Pediatric 2

7/25/2019 Pediatric 2

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27. While assessing a male neonate whose mother desires him to be circumcised,

the nurseobserves that the neonate’s urinary meatus appears to be located on the

ventral surface of the penis. The physician is notied because the nurse suspects

which of the following?a. himosisb. !ydrocelec. "pispadiasd. !ypospadias2#.

Which of the following would the nurse e$pect to assess in a child with

%own’ssyndrome?a. &arge noseb. 'mall tonguec. (bli)ue palpebral ssuresd. &owarched palate2*. Which of the following statements by a + year old girl who wears

a brace for structuralscoliosis indicates e-ective use of the brace?a. / wonder if /

can ta0e the brace o- when / go to the homecoming dance.1b. /’ll loo0 forward to

ta0ing this o- to ta0e my bath everyday.1c. /’m sure am glad that / only have to

wear this awful thing at night.1d. /’m really glad that / can ta0e this thing o-

whenever / get tired.13. When assessing a newborn for developmental dysplasia of

the hip, the nurse woulde$pect to assess which of the following?a. 'ymmetrical

gluteal foldsb. Trendelenburg signc. (rtolani’s signd. 4haracteristic limp+. Which of

the following is the priority nursing action for a child immediately following

theapplication of a spica cast?a. erform neuromuscular chec0sb. "levate the castc.

4over the perineal aread. 5eep the cast clean and dry2. Which of the following

types of immunity does an infant receive when given a %Tin6ection?a. atural,

activeb. atural, passivec. 8rticial, actived. 8rticial, passive

'usan, is a newborn with %own’s syndrome. !er parent’s have been told of

thediagnosis and are in the process of trying to ad6ust to this.

. Which of the following is most appropriate to include when counseling the

parents of 'usan?a. 'usan’s development potential is greatest during infancyb.

'usan will be severely retardedc. 'usan will be spastic, so poisoning should be

discussedd. 'usan will be as susceptible to colds as her brother 9 increased

susceptibility. Which of the following is an incorrect statement regarding %own’s

syndrome?a. /t is associated with higher incidence of congenital heart diseaseb. /t is

associated with higher incidence of :/ defects 9 duodenal atresia or stenosisc. /t is

associated with higher incidence of leu0emiad. /t is inherited as an autosomal

recessive trait;. Which of the following measures is of primary importance for

parents with a young,mentally retarded child at home?a. &imit the amount of

environmental stimulation the child is e$posed tob. !ave the same parent teach the

child new s0ills at all timesc. Teach the child socially acceptable behaviors so she

can 6oin the family outingsd. <aintains consistent routine for daily activities

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<agdalena is at > wee0s gestation and has been diagnosed as positive for

thehuman immunodeciency virus. 'he has had a healthy pregnancy to date but

hasmany )uestions about how her health problems will a-ect her newborn.



>. <agdalena as0s the nurse if she can breastfeed her baby. Which of the

followingstatements is the basis for the nurse’s response?a. ecause <agdalena

probably won’t live to raise this child, breastfeeding will providecloseness and

bonding between mother and child.b. ecause the baby is li0ely to be positive for

the !/@, breastfeeding will provide immunityfor other infectionsc. ecause

<agdalena doesn’t have symptoms of 8/%', she can breastfeedd. ecause !/@ maybe transmitted through her breastmil0, breastfeeding isn’trecommended for

<agdalena7. <agdalena has delivered a baby girl at * wee0s gestation. 8t

hours of age, thenewborn has shallow respirations at ; bpm with periods of apnea

lasting ; to 7 seconds. The nurse’s priority action would be toAa. 4ontinue routine

monitoringb. otify the doctor immediatelyc. Be)uest an order to administer

o$ygend. repare e)uipment for a respiratory arrest#. <agdalena’s newborn is

6aundiced because of an 8( blood group incompatibility and isreceiving

phototherapy. Which of the following nursing interventions is most appropriate

forher newborn?a. Beposition the infant every hoursb. &imit the infant’s oral inta0e

to + oC every hoursc. Bemove the eye patches every 2 hours to assess for

con6unctivitisd. Turn the phototherapy unit o- when drawing blood for bilirubin

levels*. efore discharging <agdalena’s newborn on the 2

nd

day of life, the nurse completes herdischarge e$amination. Which of the following

ndings would the nurse report to the doctor?a. 8. blac0, dry umbilical cordb. 8 dar0

greenishDblac0 stoolc. etechiae covering the chest and abdomend. luish purple

discoloration in the lumbosacral area

4arlo, age #, comes in to the physician’s clinic with a sore throat, enlarged

lymphnodes, elevated temperature and malaise. !e has history offre)uentstreptococcal throat infection.

3. 4arlo has bacterial pharyngitis and is put on a regimen of oral penicillin, which

of thefollowing instructions of 4arlo’s parents is most important at this time?a. !ave

him gargle with hot saline solution as neededb. :ive 4arlo the medicine for +3 days

or until it is consumedc. Eeed him soft diet until he feels betterd. "nsure he gets a

lot of @it 4 foods+. 4arlo returns in 2 months for a tonsillectomy. reparations for

hospitaliCation includeboo0s for him to read. !is mother is advised to select a boo0

with which of the followingcharacteristics?a. 'mall, paperbac0b. &argeDsiCe printc.

Begular siCe printd. &arge, with sti-ened pages2. 8fter surgery, what assessment

data may indicate that 4arlo is hemorrhaging?a. Tachycardia, hypertension,

hemoptysisb. radycardia, hypotension, increase swallowingc. Tachycardia,

hypotension, increase swallowingd. Tachycardia, hypotension, decreased

swallowing. 4arlo’s nurse prepares the family for his discharge. Which of the

following instructionsshould be emphasiCed?a. Beturn to school in +D2 wee0sb. o

vigorous activities for D wee0sc. 'aline gargles as necessary for controld. %elayed

hemorrhage may occur on the third postDop day



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+3DyearDold Tanya is admitted to the hospital with a medical diagnosis of rheumatic

fever. 'he relates a history of sore throat about a month ago. 'he isplaced on a bed

rest with B’s.

. Which of the following nursing assessment would be given the highest priority

whenassessing Tanya?a. !er response of being hospitaliCedb. The presence of a

macular rash on her trun0c. !er sleeping or resting apical pulsed. The presence of

polyarthritis and pain in her 6oints;. Tanya e$hibits manifestation of 'ydanham’s

chorea. Which of the following is (T amanifestation of this condition?a. /ntellectual

impairmentb. <uscle wea0nessc. urposeless tremorsd. "motional lability>. Which

of the following nursing plans should receive the highest priority during

Tanya’shospitaliCation?a. <inimiCe cardiac damage by 0eeping Tanya on bed restb.

Believe pain by administering prescribed analgesicc. !elp Tanya cope withhospitaliCation by providing ageDappropriate activitiesd. revent in6ury by padding

the bed side rails7. Which activity is most appropriate for Tanya during the acute

phase of her illness?a. laying bas0etballb. @isiting other children in the unitc.

5eeping a written diaryd. &istening to the records of her favorite groups#. Three of

the following lab results are crucial indicators of Tanya’s progress. Which onedoes

not?a. 8ntistreptolysin (1 titerb. 4Dreactive proteinc. rotein in the urined.

"rythrocyte sedimentation rate*. Tanya is discharged after wee0s of

hospitaliCation. Which of the following statementsbest indicates that Tanya’s

parents have understood the discharge teaching?a. Tanya should lead a sedentary

lifestyle for at least a year.1b. Tanya must ta0e daily antibiotics for an e$tended

period of time to prevent recurrence of rheumatic fever.1c. Tanya should not returnto her fthDgrade classroom but should have a home teacher therest of the year.1d.

Tanya may have permanent neurologic se)uela as a result of the 'ydenham’s

chorea.1

+DyearDold orat has hemophilia. !e is seen at the clinic for a periodic chec0Dup.

;3. When obtaining a history from orat, which of the following reported

manifestationswould be the greatest cause for concern?a. "pista$isb. allorc. "asy

bruisingd. !emarthrosis;+. !is father tells the nurse that orat loves football somuch. !e wants to try out for his 6unior high football team. !is parents are having a

hard time telling him that it is impossible.Which of the following alternatives is the

best suggestion for orat?a. 8llow him to try out for the team as long as he wears a

helmet and elbow and 0nee padsall the timeb. 'tart a collection of football

memorabiliac. %evelop an interest in swimming or table tennis insteadd. Try to

become e)uipment manager for his 6unior high team



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;2. orat is admitted to the hospital with an acute bleeding episode in his right

elbow, whichcannot be controlled at home. Which of the following will not be use to

control bleeding?a. lasmab. lasma concentratec. ac0ed c

;2. orat is admitted to the hospital with an acute bleeding episode in his right

elbow, whichcannot be controlled at home. Which of the following will not be use to

control bleeding?a. lasmab. lasma concentratec. ac0ed cellsd. 4ryoprecipitate;.

orat is recovering and will be discharged tomorrow. !is father e$presses concern

abouthis failure as a family man. The nurse ascertains that orat’s father is an$ious

to 0now if orat can have children who do not have hemophilia. 8ssuming that

orat’s future spouse isnot a carrier, which e$planation is most accurate?a. 8ll his

children will be carriersb. !is son will have the disease and his children daughters

will be carriersc. There is a ;3F chance that each of his children will have

hemophiliad. !is sons will be normal and his daughters will be carriers;. Which ofthe following is the best indicator of a successful outcome of orat’s longD

termtreatment?a. leeding episodes are prevented or treated early to minimiCe

se)uelaeb. orat is able to cope with his peers academicallyc. orat’s weight is

maintained within age appropriate rangesd. orat chooses a realistic career goal



*DmonthDold Torio has been admitted in the pediatric unit with vomiting,

colic0yabdominal pain, and abdominal distention. 8 tentative diagnosis of

intussuceptionis made.

;;. When assessing Torio, which type of stool indicates a worsening of Torio’s

condition?a. Eatty, bul0y, foulDsmellingb. %ar0, red, 6ellyDli0ec. BibbonDli0e dar0greend. 4lay colored;>. Torio is not li0ely to e$hibit which of the following

behaviors?a. &oud crying when his parents leave himb. Eear of strangersc.

'earching for hidden ob6ectsd. 'aying at least words besides dada1 and

mama1;7. Torio is scheduled for surgery. !is parents are an$ious and as0 what will

be done insurgery. Which e$planations should be given?a. The sigmoid colon will be

resected with pullDthrough anastomosisb. The obstruction will be corrected by

manual reductionc. The a-ected portion of the intestines will be resected with

permanent colostomy createdd. The ileum will be resected and a permanent

ileostomy created;#. Torio’s parents as0 what is wrong with his intestines. Which of

the following statementsbest describe Torio’s condition?a. 8 telescoping of one part

of the bowel into a more distal partb. <alrotation of the intestinesc. 8tresia of theintestinal tractd. 8bsence of parasympathetic ganglion cells;*. reoperatively, the

priorityDnursing goal for Torio is toAa. <aintain Torio’s attachment to his parentsb.

<eet Torio’s need for suc0ing and comfort while he is (c. <aintain ade)uate

hydrationd. romote ade)uate rest and sleep>3. Eollowing surgery, Torio returns to

the unit. !e is fussy and seems to be in discomfort. The nurse palpates his abdomen

and notes some distention. Which action should beimplemented rst?a. 4all the

surgeon to report this observationb. /nsert a rectal tubec. 'it Torio upright and pat

his bac0d. 4hec0 the :T for patency

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>+. What is the potential greatest threat to Torio’s continued development while he

ishospitaliCed?a. %eveloping mistrust towards the nursing sta- b. 'eparation from

his parentsc. Bestricted mobilityd. %isruption in his sleeping and eating routines

8ngel, years old, is brought to the clinic with a high fever. 'he has beenirritable

for several days and is clinging to 2 dolls and her mother says sherefuses to eat.

While performing an initial assessment, the nurse ma0es severalobservations that

may indicate that 8ngel is a victim of child abuse.

>2. 4hildren are most fre)uently abused byAa. abysitterb. Belativec. Teacherd.

4asual ac)uaintances>. The child least li0ely at ris0 for being abused is one whose

familyAa. <oves fre)uentlyb. (wns their own homec. !as e$perience divorced. !as

problems with chronic illness>. Which test is least li0ely to indicate that 8ngel has

been se$ually abused?a. 8 ap smearb. Grine culturec. Throat cultured. @aginal

culture>;. When interviewing a child suspected of being se$ually abused, the nurse

shouldAa. 8s0 leading )uestionsb. !ave the parents consentc. !ave a security guard



presentd. Gse the child’s words to describe body parts>>. 4hildren who survive

physical abuse are least li0ely to becomeAa. %epressedb. %rug abusersc. 8busive

parentsd. 8cademic achievers>7. laying with her dolls while in the e$amination

room, 8ngel was seen engaging ine$plicit se$ual behavior. The nurse should 0now

thatAa. 8ngel is mimic0ing behavior seen on T@b. 8ngel is acting out a personal

e$periencec. 'uch play is a healthy e$pression of se$ual developmentd. 8ngelneeds to be directed to a more appropriate play>#. When abuse is suspected, the

least appropriate nursing action is toAa. Ta0e a waitDandDsee positionb. 4all a local

social service agency for helpc. revent the child’s return to a dangerous

environmentd. 4onfront the parent with security present>*. The nurse is planning

nursing interventions for parents who abuse their children. /t isimportant for the

recall that these parentsAa. lans ahead as to when and how to abuse their

childrenb. 8s0 for help generally only after feeling overwhelmed with the problemc.

Gsually feel no guilt concerning the abused. 8re always a product of child abuse

environment73. When planning a client education program for sic0le cell disease,

the nurse shouldinclude which of the following topics?a. roper handwashing and

infection avoidanceb. 8 highDiron, highDprotein diet

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c. Eluid restriction to + liter per dayd. 8erobic e$ercises to increase o$ygenation7+.

Which of the following is the most common form of childhood cancer?a.

&ymphomab. rain tumorsc. &eu0emiad. (steosarcoma72. The nurse would prepare

the parents of a child with suspected leu0emia for which of thefollowing tests that

would conrm this diagnosis?a. <aternal drug useb. one marrow aspirationc.

4omplete blood countd. lood culture7. The nurse is caring for a neonate witherythroblastosis fetalis. The nurse 0nows that thisdisease results fromAa. <aternal

drug useb. rematurityc. %estruction of red blood cellsd. :estational diabetes7. Bh

incompatibility results whenAa. The neonate’s blood group is BhDpositive and the

mother’s is BhDpositiveb. The neonate’s blood group is BhDnegative and the

mother’s is BhDnegativec. The neonate’s blood group is BhDpositive and the

mother’s is BhDpositived. The neonate’s blood group is BhDnegative and the

mother’s is BhDnegative7;. When administering an antipyretic to a child, the nurse

0nows that aspirin iscontraindicated for children with viral infections because of the

possibility of developingwhich of the followingAa. Beye’s syndromeb. BeHu$

syndromec. Baynaud’s diseased. Beiter’s syndrome7>. Which of the following testsis most helpful in diagnosing hemophilia?a. leeding timeb. artial

prothromboplastin timec. latelet countd. 4omplete blood count77. The nurse

e$plains to the mother of a neonate diagnosed with erthroblastosis fetalis thatthe

e$change transfusion is necessary to prevent damage primarily to which of the

followingorgans in the neonate?a. 5idneysb. rainc. &ungsd. &iver7#. 8 parent as0s

the nurse about head lice infestation during a visit to the clinic. Which of the

following symptoms would the nurse tell the parent is most common in a child



infectedwith head lice?a. /tching of the scalpb. 'caling of the scalpc. 'erous

weeping on the scalp surfaced. inpoint hemorrhagic spots on the scalp surface7*.

/n a child with asthma, Dadrenergic agonist agents, such as albuterol, are

administeredprimarily to do which of the following?a. %ecrease postnasal dripb.

%ilate bronchioles

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c. Beduce airway inHammationd. Beduce secondary infections#3. Which of the

following statements by the family of a child with asthma indicates a needfor

additional home care teaching?a. We need to identify what things trigger these

attac0s.1b. !e is to use his bronchodilator inhaler

Pediatric 2

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