PEDS and OB Final Exam Questions and Answers Latest Updated 2024 (100% Verified Answers)

PEDS and OB Final Exam Questions and Answers Latest Updated 2024 (100% Verified Answers) A child has a right femur fracture caused by a motor vehicle accident and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedal pulse is absent on the right foot. What action should the nurse take? a. Notify the physician b. Administer an analgesic c. Release the skin traction d. Apply ice to the extremity ANS: A 2. The nurse is providing care to a 7-year-old child who has been diagnosed with avascular necrosis. The patient’s guardians ask the nurse what to expect due to this diagnosis. Which would be appropriate information to provide to the parents? a. The child will be hospitalized and placed in traction. b. The child will be treated by surgically placing a femoral screw. c. The child will be placed in a Pavlik harness for several weeks. d. The child will be given medication while on bedrest. ANS: A 3. A nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further teaching? a. “I will encourage my child to perform prescribed exercises.” b. “I will have my child wear soft fabric clothing under the brace.” c. “I should apply lotion under the brace to prevent skin break down.” d. “I should avoid the use of powder because it will cake under the brace.” ANS: C 4. A mother brings her 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the mother indicates a need for further teaching regarding this disorder? a. “Treatment needs to be started as soon as possible.” b. “I realize my infant will require follow-up care until full grown.” c. “I need to bring my infant back to the clinic in 1 month for a new cast.” d. “I need to come to the clinic every week with my infant for the casting.” ANS: C 5. A nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions would be included on the list? (Select all that apply). a. Use of fingertips to lift the cast while it is drying. b. Do not put small toys in the cast. c. Contact the physician is the child complains of numbness or tingling in the extremity. d. Use a padded ruler or another padded object to scratch under the cast if it itches. e. Place a heating pad on the lower end of the cast and over the fingers if the fingers feel cold. f. Elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling. ANS: B, C, F 1 6. A 12-old girl is noted to walk with an uneven gait, and her shoulders appear uneven. The left shoulder sits lower than the right shoulder, and her waist appears to be tilted from side to side. Which condition is the girl most likely experiencing? a. Internal femoral torsion b. Hip dysplasia c. Club foot d. Scoliosis ANS: D 7. The nurse is caring for a 13-year-old patient diagnosed with adolescent idiopathic scoliosis. The curve in her back was treated by spinal fusion with rod insertion. Which is the priority nursing intervention in the postoperative period? a. Promote adequate oral fluid intake. b. Keep oxygen saturation within normal limits. c. Ensure placement of indwelling urinary catheter. d. Maintain a straight back, no bending. ANS: B 8. A nurse is providing teaching to a parent of a child who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make? a. "The blood supply to the bone is disrupted." b. "Normal bone growth can be affected." c. "Bone marrow can be lost though the fracture." d. "The younger the child the longer the healing process will take." ANS: B 9. A nurse is caring for a school-age patient who possibly has Reye Syndrome. What are the risk factors for developing Reye Syndrome? (Select all that apply). a. Use of aspirin b. A recent infection with Influenza A c. Recent history of bacterial otitis media d. A recent infection of chicken pox e. Recent episode of Hemophilus influenza meningitis ANS: A, B, D 10. When caring for the child with Reye syndrome, the priority nursing intervention should be to: a. Monitor intake and output b. Prevent skin breakdown c. Observe for petechiae d. Do range of motion exercises ANS: A 11. A nurse is caring for a school-age child who has a concussion. Which of the following actions would the nurse implement to decrease intracranial pressure (ICP)? (Select all that apply). a. Position head midline with head of bed flat b. Avoid extreme flexion, extension or rotation of the head c. Nasal suctioning is contraindicated d. Oral suctioning is contraindicated e. Encourage coughing and deep breathing ANS: B, C 2 12. What is most important for a nurse to teach the parents of a child with Duchenne muscular dystrophy to do for their child? a. Maintain a high-calorie diet b. Institute seizure precautions c. Restrict the use of larger muscles d. Perform ROM exercises ANS: D 13. The nurse is counseling the parents of a 12-year-old child with Duchenne muscular dystrophy about problems that may develop during adolescence. What body system does the nurse expect might be affected? a. Neurological b. Integumentary c. Gastrointestinal d. Cardiopulmonary ANS:D 14. Which assessment findings should the nurse note in a school-age child with Duchenne Muscular Dystrophy (DMD)? (Select all that apply.) a. Lordosis b. Gower sign c. Kyphosis d. Scoliosis e. Waddling gait ANS: A, B, E 15. A nurse is taking care of a 10-year-old child that weighs 30 kg. The doctor has ordered azithromycin PO 300 mg x 1 dose. Azithromycin comes in an oral suspension 100mg/5 mL in a 15 mL bottle. According to the drug handbook for children 2-15 years of age, 10 mg/kg/day but not to exceed 500 mg/day. How many milliliters should be given? Enter a numeric response only. ANS: 1.5 16. A nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed ½ cup of juice, 3 oz gelatin, 1 oz of an ice pop, and 20 mL ginger ale. How many mL should the nurse record as the child's fluid intake? Enter a numeric response only. Incorrect answer: 380 ANS: 17. Four-year-old David is placed in Buck extension traction for Legg-Calvé-Perthes disease. He is crying with pain as the nurse assesses that the skin of his right foot is pale with an absence of pulse. Which action should the nurse take first? a. Notify the practitioner of the changes noted. b. Give the child medication to relieve the pain. c. Reposition the child and notify physician. d. Chart the observations and check the extremity again in 15 minutes. ANS: A 3 18. Children with Legg-Calve Perthes disease should: a. Maintain a diet high in protein, vitamins and minerals. b. Sleep on a firm mattress to prevent contractures. c. Weight bearing on the affected extremity. d. Be allowed to play basketball. ANS: 19. A 12-year-old comes into the clinical with left thigh pain and a lump over the distal femur. The nurse is aware that these symptoms can be linked to which of the following medical problems. (Select all that apply). a. Ewing sarcoma b. Osteosarcoma c. Osteoarthritis d. Osgood Schlatter’s disease ANS: A, B 20. The child has been complaining of joint pain in the knees and jaw for the last 6 weeks, both joints are swollen and warm to touch, but not red. The physician is ordering blood to rule out Junior Idiopathic Arthritis. Which of the following lab tests would the nurse expect the physician to order? (Select all that apply). a. Anti-nuclear antibody titer b. CBC with differential c. Electrolytes d. C-reactive protein e. Rheumatoid factor ANS: A, B, D, E 21. A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions should the nurse include in the plan of care? a. Assist child in a supine position. b. Keep the room well lit. c. Measure head circumference every shift. d. Implement seizure precautions. ANS: D 22. The school nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care to the student during the seizure? a. Protect the student from injury related to seizure movement. b. Remove or loosen any tight clothing around the neck or waist. c. Provide comfort and promote resting in a quiet environment. d. If incontinent, cover the student with a blanket or sheet. ANS: A 23. An important nursing intervention when caring for a child who is experiencing a seizure would be to: a. Describe and record the seizure activity observed b. Restrain the child when seizure occurs to prevent bodily injury c. Place a tongue blade between the teeth if they become clenched d. Suction the child during a seizure to prevent aspiration ANS: A 4 24. The school nurse is present at a school assembly when a student falls to the floor with a seizure. Which intervention does the nurse initiate when providing care to the student during the seizure? a. Protect the student from injury related to seizure movement. b. Remove or loosen any tight clothing around the neck or waist c. Provide comfort and promote resting in a quiet environment. d. If incontinent, cover the student with a blanket or sheet. ANS: A 25. A patient recently came into the Emergency Department with a diagnosis of Guillain-Barre Syndrome (GBS). What is the priority system to initially monitor for this patient? a. Musculoskeletal b. Neurological c. Respiratory d. Vascular ANS: C 26. The mother brings her child with cerebral palsy into the clinic and is afraid the child is having seizures as the child has the slow “worm like” or “writhing quality” movements in her arms and she drools when this occurs. The nurse explains to the mother that this is not a seizure but what type of activity? a. Athetoid b. Ataxic c. Spastic d. Hypotonic ANS: A 27. An 11-year-old child has a recurrence of Ewing Sarcoma and is verbalizing wanting to stop all treatments. The nurse is aware that the best ethical practice would be which of the following plan? a. Tell the parents that they need to force the child to have the treatment as she is too young to decide. b. Have the parents discuss treatment with the child and take the child’s view into consideration. c. Inform the child that she is not allowed to decide the course of treatment. d. Plan a meeting with the parents, child, and the medical team to provide an opportunity to discuss the child’s concerns. ANS: D 28. Nursing interventions for the child after a Cardiac Catheterization should include which actions? (Select all that apply.) a. Allow ambulation as tolerated. b. Monitor vital signs every 2 hours. c. Assess the affected extremity for temperature and color. d. Check pulses above the catheterization site for equality and symmetry. e. Remove pressure dressing after 4 hours. f. Maintain a patent peripheral intravenous catheter until discharge. ANS: C, F 5 29. Ryan is an 11-month-old with Down’s syndrome and Atrial Septal Defect. His parents report that Ryan has been lethargic and has had diarrhea the last 24 hours. His weight is 7 kg (15.4lb). His Vital signs are:  Temperature 36.5C (97.7F) rectal  Pulse 80 beats/minute  Respirations 35 breaths/minute  Pulse ox 95% on room air  His lab results are: Potassium 2.9 mmol/L  Digoxin 2.5 mg/mL 1. The nurse questions digoxin toxicity. What results support this? (Select all that apply). a. Pulse b. RR c. Dig level d. K+ level e. Temperature ANS: A, C, D 30. An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of: a. Air emboli b. Allergic reaction c. Hemolytic reaction d. Circulatory overload ANS: D 31. Which specific nursing interventions are implemented in the care of a child with leukemia who is at risk for infection? (Select all that apply). a. Maintain the child in a private room. b. Reduce exposure to environmental organisms. c. Use strict aseptic technique for all procedures. d. Avoid rectal temperatures e. Ensure that anyone entering the child’s room wears a mask. f. Apply firm pressure to a needle stick area for a least 10 minutes. ANS: A, B, C, D 32. The nurse is conducting a staff in-service on childhood blood disorders. Which statement by the student nurse would indicate a need for further instruction? a. "Give steroids with food and limit sodium intake" b. "The parent should encourage and support a positive self-concept" c. Teach about the side effects of steroid therapy including possible fluid and weight loss" d. " Provide a range of activity based on the platelet count" ANS: B 6 33. A Hispanic toddler had pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items such as Jell-O, Popsicles, and juices are left. Which statement would best explain this behavior? a. The parent is trying to feed the child only what the child likes most. b. The parent is trying to restore normal balance through appropriate “hot” remedies. c. Hispanics believe the “evil eye” enters when a person gets cold. d. Hispanics believe an innate energy, called “chi” is strengthened by eating soup. ANS: B 34. The nurse must assess a 10-month-old infant. The infant is sitting in the father’s lap and appears to be afraid of the nurse and of what happens next. Which initial action by the nurse would be most appropriate? a. Initiate a game of peek-a-boo b. Ask the father to place the infant on the examination table c. Undress the infant while he is still sitting on his father’s lap d. Talk softly to the infant while taking him from his father