NUR 3145 Peds Exam 3 Notes Questions & Answers
Chapter 25
1. What test is used to screen for carbohydrate malabsorption?
- Stool pH
2. A
... [Show More] toddler’s mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurse’s response should be based on which premise?
- The location needs to be confirmed by radiographic examination.
3. The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs?
- The object may be lodged in the esophagus.
4. What is a high-fiber food that the nurse should recommend for a child with chronic constipation?
- Popcorn
5. A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include?
- Bowel cleansing
6. What statement best describes Hirschsprung disease?
- The colon has an aganglionic segment
7. What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction?
- Marking the point of measurement with a pen
8. A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child?
- It is essential because it will be an adjustment
9. A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube?
- Prevent abdominal distention.
10. A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent?
- Thicken feedings and enlarge the nipple hole.
11. After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time?
- Notify the practitioner.
12. An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent?
- Stress management may be helpful.
13. What clinical manifestation should be the most suggestive of acute appendicitis?
- Colicky, cramping, abdominal pain around the umbilicus
14. When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?
- Sudden relief from pain
15. The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation?
- Allow the child to assume a position of comfort.
16. What statement is most descriptive of Meckel diverticulum?
- Intestinal bleeding may be mild or profuse.
17. One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation?
- Rectal bleeding
18. Nutritional management of the child with Crohn disease includes a diet that has which component?
- Increased protein
19. What information should the nurse include when teaching an adolescent with Crohn disease (CD)?
- How to cope with stress and adjust to chronic illness
20. A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication?
- Metabolic alkalosis
21. What term describes invagination of one segment of bowel within another?
- Intussusception
22. A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest?
- Popcorn
23. An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason?
- Stimulate adaptation of the small intestine
24. Melena, the passage of black, tarry stools, suggests bleeding from which source?
- The upper gastrointestinal (GI) tract
25. A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock?
- Restlessness
26. What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis?
- Anorexia and malaise
27. What immunization is recommended for all newborns?
- Hepatitis B vaccine
28. The nurse is discussing home care with a mother whose 6-year-old child has hepatitis A. What information should the nurse include?
- Teach infection control measures to family members.
29. What therapeutic intervention provides the best chance of survival for a child with cirrhosis?
- Liver transplantation
30. The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula?
- Excessive frothy saliva
31. The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include?
- Raise the patients head and give nothing by mouth.
32. The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include?
- Leave the tube open to gravity drainage.
33. What should preoperative care of a newborn with an anorectal malformation include?
- Gastrointestinal decompression
34. A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family?
- Changes in stooling patterns to report to the practitioner
35. The parents of a newborn with an umbilical hernia ask about treatment options. The nurse’s response should be based on which knowledge?
- The defect usually resolves spontaneously by 3 to 5 years of age.
36. The nurse is preparing to care for a newborn with an omphalocele. The nurse should understand that care of the infant should include what intervention?
- Covering the intact bowel with a nonadherent dressing to prevent injury
37. What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia?
- Liver transplantation may be needed eventually.
38. A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect?
- Hirschsprung disease
39. A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include?
- Assessing bowel function
40. An infant is born with a gastroschisis. Care preoperatively should include which priority intervention?
- Covering the defect with a sterile bowel bag
41. What is the purpose in using cimetidine (Tagamet) for gastroesophageal reflux?
- The medication reduces gastric acid secretion.
42. A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs?
- The infant is taking the Pedialyte without vomiting or distention.
43. The nurse is assisting a child with celiac disease to select foods from a menu. What foods should the nurse suggest?
- Corn on the cob with butter
44. An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for?
- Central venous catheter infection, electrolyte losses, and hyperglycemia
45. A child is being admitted to the hospital with acute gastroenteritis. The health care provider prescribes an antiemetic. What antiemetic does the nurse anticipate being prescribed?
- Ondansetron (Zofran)
46. The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time?
- 30 minutes before breakfast
47. An infant had a gastrostomy tube placed for feedings after a Nissen fundoplication and bolus feedings are initiated. Between feedings while the tube is clamped, the infant becomes irritable, and there is evidence of cramping. What action should the nurse implement?
- Vent the gastrostomy tube.
48. What intervention is contraindicated in a suspected case of appendicitis?
- Enemas
49. The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe?
- Currant jellylike
50. The nurse is evaluating the laboratory results of a stool sample. What is a normal finding?
- The laboratory reports a negative guaiac.
Chapter 27
1. What term is defined as the volume of blood ejected by the heart in 1 minute?
- Cardiac output
2. A chest radiography examination is ordered for a child with suspected cardiac problems. The child’s parent asks the nurse, what will the x-ray show about the heart? The nurse’s response should be based on knowledge that the radiograph provides which information?
- Supplies information on heart size and pulmonary blood flow patterns
3. A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching?
- Preoperative teaching should be adapted to his level of development so that he can understand.
4. After returning from cardiac catheterization, the nurse monitors the child’s vital signs. The heart rate should be counted for how many seconds.
- 60
5. After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond?
- Notify the practitioner of the observation.
6. The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially?
- Apply direct pressure above the catheterization site.
7. What statement best identifies the cause of heart failure (HF)?
- Consequence of an underlying cardiac defect
8. The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time?
- Report data to the practitioner.
9. What drug is an angiotensin-converting enzyme (ACE) inhibitor?
- Captopril (Capoten)
10. A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate?
- 90 beats/min
11. What clinical manifestation is a common sign of digoxin toxicity?
- vomiting
12. The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse’s response should be based on which knowledge?
- Parents need to learn specific, important guidelines for administration of digoxin.
13. What nutritional component should be altered in the infant with heart failure (HF)?
- increases in calories
14. Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infant’s status, which finding is indicative of achieving this goal?
- Appropriate weight gain for age
15. The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk?
- Prevent dehydration.
16. A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action?
- Place the child in the kneechest position.
17. A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition?
- Heart failure
18. What blood flow pattern occurs in a ventricular septal defect?
- Increased pulmonary blood flow
19. The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication?
- Pulmonary vascular congestion
20. What cardiovascular defect results in obstruction to blood flow?
- Aortic stenosis
21. What structural defects constitute tetralogy of Fallot?
- Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy
22. The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern?
- The child needs opportunities to play with peers.
23. What preparation should the nurse consider when educating a school-age child and the family for heart surgery?
- Let the child hear the sounds of a cardiac monitor, including alarms.
24. Seventy-two hours after cardiac surgery, a young child has a temperature of
38.4 C (101.1 F). What action should the nurse perform?
- Report findings to the practitioner.
25. What nursing consideration is important when suctioning a young child who has had heart surgery?
- Administer supplemental oxygen before and after suctioning.
26. The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurses initial intervention?
- Notify the practitioner of these findings.
27. A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother?
- Immediately bring the child to the clinic for evaluation.
28. What primary nursing intervention should be implemented to prevent bacterial endocarditis?
- Counsel parents of high-risk children.
29. What sign/symptom is a major clinical manifestation of rheumatic fever (RF)?
- Polyarthritis
30. What action by the school nurse is important in the prevention of rheumatic fever (RF)?
- Refer children with sore throats for throat cultures.
31. When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care?
- Therapeutic management includes administration of gamma globulin and salicylates.
32. Nursing care of the child with Kawasaki disease is challenging because of which occurrence?
- The child’s irritability
33. The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a child’s BP?
- Measure BP with the child in the sitting position on three separate occasions.
34. What type of drug reduces hypertension by interfering with the production of angiotensin II?
- Angiotensin-converting enzyme (ACE) inhibitors
35. Selective cholesterol screening is recommended for children older than the age of 2 years with which risk factor?
- Body mass index (BMI) = 95th percentile
36. What condition is the leading cause of death after heart transplantation?
- Rejection
37. The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching?
- I should change the bandage every day for the next 2 days.
38. A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which?
- Serum potassium
39. An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented?
- polycythemia
40. What child has a cyanotic congenital heart defect?
- A 2-month-old infant with tetralogy of Fallot
41. The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents?
- Give the medication at regular intervals.
42. Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what?
- Wheezing
43. The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication?
- Pulmonary hypertension
44. A 1-year-old has been admitted for complete repair of a tetralogy of Fallot. What assessment finding should the nurse expect to be documented?
- Increasing cyanosis
45. A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is done that shows left-to- right shunting. This assessment data is characteristic of what?
- Ventricular septal defect
46. An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse?
- Prostaglandin E1 will be given continuously until corrective surgery is performed.
47. What medication used to treat heart failure (HF) is a diuretic?
- Hydrochlorothiazide (Diuril)
48. The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose and draws up 4 ml of the drug. The most appropriate nursing action is which?
- Do not give the dose; suspect a dosage error.
49. A 12-year-old child with Down syndrome is admitted to the hospital for surgical correction of a heart defect. The boys mental age is that of a 3-year-old child. The nurse should prepare the child and family for surgery by what method?
- Provide teaching to the parents, keeping the information to the child simple.
50. Bacterial infective endocarditis (IE) should be treated with which protocol?
- IV antibiotics (penicillin type) for 2 to 8 weeks
51. A child is recovering from Kawasaki disease (KD). The child should be monitored for which?
- Electrocardiograph (ECG) changes
52. The test that provides the most reliable evidence of recent streptococcal infection is which?
- Antstreptolysin O test [Show Less]