PROFESSIONAL SERVICES

CLINICAL DIVISION

PEDIATRIC ASSESSMENT TEST

  1. A baby was born 2 hours ago by Cesarean section. The newborn has a myelomeningocele with the sac intact and has been places in an incubator. The nurse, when planning care for the baby, should focus on potential for:

a)Disuse syndrome

b)Infection

c)Fluid volume deficit

d)Decreased cardiac output

  1. Appropriate nursing interventions for a newborn’s myelomeningocele sac prior to surgery include using sterile technique and:

a)Leaving the sac open to air

b)Applying petrolatum to cover the sac

c)Applying moist saline dressings

d)Applying dry dressings

  1. To maintain proper alignment of the hips and lower extremities in a baby with myelomeningocele, the nursing should position the baby with the:

a)Hips abducted and feet in a neutral position

b)Hips adducted and feet flexed

c)Hops subluxed and feet extended

d)Hips adducted and feet in a natural position

  1. Prior to surgery for a myelomeningocele, the nurse would place the baby in which of the following positions?

a)Prone

b)Right side

c)Left side

d)Dorsal

  1. A newborn baby is diagnosed with a myelomeningocele. The nurse measures his head circumference daily to assess for the development of what complication?

a)Hydrocele

b)Hordeolum

c)Hypsarrhythmia

d)Hydrocephalus

  1. A 4 –month old infant is admitted to the hospital with acute diarrhea and dehydration. Initial nursing assessment of the infant reveals:

a)Tenting of skin

b)Low hematocrit

c)Bulging fontanelle

d)Weight gain

  1. The nurse would place a 4-month old infant with diarrhea in which of the following types of isolation?

a)Reverse

b)Enteric

c)Strict

d)Wound and skin

  1. The nurse should assess a 4-month old infant who has diarrhea and dehydration for:

a)Metabolic acidosis

b)Metabolic alkalosis

c)Respiratory acidosis

d)Respiratory alkalosis

  1. The doctor has ordered that KCl be added to a 4-month old infant’s IV infusion. The nurse should:

a)Give the KCL as soon as ordered to prevent hypocalcaemia

b)Give the KCL within the 1st hour of admission

c)Wait to give the KCL until an adequate urinary output is documented

d)Wait to give the KCL until the complete blood count CBC results are available and within normal limits.

  1. As the nurse monitors the 4-month old’s progress, which symptom might indicate she is becoming over hydrated from IV fluids she is receiving?

a)Edema at IV site

b)Vomiting

c)Below normal temperature

d)Bubbling rales

  1. As part of the admission history, the nurse asked a mother about a 4-month old infant’s immunization record. Which of the following immunizations are recommended to be given at 4 months?

a)Measles

b)Tetanus

c)Mumps

d)Influenza Virus

  1. A 13-year old female client has asthma. The nurse teaches her ways to reduce possible asthma attacks and explains the need to avoid:

a)Mild exercise

b)Turtles as pets

c)Swimming

d)Extremes in temperature

  1. The nurse instructs a client that during an asthma attack she may feel more comfortable in which of the following positions?

a)High Fowler

b)Prone

c)Side-lying

d)Dorsal

  1. A client is hospitalized with status asthmaticus. The physician has ordered IV theophylline. Which of the following would be a side effect of the drug the nurse should observe for?

a)Seizures

b)Dysrythmias

c)Drowsiness

d)Headache

  1. As the nurse monitors the progress of a 14-year old client with asthma, she observes for early signs of impending airway obstruction. Which of the following symptoms would cause the nurse concern?

a)Decreased pulse

b)Flaring nares

c)Lethargy

d)Decreased respiratory rate

  1. Once a 14-year old client’s post-status-asthmaticus attack has stabilized, which of the following activities would the nurse choose as being the most appropriate for the client while in the hospital?

a)Working a jigsaw puzzle

b)Talking on the phone to friends

c)Watching television

d)Doing arts and crafts

  1. A 1-year old infant is admitted to the hospital with eczema. There is an order for “diet for age.” Which of the following should the nurse avoid in the infant’s diet?

a)Milk and wheat cereal

b)Carrots and beef

c)Apple juice and coke

d)Mashed potatoes and tea

  1. A 1-year old infant with eczema is placed in elbow restraints to keep him from scratching. To prevent problems with immobility, the nurse should:

a)Allow him out of restraints when supervised by the nurse or mother

b)Release restraints for meals and bath time

c)Release restraints one at a time every 4 hours

d)Allow him out of restraints when he is asleep at night and during naps

  1. The parents of the 1-year old infant with eczema are concerned about his appearance. He developed a secondary infection that makes him look grotesque. How can the nurse be most supportive of the parents’ feelings?

a)Divert the conversation to another topic so they will not focus on the infant’s appearance

b)Encourage them to discuss their fears and concerns

c)Tell them not to worry, that this condition will improve eventually

  1. The nurse is doing discharge teaching to the mother of the infant with eczema because the infant’s pruritus will continue after he goes home. In evaluating the mother’s understanding, the nurse would expect her to realize the importance of having the infant:

a)Take cornstarch batsh

b)Wear cotton shorts and short-sleeve shirts

c)Wear wool blend long-sleeve jumpsuits

d)Take salt baths 3 times a day

  1. A 2-year old child is admitted to the hospital with Hirchspring’s disease. During the nursing history, the mother describe the child’s stool as foul-smelling and:

a)Small, hard pebbles

b)Large and frothy

c)Cordlike

d)Ribbonlike

  1. The nurse explains to a toddler’s parents that the treatment of choice for Hirschspring’s disease (aganglionic colon) would be:

a)Surgical removal of affected colon

b)Modified diet high in fiber

c)Medication to stimulate the colon

d)Permanent Colostomy

  1. A 7-year old child is admitted to the hospital with nephritic syndrome. During the assessment, the nurse is aware that a classic symptom is:

a)Increased urine output

b)Hematuria

c)Elevated blood pressure

d)Proteinura

  1. During the edematous phase of nephritic syndrome, an important nursing intervention is to:

a)Provide meticulous skin care

b)Encourage fluid intake

c)Encourage moderate activity

d)Weigh the client every other day

  1. A 7-year old boy with nephritic syndrome is placed on steroid therapy. Which statement by his mother indicates to the nurse an understanding of steroid therapy?

a)“Steroids will improve his acne.”

b)“He will have permanent Cushing features.”

c)“Steroids will mask infections.”

d)“He may get diarrhea.”

  1. The physician has ordered prednisone for a child who has nephritic syndrome. The nurse should observe for all side effects, but the one that is most serious is:

a)Cushing features

b)Decreased respirations

c)Metabolic alkalosis

d)Adrenal suppression

  1. In evaluating the effectiveness of the prednisone therapy, the nurse realizes that a child with nephritic syndrome will continue to take the drug until after:

a)Edemas has disappeared

b)Urine no longer contains protein

c)Hematuria has resolved

d)His “moon” face has disappeared

  1. A 3-year old child is brought to the emergency room by her parents. She has a broken right leg. The mother tells the admitting nurse that the child had fallen off her tricycle. The father tells the physician that the child had fallen down the stairs. The parents are concerned about their child’s condition, and it is obvious she loves them. She is quiet and not talkative. She is the youngest of four children. During the initial assessment, what should clue the nurse to the possibility of child abuse?

a)The child’s not being talkative

b)Report of conflicting data

c)The child’s being the youngest child

d)Parents’ concern about her condition

  1. Which of the following data the nurse learns about a mother in conversation support the possibility of child abuse of her 3-year old daughter?

a)Has a healthy self-esteem

b)Has a history of a happy childhood

c)Viewed the child differently than the other children

d)Thought the child was developmentally advanced for her age

  1. In identifying realistic goals in working with the parents of a 3-year old abused child, the nurse should understand abusive parents have not mastered the task of:

a)Developing a trusting relationship

b)Role gratification

c)Functioning outside the home

d)Developing a value system

  1. In planning care for a 3-year old abused child, the nurse realizes that the parents are lacking in knowledge related to:

a)Appropriate play activities for the child

b)Normal growth and development

c)Nutritional needs for the child

d)Child psychology

  1. The nurse has a legal responsibility in child abuse cases to:

a)Collect additional data before taking further action

b)Directly report her suspicions to the local child protection agency

c)Discuss her suspicions with the parents

d)Notify the physician of her suspicions

  1. A 6-year old is hospitalized with a urinary tract infection (UTI). The nurse should teach the child that the best way to prevent recurrent UTI’s is to:

a)Void 3 times a day

b)Wipe from front to back

c)Drink plenty of milk

d)Wear nylon underwear

  1. A mother brings her 3-month old son to the emergency room. He is crying with apparent acute abdominal pain. After initial assessment, intussusceptions are suspected. What type of stool would the nurse expect the mother to report?

a)Black tarlike

b)Ribbonlike

c)Red currant-jellylike

d)Frothy and foul smelling

  1. A 1-month old infant is at the physician’s office for a follow-up visit after surgery for pyloric stenosis. The nurse would identify which of the following as the best indicator that the infant is recovering well from his surgery?

a)Mother reports infant is feeding well every 4 hours

b)The infant has demonstrated a satisfactory weight gain

c)The infant is in the 90th percentile in length on the growth chart

d)Mother reports infant has a normal stool pattern

  1. A 15-year old girl is 5 ft 7 in tall and weighs 98 lbs. She perceives herself as overweight. She has been hospitalized with anorexia nervosa. The nurse, when planning care, should focus on prevention of:

a)Vomiting

b)Weight loss

c)Malnutrition

d)Depression

  1. A physician diagnosis a teenager as having anorexia nervosa. The nurse would expect the parents of a patient with anorexia nervosa to describe her as being:

a)A conformer

b)Independent

c)Disruptive

d)A low achiever

  1. With a 15-year old patient’s severe weight loss and disrupted metabolism due to anorexia nervosa, the nurse would expect to observe which of the following symptoms?

a)Heat intolerance

b)Decreased temperature

c)Dysmenorrhea

d)Tachycardia

  1. A baby has died from sudden infant death syndrome (SIDS). SIDS is often initially mistaken for:

a)Failure to thrive

b)Viral infection

c)Meningitis

d)Child abuse

  1. When the parents have lost an infant to SIDS, the nurse would plan to insert teaching content about the parents’ reactions. The nurse would plan to include content related to:

a)Anger

b)Depression

c)Guilt

d)Hostility

  1. A 5-year old child is hospitalized with bilateral eye patches in place following surgery. Which of the following is the most important nursing intervention?

a)Speak to him when entering the room

b)Allow his parents to stay with him

c)Let him have familiar toys from home

d)Keep the side rails up

  1. The nurse is teaching a mother how to administer eye drops to her 5-year old son. The nurse tells her to place the drops:

a)Under the upper eyelid

b)On the sclera as the child looks to the side

c)In the conjunctival cul-de-sac

d)Anywhere that make contact with the eyes surface

  1. During a parenting class for toddlers, the nurse informs parents that the major cause of blindness in children older than 2 years old is:

a)Glaucoma

b)Trauma

c)Hyperopia

d)Infection

  1. The nurse in the newborn nursery is assessing an infant. The nurse observes an opacity of the lens of the eyes, which she knows is a symptom of:

a)Retinoblastoma

b)Cataracts

c)Glaucoma

d)Blindness

  1. During the initial assessment of child with Reye’s Syndrome, the mother reports that about a week ago the child had:

a)Mumps

b)Meningitis

c)Influenza

d)Cellulites

  1. The most important nursing intervention in caring for a child with Reye’s Syndrome is to:

a)Prevent skin breakdown

b)Monitor intake and output

c)Do range of motion exercises

d)Turn every 2 hours

  1. Because of liver involvement associated with Reye’s Syndrome, the nurse should use which special precaution when caring for children with this condition?

a)Administering IM injections

b)Monitoring output from the catheter

c)Assessing the level of consciousness

d)Turning the child

  1. A 1-year old infant is admitted to the hospital to rule out cystic fibrosis. During the admission process, the infant passes a stool. The nurse, realizing that his stool is symptomatic of cystic fibrosis, charts it as:

a)Small and constipated

b)Green and odorous

c)Large and bulky

d)Yellow and loose

  1. A 15-lb, 1-year old infant is admitted to rule out cystic fibrosis. He weighed 7 lb at birth. In analyzing data related to the infant’s weight, the nurse knows he should currently weigh how many pounds?

a)14

b)16

c)21

d)24

  1. The nurse would expect the physician to order which of the following tests to diagnose cystic fibrosis:

a)Sputum culture

b)Stool culture

c)Chest x-ray

d)Sweat test

  1. The priority nursing goal for a family whose son is diagnosed with cystic fibrosis. He is receiving pancreatic enzymes. Once the pancreatic enzymes the child is taking are effective, he will:

a)Stabilize his condition

b)Provide emotional support

c)Locate financial resources

d)Develop long-range plans

  1. A child is diagnosed with cystic fibrosis. He is receiving pancreatic enzymes. Once the pancreatic enzymes the child is taking are effective, he will:

a)Have normal bowel movements

b)Increase 2 lb in weight per week

c)Have decreased NaCl in his sweat

d)Have fewer respiratory infections per year

  1. A 6-year old girl is hospitalized with acute lymphocyte leukemia. She is placed on protective isolation, which concerns her parents. The nurse should explain that this will:

a)Protect her from too many visitors

b)Protect her from infectious organisms

c)Provide a quiet, private environment for her

d)Keep other children away from the child

  1. A child who has lymphocytic leukemia is upset about alopecia from her chemotherapy treatments. The nurse should explain to her that:

a)She can wear a wig

b)This is an unavoidable side effect

c)Her hair will grow back in a few months

d)She can stay home until she adjusts to her hair loss

  1. The nurse discusses mouth care with a 6-year old girl who has acute lymphocytic leukemia and her mother. The nurse explains that when toothbrushing is contraindicated, the most effective way to clean teeth is:

a)Rinsing with water

b)Chewing gum after eating

c)Rinsing with hydrogen peroxide

d)Use of a water pick

  1. A 12-year old girl is hospitalized with a diagnosis of rheumatic fever. To minimize her joint pain during acute episodes, the nurse should teach the parents to:

a)Immobilize the joints in a functional position

b)Do full range of motion on all joints

c)Massage joints briskly with lotion after her bath

  1. Discharge planning of a child with rheumatic fever should include teaching the child and parents to recognize which of the following toxic symptoms of sodium salicylate?

a)Blurred vision and itching

b)Chills and fever

c)Acetone breath odor

d)Tinnitus and nausea