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A newborn has just been delievered via C-Section with a myelomeningocele which was
detected pre-natally via amniocentecic. The child is scheduled to have surgery within
the first 48 hours. Which of the following nursing actions is appropriate?
A. Place child in semi-fowlers position to decrease pressure on the spinal cord
B. Apply heat lamp to facilitate drying and toughening of the sac
C. Apply soft restraints to prevent disruption of the sac
D. Assess head circumference and fontenals for signs of ICP. - answersD
A child with autism spectrum disorder (ASD) is admitted to the hospital with
pneuomonia. The nurse should plan which priority intervention when caring for this
child?
A. Maintain a structured routine and keep stimulation to a minimim
B. Communicate at child;s level and maintain eye contact
C. Use therapeutic touch to calm child with procedures
D. Switch from one assessment activity to another quickly? - answersA
A child is admitted with acute glomerularnephritis. The nurse would expect the UA
during this acute phase to show which of the following?
A. Bacteruria, hematuria
B. Hematuria, proteinuria
C. Bacteruria, increase specific gravity
D. Proteinuria, decreased specific gravity - answersB
A child has been admitted to the pedatric unit with suspected meningitis. The CSF
aanalysis reveals the following: Apperance: Clear, WBC: within normal limits, Protein:
within normal limits, Glucose: within normal limits, Culture: negative. Based on the
results, the nurse suspects that the child has:
A. Bacertial Meningitis
B. Meningococcal meningitis
C. Viral meningitis
,D. Hydrocephalous - answersC
A two year old has had one bout of nephrosis (nephrotic syndrome) His mother
suspected a recurrence when she observed swelling around his eyes. The nurse helps
to confirrm the condition by recognizing what additional sympton?
A. Blood presssure 140/90
B. Marked proteinuria
C. Tea colored urine
D. A history of positive strep infections - answersB
The mother of a 1 month old infant tells the nurse she worries that her baby will get
meningitits like her oldest son did when he was an infant. The nurse should base her
response on which statement?
A. Meningitis rarely occurs during infancy, however after the first year of life, it is more
common.
B. Often a genetic predisposition to meningitis is found and family members are more
likely to get it.
C. Vaccination to prevent all types of meningitits is now avaliable and should be
administered at 6 months.
D. Vaccination to prevent Haemophilus influenzae type B meningitits has decreased the
frequency of this disease in children. - answersD
A six week old infant is brought to the pediatricians office for a well-baby visit. During
examinations the physcian displaces the femoral head and reduces it back into place by
manipulation of the thighs and hips. The nurse recognizes that the physcian is
assessing:
A. Barlow and ortalani tests for developmental dysplasia of the hip
B. Gower test for developmental dysplasia of the hip
C. Pavlik test for developmental dysplasia of the hip
D. Trendelenburg test for developmental dysplasia of the hip - answersA
A 10 year old is admitted with possible appendicitis. The doctor's history and physical
indicates a WBC count of 17,000, increased segmented neutrophils, decreased
lymphocytes, and 6% bands. The patient complains of abdominal pain, localized at
Mcberney's point. Which statement most accurately describes the data?
A. Lab work revels a left shift and pain localized in the right lower quadrant
B. Lab work reveals a right shift and pain localized in the left upper quadrant
C. Lab work reveals normal findings with pain localized in the epigastric area.
D. Lab work reveals a possible viral infection with pain localized in the left upper
quadrant. - answersA
A nurse is caring for a boy with probable intusseception. He had diarrhea before
admission but while waiting for administration of air pressure to reduce the
intusseception he produced a normal brown stool. Which nursing action is the most
appropriete.
A. Notify practitioner
,B. Measure abdomnial girth
C. Auscultate for bowel sounds
D. Take vital signs, including blood pressure. - answersA
The nurse is evaluating a child who is being treated for nephrotic syndrome. Which
observation indicated successful treatment of nephrosis?
A. Diuresis and weight loss
B. improved appetitie and weight gain
C. Increase in urine specific gravity
D. Return of temperature and pulse to normal - answersA
A young child is brought to the emergency room with suspected meningitis. Blood work
with cultures, a urine specimen with a culture and sensitivity, and the spinal tap were
completed in the ER and he is being admitted to the pedatric unit for continued care.
Which of the following is a major priority of nursing care?
A. Encourage oral intake of clear liquids. Progress diet as tolerated
B. Inititate isolation procedure if warranted after the CSF analysis is completed.
C. Inititate isolation procedire immediatly and administer ordered antibiotics
D. Administer sedatives/analgesic on a prescribed schedule to manage pain. -
answersC
The nurse is caring for a 4-year old child immobilized by a fractured leg. Which
complication should the nurse monitor related to the childs immobilzation status.
A. The metabolic rate increases.
B. Increased joint mobility leading to contractures
C. Hypocalcemia due to release of excess calcium
D. Venous stasis leading to thrombi or emboli formation. - answersD
An adolescent who has chronic SCFE (slipped capital femoral epiphysis) sustains a fall
during gym class andis transported to the hospital with severe pain. Which is the most
appropriate explanation for what happened.
A. The child has probably experienced a fracture
B. The child has expereienced an acute on chronic phenomenom
C. The child has developed idopathic avascular necrosis.
D. the child has developmental dysplasia of the hip - answersD
A 13 year old was found to have a noticable rib hump during the scholosis screening by
the school nurse. What would be the most accurate information for the oarents in
answering their questions about scolosis?
A. "It is important to follow through on getting the child checked by an orthopedic doctor"
B. "Scoliosis is very common in teen girls and it will diminish as she continues to grow"
C."This is probably not a severe problem, since this is the first that symptoms have
been noted"
D. "Most teens with curvatures of 10 degrees will need some type of bracing" -
answersA
, A nurse is caring for a child who is scheduled for an appendectomy. The nurse reviews
the physcian's preoperative orders. Which order should be questioned?
A. 0.9% NS IV at 50ml/hr
B. NPO after midnight
C.Mefoxin 1 GM IVPB on call for surgery
D. Activity as tolerated, up ad lid - answersD
A newborn male infant has been found to have unilateral talpies equinovarus ( club foot)
deformation. Which would be the most important information to give the parent?
A. The baby will probably need to start serial casing as soon as possible.
B. The child will need a Pavlik harness to keep the extremeties strechted
C. The child will need to undergo electromuography studies to confirm diagnosis.
D. The child will need to undergo testing to confirm diagnosis - answersA
A two year old with cerebral palsy is on continous tube feedings. Which intervention
should the nurse expect to see ordered to ensure proper hydration and *********?
A. Administer 1 ampule Sodium Bocarb IV push every 4 hours to prevent acidosis
B. Administer water trough the PEG tube every 4 hours to prevent hypertonic
dehydration
C. Adminster water through the PEG tube every 4 hours to prevent hypotonic
dehydration
D. Adminster sterile saline through the PEG tube every 4 hours to prevent - answersC
An abdnomial flat plate xray ordered for a child admitted with suspected intussecception
reveals no free air beneath the diaphram. What order should the nurse anticipate next
from the physcian?
A. Transport child to radiology and prepare him for a barium enema
B.Transport child to radiology and prepare him for an upper GI series
C. Transport child to radiology for an enema with air or water-soluable contrast
D. Transport child to the operating room and prepare him for abdominal surgery -
answersA
A 12 year old has been diagnoses with slipped capital femoral epiphysis. In addition to
pain, what other assessment would the nurse expect to find?
A. Osteomylytisis of the hip
B. Asymmetrical gluteal folds
C. External rotation of the hip
D.Flexion of the hip - answersC
The parent of a 5 year old child with Duchenes Muscular Dystrophy is bringing her child
to the clinic for a follow up. She reports that she has noticed that her son's calves
seems to be enlarged since the last visit. Which explanation by the nurse is
appropriete?
A. This is due to pseudohypertrophy in which fat replaces muscle in the calves
B. This is due to Gower's sign in which the calves
C. This is due to increased liver enzymes, which indicate muscle damage