Peds NCLEX Questions and Answers with accurate solution

Peds NCLEX Questions and Answers with accurate solution 1. Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. Part of the discharge teaching by the nurse for the parents includes: A. administration of IV fluids. B. cardiopulmonary resuscitation. C. reassurance that the infant cannot be electrocuted during monitoring. D. advisement that the infant not be left with other caretakers, such as babysitters. - B. cardiopulmonary resuscitation. CPR is essential for parents and caregivers to know. A. administration of IV fluids. Most likely, the child will not have venous access, so home IV therapy is not necessary. C. reassurance that the infant cannot be electrocuted during monitoring. The monitor is insulated and grounded. D. advisement that the infant not be left with other caretakers, such as babysitters. The parents should arrange for other caregivers to help out. All need to be taught how to use the monitoring equipment and how to perform CPR. 2. A humidified atmosphere is recommended for a young child with an upper respiratory tract infection because this environment facilitates: A. liquefying secretions. B. improving oxygenation. C. promoting ventilation. D. soothing inflamed mucous membrane. - D. soothing inflamed mucous membrane. By humidifying the inspired air, the membranes inflamed by the infection and dry air are soothed. A. liquefying secretions. The size of the droplets is too large to liquefy secretions. B. improving oxygenation. No additional oxygen is provided with humidified air. C. promoting ventilation. The humidity has no effect on ventilation. 3. A child with acute streptococcal pharyngitis should be treated with antibiotics to prevent: A. otitis media. B. diabetes insipidus. C. nephrotic syndrome. D. acute rheumatic fever. - D. acute rheumatic fever. Children with group A beta-hemolytic streptococci (GABHS) infection are at risk for acute rheumatic fever and acute glomerulonephritis. A. otitis media. Otitis media is not a sequela to GABHS. B. diabetes insipidus. Diabetes insipidus is not a sequela to GABHS. C. nephrotic syndrome. Children are at risk for glomerulonephritis, not nephrotic syndrome. 4. The mother of a 20-month-old child tells the nurse that the child has a barking cough at night. The child's temperature is 37° C (98.6° F). Based on the nurse's knowledge of upper respiratory infections, this is a symptom of croup. The nurse should recommend to: A. control the fever with acetaminophen and call if the cough gets worse tonight. B. try a cool-mist vaporizer at night and watch for signs of difficulty breathing. C. try over-the-counter cough medicine and come to the clinic tomorrow if there is no improvement. D. admit to the hospital and observe for impending epiglottitis. - B. try a cool-mist vaporizer at night and watch for signs of difficulty breathing. Because the child is not having difficulty breathing, the nurse should teach the parents the signs of respiratory distress and tell them to come to the emergency department if they develop. Cool mist is recommended to provide relief. A. control the fever with acetaminophen and call if the cough gets worse tonight. The child does not have a temperature to manage. C. try over-the-counter cough medicine and come to the clinic tomorrow if there is no improvement. Cough suppressants are not indicated. D. admit to the hospital and observe for impending epiglottitis. A barking cough and temperature of 37° C are characteristic of laryngotracheobronchitis, not epiglottitis. 5. An infant with a congenital heart defect is receiving palivizumab (Synagis). The purpose of this is to: A. prevent RSV infection. B. prevent secondary bacterial infection. C. decrease toxicity of antiviral agents. D. make isolation of infant with RSV unnecessary. - A. prevent RSV infection. Synagis is a monoclonal antibody specific for RSV. Monthly administration is initiated to prevent infection with RSV. B. prevent secondary bacterial infection. The antibody is specific to RSV, not bacterial infection. C. decrease toxicity of antiviral agents. Synagis will have no effect on the toxicity of antiviral agents. D. make isolation of infant with RSV unnecessary. The goal of this drug is prevention of RSV. It will not affect the need to isolate the child if RSV develops. 6. Asthma is now classified into four categories: mild intermittent, mild persistent, moderate persistent, and severe persistent. Clinical features used to differentiate these categories include (select all that apply): A. lung function. B. age of the child C. associated allergies. D. frequency of symptoms. E. frequency and severity of exacerbations. - A. lung function. D. frequency of symptoms. E. frequency and severity of exacerbations. 7. A child with asthma is having pulmonary function tests. Which explains the purpose of the forced expiratory volume (FEV1)? A. Confirm the diagnosis of asthma B. Determine the cause of asthma C. Identify the "triggers" of asthma D. Assess the severity of asthma - D. Assess the severity of asthma The forced expiratory volume measures the maximum amount of air that can be forcefully exhaled in the first second. This can provide an objective measure of pulmonary function compared with the child's baseline. A. Confirm the diagnosis of asthma Diagnosis of asthma is made on the basis of clinical manifestations, history, and physical examination. B. Determine the cause of asthma The cause of asthma is inflammation, bronchospasm, and obstruction. C. Identify the "triggers" of asthma Some of the triggers of asthma are identified with allergy testing. 8. A 4-year-old child needs to use a metered-dose inhaler to treat asthma. The child cannot coordinate her breathing to use it effectively. The appropriate intervention by the nurse is to use a: A. spacer. B. nebulizer. C. peak expiratory flow meter. D. trial of chest physiotherapy. - A. spacer. The medication in a metered-dose inhaler is sprayed into the spacer. The child can then inhale the medication without having to coordinate the spraying and breathing. B. nebulizer. A nebulizer is a mechanism used to administer medications, but it cannot be used with metered-dose inhalers. C. peak expiratory flow meter. This is a measure of pulmonary function not related to medication administration. D. trial of chest physiotherapy. This is unrelated to medication administration.