1106 Unit 3 Test

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MarieRN
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181457
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1106 Unit 3 Test
Updated:
2012-11-03 18:57:02
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Pediatrics
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Chapters 24, 26-28
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  1. One of the most common causes of death in a child with muscular dystrophy is:
    a.     renal failure.
    b.     osteomyelitis.
    c.     cardiac failure.
    d.     liver disease.
    c
  2. Which type of traction would the nurse expect to be used for a 20-month-old child who has a fractured femur?
    a.      Buck extension
    b.      Bryant's
    c.      Russell's
    d.     Ninety-ninety
    b
  3. The nurse is aware that a fracture involving the epiphyseal plate in long bone can result in:
    a.      reduced red blood cell production.
    b.     excessive calcium storage.
    c.      impaired bone growth.
    d.     delayed bone healing.
    c
  4. When a child is referred to a physician after scoliosis screening, the plan is to defer treatment and watch the child. The nurse determines that the child's curvature must be less than:
    a.      10 degrees.
    b.      20 degrees.
    c.      30 degrees.
    d.     40 degrees.
    b
  5. Which is an expected assessment finding in a child with suspected scoliosis?
    a.      Prominent clavicle
    b.     Expiratory wheeze
    c.       Asymmetry of the shoulders
    d.     Delayed breast development
    c
  6. Which disease is usually inherited as an X-linked disorder?
    a.      Legg–Calvé–Perthes disease
    b.     Scoliosis
    c.      Juvenile idiopathic arthritis
    d.      Duchenne's muscular dystrophy
    d
  7. The nurse is reinforcing the physician's explanation of treatment for Legg–Calvé–Perthes disease. What information would the nurse review with parents?
    a.      Buck's extension traction
    b.     Muscle strengthening with weights
    c.      Surgery to stabilize the joint
    d.      Ambulation-abduction casts or braces
    d
  8. The nurse completed a neurovascular check on a child in Russell's traction for a fractured femur. Which finding should be reported to the charge nurse?
    a.      Foot is warm to the touch.
    b.     Can wiggle toes.
    c.       Toes feel tingly.
    d.     Capillary refill of toes < 3 seconds
    c
  9. The treatment of osteomyelitis includes the use of:
    a.      steroids.
    b.      antibiotics.
    c.      traction.
    d.     hydrotherapy.
    b
  10. The development of uveitis is an autoimmune compliaction of:
    a.      Legg–Calvé–Perthes disease
    b.     osteomyelitis.
    c.       juvenile rheumatoid arthritis.
    d.     torticollis.
    c
  11. An appropriate nursing action when caring for a child in Bryant's traction is to:
    a.      remove the weights when bathing.
    b.     support the weights when the bed is moved.
    c.      position the child so the buttocks touch the bed.
    d.      position the child's legs at right angles to the body.
    d
  12. Which is a priority nursing diagnosis for an adolescent treated for osteosarcoma?
    a.      Risk for infection
    b.     Post-trauma syndrome
    c.       Disturbed body image
    d.     Risk for trauma
    c
  13. A toddler has been walking independently for one month. Observation of a toddler's gait reveals the child's feet are wide apart and the gait is unsteady. How would the nurse interpret the finding?
    a.      The child appears to have genu varum.
    b.     Orthotic devices in the shoes will improve the gait.
    c.      A comprehensive neurological assessment is indicated.
    d.      This is a normal gait for a child in the toddler age group.
    d
  14. The mother of an infant born with congenital torticollis tells the nurse she is concerned that her child will always have limited neck motion. What is the best nursing response to the mother's concern?
    a.      "Your child will always need to wear a neck brace."
    b.     "Surgery is the treatment of choice to correct the problem."
    c.       "The condition will most likely resolve by 2-6 months."
    d.     "There is nothing you can do to improve the condition."
    c
  15. A child is being removed from the home of an abusive parent. The child is crying and a co-worker wonders if this could be a sign that the child was not abused. The nurse understands the child:
    a.      would not be crying if they had been abused in the home.
    b.      will mourn the loss of the family, even if there was abuse.
    c.      is seeking attention from any available adult.
    d.     doesn't really understand what is happening.
    b
  16. Which statement by a mother might indicate future problems related to the care of a newborn infant?
    a.      "I am happy that my mother will be here for a few weeks. I will have time to recuperate and adjust to my larger family."
    b.     "May I call you with questions? This is my first child and although I feel prepared, I am feeling frightened by the responsibility."
    c.       "The baby cries all the time. She doesn't seem to like me. I didn't think it would be like this. Sometimes I think she is just trying to irritate me."
    d.     "Our baby has colic. We are taking turns rocking her and getting up with her at night. When will we get a full night of sleep?"
    c
  17. What would be the priority nursing intervention when a nurse is caring for a child wearing an Ace bandage for a
    sprained ankle?
    a.      Ensure the ankle is elevated on a pillow.
    b.      Perform a neurovascular assessment.
    c.      Apply a fresh ice pack to the sprained ankle.
    d.     Determine when the child received analgesia.
    b
  18. What is the most common congenital heart defect occurring in children?
    a.       Ventricular septal defect
    b.     Coarctation of the aorta
    c.      Atrial septal defect
    d.     Patent ductus arteriosus
    a
  19. What is the best method of feeding an infant in congestive heart failure from a large ventricular septal defect?
    a.      Space feedings at least every 3-4 hours.
    b.     Give frequent, large feedings.
    c.      Feed intravenously.
    d.      Feed smaller amounts more frequently.
    d
  20. Digoxin (Lanoxin) is withheld if the pulse of the newborn is below             bpm.
    a.      120
    b.     110
    c.       100
    d.     90
    c
  21. When an infant is receiving digoxin (Lanoxin), the nurse would be alert to which finding as a sign of toxicity?
    a.      Fluid retention
    b.     Diarrhea
    c.       Nausea and vomiting
    d.     Weight loss
    c
  22. A nurse's responsibility when a child is receiving diuretics is to:
    a.      withhold fluids.
    b.      monitor serum electrolyte levels.
    c.      place on seizure precautions.
    d.     check the dosage with another nurse before administering.
    b
  23. Hypertension is identified in a 10-year-old child during routine screening. The nurse should expect which plan of care to be implemented initially?
    a.      The child is started on a diuretic.
    b.     Beta-adrenergic blockers are prescribed.
    c.       An exercise and diet program is developed.
    d.     A blood pressure measurement is scheduled in 4 weeks.
    c
  24. An infant with tetralogy of Fallot becomes hypercyanotic. The nurse would place the infant in the                             position.
    a.      high Fowler's
    b.     Trendelenburg
    c.      side-lying
    d.      knee-chest
    d
  25. An infant with a congenital heart abnormality would most likely experience:
    a.       difficulty feeding.
    b.     difficulty sleeping.
    c.      normal weight gain.
    d.     decreased blood pressure.
    a
  26. A congenital heart defect that results in decreased pulmonary blood flow is:
    a.      atrial septal defect.
    b.     aortic stenosis.
    c.       tetralogy of Fallot.
    d.     patent ductus arteriosus.
    c
  27. The nurse measuring an infant's blood pressure finds it is higher in the arms than the legs. The finding is associated with which congenital heart defect?
    a.      Ventricular septal defect
    b.      Coarctation of the aorta
    c.      Hypoplastic left heart syndrome
    d.     Tetralogy of Fallot
    b
  28. By what age do children realize that death is final and permanent?
    a.      3 years
    b.     4 years
    c.      7 years
    d.      10 years
    d
  29. Iron absorption is increase by taking it with:
    a.       orange juice.
    b.     cereal.
    c.      milk.
    d.     eggs.
    a
  30. It is recommended that iron-fortified formula be given to infants through age:
    a.      3 months.
    b.     6 months.
    c.      9 months.
    d.      12 months.
    d
  31. Which of the following presents the greatest risk to the child with hemophilia?
    a.      Hematuria
    b.     Hemarthrosis
    c.       Intracranial bleeding
    d.     Iron deficiency anemia
    c
  32. Signs and symptoms that might indicate that a child has idiopathic thrombocytopenic purpura include:
    a.      headaches and hematuria.
    b.     anemia and purpura.
    c.       petechiae and purpura.
    d.     hematuria and petechiae.
    c
  33. The diagnostic test that confirms a diagnosis of leukemia is a(n):
    a.      lumbar puncture.
    b.      bone marrow aspiration.
    c.      complete blood count.
    d.     x-ray of the bones.
    b
  34. When caring for a child on steroid therapy, it is important to seek immediate medical attention if the child:
    a.      vomits.
    b.      develops a fever.
    c.      skips a meal.
    d.     gains weight.
    b
  35. Children with Hodgkin's disease usually present with a(n):
    a.      unexpected sudden weight loss.
    b.      painless cervical neck lump.
    c.      enlarged abdomen.
    d.     high fever.
    b
  36. Children with hemophilia should avoid:
    a.      swimming.
    b.      salicylates.
    c.      citrus fruits.
    d.     analgesics.
    b
  37. Children with sickle cell trait:
    a.      have a 10% chance of developing the disease.
    b.     have a 25% chance of developing the disease.
    c.      have a 50% chance of developing the disease.
    d.      will not develop the disease.
    d
  38. An appropriate nursing intervention for the child admitted to the hospital in sickle cell crisis would be to:
    a.      apply ice to painful areas.
    b.     encourage the child to ambulate.
    c.      provide foods high in iron at meals.
    d.      monitor the child's response to analgesics.
    d
  39. Immediate nursing care of a child with hemophilia who has hemarthrosis includes:
    a.      application of heat.
    b.     active and passive range-of-motion exercises.
    c.       immobilization of the area of pain.
    d.     withholding factor VIII.
    c
  40. The greatest concern of a nurse caring for a child with ITP is:
    a.       injuries that might initiate bleeding.
    b.     a reaction to platelets.
    c.      Non-compliance with aspirin therapy.
    d.     development of a secondary bacterial infection.
    a
  41. Anxiety can be decreased in both the family and the child who has cancer by:
    a.      not telling the child that he or she has cancer.
    b.      explaining all the procedures before they are done.
    c.      placing the child with an older child who has the same diagnosis.
    d.     discouraging the child and parents from discussing the issue of death.
    b
  42. A common childhood disease that can have devastating effects on an immunosuppressed child is:
    a.      measles.
    b.      chickenpox.
    c.      rubella.
    d.     nasopharyngitis.
    b
  43. Nursing care of an adolescent with cancer who is refusing to cooperate with treatment should include:
    a.      asking the parents to make the adolescent cooperate.
    b.      allowing the adolescent to make some choices.
    c.      withholding favorite foods until the behavior changes.
    d.     restricting visitors until the behavior is modified.
    b
  44. What would be the initial nursing action when a child receiving a transfusion of packed red blood cells complains of chills and back pain?
    a.      Reduce the infusion rate.
    b.     Take the child's blood pressure.
    c.      Administer Benadryl as ordered.
    d.      Discontinue the transfusion.
    d
  45. Which diagnostic test permits visualization of the upper GI tract?
    a.      Colonoscopy
    b.     Sigmoidoscopy
    c.       Endoscopy
    d.     Proctoscopy
    c
  46. Children with failure to thrive below the              percentile in weight and height on growth charts.
    a.       3rd
    b.     6th
    c.      10th
    d.     15th
    a
  47. Which approach might best support maternal attachment when caring for a child with failure to thrive?
    a.      Point out areas where the mother needs improvement.
    b.     Send the mother to a parenting class.
    c.       Encourage the mother to participate in the child's
    care.
    d.     Leave the room when the mother visits.
    c
  48. Which signs and symptoms are characteristic of pinworms?
    a.      Diarrhea, itching, and fever
    b.     Nausea, vomiting, and itching.
    c.      Nausea, vomiting, and weight loss
    d.      Itching, irritability, and restlessness
    d
  49. Children with intussusception may have bowel movements containing blood and mucus and no feces. These are called:
    a.       currant jelly stools.
    b.     mucoid stools.
    c.      steatorrhea.
    d.     occult blood stools.
    a
  50. A newborn's total body weight is about                                  water.
    a.       77%
    b.     65%
    c.      55%
    d.     45%
    a
  51. Which action should the nurse take before adding potassium to a child's IV?
    a.      Take a baseline blood pressure.
    b.     Determine if the child can tolerate oral fluids.
    c.       Establish that the child is voiding.
    d.     Place the child on a cardiac monitor.
    c
  52. The greatest threat to life in isotonic dehydration is:
    a.      hypervolemic shock.
    b.      hypovolemic shock.
    c.      respiratory acidosis.
    d.     respiratory alkalosis.
    b
  53. The nurse taking a history from parents of an infant with pyloric stenosis would expect them to report the infant experienced which sign?
    a.      Constipation
    b.      Projectile vomiting
    c.      Diarrhea
    d.     Anorexia
    b
  54. When a child has pinworms, the nurse should know that:
    a.      it is a sign of poor hygiene.
    b.     the child will be hospitalized.
    c.       any family member with symptoms should be treated.
    d.     a warm stool specimen is sent to the lab.
    c
  55. Which information would the nurse give to parents of an infant with gastroesophageal reflux disease?
    a.      Feed the infant half-strength formula.
    b.     Position in an infant seat after feeding.
    c.      Increase the time between feedings.
    d.      Place prone with the head elevated after feeding.
    d
  56. The nurse doing a newborn assessment knows the earliest sign of Hirschsprung's disease is:
    a.       failure to pass meconium.
    b.     large, bulky, and frothy stools.
    c.      acute, sudden diarrhea.
    d.     ribbon-like stools.
    a
  57. The organ damaged by acetaminophen poisoning is the:
    a.      gallbladder.
    b.     pancreas.
    c.       liver.
    d.     stomach.
    c
  58. The nurse would explain to parents that infants are more susceptible to accidental ingestion of foreign bodies because they are:
    a.      often left unattended.
    b.      likely to put everything in their mouths.
    c.      constantly hungry.
    d.     seeking parental attention.
    b
  59. The nurse was giving a newborn her first feeding when the baby started coughing and choking. This is indicative of which condition?
    a.      Celiac disease
    b.     Enterocolitis
    c.       Tracheoesophageal atresia
    d.     Pyloric stenosis
    c
  60. A child appears apathetic and weak. His grow this below normal for his age. There is a white streak in the child's hair. The nurse recognizes these signs as characteristic of:
    a.      rickets.
    b.     scurvy.
    c.      gastroesophageal reflux.
    d.      kwashiorkor.
    d
  61. A child's arterial blood gas results are: pH 7.30, PaCO2 36, HCO3 21. The nurse determines the child is experiencing which acid-base imbalance?
    a.      Respiratory acidosis
    b.     Respiratory alkalosis
    c.       Metabolic acidosis
    d.     Metabolic alkalosis
    c

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