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ob&peds exam 5 part 1
ob&peds exam 5 part 1
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1
1.Which type of traction would the nurse expect to be used for a 20-month-old child who has a fractured femur?
Ninety-ninety
Buck's extension
Bryant's
Russell's
2
Signs of increased intracranial pressure in a 3-year-old child include:
headache, lethargy.
apnea, crossed eyes.
painful head movement, anorexia.
high-pitched cry, bulging fontanelles.
3
Digoxin (Lanoxin) is withheld if the pulse of a newborn is lower than _____bpm.
100
90
110
120
4
A child newly diagnosed w/leukemia isnt up to date on immunizations. Which is an essential step in response to this?
administer immunizations on alternating days from chemotherapy.
delay treatment until all immunizations have taken effect.
delay active immunizations during chemotherapy.
give immunizations according to the expected schedule
5
a child receiving digoxin for the heart failure. What is a cardinal sign of digoxin toxicity?
headache
constipation
Respiratory distress
Sudden change in pulse
6
What is the most common congenital heart defect occurring in children?
ventricular septal defect
atrial septal defect
coarctation of the aorta
patent ductus arteriosus
7
Which defects are associated with tetralogy of Fallot? (
Select all that apply.
)
Ventricular septal defect
Dextroposition of the aorta
Pulmonary artery stenosis
Hypertrophy of the right ventricle
Atrial septal defect
Patent ductus arteriosus
8
When caring for a child on steroid therapy, it is important to seek immediate medical attention if the child:
develops a fever
loses her hair
vomits
skips a meal
9
Which factor is most likely to trigger seizures in a child with epilepsy?
Sensitivity to light
Loud noises
Hypothermia
High-fat diet
10
Children with Hodgkin's disease usually present with a(n):
painless cervical neck lump
Unexpected sudden weight gain
enlarged abdomen
high fever
11
Which diagnostic test is a standardized diagnostic test for rheumatic fever?
sedimentation rate
rubella titer
Antistreptolysin O titer
WBC count
12
A neurologic assessment is part of a comprehensive musculoskeletal assessment.
True
False
13
vitals on an infant admitted w/signs of respiratory distress. what should be reported to the HCP? SATA
Respiratory rate of 35 breaths per minute
Blood pressure is higher in the legs than in the arms
Blood pressure is lower in the legs than in the arms
Cyanosis of the lips
14
The nurse recognizes which as symptoms of meningitis?
Intense thirst and stiff neck
Hyperactivity and vomiting
Irritability and fever
Loss of vision and malaise
15
An abnormal S-shaped curvature of the spine seen in school-age children is:
sciatica.
scoliosis.
sclerosis.
scabies.
16
a child w/ possible Kawasaki disease is admitted. a characteristic sign or symptom that should be observed & documented?
decreased level of consciousness
peeling skin on fingers
cardiac dysrhythmia
decreased urine output
17
What will the nurse include when performing cranial or neurological assessments? (
Select all that apply.
)
Motor activity
Lung sounds
Vital signs
Level of consciousness
Pupil assessment
18
When an infant is receiving digoxin (Lanoxin), the nurse would be alert to which finding as a sign of toxicity?
fluid retention
diarrhea
weight loss
nausea and vomiting
19
teen w/a tibia fracture reports pain meds are not working. u notice edema of toes & capillary refill of 6sec,priority?
try nonpharmacological techniques of pain relief.
explain to the teen a new fracture is expected to be painful the 1st day
call the health care provider immediately.
find out if there is an order for a stronger pain medication.
20
What is the priority for the care of a child with decreased level of consciousness resulting from a head injury?
Maintain a patent airway.
Monitor fluid balance.
Prevent skin breakdown.
Perform passive range-of-motion exercises.
21
Immediate nursing care of a child with hemophilia who has hemarthrosis includes:
withholding factor VIII
application of heat
immobilization of the area of pain
active and passive range-of-motion exercises
22
The nurse monitors fluid intake and output in children with a head injury to:
control cerebral edema
prevent aspiration.
decrease headaches.
prevent renal damage.
23
diagnosis related to the development of Reye’s syndrome in conjunction with aspirin administration in the peds pt?
varicella
meningitis
encephalitis
strep throat
24
signs and symptoms that might indicate that a child has ITP include:
anemia and purpura
hematuria and petechiae
petechiae and purpura
headaches and hematuria
25
a nurse's responsibility when a child is receiving diuretics to:
withhold fluids.
place on seizure precautions.
check the dosage with another nurse before administering.
monitor serum electrolyte levels.
26
A child has heart surgery,returns to the peds unit w/a chest tube & drainage bottles in place. priority for chest tubes?
Keep the drainage bottles below the chest level at all times.
Clamp the chest tubes when turning the patient.
Empty the chest tube drainage bottles each shift.
Place the drainage bottles on the bed when moving the bed.
27
The presence of blood in the anterior chamber of the eye is called
hyphema
encephalitis
orbital cellulitis
varicella
28
Nursing care for a child following a generalized tonic-clonic seizure would include:
attempting to hold the tongue
turning on his or her side.
administering oxygen
restraining extremities.
29
Which nursing action is appropriate when caring for a hospitalized child who is hearing-impaired?
Speak in a loud, clear tone.
Speak in an exaggerated tone.
Stand close to the child and speak slowly.
Speak at eye level with the child.
30
What is considered a manifestation of retinoblastoma?
Yellowish-white reflex seen in the pupil
Increase in tear production
Cloudy appearing cornea
Red-eye reflex seen behind the retina
31
An appropriate nursing intervention for an infant with bacterial meningitis is to:
position the infant on the right side.
keep the room quiet and indirectly lit.
place in isolation until discharged.
restrain the infant when awake.
32
iron supplement absorption is increased by taking it with:
eggs
orange juice
cereal
milk
33
A congenital heart defect that results in decreased pulmonary blood flow is:
atrial septal defect
tetralogy of fallot
ventricular septal defect
patent ductus arteriosus
34
Otitis media frequently occurs after a child has an upper respiratory infection.
True
False
35
Which disease is usually inherited as a sex-linked disorder?
Scoliosis
Duchenne's muscular dystrophy
Juvenile idiopathic arthritis
Legg-Calvé-Perthes disease
36
It is recommended that iron-fortified formula be given to infants through age:
9 months
12 months
6 months
3 months
37
Which is an expected assessment finding in a child with suspected scoliosis?
Delayed breast development
Asymmetry of the shoulders
Prominent clavicle
Expiratory wheeze
38
A 3yo removed from a abusive parent is crying.a worker wonders if this is a sign he wasnt abused. the nurse understands:
will mourn the loss of family, even if there was abuse.
doesn't really understand what is happening.
would not be crying if he or she had been abused in the home.
is seeking attention from any available adult.
39
A newborn's feet may turn inward or outward.
True
False
40
Children with hemophilia should avoid:
swimming
analgesics
citrus fruits
salicylates
41
an infant's blood pressure is higher in the arms than the legs. This is associated w/which congenital heart defect?
hypoplastic left heart syndrome
coarctation of the aorta
tetralogy of fallot
patent ductus arteriosus
42
The treatment of osteomyelitis includes the use of:
antibiotics
steroids
traction
hydrotherapy
43
Which symptoms are indicative of rheumatic fever (RF)? (
Select all that apply.
)
Peeling skin
Migratory polyarthritis
Abdominal pain
Chorea
Vomiting
44
Which statement by a mother might indicate future problems related to the care of a newborn infant?
she cries all the time&dont seem to like me. shes trying to irritate me.
she has colic,we take turns w/her but when will we get a full nights sleep?
can i call u w/questions? This is my 1st child & i feel frightened.
Im happy my mom will be here,ill have time to recuperate&adjust
45
parent education: after a surgical insertion of a pressure equalization tube during myringotomy after eardrum rupture?
Avoid getting water in the child's ears.
Position the child on his back for sleep.
Use cott
The tube may fall out spontaneously within 6 to 12 months.
46
what would be the initial nursing action when a child receiving a transfusion of packed RBC c/o chills and back pain?
take the child's blood pressure
reduce the infusion rate
discontinue the transfusion
administer Benadryl as ordered
47
Hypertension is identified in a 10yo during routine screening. what plan of care is implemented initially?
beta-adrenergic blockers are prescribed.
an exercise and diet program is developed.
the child is started on a diuretic.
a blood pressure measurement is scheduled in 4 weeks.
48
An infant brought to the ER w/a high fever, irritability, & a high-pitched cry would immediately be evaluated for:
meningitis
Reye's syndrome.
retinoblastoma.
neuroblastoma.
49
A toddler has been walking for 1m. his gait reveals his feet are wide apart&the gait is unsteady. interpret this finding
Orthotic devices in the shoes will improve the gait.
A comprehensive neurologic assessment is indicated.
This is a normal gait for a child in the toddler age group
The child appears to have genu varum.
50
Which signs indicate congenital cardiac problems? (
Select all that apply.
)
Greater than normal weight gain
Clubbing of fingers
Dyspnea
Bradycardia
Pulsations in neck veins
Tachypnea
51
An infant with congestive heart failure would most likely experience:
difficulty feeding.
bradypnea.
excessive or rapid weight gain.
erythema.
52
when giving digoxin (Lanoxin) to an infant, it should be withheld & the health care provider notified if the:
pulse rate is below 100 beats/minute.
infant is dyspneic.
respiratory rate is above 40 breaths/minute.
pulse rate is below 60 beats/minute.
53
The nurse reinforces home care instructions for parents of a child who has had an above-the-knee cast applied.
Keep small toys out of the child’s reach.
Use fingertips to lift the cast until it is fully dry.
ace a heating pad on the toes if they feel cold.
Contact the health care provider if the child complains of numbness.
Elevate the leg on pillows.
54
When taking the history of a child with encephalitis, it is important to note recent:
respiratory infection
drug therapy
cat scratches.
exposure to poison ivy.
55
An appropriate nursing intervention for the child admitted to the hospital in sickle cell crisis would be to:
apply ice to painful areas
provide foods high in iron at meals
encourage the child to ambulate
monitor the childs response to analgesics.
56
HCP explains treatment for Legg-Calve-Perthes disease. What information would the nurse review with parents?
Ambulation-abduction casts or braces
Buck's extension traction
Surgery to stabilize the joint
Muscle strengthening with weights
57
a infant w/congenital torticollis's mom is worried he will always have limited neck motion. best response to the mother?
"There is nothing you can do to improve the condition.”
"Your child will always need to wear a neck brace."
"The condition will most likely resolve by age 2-6 months."
"Surgery is the treatment of choice to correct the problem."
58
By what age do children realize that death is final and permanent?
10 years
3 years
5 years
7 years
59
Which is the most useful diagnostic procedure in diagnosing a seizure disorder?
Lumbar puncture
Brain scan
Skull radiography
Electroencephalography
60
Young children may appears “bow-legged” until 5 years of age.
True
False
61
Which question will help determine a plan of care during hospitalization for a 5yo who has intellectual impairment?
"What is her bedtime routine?”
"Can the child dress herself?"
"What is her favorite breakfast food?"
"Is she toilet trained?"
62
An appropriate nursing action when caring for a child in Bryant's traction is to:
position the child so the buttocks touch the bed.
position the child's legs at right angles to the body.
support the weights when the bed is moved.
remove the weights when bathing.
63
what indicates that an infant with congestive heart failure (CHF) is carefully following the prescribed medical regimen?
The child exhibits normal weight for age.
The child has an elevated RBC.
The child takes antibiotics daily.
The child’s pulse rate is less than 50 beats/minute.
64
priority nursing actions when administering Diuril (chlorothiazide) to a child diagnosed with CHF?
Hold dose if patient vomits and until doctors write order to repeat dose
Measure pulse for 1 minute and review ECG
Intake and output and periods of rest
Monitor serum electrolytes and daily weight
65
Prolonged exposure to moisture is a precipitating factor for otitis externa
.
True
False
66
Children who do not walk independently by 12 months of age should be evaluated for a musculoskeletal problem
False
True
67
Which presents the greatest risk to the child with hemophilia?
hemarthrosis
hematuria
intracranial bleeding
iron deficiency anemia
68
A 7m old child had a febrile seizure. Which statement would the nurse give to the infant's parents?-"Febrile seizures:
indicate a permanent, underlying neurologic problem."
are usually controlled with phenobarbital."
rarely occur before an infant's first birthday."
rarely develop into epilepsy."
69
When a child has otitis externa, the tympanic membrane is erythematous.
True
False
70
What is the best method for feeding an infant with congestive heart failure from a large ventricular septal defect?
give frequent, large feedings
feed intravenously
feed smaller amounts more frequently
space feedings at least every 3-4 hours
71
A “neurovascular check” for tissue perfusion includes which of the following observation? SATA.
pulse
movement and sensation
color and capillary refill
equal pupil size of eyes
72
The development of uveitis is an autoimmune complication of:
juvenile rheumatoid arthritis.
Legg-Calvé-Perthes disease.
torticollis.
osteomyelitis.
73
Which is a priority nursing diagnosis for an adolescent treated for osteosarcoma?
Risk for trauma
Posttrauma syndrome
Disturbed body image
Risk for infection
74
Early signs of Reye's syndrome include:
vomiting and lethargy.
diarrhea and headache.
nausea and malaise.
hyperactivity and vomiting
75
a child is referred for a scoliosis screening, The nurse determines that the child's curvature must be less than:
10 degrees
30 degrees
20 degrees
40 degrees
76
1.One of the most common causes of death in a child with muscular dystrophy is:
osteomyelitis
cardiac failure
renal failure
liver disease
77
an infant with tetralogy of fallot becomes hypercyanotic. the nurse would place the infant in the ___ position.
trendelenburg
knee-chest
side-lying
high-fowler's
78
The greatest concern of a nurse caring for a child with ITP is:
noncompliance with aspirin therapy
development of a secondary bacterial infection
a reaction to excess platelets
injuries that might initiate bleeding
79
Which signs/symptoms are characteristics of brain tumors in children? (
Select all that apply.
)
Decreased blood pressure
Headache upon awakening
Seizure activity
Projectile vomiting
80
Children who carry the sickle cell trait:
have a 25% chance of developing the disease
have a 50% chance of developing the disease
have a 10% chance of developing the disease
will not develop any symptoms of the disease.
81
anxiety can be decreased in both the family and the child who has cancer by:
placing the child with an older child who has the same diagnosis.
explaining all procedures before they are done.
discouraging the child and parents from discussing the issue of death.
not telling the child that he or she has cancer.
82
A type of fracture in a young child that may be indicative of child abuse is:
greenstick fracture of the tibia
pathological fracture of the fibula
aligned fracture of the wrist
spiral fracture of the femur
83
A infant w/tetralogy of Fallot is having a tet spell w/ cyanosis&dyspnea. what position should the infant be place?
knee-chest
trendelenburg's
fowler's
prone
84
The diagnostic test that confirms a diagnosis of leukemia is a(n):
complete blood count
spinal tap
bone marrow aspiration
x-ray of the bones
85
priority nursing intervention for a child wearing an Ace bandage for a sprained ankle?
Perform a neurovascular assessment.
Apply a fresh ice pack to the sprained ankle.
Ensure the ankle is elevated on a pillow.
Determine when the child received analgesia.
86
1.nurse is aware that a fracture involving the epiphyseal plate in a long bone can result in:
a.reduced red blood cell production
excessive calcium storage.
impaired bone growth.
delayed bone healing
87
A yellow bruise is approximately:
2 days old.
5 to 7 days old.
7 to 10 days old.
10 to 14 days old.
88
A practice that has been helpful in preventing intellectual disability is:
a urine test at age 6 months.
a blood test at birth.
administering the Stanford-Binet test.
careful preschool developmental screening.
89
The priority nursing intervention when administering Dilantin(phenytoin) to a patient diagnosed with epilepsy is:
encouraging bed rest.
administering the drug with milk.
providing detailed oral hygiene.
recording the blood pressure.
90
What is an appropriate nursing intervention for feeding a child with spastic type cerebral palsy?
Tilt the head backward 30 degrees.
Touch the tip of the tongue with the spoon.
Stroke downward under the chin area.
Feed with a rubber-coated spoon.
91
The nurse teaching parents about adverse effects of phenytoin (Dilantin) would explain this medication can cause:
drowsiness
gum overgrowth
liver toxicity
blurred vision
92
Prevention of rheumatic fever can best be accomplished by:
treating all colds with antibiotics.
sending children with sore throats home from school.
keeping children with fever home.
having sore throats cultured as soon as possible.
93
Which disorder causes unoxygenated blood to enter the systemic arterial circulation?
Coarctation of the aorta
Tetralogy of Fallot
Patent ductus arteriosus
Atrial stenosis
94
neuro check on a child in Russell's traction for a fractured femur. Which finding should be reported?
Foot is warm to the touch.
Can wiggle toes.
capillary refill of toes less than 3 seconds.
toes feel tingly
95
Anxiety can be decreased in both the family and the child who has cancer by:
placing the child with an older child who has the same diagnosis.
discouraging the child and parents from discussing the issue of death.
explaining all procedures before they are done.
not telling the child that he or she has cancer.
96
nursing care of an adolescent w/cancer who is refusing to cooperate w/ treatment should include:
asking the parents to make the adolescent cooperate.
withholding the influences of group therapy until the behavior changes.
allowing the adolescent to make some choices.
restricting visits from friends until the behavior is modified.