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Peds Exam 4 Flashcards | StudBud
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Peds Exam 4
Peds Exam 4
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1
When teaching students about skeletal development in children, what information would the instructor include?
The infant's skeleton has undergone complete ossification by birth.
A young child's bones commonly bend instead of break with an injury.
The growth plate is made up of the epiphysis.
Children's bones have a thin periosteum and limited blood supply.
2
Caring for a 10 y/o in traction you notices that the skin over the calcaneus appears slightly red& irritated. 1st action
Make sure the skin is clean and dry.
Gently massage his foot to promote circulation.
Reposition the child's foot on a pressure-reducing device.
Apply lotion to his foot to maintain skin integrity.
3
Caring for a 10 y/o with Duchenne muscular dystrophy. Which intervention would best promote maximum chest expansion?
Chest percussion
Coughing
Upright positioning
Deep-breathing exercises
4
A child is brought to the ED after a concussion. The child is to be discharged. Included in the discharge instructions?
"Call your medical provider if he vomits more than five times."
"Wake him every 2 hours to check his movement and responses."
"Any watery fluid draining from his ears is normal."
"Expect his headache to get worse initially and then disappear."
5
A baby with cerebral palsy is limp, flaccid with uncontrolled, slow, worm-like, writhing, & twisting movements. Document
Athetoid
Mixed
Ataxic
Spastic
6
An 18 mo in the ED with mom for possible fracture, X-ray confirms a fracture. Type of fracture for possible child abuse?
Spiral fracture
Plastic deformity
Greenstick fracture
Buckle fracture
7
Educating the parents of a 7 y/o girl diagnosed with epilepsy. Which teaching technique would be most appropriate?
Giving the parents information in small amounts at a time
Discussing the surgical procedure for epilepsy
Assessing the parents' knowledge of the anticonvulsant medications
Demonstrating proper seizure safety procedures
8
The nurse is teaching students about myelinization in kids. Which statement indicates that the teaching was successful?
The process occurs in a head-to-toe fashion.
Myelinization is completed by 4 years of age.
The speed of nerve impulses slows as myelinization occurs.
Nerve impulses become less specific in focus with myelinization.
9
A child with increased ICP is being treated with hyperventilation. The nurse understands this treatment is based on?
Hyperexcitability of the nerves is reduced.
PaCO2 levels decrease, causing vasoconstriction.
Drainage of cerebrospinal fluid occurs.
Activity is controlled via a stimulator.
10
A instructor is discussioning spinal muscular atrophy (SMA). When describing type 2 SMA, which info is included in care?
Difficulty with swallowing
Genetic disease with autosomal recessive inheritance
Weakness most severe in shoulders and hips
Onset before 6 months of age
Slowly progressing condition
11
Conducting an examination of a child with suspected developmental dysplasia of the hip. Finding helps confirm diagnosis
A distinct "clunk" is heard with Barlow and Ortolani maneuvers.
The thigh and gluteal folds are symmetric.
Abduction occurs to 75 degrees & adduction to within 30 degrees
A high-pitched "click" is heard with hip flexion or extension.
12
Preparing a program for parents about injury prevention. Important contributing factors for cervical spine injury?
Incomplete myelinization
Immaturity of the central nervous system
Increased mobility of the spine
Exposure to teratogens while in utero
13
As a result of seizures, a CT scan showed that an 18m has intracranial arteriovenous malformation. Action to prevent?
Respiratory paralysis
Drug interactions
Developmental disabilities
Hemorrhagic stroke
14
The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. Document
Decorticate posturing
Nystagmus
Sunsetting
Doll's eye
15
What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure?
Cheyne-Stokes respirations
Bradycardia
Projectile vomiting
Fixed, dilated pupils
16
A 4-year-old boy has a febrile seizure during a well-child visit. What action would be a priority?
Using a tongue blade to pry open the child's jaw
Hyperextending the child's head while placing him on his side
Loosening the child's clothing to ensure a patent airway
Protecting the child from harm during the seizure
17
Children have larger heads & a higher center of gravity. When teaching parents, the nurse include an increased risk of?
Caput succedaneum
Posterior plagiocephaly
Head trauma
Febrile seizures
18
A child with Duchenne muscular dystrophy is on prednisone. Which statement indicates the need for more teaching?
"He might gain some weight with this drug."
"We need to watch carefully for possible infection."
"We should give this drug before he eats anything."
"The drug should not be stopped suddenly."
19
A 4 y/o boy has a history of seizures & has been started on a ketogenic diet. Which meal would be most appropriate?
Fried eggs, bacon, and iced tea
A grilled cheese sandwich, potato chips, and a milkshake
A hamburger on a bun, French fries, and milk
Spaghetti with meatballs, garlic bread, and a cola drink
20
Doctor has ordered rectal diazepam for a 2 y/o with status epilepticus. Which instruction is essential to teach parents?
Gradually reduce the dosage as seizures stop.
Monitor for an allergic reaction to the medication.
Watch for fever indicating infection.
Monitor their child's level of sedation.
21
The nurse is assessing an 11-year-old girl with scoliosis. What would the nurse expect to find?
Diminished motor function
Even curve at the waistline
Hyperactive reflexes
Complaints of severe back pain
Asymmetric shoulder elevation
Pronounced one-sided hump on bending over
22
Caring for a 2 y/o in a bilateral brace with tibia vara. Her parents are upset by her limited mobility. Best response?
Let's put our heads together on how to keep her busy.
If you don't do the therapy, she could develop severe bowing of her legs.
"It's important to use the brace or your daughter may need surgery."
You'll need to accept this since treatment may be for several years.
23
What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure?
Cheyne-Stokes respirations
Fixed, dilated pupils
Bradycardia
Projectile vomiting
24
Child with spastic cerebral palsy is ordered botulin toxin. The nurse prepares to administer this drug by which route?
Intramuscular injection
Subcutaneous injection
Intravenous infusion
Oral
25
What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele?
Positioning supine with a pillow under the buttocks
Applying a diaper to prevent fecal soiling of the sac
Wrapping the infant snugly in a blanket
Covering the sac with saline-soaked nonadhesive gauze
26
The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding?
Absence of hypotonia
Sluggish deep tendon reflexes
Lack of purposeful muscular control
Full range of motion in extremities
27
When describing a child's risk for a musculoskeletal injury, explain that bone growth occurs primarily in which area?
Epiphysis
Growth plate
Physis
Metaphysis
28
A nurse is presenting to expectant parents about neural tube defects & prevention. Which would be emphasized?
Folic acid supplementation
Smoking cessation
Increased calcium intake
Aerobic exercise
29
A 3-month-old with developmental dysplasia of the hip is being treated with a Pavlik harness. Correct Statements?
"We should change her diaper without taking her out of the harness."
"We need to send the harness to the dry cleaners to have it cleaned."
"We need to call the doctor if she is not able to actively kick her legs."
"We need to check the area behind her knees for redness and irritation."
"We need to adjust the straps so that they are snug but not too tight."
30
An infant with osteogenesis imperfecta & teaching how to reduce the risk of injury. Response that needs more teaching
"I must carefully lift the baby from under the armpits."
"We must avoid lifting the legs by the ankles to change diapers."
"I should not bend an arm or leg into an awkward position."
"I need to avoid pushing or pulling on an arm or leg."
31
Students are reviewing info on head injuries in kids. Identify the most common type of skull fracture in kids?
Linear
Diastatic
Basilar
Depressed
32
A 10-month-old is brought to the ED by her parents after they found her face down in the bathtub. Priority assessment?
Airway, breathing, and circulation
Level of consciousness
Vital signs
Pupillary response
33
The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator?
Lack of spontaneous movement
Inability to bear weight
Point tenderness
Bruising
34
A 14 y/o boy diagnosed with scoliosis is afraid it will impact his spot on the water polo team. Best response?
Lets talk to a boy with scoliosis, whos winning trophies for his swim team.
"If you wear your brace properly, you may not need surgery."
"Let's talk to the doctor about your treatment options."
"The good news is that you have very minimal curvature of your spine."
35
Teaching the parents of a child who has a shunt inserted as treatment for hydrocephalus. Teaching is effective when?
If he doesn't get an infection in the 1st week, the risk is reduced."
The shunt will help to prevent any further complications from his disease.
"Having the shunt put in decreases his risk for developmental problems."
"He will need more surgeries to replace the shunt as he grows."
36
Care plan for a 6 y/o with muscular dystrophy. He was injured when he fell out of bed. Intervention to prevent further
Recommend the bed's side rails be raised throughout the day and night.
Recommend raising the bed's side rails when a caregiver is not present.
Encourage a loose restraint to be used when he is in bed.
Suggest a caregiver be present continuously to prevent falls from bed.
37
A 10 y/o boy fell down the stairs & hit his head and is being monitored overnight. What warrants further assessment?
The child reports a backache.
The child is increasingly irritable with his mother and caregivers.
The child refuses offers of snacks.
The child reports his stomach is upset.
38
Reviewing info on seizures in babies. More review is needed when they identify which type as common in babies
Myoclonic
Focal clonic
Tonic
Multifocal clonic
39
Teaching about injury prevention. What should be included as an important contributing factor to cervical spine injury?
Immaturity of the central nervous system
Incomplete myelinization
Increased mobility of the spine
Exposure to teratogens while in utero
40
When assessing a child's level of consciousness, you note that the child falls asleep unless he is stimulated. Document?
Confusion
Stupor
Coma
Obtunded
41
Caring for a newborn born at 29 weeks, being alert for signs & symptoms of what condition?
Neonatal conjunctivitis
Incomplete myelinization
Intracranial hemorrhage
Facial deformities
42
Talking with parents of a child who had a febrile seizure. The nurse would integrate what information into the talk?
The child's risk for cognitive problems is greatly increased.
Febrile seizures are benign in nature.
The child's risk for epilepsy is now increased.
Structural damage occurs with febrile seizure.
43
A nurse is teaching students how to do CPR on a child. 2 students practice using an infant manikin. Proper technique
Compressing 30 times for every 2 breaths
Using two hands to perform chest compressions
Placing the heel of the hand on the midsternal
Giving 2 breaths followed by 15 compressions
44
Postop care for a 14 m/o girl who has had myelomeningocele repair. Moms anxious & afraid to care for her. Best response?
"There is a lot to learn, and you need a positive attitude."
"I will help you become comfortable in caring for your daughter."
"You will need to learn to collaborate with all the caregivers."
"You must learn how to care for your daughter at home."
45
Hydrocephalus is suspected in a 4-month-old infant. Which would the nurse expect to assess?
Diminished reflexes
Sunken fontanels
Skull symmetry
Lower extremity spasticity
