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PEDS EXAM I
PEDS EXAM I
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1
What should you assess for after a tonsillectomy?
bleeding
any airway obstructions
pain
2
During manual ventilation, squeezing to 20 PIP is vital to preventing a pneumothorax.
True
False
3
What levels of play are appropriate for a toddler?
observing other children
blocks, balls, push toys, books
parallel play
engaging in activities close by
4
Which of the following are nsg interventions for pt post-op from a cardiac catheterization?
apply pressure 2.5 cm above the catheter entry site
calm environment while conserving the child's energy
CV/O2 monitoring for dysrhythmias
lie the client completely flat
5
When is the Influenza type B vaccine given?
2 months, 4 months, 6 months, and 12-15 months
11-12 years old
11-18 years old
3 months, 6 months, and 15 months
6
What is this pain scale called and what age group is it used for?
FACES: preschool - 3 years old
FACES: adolescents
FACES: infant
NUMERIC: toddlers
7
Always view the parent as the expert of their child.
False
True
8
Toddlers develop a sense of personal control of physical skills & independence. Having success w these skills shows...
stage 4: initiative vs guilt
stage 2: autonomy vs shame and doubt
9
When are solids started?
1 year
4-6 months
8 months
10
Bronchitis is an upper airway infection that involves a cough and runny nose.
True
False
11
This is the FLACC pain scale and it is used for infants 2 months-7 months old.
True
False
12
Non-accidental trauma is the same as abuse.
True
False
13
Epiglottitis...
is usally caused by H. flu
avoid throat cultures, tongue blades, and oral temperatures
is life-threatening
if requires intubation, you only get 1 try
14
If a child cannot breathe, what affect does that have on eating?
they will not eat bc they are unable to use the suck/swallow/breathe tech
if they lose enough weight, the nurses call this "failure to thrive"
they will lose weight and may require an NG tube
15
What is the name of this pain scale and which age group is it used for?
NIPS: infants
NUMBERS: older children
FACES: infants
FLACC: 13 months
16
Stage 4 of Erikson's stages (industry vs inferiority)...
success leads to a sense of competence
is where children begin to have more academic demands
revolves around school-age children
failure leads to a sense of inferiority
17
What interventions can the nurse do before starting O2 therapy?
raise the HOB
chest percussion
encourage coughing
suction
18
Stage 3 is initiative vs guilt, meaning that preschoolers begin to assert control and a sense of purpose.
False
True
19
The rotavirus vaccine is given at 2 months of age, the 2nd dose at 4 months, and the 3rd dose at 6 months of age.
False
True
20
Stridor, rhonchi, wheezing, and crackles can be considered noisy upper respiratory sounds.
False
True
21
What is magical thinking?
something that happens to preschool-aged children
When children think that something in their mind will come true
22
Rattles, teething toys, mirrors, blocks, and playing patty cake are levels of play for what age group?
preschoolers
infants
toddlers
neonates
23
CROUP...
leads to a barking cough
is the same as BRUE
is inflammation of a part of the respiratory tract
can be treated with cool mist nebulizer, epinephrine, & corticosteroids
24
Associative play, being cooperative, playing ball, puzzles, role-playing, & magical thinking are levels of play for?
school-aged
adolescents
toddlers
preschoolers
25
Which of the following are S/S of epiglottitis?
croaking, drooling
cherry-red edematous epiglottis
restlessness
child assumes Tripod position to breathe
26
What are the risk factors for the LGBT+ pediatric population?
bullying
suicide and depression
discrimmination
victimization
27
What stressors does the hospitalized child encounter?
painful/invasive procedures
loss of privacy, autonomy
separation from parents/peers
fear of bodily injury
28
Pharyngitis is the same as...
epiglottitis
hay fever
nasopharyngitis
a sore throat
29
Nasopharyngitis is the same as...
hay fever
the flu
pertussis
the common cold
30
Which of the following are anatomical differences in a child?
larger tonsils/lymph nodes = nose breathing
decreased metabolic rate
the larynx is more flexible
shorter/more narrow upper airway
31
Should you rely on a cardiac monitor for HR?
no
yes
32
Can nurses initiate oxygen without an order?
no, the order will usually say "O2 to keep sats > 95%"
yes and they also pick what method of administration
33
A rapid, intense cough that leads to periods of apnea most closely resembles?
pharyngitis
pertussis
whooping cough
epiglottitis
34
The are 5 doses of the DTaP vaccine. When are they given?
2 months, 4 months, 6 months, 15-18 months, and 4-6 years old
1 month, 3 months, 6 months, 15-18 months, 3-5 years old
35
Which of the following are nursing interventions for a patient with CF?
monitor VS, O2 sat, respiratory effort
a diet high in protein and calories
monitor blood glucose and give insulin PRN
suctioning
36
The Hepatitis A vaccine is a 3 dose series given between 12-23 months of age.
False
True
37
Table foods that are cooked, chopped, and unseasoned are appropriate by...
1 year
18 months
30 months
9 months old
38
Laryngomalacia is a cartilage abnormality that causes airway obstruction, crowing noises, &stridor when child is supine.
True
False
39
A cyanotic shunting pattern results from blood being pushed from the left side of the heart into the right.
False
True
40
The first dose of the Hepatitis B vaccine is given at birth.
True
False
41
At what ages is the pneumococcal conjugate vaccine given?
2 months, 4 months, 6 months, and 12-15 months (4 doses)
1 month, 3 months, 4 months (3 doses)
42
How is perfusion assessed?
temperature bilaterally
capillary refill
color
HR
43
Which of the following are late signs of increased WOB?
retractions
bradypnea, bradycardia
delayed capillary refill
change in LOC
44
What are the S/S of forward HF?
tachypnea, dyspnea, stridor, retractions, crackles, sweating
hepatomegaly, splenomegaly, edema, ascites, JVD
45
What are the rules of applying pulse oximetry?
use the side of the foot for infants
use the big toe or thumb for toddlers
use the side of the foot for toddlers
use the fingers for older children
46
Which of the following are S/S of rheumatic fever?
chest pain
macular rash, tremors
bradycardia
enlarged heart, joint pain
47
When are vegetables and fruits started?
1 year
6-8 months
48
The primary cause of rheumatic fever is Group B strep.
False
True
49
How would you wean children from oxygen?
1 L: decrease to 0.5 L and monitor sat drops (should drop and then return)
1 L: turn oxygen off completely and monitor for sat drops
50
The escalation of O2 therapy starts with a NC, then a simple face mask, nonrebreather, and manual ventilation.
True
False
51
RDS is a deficiency in ___, leading to poor gas exchange, shallow respirations, grunting, and cyanosis.
vitamin D
oxygen
surfactant
iron
52
What are acyanotic congenital heart diseases?
valve stenosis & coarctation of aorta
patent ductus arteriosus
VSD and ASD
truncus arteriosus
53
Cystic Fibrosis...
would lead to the admin of pancreatic enzymes and fat-soluble vitamins
is an autosomal dominant disorder
requires lifelong CPT
is an imbalance of Na+ transport, leading to thick mucus that blocks organs
54
Which of the following symptoms occur from chronic hypoxia in an infant?
delayed growth
polycythemia
loss of appetite
clubbing, poor feeding, weight loss
55
What is PIP?
positive inspiratory pressure that should not exceed 20 mmHg
positive inspiratory pressure that shuould not exceed 30 mmHg
56
Acute otitis media is an ear infection that causes pain, fever, and chronic hearing loss.
False
True
57
Oxygen > 50% for prolonged periods of time (48 hrs) can lead to reduced work of the lungs. What is this known as?
blown by
oxygen toxicity
58
90% of bacterial endocarditis cases occur in patients with congenital heart defects.
False
True
59
When is the Varicella (VAR) vaccine given?
a second dose at 4-6 years old
10-12 months old
12-15 months old
a second dose at 7-8 years old
60
If your patient seems to be choking, is wheezing, and you hear a stridor, they are most likely experiencing?
pharyngitis
pertussis
asthma
foreign body aspiration
61
The numeric pain scale can be used for children from 5 years old until adulthood.
False
True
62
Which of the following are early signs of increased WOB?
change in LOC
increased RR and heart rate
decreased O2 sat
nasal flaring
63
What is the most reliable diagnosis of rheumatic fever?
serum antistreptolysin-O titer
ESR
CRP
GABHS culture
64
What medications are used to treat a rheumatic fever?
aspirin
erythromycin
penicillin
vancomycin
65
Suctioning is a nursing responsibility.
False
True
66
The pneumococcal polysaccharide vaccine is reserved for high-risk individuals between the ages of 2-18 years old.
True
False
67
The DTaP vaccine protects against...
hepatitis C
tetanus
diptheria
pertussis
68
Adolescents go thru Stage 5, identity vs role confusion, which is where they start to develop a sense of self &identity.
True
False
69
What is a tracheoesophageal fistula?
failure of the esophagus to develop as a continuous passage
a connection that can effect ventilation
an abnormal connection to the trachea
70
BP and temperature should be taken last because they are the most invasive.
True
False
71
Which of the following symptoms are associated with asthma?
wheezing/tachypnea
chronic cough at night
prolonged inspiratory phase
barrel chest
72
The MMR vaccine is given...
a second dose at 4-6 years old
a second dose at 2-3 years old
at 12-5 months
at 1-2 months
73
What percent of oxygen does a simple face mask deliver?
24-50%
100%
10-20%
74
What pathology gets regular CPT?
CF
epiglottitis
75
A child (0-18 months old) trusting their caregiver who is both reliable and affectionate involves which Erikson stage?
stage 2: autonomy vs shame and doubt
stage 1: trust vs mistrust
76
The most common cause of pharyngitis is Group B strep.
True
False
77
What vital signs work together clinically?
HR and RR
BP and RR
HR and O2
HR and BP
78
Suctioning an ET tube or tracheostomy is a clean procedure.
True
False
79
When are the second and third doses of the Hep B vaccine given?
1-2 months of age; 6-18 months of age
1-2 months of age; 4-6 months of age
80
The MMR vaccine protects against...
measles
rubella
meningitis
mumps
81
Which of the following are appropriate levels of play for school-aged children?
outdoor play, reading, puzzles
playing dress-up
hobbies, magic tricks, sports
arts and crafts
82
GABHS...
is group A strep
can reside in the tonsils and lead to a tonsillectomy
can cause secondary infections throughout the body if not tx completely
should be treated with a throat culture and antibiotics
83
Kawasaki disease...
can result in a coronary artery aneurysm
treated with immunoglobulins, aspirin, and steroids
is inflammation of the vascular system
a fever not respond to antipyretics, strawberry tongue, edema of hands/feet
84
The meningococcal B vaccine is reserved for high-risk individuals between the ages of 11-18 years old.
False
True
85
A cessation of breathing for > 20 seconds, leading to cyanosis, bradycardia, and hypotonia is?
apnea
BRUE
tracheoesophageal fistula
RDS
86
Should the nurse ever "fib" to a child or family to help with stress?
no
yes
87
A BRUE diagnosis...
is a brief unresolved unexplained event
does not happen very often anymore
is usually caused by reflux d/t overfeeding
leads to episodes of apnea with color change, hypotonia, and choking
88
Which of the following are S/S of allergic rhinitis?
sneezing, runny nose
fatigue, malaise
congestion, HA
eye swelling
89
Children can compensate for a while, but once they tire out, they crash very quickly.
True
False
90
The inactivated poliovirus vaccine is given...
2 months, 4 months, 6-18 months, and 4-6 years old
at 2 months, 4 months, 19 months, and 7 years old
91
The Tdap vaccine is given every 10 years for children > 7 years old.
True
False
92
What is another name for bronchopulmonary dysplasia?
chronic lung disease d/t prolonged oxygen therapy
epiglottitis
tonsillitis
tracheoesophageal fistula
93
We should always start with the highest level of oxygen to ensure we correct the underlying problem.
True
False
94
What is a TET spell?
cyanosis from crying/playing
a medical emergency
should result in putting the child in the knee-chest position
a complication of ventricular septal defect
95
Which of the following are noisy LOWER respiratory sounds?
wheezing
coarse crackles
stridor
rales
96
Iron-fortified cereal is started first over a 4-7 day period to observe for any signs of allergies or intolerance.
True
False
97
The meningococcal vaccine doses are given later in life. Specifically at 11-12 years old, and then at 16 years old.
True
False
98
Your patient becomes hypoxic while suctioning. What should you do?
stop suctioning, administer atropine, and continue suctioning
stop suctioning and hyperoxgenate
99
Status asthmaticus...
is a medical emergency
could require CPR and/or intubation
does not respond to therapy
is an asthma attack lasting > 5 minutes
100
Prophylactic antibiotics should be given before dental procedures in a patient with bacterial endocarditis.
False
True
