NR 602 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 602 FINAL EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. triad symptoms intussusception Correct Answer • Paroxysmal, episodic abdominal pain with vomiting every 5 to 30 minutes. Vomiting is nonbilious initially. Some children do not have any pain. • Screaming with drawing up of the legs with periods of calm, sleeping, or lethargy between episodes. • Stool, possibly diarrhea in nature, with blood ("currant jelly"). 2. diagnosis of intussusception Correct Answer ultrasound is gold standard 3. Dance sign Correct Answer Sausage like mass in RUQ with emptiness in RLQ (intussusception) 4. Physical exam intussusception Correct Answer • Observe the infant's appearance and behavior over a period of time; often the child appears glassy-eyed and groggy between episodes, almost as if sedated. • Dance sign • The abdomen is often distended and tender to palpation. • Grossly bloody or guaiac-positive stools. 5. Management intussusception Correct Answer • Radiologic reduction using a therapeutic air contrast enema under fluoroscopy is the gold standard. • Surgery is necessary if perforation, peritonitis, or hypovolemic shock is suspected or radiologic reduction fails. • IV antibiotics are often administered to cover potential intestinal perforation. 6. imaging ingested FB Correct Answer A single frontal radiograph that includes the neck, chest, and entire abdomen is usually sufficient to locate the object. Esophageal objects should be precisely located with frontal and lateral chest radiographs. Coins in the esophagus are usually seen on the frontal view, whereas tracheal coins are more often seen from the side view 7. esophageal foreign bodies Correct Answer must be removed, considered obstruction 8. management lower GI tract or stomach Correct Answer Most can be left to pass through GI system. Sharp items must be removed- and button batteries. 9. symptoms appendicitis Correct Answer • Pain: Initially poorly defined periumbilical pain (earliest sign); acute onset of severe pain is not typical of acute appendicitis. A shifting of pain to the RLQ may occur after a few hours and becomes more intense, continuous, and localized. • Nausea and vomiting: Typically occurs after pain; however, in retrocecal appendicitis, this may be reversed. In gastroenteritis, vomiting precedes the pain. • Anorexia occurs (although up to 50% of children state that they are hungry). • Stool is low volume with mucus; diarrhea is atypical but can occur especially after perforation (gastroenteritis has high volume, watery stools). • Fever is neither sensitive nor specific for appendicitis; many children present as afebrile or with low-grade fever. High fever may be associated with perforation. 10. physical exam appendicitis Correct Answer • RLQ pain, pain over McBurney's pt • Heel-drop jarring test • Positive psoas sign or obturator sign (or both). • Rovsing sign or rebound tenderness • Tenderness and possibly a mass (abscess) on the right side on rectal examination. 11. highest accuracy in diagnosis appendicitis Correct Answer CT 12. complications appendicitis Correct Answer Perforation, peritonitis, pelvic abscess, ileus, obstruction, sepsis, shock, and death can occur 13. colic definition Correct Answer Colic is defined as crying for no apparent reason that lasts for 3 hours or more per day and occurs 3 days or more per week in an otherwise healthy infant younger than 3 months of age 14. management colic with probiotics Correct Answer No studies have shown any benefit 15. treatment for colic Correct Answer • Relieve parental stress with the reassurance that crying will stop • Trial of background noise • Rocking the baby (not shaking) • no colic meds • anti-gas meds are helpful for gas, not colic • no need to change formula 16. urine culture should be done when Correct Answer urine sample positive for nitrites or leukocyte esterase if the child has symptoms of UTI, the risk criteria for UTIs are met, or the child has a high fever without a source 17. enuresis diagnosis Correct Answer According to the ICCS a diagnosis of enuresis requires a minimum age of 5 years old, and one episode a month for a duration of 3 months. 18. before treating nocturnal enuresis Correct Answer • Constipation: It cannot be overemphasized how important it is to determine if constipation or impaction exists before treating nocturnal enuresis. 19. causes of enuresis: • Familial disposition • Neurologic developmental delay. • ADHD, mental health disorders • Functional small bladder capacity • Sleep disorders: Obstructive sleep apnea and disordered sleep patterns result in increased nocturnal enuresis incidence • Stress and family disruptions • Polyuria: This can be caused by nocturnal drinking as well as caffeine intake • Inappropriate toilet training: This is especially common when parents are overly demanding or punitive of the child. 20. history questions enuresis Correct Answer • Urgency, dysuria, or dribbling • Are there voiding or stooling postponement behaviors? • Number of voids per day: is nocturia present? • Cluster voiding: for example, is the child waiting until after school? • Frequency of wetting—day and night • Type of urinary stream 21. referral warranted for enuresis: • Weak or interrupted urinary stream • Need to use abdominal pressure to urinate • Combined daytime incontinence and nocturnal enuresis 22. physical exam enuresis Correct Answer • Assess the external genitalia for signs of irritation, infection, labial fusion, and/or meatal stenosis. • Examine the abdomen for masses, especially at the suprapubic midline and in the left lower quadrant. • Examine the lower back for dimples and hair tufts. • Assess for neurologic function and deep tendon reflexes.