranes and pulmonary system. The activities that expose the
,child to dust and heat would play a role in placing the child at risk for an upper respiratory tract infection
and compromising her respiratory function.
Preschool: When developing a recreational therapy plan of care for a 3-year-old child hospitalized with
pneumonia and cystic fibrosis, which of the following toys would be appropriate?
A. 100 piece jigsaw puzzle
B. Child's favorite doll
C. Fuzzy stuffed animal
D. Scissors, paper, and paste
B. Child's favorite doll
Rationale:
The child's favorite doll is an appropriate choice for a toy. The doll provides support and is familiar to the
child. Although a 3-year-old may enjoy puzzles, a 100-piece jigsaw puzzle would be too complicated for
an ill 3-year-old child. Because of the child's lung and respiratory issues, a fuzzy stuffed animal would not
be an appropriate choice because of its potential as a reservoir for dust and bacteria, which could
possibly predispose the child to additional respiratory problems. Scissors, paper, and paste are not
appropriate for a 3-year-old unless the child is supervised closely.
Toddler: When developing the plan of care for a child with cystic fibrosis (CF) who is scheduled to receive
postural drainage, the nurse should anticipate performing postural drainage at which of the following
times?
A. After meals
B. Before meals
C. After rest periods
D. Before inhalation treatments
B. Before meals
, Rationale: Postural drainage for the CF patient is best before meals because the stomach is empty and
this will reduce the risk of vomiting.
Infant: A 9-month-old child with cystic fibrosis does not like taking pancreatic enzyme supplement with
meals and snacks. The mother does not like to force the child to take the supplement. The most
important reason for the child to take the pancreatic enzyme supplement with meals and snacks is:
A. The child will become dehydrated if the supplement is not taken with meals and snacks
B. The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates,
and proteins.
C. The child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear
D. The child will experience severe diarrhea if the supplement is not taken as prescribed
B. The child needs these pancreatic enzymes to help the digestive system absorb fats, carbohydrates,
and proteins.
Rationale: CF patients have pancreatic fibrosis, which causes blockage of the pancreatic ducts, thus
pancreatic enzymes cannot reach the duodenum. Thus, these enzymes must be added with their meals
to facilitate proper digestion and absorption of nutrients.
Infant: Discharge teaching for a 3-month-old infant with a cardiac defect who is to receive digoxin should
include which of the following? Select all that apply
1. Give the medication at regular interval
2. Mix the medication with a small volume of breast milk or formula
3. Repeat the dose one time if the child vomits immediately after administration
4. Notify the primary care provider of poor feeding or vomiting
5. Make up any missed doses as soon as realized
6. Notify the primary care provider if more than 2 consecutive doses are missed
7. Keep medication in a safe place, preferably a locked cabinet
8. Induce vomiting if there is an accidental overdose
1. Give the medication at regular interval
