Exam Review
- Aspirin is a part of the treatment for children with Kawasaki disease.A)TrueB)False
- A child in compensated shock will which symptoms?A)Somnolence, hypotension, oliguriaB)Irritability, tachypnea, hypotensionC)Irritability, capillary refill time > 2 sec, bradycardiaD)Irritability, tachycardia, poor peripheral perfusion
- The primary problem in cystic fibrosis is the production of thin, watery mucus that helps clear airways.A)TrueB)False
- You are discussing prevention of infective endocarditis with parents of a child with a complex congenital heart defect. A critical teaching point to emphasize includes:A)Delay dental visits until the child’s heart defect is fully repairedB)High dose IV antibiotics for 2-8 weeksC)Administration of daily prophylactic antibioticsD)Administration of antibiotics one hour prior to all dental procedures
Exam Review
- Which congenital heart disease causes cyanosis when not repaired? (select all that apply)(SATA)A)Pulmonary atresiaB)Patent ductus arteriosus (PDA)C)Transposition of great arteriesD)Tetralogy of Fallot
- An 18-month-old is admitted to the emergency department in hypovolemic shock. What would be the correct order of nursing interventions (assuming MD orders are written)?A)Oxygen, IV fluid bolus of 20 ml/kg, medications to support cardiac functionB)IV at 2X maintenance, oxygen, medication to support cardiac functionC)Oxygen, IV fluid bolus of 10 ml/kg, medication to support cardiac function.D)Oxygen, medication to support cardiac function, IV fluid bolus of 20 ml/kg
- Children with a history of Respiratory syncytial virus (RSV) infection are at an increase risk of developing asthma later in life.A)TrueB)False
- Which intervention should be included in the plan of care for an infant with the nursing diagnosis Fluid Volume Excess related to congestive heart failure?A)Administer digoxin as ordered by the physicianB)Notify the physician when weight gain exceeds more than 20g/dayC)Weight the infant every day on the same scale at the same timeD)Put the infant in a car seat to minimize movement
Exam Review
- Which strategy is appropriate when feeding the infant with congestive heart failure?A)Always bottle feed every 4 hoursB)Feed larger volumes of concentrated formula less frequentlyC)Continue the feeding until a sufficient amount of formula is takenD)Limit feeding to no more than 30 minutes
- Which type of respiratory condition is always considered an emergency?A)LaryngitisB)LaryngotracheobronchitisC)EpiglottitisD)Spasmodic croup
- The nurse is teaching parents about administering digoxin. What instructions should the nurse tell the parents?A)If a dose is missed, give an extra doseB)Give the medication mixed with the child’s formulaC)If the child vomits, give another doseD)Give the medication at regular intervals
- Cystic fibrosis (CF) is suspected in a toddler. Which test is essential in establishing this diagnosis?A)Urine creatinineB)Sweat chloride testC)Serum calciumD)bronchoscopy
Exam Review
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Highlight the conditions requiring immediate follow-up in the “follow-up” category. Assessment: Weight:15.9 kg Height: 41 in Heart rate: 122 beats per minute Blood pressure: 96/44 Child is anxious, looks thin, and has dry lips and dry mucous membranes. Upon neck palpation the child has several enlarged cervical lymph nodes and has a “sweet odor to her breath, The remainder of the examination is within normal limits.A)Weight:15.9 kgB)Height: 41 inC)Blood pressure: 96/44D)anxiousE)looks thinF)has dry lips and dry mucous membranesG)Heart rate: 122 beats per minuteH)several enlarged cervical lymph nodesI)sweet odor to her breath
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. While assessing the child the nurse recognizes that ______, _____, and ____ are signs of _____, a possible diagnosis. The nurse anticipates the provider will order the following tests, _____ and _____ to help confirm or rule out the diagnosis
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Phase 2 The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones. The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild. Choose the most likely options for the information missing from the statements below by selecting from the lists of options provided. Bases on the available test results the nurse suspects the child may be experiencing _____, because of _____ and _____ in the urine. The nurse anticipates that the child will need _____ and _____ as soon as possible.
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Phase 2 The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones. The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild. Below are several responses the nurse can make to the child’s grandparents. Drag and drop the nurse’s responses to the child’s grandparents to either ‘therapeutic” or “nontherapeutic” based on how you would best categorize the responses.A)“There is no need to worry, this diagnosis is common in children.”B)“Yes, you could have attributed to this problem by not limiting the amount of sugar your grandchild eats.”C)“By administering IV insulin and IV fluids, we can help your grandchild feel better.”D)“It is important that you understand that this is not something you could have prevented.”E)“I understand all of this can be overwhelming, but we are here to support you through this new diagnosis”
Exam Review
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Phase 2 The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones. The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild. Which of the following responses by the nurse are appropriate? (Select all that apply)A)“It will be hard for you to continue taking dance and gymnastics now that you have been diagnosed with diabetes mellitus type 1”B)“You may have a hard time making friends who understand your diagnosis.”C)“You will always have diabetes mellitus type 1, but this does not mean that you cannot be a normal child.”D)“You will need to monitor your blood sugar and carbohydrate intake, but you can still participate in your favorite activities.”
- Phase 1 A 5 year old is brought to her pediatrician for an annual routine checkup. Her grandparents, who are also the legal guardians, are with her. The child has not seen her pediatrician in a year. The child recently had a visit to the urgent care center and was treated for strep throat. The grandparents are concerned about the child’s weight gain. They state no matter how much she eats she cannot gain weight and is hungry all of the time. Phase 2 The primary care office does not have a glucometer available, so the provider orders a urinalysis dip stick test. The urinalysis shows a glucose of over 500mg/dl with blood, leukocytes, and ketones. The results are shared with the grandparents along with the potential diagnosis and complications. The child’s grandparents are visibly upset and start asking the nurse questions about their grandchild. Place each nursing action for the infant’s care during hospitalization into one of the 3 categories: indicated (appropriate or necessary), contraindicated (could be harmful), or non-essential (makes no difference or not necessary)A)“As long as we monitor what our granddaughter eats, she should not need to use insulin”B)“We will need to help our grandchild monitor her blood sugar levels on a daily basis”C)“We will keep our medications in childproof containers and out of reach.”D)“We will help our grandchild plan out her daily meals and count carbohydratesE)“It is important that we understand the signs and symptoms of hypoglycemia and hyperglycemia.”
- A 5-year-old child with asthma is ordered albuterol. The nurse know that the primary action of albuterol is to:A)Relax bronchial smooth muscles to decrease bronchospasmB)Decrease mucus production in the bronchioles to improve aerationC)Decrease inflammation in the bronchioles to open up the airwayD)Slow the respiratory rate to improve oxygenation
- A 3-year-old child with a complex cardiac defect is admitted with infective endocarditis. Management (in what order) would..A)Obtain blood cultures, administer high dose antibiotics, assess for cardiac decompensationB)Obtain CBC, CXR and start child on high dose aspirinC)Watch for signs of cyanosis & administer high dose steroidsD)Start high dose antibiotics, obtain serial blood cultures, put the child on high flow oxygen
Exam Review
- What nursing action is appropriate to take when an infant with a congenital heart defect has increased respiratory rate, is sweating, and is not feeding well?A)Check the infant’s temperatureB)Alert the physicianC)Increase the oxygen rateD)Withhold oral feeding
- While caring for an 18 month old male with a diagnosis of kawasaki disease, which of the following would be an indication of deterioration?A)Cardiac arrhythmiaB)Strep throatC)HypotensionD)bradycardia
- Samatha, age 4, has a glucose level of 329mg/dl. She is eating the following for lunch: grilled chicken, juice(15g carb), mashed potatoes (30g carb), applesauce (15g carb). Her insulin order is as follows: Provide insulin coverage for meals at 1 unit novolog/1 carbohydrate exchange (15g carb=1 carb exchange) and, Provide insulin correction for blood glucose level based on scale: Up to 249mg/dl: no correction 250-299 mg/dl: 0.5 unit novolog 300-349 mg/dl: 1 unit novolog 350-399 mg/dl: 1.5 unit novolog How much total insulin should Samantha receive?A)5 units novologB)5.5 units novologC)4 units novologD)2.5 units novolog
- The nurse encourages the mother of a toddler with acute laryngotracheobronchitis (LTB) to stay at the bedside as much as possible. What is the nurse’s primary rationale for this action?A)The mother’s presence will reduce anxiety and ease the child’s respiratory efforts.B)Separation from the mother is a major developmental threat at this age.C)Mothers of hospitalized toddlers often experience guilt.D)The mother can provide constant observations of the child’s respiratory efforts.