Pediatric Questions III

61. A newborn is found to have exstrophy of the bladder. The nurse should evaluate the infant for:

a. Hypospadias c. Cryptorchidism

b. Epispadias d. Acute tubular necrosis

62. A child has been admitted to the hospital with a diagnosis or “rule out nephrosis.” The nurse would assess the child for:

a. Hematuria c. Petechial rash

b. Edema d. Dehydration

63. The nurse is caring for a toddler who is not toilet-trained. The doctor has ordered intake and output measurement. The nurse will most accurately measure the urine by:

a. Estimating output as small, moderate, or large and recording on the child’s chart.

b. Weighing each wet diaper and recording the amount of urine output as the weight of the diaper.

c. Subtract the weight of a dry diaper from a wet diaper and record this amount.

d. Determine urine output by the number of diaper changes in each 24-hour period.

64. The nurse is teaching the parents of preschooler information about urinary tract infection and means of reducing their recurrence. Which statement by the parents indicated the need for additional teaching?

a. “I should try to get her to drink a lot of water and juices.”

b. “I will buy her underwear a little large.”

c. “Soaking in a bubble bath will reduce meatal irritation.”

d. “If I notice her starting to wet the bed again, I need to have her checked for another urinary tract infection.”

65. The nurse would include which of the following in the care of a child with acute glomerulonephritis?

a. Careful handling of edematous extremities

b. Observing the child for evidence of hypotension

c. Providing fun activities for the child on bed rest

d. Feeding the child a protein-restricted diet

66. A urinalysis is ordered for a child with a throat culture positive for group-A beta-hemolytic streptococcus (strep throat). The mother asks why this test is being ordered. The nurse Explains:

a. The urinalysis will indicate whether an HIV infection is also present.

b. Urinary tract infections are common with streptococcal infections and need to receive prompt treatment.

c. Pyelonephritis is a potential complication of antibiotic therapy.

d. Group-A beta-hemolytic streptococcus infections can be followed by the complication of acute glomerulonephritis.

67. An appropriate nursing diagnosis for a toddler with unrepaired exstrophy of the bladder would be:

a. Disorganized infant behavior

b. Sexual dysfunction

c. Urinary retention

d. Risk for infection

68. A child has been admitted to the unit with acute glomerulonephritis. The test that would confirm this diagnosis is:

a. Antistreptolysis-O (ASO) titer

b. Urinalysis

c. Blood cultures

d. White blood cell (WBC) count

69. The doctor orders a clean-catch urine specimen on an infant who is not toilet-trained. The best means of collecting this urine would be to:

a. Perform a straight catheterization

b. Apply a urine collection bag

c. Use diaper analysis

d. Perform Foley catheterization

70. A teenage child is being treated for renal failure. The nurse would ensure that the child follows a:

a. High-sodium diet c. Low-sodium diet

b. High-protein diet d. Low-fiber diet

71. A mother tells the nurse that her child has been diagnosed with hypertrophy of the thyroid gland. The mother states the doctor called it something else and asks the nurse what the other name for this is. The nurse’s reply should be:

a. Glandular enlargement c. Lymphadenopathy

b. Goiter d. Thyrotoxicosis

72. An infant was born 24 hours ago. The nurse has been instructed to collect blood by heel stick for neonatal screening for congenital hypothyroidism before the baby is discharged. The nurse discusses options with the pediatrician knowing that 24 to 48 hours after birth is not the optimal time to collect this specimen because:

a. At 24 hours, the T4 level will be extremely low

b. There is an immediate rise in the TSH after birth

c. The baby needs to digest formula before a blood sample can be taken

d. A thyroid scan should be done first

73. The nurse is administering propylthiouracil to a 12-year old female recently diagnosed with Graves’ disease. The child has been receiving the drug 3 times a day for 3 weeks. She suddenly complains of severe soar throat. What would be the appropriate nursing action?

a. Continue to give the medication or she will continue to exhibit signs of Grave’s disease

b. Offer lozenges for the relief of the sore throat

c. Hold that dose and report the complaint to the physician since a sore throat is a common side effect

d. Assume that she is complaining in order to avoid going to the school room in the hospital

74. A 10-year old diabetic client told the nurse that he had some early signs of hypoglycemia while attending school. What would be the best action for the child to take?

a. Take an extra shot of regular insulin

b. Drink a glass of orange juice

c. Skip the next dose of insulin

d. Start exercising

75. The nurse is teaching an adolescent client about the different types of insulin. The client takes NPH insulin at 8:00 A.M. The nurse would instruct the client that he could possibly expect an insulin reaction at what time of the day?

a. While working out at 9:00 A.M.

b. While taking a test at 10:00 A.M.

c. While eating lunch at noon

d. While golfing after school at 3:00 P.M.

76. A teenage mother arrives at the clinic with her new baby who has recently been diagnosed with congenital hypothyroidism. When instructing the mother about administering levothyroxine medication, the nurse would include the information that she should:

a. Crush the medication and place in a full bottle of formula or juice to disguise the taste

b. Administer the medication every third day

c. Give the crushed medication in a syringe or in the nipple mixed with a small amount of formula

d. Understand that the medication will not be needed after age 5

77. A new mother of an infant diagnosed with phenylketonuria (PKU) meets with the nurse who informs her that PKU follows autosomal recessive inheritance. The mother states that is a relief since she now knows her next baby will not have the disease. What additional information does the mother need?

a. With autosomal recessive inheritance, each baby has a 25 percent chance of having the disease

b. Only female babies will have PKU

c. The mother passes the gene only to male offspring

d. Since she already has one baby with the disease, the next one will probably be a carrier for the disease

78. A 4-month old infant has been diagnosed with PKU. The child has eczema and sensitivity to the sunlight. The mother asks the nurse why her child’s skin is so sensitive. An appropriate explanation by the nurse would be:

a. “Some children just have sensitive skin.”

b. “Your child will outgrow his sensitivity when he is 5 years old. Just use sunscreen for now.”

c. “Your child has a deficiency in melanin because of decreased tyrosine. You will always have to take special care of his skin.”

d. “The phenylketones in your baby’s blood concentrate the sun’s rays, making burning more likely. Children with PKU can never be in the sun.

79. The nurse was working with a group of parents of children with phenylketonuria. The nurse has completed family teaching on the dietary restrictions. The parents are given sample menus to choose a meal for their child. Which menu choice indicates understanding of the dietary instructions?

a. A hamburger and a diet soda sweetened with aspartame

b. Steak and mashed potatoes with orange juice

c. A large bowl of cereal with strawberries and apple juice

d. Milkshakes and grilled cheese sandwich

80. Mothers in the waiting room of the endocrine clinic are discussing their children’s illnesses. The mothers of children with phenylketonuria and congenital hypothyroidism recognize there is a common goal in the early treatment of their children. That goal is the avoidance of:

a. Mental retardation c. Obesity

b. Fever d. Protein foods

81. A 6-year-old child has a cast applied for a fractured radius. The nurse completes an orthopedic assessment on this child. Which of the following symptoms requires immediate attention and should be reported to the physician?

a. Capillary refill of 4 seconds in the affected hand

b. Edema in the affected fingers that improves with elevation

c. Child describing feeling of the affected hand being asleep

d. Skin surrounding the cast is warm

82. Which of the following nursing care measures takes highest priority in caring for a child in skeletal traction?

a. Assessing bowel sounds every shift

b. Assessing temperature every 4 hours

c. Providing adequate nutrition

d. Providing age-appropriate activities

83. A nurse performs a triage in a pediatric orthopedic clinic. Which of the following should the nurse recognize as a symptom of slipped capitol femoral epiphysis?

a. Pain in the hip of a preadolescent child

b. Acute onset of knee pain

c. Presence of a limp in a school aged child

d. Painful external rotation of the affected leg

84. Which of the following statements made by the parent of a child being discharged with osteomyelitis requires further teaching by the nurse?

a. “I can stop the antibiotics when I see that my child is feeling better.”

b. “We will make sure that our child has plenty of calcium and protein.”

c. “I will look at the intravenous site for signs of infection a couple of times a day.”

d. “My child won’t take physical education at school until allowed by the doctor.”

85. A 5-month-old infant is being assessed for develop0mental dysplasia of the hip. The nurse will look for a positive:

a. Ortolani sign c. Allis sign

b. Barlow sign d. Trendelenburg sign

86. A newborn is being admitted to the newborn nursery. The nurse would assess the infant for congenital defects. In addition to the abnormal position of the foot, the nurse would note which of the following if clubfoot were present?

a. Affected foot is larger and longer

b. Affected limb is longer

c. There is calf muscle atrophy of the affected limb

d. Affected foot is cooler

87. A child is admitted with osteogenesis imperfecta (OI). In reviewing laboratory findings, the nurse would expect to find abnormal levels of:

a. Calcium c. Precollagen type I

b. Phosphorus d. Vitamin D

88. Which of the following statements made by a parent of a child with OI needs clarification by the nurse?

a. “My child may be able to participate in sports.”

b. “There are no medications available to help this disease process.”

c. “Surgery may be needed to place rods in the bone for stability.”

d. “My child will need to be home schooled to protect him from injury.”

89. Which of the following interventions is inappropriate to incorporate into the plan of care for a child with Duchenne muscular dystrophy hospitalized for a respiratory infection?

a. Physical therapy

b. Vigorous antibiotic therapy

c. Passive range of motion exercises

d. Strict bed rest

90. A 14-year-old adolescent has just been fitted for a Milwaukee brace. Which of the following should the nurse include in teaching about this brace?

a. The brace should be worn only when the adolescent is sleeping or in the recumbent position

b. The brace should be worn next to the skin

c. Exercises to increase pelvic tilt should be done several times per day while in the brace

d. The adolescent should experience no pain as a result of wearing this brace

91. When bathing a 3-year-old with eczema, the nurse tells the mother to have the bathwater:

a. As hot as the child can tolerate

b. Hot to the touch on the inner wrist

c. Tepid

d. Cool

92. The nurse explains to the mother that a child who has begun treatment for impetigo with a topical antibiotic can return to daycare:

a. Immediately

b. After 48 hours

c. As soon as crust are evident

d. When crusts fall off

93. When assessing a child’s hair and scalp, the nurse notices what looks like dandruff but it does not flake off easily. The nurse suspects the child has:

a. Scabies c. Pediculosis capitus

b. Eczema d. Impetigo

94. The nurse plans to position a child with a circumferential burn of the right leg”

a. Flat in bed

b. With the right leg dependent

c. On the left side

d. With the right leg elevated

95. A 3-year-old child has been diagnosed with eczema. The nurse will assess for:

a. Pruritus c. Vesicles

b. Pustules d. Lichenification

96. A child has been diagnosed with eczema. While taking the nursing history, the nurse will assess for a family history of:

a. Scabies b. Cellulitis c. Asthma d. Impetigo

97. When assessing a child with Periorbital cellulites, the nurse will want to ask the parent about a recent history of:

a. Otitis media c. Dog bite

b. Sinusitis d. Sun exposure

98. A child will be treated at home for cellulites of the left leg. The nurse will include in client education the need for:

a. Continuing oral antibiotics until the prescription is completed

b. Strict bed rest with the left leg elevated

c. Increased fluid intake

d. Limiting visitors to prevent spreading infection

99. When teaching a mother how to use an anti-lice shampoo, the nurse should include the information that she should:

a. Use ample shampoo to cover the hair

b. Apply about 2 ounces of shampoo to wet hair

c. Leaver the shampoo on hair for 20 to 30 minutes before rinsing

d. Use hot water for both shampoo and rinse

100. The nurse would share which of the following pieces of information to increase treatment compliance in a teenager with eczema?

a. The appearance of the skin will improve in a few days

b. Avoiding foods with eggs and milk will speed healing

c. Scarring is not likely if the treatment plan is followed

d. This problem will not likely recur past adolescence

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