PEDIATRIC HOMEWORK 2 (CHAPTERS 25-33) 1. The primary symptom in croup is: A. Dysphagia. B. cough. C. fever D. pain. 2.

A nurse is caring for a 7-year-old patient immediately following a tonsillectomy. The best position for this patient is: A. High Fowlers B. Partly on the back and partly on side C. Partly on the side and partly on the abdomen D. supine 3. Chronic respiratory distress manifests with which symptom(s)? Select all that apply. A. Productive cough B. Failure to thrive C. Irritability D. Pupil constriction E. Retractions 4. Cystic fibrosis is a _______________ system disease. A. Respiratory B. endocrine C. gastrointestinal D. multi 5. Put the three stages of inhalation injury in proper order. A. Pulmonary edema B. Bronchopneumonia C. Pulmonary insufficiency 6. Deoxygenated blood enters the systemic arterial circulation in which disorder? A. Patent ductus arteriosus B. Tetralogy of Fallot C. Coarctation of the aorta D. Atrial stenosis 7. The nurse is caring for a child receiving digoxin (Lanoxin) for the diagnosis of heart failure. Which manifestation is a cardinal sign of digoxin toxicity? A. Respiratory distress B. Extreme bradycardia C. Constipation D. Headache 8. A standardized diagnostic test for rheumatic fever is: A. sedimentation rate B. WBC count. C. antistreptolysin O titer D. rubella titer. 9. Which observation indicates that an infant with CHF is carefully following the prescribed medical regimen? A. The child takes antibiotics daily.

B. The child exhibits normal weight for age. C. The child has an elevated RBC. D. The childs pulse rate is under 50 beats/min. 10. Rheumatic fever is manifested by which symptom(s)? Select all that apply. A. Abdominal pain B. Migratory polyarthritis C. Peeling skin D. Chorea E. Vomiting 11. Tetralogy of Fallot is associated with which defect(s)? Select all that apply. A. Atrial septal defect B. Ventricular septal defect C. Dextroposition of the aorta D. Pulmonary artery stenosis E. Pulmonary artery stenosis F. Patent ductus arteriosus 12. The most common form of childhood cancer is: A. lymphoma. B. a brain tumor. C. leukemia. D. osteosarcoma. 13. The nurse is caring for a 5-year-old child with leukemia who was admitted to the hospital with the primary diagnosis of pneumonia. The nurse knows the most likely cause of this childs pneumonia is: A. eosinophilia. B. neutropenia. C. thrombocytopenia. D. anemia. 14. When educating parents in regard to care of their child following a lymphangiogram, the nurse should include that following this procedure: A. the child may be lethargic. B. slight hair loss may occur. C. diarrhea is common. D. the skin and urine may take on a bluish color. 15. The classic symptom of idiopathic (immunological) thrombocytopenia purpura (ITP) is: A. bruising. B. fever. C. nosebleed. D. irregular pulse. 16. The highest incidence of iron-deficiency anemia occurs between: A. birth and 4 weeks. B. 9 and 24 months. C. 3 and 5 years old. D. 12 and 16 years old 17. Which are included in the stages of dying as detailed by Kubler-Ross (1975)? Select all that apply.

A. Bargaining B. Denial C. Remorse D. Anger E. Acceptance F. Depression 18. An 8-year-old boy diagnosed with hemophilia presents at the emergency department with hemoarthrosis from a fall on the school playground. What is included in the traditional approach to care? Select all that apply. A. Warm compresses B. Compression C. Ice D. Continuous pulse oximetry E. Rest F. Elevation 19. A clinical manifestation that suggests pyloric stenosis is: A. regurgitation. B. projectile vomiting. C. bloody stool. D. steatorrhea 20. A child is admitted to the emergency department with suspected intussusception. A significant assessment that would support this diagnosis is: A. a gradual onset of pain. B. currant jelly stools. C. frothy, bulky stools. D. vague abdominal pain. 21. A newborn does not pass meconium within the first 48 hours after birth. The nurse knows this may indicate the newborn has: A. an abdominal wall defect. B. intussusception. C. Hirschsprungs disease. D. celiac disease. 22. A child is admitted to the hospital with dehydration, and the physician orders potassium to be added to the childs IV. The nurse is aware that an important assessment prior to the administration of potassium is: A. skin integrity. B. mucous membranes. C. bowel status. D. genitourinary status. 23. What may be included in the treatment of salicylate poisoning? Select all that apply. A. Vitamin K B. Mucomyst C. Peritoneal dialysis D. Chelating agents E. Syrup of ipecac 24. Which organism is the most common cause of urinary tract infections in children?

A. Escherichia coli B. Staphylococcus C. Klebsiella D. Pseudomonas 25. A diagnosis that often accompanies cryptorchidism is: A. Wilms tumor. B. pyloric stenosis. C. paraphimosis. D. inguinal hernia. 26. A16-year-old boy enters the emergency department reporting acute scrotal pain. He is diagnosed with testicular torsion. The nurse knows the treatment of this condition involves: A. application of cool compresses. B. immediate surgery. C. ultrasound-guided external manipulation. D. rest and elevation. 27. The bladder capacity of a 4-year-old child is approximately: A. 2 ounces. B. 4 ounces. C. 6 ounces. D. 8 ounces. 28. What is included in preventive teaching for urinary tract infections (UTIs) in girls? Select all that apply. A. Wearing nylon underwear B. Encouraging fluids C. Wiping front to back D. Avoiding use of bubble bath E. Encouraging use of talcum powder 29. A 1-year-old child has been treated for 2 weeks for an electrical burn of the mouth sustained from biting into an electrical cord. The childs mother calls the nurse reporting concern because her childs burn continues to bleed at times throughout the day. The nurse educates the childs mother: A. to take her child to the emergency department immediately. B. to medicate with acetaminophen every 4 hours. C. that electrical burns of the mouth may bleed for several weeks. D. to have the child rinse and spit with salt water. 30. A child is being treated for frostbite of the right hand. The nurse knows this condition is improving when the: A. hand appears pale and is pain free. B. hand is deep purple and the patient reports severe pain. C. radial pulse is palpable. D. hand blanches with pressure applied. 31. Tinea capitis is characterized by: A. lesions located between the toes. B. an oval, scaly inflamed ring with a clear center. C. a raised, scaly rash in the groin area. D. patches of alopecia.

32. Which intervention(s) can be used to prevent diaper dermatitis? Select all that apply. A. Expose diaper area to air and light. B. Use perfumed baby wipes for cleansing. C. Apply ointments with vitamins A and D and lanolin. D. Cleanse with deodorant soap and water. E. Apply corticosteroid ointment. 33. Which type(s) of skin graft is (are) considered permanent? Select all that apply. A. Homografts B. Autografts C. Isografts D. Xenografts E. Heterografts 34. Tay-Sachs disease involves a deficiency of: A. phenylketonuria. B. galactose. C. leucine. D. hexosaminidase. 35. The pediatric nurse is providing discharge instructions to parents whose infant is prescribed Synthroid for the medical diagnosis of hypothyroidism. Which statement made by the mother indicates a knowledge deficit? A. My childs medication is taken at the same time each day. B. I am looking forward to my child being able to stop this medication. C. It may take 1 to 3 weeks for the medication to reach the full therapeutic effect. D. Side effects include hair loss, insomnia, and aggressiveness. 36. Which is not a potential cause of diabetes insipidus? A. Head injury B. Heredity C. Brain tumor D. Viral syndrome 37. The initial signs of diabetes insipidus are: A. polyuria and dysphagia. B. diaphoresis and polydipsia. C. weight loss and lethargy. D. polydipsia and polyuria. 38. Hypothyroidism in an infant is manifested by which symptom(s)? Select all that apply. A. Noisy respiration B. Excess perspiration C. Enlarged tongue D. Diarrhea E. Lethargy 39. The pediatric nurse is admitting a child diagnosed with tuberculosis. This patients room will be prepared for: A. contact precautions. B. airborne infection isolation. C. droplet isolation.

D. enteric precautions. 40. An allergy to eggs should be reported before receiving a vaccine for: A. polio. B. hepatitis B. C. respiratory syncytial virus. D. varicella. 41. The most common opportunistic infection to first affect the pediatric patient diagnosed as HIV positive is: A. Kaposis sarcoma. B. meningitis. C. Pneumocystis jiroveci pneumonia. D. cytomegalovirus. 42. The nurse should ensure that __________________ is available in the unit where vaccines are administered. A. epinephrine B. amoxicillin C. Mucomyst D. Ativan 43. The resource that defines mental disorders and is used by health professionals to aid in diagnoses of specific mental health conditions is the: A. Physicians Desk Reference. B. American Journal of Psychiatry. C. Diagnostic and Statistical Manual of Mental Disorders. D. Manual of Psychiatric Disorders. 44. A child is being treated for mental illness at a modern child guidance clinic and is reading stories about other children in a similar situation. The nurse instructs the childs parent that this is known as: A. bibliotherapy. B. play therapy. C. behavior modification. D. milieu therapy. 45. A 16-year-old boy is being examined in the emergency department. While completing the initial assessment, the nurse notes constricted pupils bilaterally, decreased respirations, and needle marks. The patient states he regularly uses smack. The nurse knows that this is the street name for: A. LSD. B. cocaine. C. marijuana. D. heroin. 46. Children of alcoholics often display which coping pattern(s)? Select all that apply. A. Determination B. Flight C. Perfect child D. Procrastinator E. Fight F. Super coper

47. A female patient at an outpatient clinic tells the nurse that she is menopausal and would like to know the best diet she should follow. The nurse suggests and provides education in regard to a: A. high-carbohydrate, low-fat diet. B. low-fat, high-fiber and soy diet. C. low-fat, low-carbohydrate, high-protein diet. D. low-salt, high-fiber, low-protein diet. 48. A form of CAM therapy that can easily be mistaken for child abuse because of the lingering marks on the skin after treatment is: A. coin rubbing. B. reflexology. C. acupressure. D. Ayurveda. 49. The medication digitalis originates from: A. poppy flowers. B. cinchona trees. C. foxglove. D. chamomile. 50. Which commonly used herb in pediatrics is thought to reduce anxiety? A. Siete Jarabes B. Psyllium C. Licorice D. Kava Kava 51. Which essential oils are contraindicated during pregnancy? Select all that apply. A. Lavender B. Anise C. Wintergreen D. Jasmine E. Peppermint 52. A two month old infant is brought to the clinic for the first immunization against DPT. The nurse should administer the vaccine via what route? a) b) c) d) Oral. Intramascular Subcutaneous Intradermal

53. The nurse teaches the clients mother about the normal reaction that the infant might experience 12 to 24 hours after the DPT immunization, which of the following reactions would the nurse discuss? a) b) c) d) Lethargy. Mild fever. Diarrhea Nasal Congestion

54. A child age 7 was unable to receive the measles, mumps, and rubella (MMR) vaccine at the recommended scheduled time. When would the nurse expect to administer MMR vaccine? A. In a month from now B. In a year from now C. At age 10 D. At age 13 55. Which of the following would the nurse identify as the initial priority for a child with acute lymphocytic leukemia? A. Instituting infection control precautions B. Encouraging adequate intake of iron-rich foods C. Assisting with coping with chronic illness D. Administering medications via IM injections 56. Which of the following should the nurse expect to note as a frequent complication for a child with congenital heart disease? A. Susceptibility to respiratory infection B. Bleeding tendencies C. Frequent vomiting and diarrhea D. Seizure disorder 57. Which of the following would the nurse do first for a 3-year-old boy who arrives in the emergency room with a temperature of 105 degrees, inspiratory stridor, and restlessness, who is learning forward and drooling? A. Auscultate his lungs and place him in a mist tent. B. Have him lie down and rest after encouraging fluids. C. Examine his throat and perform a throat culture D. Notify the physician immediately and prepare for intubation. 58. Which of the following would the nurse need to keep in mind as a predisposing factor when formulating a teaching plan for child with a urinary tract infection? A. A shorter urethra in females B. Frequent emptying of the bladder C. Increased fluid intake D. Ingestion of acidic juices 59. At which of the following ages would the nurse expect to administer the varicella zoster vaccine to child? A. At birth B. 2 months C. 6 months D. 12 months 60. Which of the following nursing diagnoses would be inappropriate for the infant with gastroesophageal reflux (GER)? A. Fluid volume deficit B. Risk for aspiration C. Altered nutrition: less than body requirements D. Altered oral mucous membranes 61. Which of the following parameters would the nurse monitor to evaluate the effectiveness of thickened feedings for an infant with gastroesophageal reflux (GER)?

A. Vomiting B. Stools C. Uterine D. Weight 62. Discharge teaching for a child with celiac disease would include instructions about avoiding which of the following? A. Rice B. Milk C. Wheat D. Chicken 63. Which of the following would the nurse expect to assess in a child with celiac disease having a celiac crisis secondary to an upper respiratory infection? A. Respiratory distress B. Lethargy C. Watery diarrhea D. Weight gain 64. Which of the following should the nurse do first after noting that a child with Hirschsprung disease has a fever and watery explosive diarrhea? A. Notify the physician immediately B. Administer antidiarrheal medications C. Monitor child ever 30 minutes D. Nothing, this is characteristic of Hirschsprung disease 65. A newborns failure to pass meconium within the first 24 hours after birth may indicate which of the following? A. Hirschsprung disease B. Celiac disease C. Intussusception D. Abdominal wall defect 66. When assessing a child for possible intussusception, which of the following would be least likely to provide valuable information? A. Stool inspection B. Pain pattern C. Family history D. Abdominal palpation 67. The following observations are noted in a child under the acute phase of Kawasaki disease except: A. Fever B. Increase platelet count C. Conjunctivitis D. Increase WBC count 68. As the nurse is assessing a 3-year old child, the toddler appears good. However the childs mother told the nurse that her child usually appears ill at nighttime. The cough is barking and inspiratory stridor is noted. The nurse interprets this as:

A. Laryngotracheobronchitis B. Epiglotitis C. Pneumonia D. Bronchitis 69. The surgical management for atrial septal defect (ASD) and ventricular septal defect (VSD) is which of the following? A. Dacron or Silastic patch placement B. Ductal ligation C. Fontan procedure D. Brock Procedure 70. The fetal accessory that is located in between the two atria is called: A. Foramen ovale B. Ductus venosus C. Ductus arteriosus D. Pulmonary arteries 71. To manage the chorea in rheumatic fever which of the following is administered? A. Ampicillin B. Erythromycin C. Diazepam D. Mannitol 72. The child was admitted in the ER with the presenting symptoms of sitting in a leaning position, with the tongue protruding, drooling and muffled cough. The nurse should prepare what equipment at the bedside? A. A. Tongue depressor B. Intubation set C. Sterile gauze D. Clamp

73. A child is diagnosed with Kawasaki Disease. Which of the following manifestations is seen during the subacute phase of the disease? A. Fever B. Conjunctivitis C. Strawberry tongue D. Desquamation of palms and soles 74. Which of the following would be inappropriate when administering chemotherapy to a child? a. Monitoring the child for both general and specific adverse effects b. Observing the child for 10 minutes to note for signs of anaphylaxis c. Administering medication through a free-flowing intravenous line d. Assessing for signs of infusion infiltration and irritation 75. Which of the following organisms is responsible for the development of rheumatic fever? a. Streptococcal pneumonia b. Haemophilus influenza c. Group A -hemolytic streptococcus d. Staphylococcus aureus 76. Which of the following is most likely associated with a cerebrovascular accident (CVA) resulting from congenital heart disease? a. Polycythemia b. Cardiomyopathy c. Endocarditis d. Low blood pressure 77. How does the nurse appropriately administer mycostatin suspension in an infant? a. Have the infant drink water, and then administer mycostatin in a syringe b. Place mycostatin on the nipple of the feeding bottle and have the infant suck it c. Mix mycostatin with formula d. Swab mycostatin on the affected areas 78. Which of the following situations increase risk of lead poisoning in children? a. playing in the park with heavy traffic and with many vehicles passing by b. playing sand in the park c. playing plastic balls with other children d. playing with stuffed toys at home 79. A patient is using bronchodilators for asthma. The side effects of these drugs that you need to monitor this patient for include: a. tachycardia, nausea, vomiting, heart palpitations, inability to sleep, restlessness, and seizures. b. tachycardia, headache, dyspnea, temp . 101 F, and wheezing.

c. blurred vision, tachycardia, hypertension, headache, insomnia, and oliguria. d. restlessness, insomnia, blurred vision, hypertension, chest pain, and muscle weakness. 80. The nurse is drawing blood from the diabetic patient for a glycosolated hemoglobin test. She explains to the woman that the test is used to determine: a. the highest glucose level in the past week. b. her insulin level. c. glucose levels over the past several months. d. her usual fasting glucose level. 81. The patient with suspected rheumatic fever is admitted to the pediatric unit. When obtaining the childs history, the nurse considers which information to be most important? a. A fever that started 3 days ago b. Lack of interest in food c. A recent episode of pharyngitis d. Vomiting for 2 days 82. When performing a physical examination on an infant, the nurse in charge notes abnormally low-set ears. This findings is associated with: a. Otogenous tetanus b. Tracheoesophageal fistula c. Congenital heart defects d. Renal anomalies 83. The nurse is evaluating a female child with acute poststreptoccocal glomerulonephritis for signs of improvement. Which finding typically is the earliest sign of improvement? a. Increased urine output b. Increased appetite c. Increased energy level d. Decreased diarrhea 84. The doctor prescribes corticosteroids for a child with nephritic syndrome. What is the primary purpose of administering corticosteroids to this child? a. To increase blood pressure b. To reduce inflammation c. To decrease proteinuria d. To prevent infection 85. Parents bring their infant to the clinic, seeking treatment for vomiting and diarrhea that has lasted for 2 days. On assessment, the nurse in charge detects dry mucous membranes and lethargy. What other findings suggests a fluid volume deficit? a. A sunken fontanel b. Decreased pulse rate c. Increased blood pressure d. Low urine specific gravity

86. Maureen, age 12, is brought to the clinic for evaluation for a suspected eating disorder. To best assess the effects of role and relationship patterns on the childs nutritional intake, the nurse should ask: a. What activities do you engage in during the day? b. Do you have any allergies to foods? c. Do you like yourself physically? d. What kinds of food do you like to eat? 87. Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely? a. At 1 to 2 years of age b. At I week to 1 year of age, peaking at 2 to 4 months c. At 6 months to 1 year of age, peaking at 10 months d. At 6 to 8 weeks of age 88. When evaluating a severely depressed adolescent, the nurse knows that one indicator of a high risk for suicide is: a. Depression b. Excessive sleepiness c. A history of cocaine use d. A preoccupation with death 89. A child is diagnosed with Wilms tumor. During assessment, the nurse in charge expects to detect: a. Gross hematuria b. Dysuria c. Nausea and vomiting d. An abdominal mass 90. When caring for an 11-month-old infant with dehydration and metabolic acidosis, the nurse expects to see which of the following? a. A reduced white blood cell count b. A decreased platelet count c. Shallow respirations d. Tachypnea 91. After the nurse provides dietary restrictions to the parents of a child with celiac disease, which statement by the parents indicates effective teaching? a. Well follow these instructions until our childs symptoms disappear. b. Our child must maintain these dietary restrictions until adulthood. c. Our child must maintain these dietary restrictions lifelong. d. Well follow these instructions until our child has completely grown and developed.

92. An infant is hospitalized for treatment of nonorganic failure to thrive. Which nursing action is most appropriate for this infant? a. Encouraging the infant to hold a bottle b. Keeping the infant on bed rest to conserve energy c. Rotating caregivers to provide more stimulation d. Maintaining a consistent, structured environment 93. The mother of a 3-month-old infant calls the clinic and states that her child has a diaper rash. What should the nurse advise? a. Switch to cloth diapers until the rash is gone b. Use baby wipes with each diaper change. c. Leave the diaper off while the infant sleeps. d. Offer extra fluids to the infant until the rash improves. 94. The nurse is teaching the parents of a young child how to handle poisoning. If the child ingests poison, what should the parents do first? a. Administer ipecac syrup b. Call an ambulance immediately c. Call the poison control center d. Punish the child for being bad 95. A child has third-degree burns of the hands, face, and chest. Which nursing diagnosis takes priority? a. Ineffective airway clearance related to edema b. Disturbed body image related to physical appearance c. Impaired urinary elimination related to fluid loss d. Risk for infection related to epidermal disruption 96. . Failure of the Foramen Ovale to close will cause what Congenital Heart Disease? a. Total anomalous Pulmunary Artery b. Atrial Septal defect c. Transposition of great arteries d. Pulmunary Stenosis 97. When assessing a child with aspirin overdose, which of the following will be expected? a. Metabolic alkalosis b. Respiratory alkalosis c. Metabolic acidosis d. Respiratory acidosis 98. When assessing a family for potential child abuse risks, the nurse would observe for which of the following?

a. Periodic exposure to stress b. Low socio-economic status c. High level of self esteem d. Problematic pregnancies 99. Which of the following is an inappropriate intervention when caring for a child with HIV? a. Teaching family about disease transmission b. Offering large amount of fresh fruits and vegetables c. Encouraging child to perform at optimal level d. Teach proper hand washing technique 100. Situation: A 2 years old is rushed to the ER due to cyanosis precipitated by crying. Her mother observed that after playing she gets tired. She was diagnosed with Tetralogy of Fallot. The goal of nursing care for her is to: a. Prevent infection b. Promote normal growth and development c. Decrease hypoxic spells d. Hydrate adequately 101. The immediate nursing intervention for cyanosis for the above patient is: a. Call up the pediatrician b. Place her in knee chest position c. Administer oxygen inhalation d. Transfer her to the PICU 102. Which of the following respiratory condition is always considered a medical emergency? a. Laryngeotracheobronchitis (LTB) b. Epiglottitis c. Asthma d. Cystic Fibrosis 103. Which of the following statements by the family of a child with asthma indicates a need for additional teaching? a. We need to identify what things triggers his attacks b. He is to use bronchodilator inhaler before steroid inhaler c. Well make sure he avoids exercise to prevent asthma attacks d. he should increase his fluid intake regularly to thin secretions 104. A newborns failure to pass meconium within 24 hours after birth may indicate which of the following? a. Aganglionic Mega colon b. Celiac disease c. Intussusception d. Abdominal wall defect

105. While assessing a male neonate whose mother desires him to be circumcised, the nurse observes that the neonates urinary meatus appears to be located on the ventral surface of the penis. The physician is notified because the nurse would suspect which of the following? a. Phimosis b. Hydrocele c. Epispadias d. Hypospadias 106. For a child with recurring nephritic syndrome, which of the following areas of potential disturbances should be a prime consideration when planning ongoing nursing care? a. Muscle coordination b. Sexual maturation c. Intellectual development d. Body image