PEDS NCLEX QUESTIONS|UPDATED&VERIFIED|GUARANTEED SUCCESS

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. 9. One of the goals for children with asthma is to prevent respiratory infection. The reason for this goal is that respiratory infection can: A. encourage exercise-induced asthma. B. increase sensitivity to allergens. C. lessen the effectiveness of medications. D. trigger an episode or aggravate an asthmatic state. D. trigger an episode or aggravate an asthmatic state. Respiratory infections can trigger an asthmatic attack. Annual influenza vaccine is recommended. All respiratory equipment should be kept clean. A. encourage exercise-induced asthma. Exercise-induced asthma is caused by vigorous activity. B. increase sensitivity to allergens. Sensitivity to allergens is independent of respiratory infection. C. lessen the effectiveness of medications. The infection affects the asthma, not the medications. 10. Cystic fibrosis may affect single or multiple systems of the body. The primary factor responsible for possible multiple clinical manifestations is: A. mechanical obstruction caused by increased viscosity of mucous gland secretions. B. atrophic changes in mucosal wall of intestines. C. hypoactivity of the autonomic nervous system. D. hyperactivity of sweat glands. A. mechanical obstruction caused by increased viscosity of mucous gland secretions. Children with cystic fibrosis have thick mucous gland secretions. The viscous secretions obstruct small passages in organs such as the pancreas. B. atrophic changes in mucosal wall of intestines. Thick mucous secretions are the probable cause of the multiple body system involvement. C. hypoactivity of the autonomic nervous system. There is an identified autonomic nervous system anomaly, but it is not hypoactivity. D. hyperactivity of sweat glands. The sweat glands are not hyperactive. The child loses a greater amount of salt because of abnormal chloride movement. 11. The parent of a child with cystic fibrosis calls the clinic nurse and describes signs and symptoms of tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The most appropriate action by the nurse is to tell the parent to immediately bring the child to the clinic. These symptoms are suggestive of: A. pneumothorax. B. bronchodilation. C. carbon dioxide retention. D. increased viscosity of sputum. A. pneumothorax. The child is exhibiting signs of increasing respiratory distress suggestive of pneumothorax. The child needs to be seen as soon as possible. B. bronchodilation. These conditions would not produce the symptoms listed. C. carbon dioxide retention. These conditions would not produce the symptoms listed. D. increased viscosity of sputum. The increased viscosity of sputum is characteristic of cystic fibrosis. The described change in respiratory status is potentially due to a pneumothorax. 12. Absorption of fat-soluble vitamins is decreased in children with cystic fibrosis; therefore supplementation of which vitamins is necessary? A. C, D B. A, E, K C. A, D, E, K D. C, folic acid C. A, D, E, K A, D, E, and K are the fat-soluble vitamins that need to be supplemented. A. C, D C is not one of the fat-soluble vitamins. B. A, E, K D also needs to be supplemented. D. C, folic acid C and folic acid are not fat-soluble. 13. Which procedure uses high-frequency sound waves created by a transducer to produce an image of cardiac structures? A. Echocardiography B. Electrocardiography C. Cardiac catheterization D. Electrophysiology (EPS) A. Echocardiography Echocardiography uses high-frequency sound waves. The child must lie completely still. With the improvements in technology, diagnosis can sometimes be made without cardiac catheterization. B. Electrocardiography Electrocardiography is a tracing of the electrical path of the depolarization action of myocardial cells. C. Cardiac catheterization Cardiac catheterization is an invasive procedure in which a catheter is threaded into the heart. D. Electrophysiology (EPS) EPS is an invasive procedure in which catheters with electrodes are used to record the impulses of the heart directly from the conduction system. 14. A nurse caring for a child post cardiac catheterization assesses that the distal pulse of the catheter site is weaker and capillary refill is less than three seconds. The most appropriate nursing action is to: A. elevate the affected extremity. B. notify the physician of the observation. C. apply warm compresses to the insertion site. D. record the assessment finding and continue to monitor. D. record the assessment finding and continue to monitor. The pulse distal to the catheter insertion site may be weaker for the first few hours after catheterization. It should gradually increase in strength. A. elevate the affected extremity. Elevation is not necessary; the extremity is kept straight. B. notify the physician of the observation. Because a weaker pulse is an expected finding, the nurse should document this and continue to monitor. C. apply warm compresses to the insertion site. The insertion site is kept dry. 15. Traditionally, congenital heart defects have been divided into acyanotic or cyanotic defects. Based on the nurse's knowledge of congenital heart defects, this system is: A. helpful, because it explains the hemodynamics involved. B. helpful, because cyanotic defects are easily identified. C. problematic, because cyanosis is rarely present in children. D. problematic, because acyanotic heart defects may have cyanosis. D. problematic, because acyanotic heart defects may have cyanosis. The classification is problematic. Children with traditionally named acyanotic defects may be cyanotic, and children with traditionally classified cyanotic defects may appear pink, although they may eventually become cyanotic. A. helpful, because it explains the hemodynamics involved. The classification does not reflect the path of blood flow within the heart. B. helpful, because cyanotic defects are easily identified. Children with cyanosis may be easily identified, but that does not help with the diagnosis. C. problematic, because cyanosis is rarely present in children. Cyanosis is present when children have defects in which oxygenated blood and unoxygenated blood are mixed.