nur 106peds all exam reviewpeds all exam review exam 1exam 2sata questionsnclex saunders sata questions

A child with autism has been admitted to the pediatric unit for observation. Which intervention is best? - assign a private room and allow parents to bring in the child’s belongings 2. The nurse is assessing a newborn that had undergone vaginal delivery. Which of the following findings is least likely to be observed in a normal newborn? - respirations are regular, mouth breathing 60 -80 bpm 3. A nurse is assessing a 2 1/2 year old toddler at a well child visit. Which clinical finding should be reported to the health care provider? - head circumference exceeds chest circumference 4. What is the best plan for a child in the intensive care unit with severe postoperative pain after a motor vehicle collision? The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale? - Plan a preventive schedule of pain medication around the clock 5. A seven month old patient with up to date immunizations has a runny nose, a low grade fever, and a paroxysmal cough that has worsened over the past few days. The patient has coughed so hard that scleral hemorrhages are present. The most likely diagnosis is? - pertussis 6. The nurse is discussing sexuality with the parents of an adolescent girl who has moderate cognitive impairment. What factor should the nurse consider when dealing with this issue? - individuals with cognitive impairment need a well-defined, concrete code of sexual conduct 7. What description applies to Fragile X syndrome? -Second most common genetic cause of cognitive impairment (Klinefelter - XXY - gynecomastia, Turner - NO X, short stature, Fragile X￾autism like) 8. The nurse should suspect a hearing impairment in an infant who fails to demonstrate which behavior? - babbling by age 12 mos 9. The community is planning prevention measures designed to avoid conditions that can cause cognitive impairment. Taking folic acid supplements during pregnancy to prevent neural tube defects is which type of prevention strategy? - Primary prevention (vitamins) (secondary prevention are newborn screening, tertiary prevention is treating the disease that already exist) 10. What is the best method to verify the placement of a nasogastric tube before each use? - radiologic confirmation 11. Phenylketonuria is a genetic disease that results in the body's inability to correctly metabolize which? - Phenylalanine (stop formula and breastfeeding) 12. Please select from the following list the two basic concepts used by the pediatric Nurse to foster family care with children and their families: - Enabling and Empowerment 13. Secondary prevention for cognitive impairment includes what activity? - Newborn screening for treatable inborn errors of metabolism 14. A child has been diagnosed with giardiasis. Which prescribed medication should the nurse expect to administer? - Tindazole (tindamax) , metronidazole (flagyl) 15. Which concept reinforces the development of a sense of trust for infants? - they can predict what is coming and their needs are consistently met 16. The nurse wants to provide a 3 month old infant with stimulation. What is the best toy for the nurse to provide? - mobile with music box 17. The nurse is assessing a 12 year old child with foreign object in the left eye. What action should the nurse take? - remove a freely movable object with the pointed corner of gauze pad moistened with water 18. A child's chart indicates astigmatism. For what should the nurse assess? - unequal curvatue in refractive apparatus (myopia: nearsightedness, hyperopia: farsightedness, strabismus: cross eyed) 19. When planning care for a 8 year old boy with down syndrome, the nurse should: - assess the child's developmental level and plan care accordingly 20. Children do not like the discomfort associated with venous , arterial and capillary punctures. Which of the following is the most appropriate pain reduction technique to use with most children before these painful procedures? - Apply EMLA creme topically over the site if time permits 21. A patient reports to the nuse that her child has inflamed conjunctivitis of both eyes with watery to thick discharge, itching and swollen eyelids. These manisfestations suggest? - allergic conjuntivitis 22. Which of the following is the causative agent of scarlet fever? - Group A beta hemolytic- streptococci (GABHS) 23. The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. Which of the following should the nurse consider as an "approach behavior" that results in the parental movement towards adjustment? - anticipating future problems and seeking guidance and answers 24. Which statement best describes the problem of regulation of body temperature in a premature infant? - There is lack of subcutaneous fat which furnishes insulation. notes from book: -First, the newborn’s large surface area relative to his or her weight facilitates heat loss to the environment -The second factor that contributes to loss of body heat is the newborn’s thin layer of subcutaneous fat - infant cannot produce heat on his/her own (ie, children and adults shiver) 25. weight: doubles by 6 months, triples by 12 mos, quadruples by 24 mos 26. A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parent's care. Which statement best describes the health care needs of foster children? - foster children tend to have a higher than normal incidence of acute and chronic health problems 27. Which condition/ behavior manifested by a 24 month old infant warrants further evaluation? - unable to pull to a standing position 28. During a routine health assessment, the nurse notes that a 8 week old infant has a significant head lag . Which is the most appropriate action? - refer the child for further evaluation if the anterior fontanel is still open 29. The apgar score of an infant 5 minutes after birth is 5. Which is the nurse's best interpretation of this? - immediate attention needed APGAR SCORING: 0-3= severe distress, 4- 6= moderate difficulty, 7- 10 is not indicative of distress and is adjusting to Extrauterine life -assessed in the 1st minute and 5 mins after birth and is repeated every 5 mins until infants condition stabilizes 30. Then nurse observes that a new mother avoids making eye contact with her infat. What should the nurse do? - assess the mother for other attachment behaviors 31. Which findings in the newborn is considered abnormal - profuse drooling 32. When assessing a child's cultural background, the nurse in charge should keep in mind that: - several layers of influence help to determine children's cultural identity 33. The nurse is caring for a patient who has chosen to breastfeed her infant, Which statement should the nurse include when teaching the mother about breastfeeding problems that may occur? - If engorgement occurs, use warm compress before a feeding and wear a well fitting bra at all times. 34. Select the vaccines usually given to children at 12 year of age according to the immunization schedule - tdap, MEN, HPV, INF VACCINATIONS: 35. What developmental period do children have the most difficulty coping with death, particularly if its their own: - Adolescence 36. The nurse is administering the first hepatitis A vaccine to an 18 month old child. When should the child return to the clinic for the second dose of the hep A vaccination - after 6 months 37. The nurse is planning to counsel family members as a group to assess the family's group dynamics. Which theoretic family model is the nurse using as a framework? - family systems theory 38. Where is the best place to observe for the presence of petechiae in dark-skinned individuals? - Oral mucosa 39. The nurse is testing an infant’s visual acuity. By which age should the infant be able to fix on and follow a target - 3 to 4 months 40. When assessing a preschooler’s chest, what should the nurse expect? - movement of the chest wall to be symmetric bilarterally and coordinated with breathing. - (6 to 7 yrs, respiratory movement is abdominal breathing or diaphragmatic) 41. normal breath sounds are: - vesicular, bronchial and bronchovesicular 42. what are nomal hear sounds: - S1, S2, S3 - S4 requires immediate medical evaluation 43. Examination of the abdomen is performed correctly by the nurse in which order? - Inspection, auscultation, palpation , percussion 44. During examination of a toddler’s extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which? - normal because lower back and leg muscles not fully developed (babies up to 3 years old appear potbellied and bowlegged) 45. Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? - oral surcrose and non- nutritive sucking 46. What is a significant common side effect that occurs with opioid administration? - constipation , sedation, urinary retention, pruritus (itching) 47. The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? - provides most rapid onset of effect, usually in about 5 minutes 48. A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety - Lorazepam (ativan) (before any dressing changes, you have to medicate the patient first) 49. A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered to control anxiety - gabapentin (neurontin) 50. Pertussis vaccination should begin at which age? - 2 months 51. Which muscle is contraindicated for the administration of immunizations in infants and young children? - dorsogluteal (preferred site is vastus lateralis) 52. herpes zoster is caused by: - varicella virus 53. The nurse should know what about Lyme disease? - caused by a spirochete that enters the skin through a tick bite (rash is called ERYTHEMA MIGRANS, child should wear longsleeves and pants near rivers) 54. AIRBONE: - varicella, tuberculosis, measles (rubella) 55. DROPLETS: -pertussis, influenza, scarlet fever 56. CONTACT: - rsv 57. The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? - the child has a disorder that causes a deficient immune system (the mmr and varicella are live vaccines and should not be used for children who are immunosuppressed) 58 - An immunocompromised child has been exposed to chickenpox. What should the nurse anticipate to be prescribed to the exposed child? - varicella-zoster immune globulin 59. The nurse is assessing a child suspected of having pinworms. Which is the most common symptom the nurse expects to assess? - intense perianal itching, - to assess tape test in the morning 60. A child has been diagnosed with scabies. Which statement by the parent indicates understanding of the nurse’s teaching about scabies? - everyone in the house has to get treated 61. Child with pediculosis capitis (lice) should be prescribed: - Permethrin 1% (NIX) (child should be treated at home and should not be sent to school until all eggs are treated) 62. Which statement best represents the first stage or the first period of reactivity in the infant? - is an excellent time to acquaint the parents with the newborn (second period of reactivity begins when the infant awakes from a deep sleep and ends when the amounts of respiratoy mucus have decreased) 63. The nurse should expect the apical heart rate of a stabilized newborn to be in which range? - 120 to 140 bpm 64. When doing the first assessment of a male newborn, the nurse notes that the scrotum is large, edematous, and pendulous. What should this be interpreted as? - a normal finding 65. Why are rectal temperatures not recommended in newborns? - they can cause perforation of rectal mucosa 66. SUTURES: - saggital = separates the parietal bones - frontal = " the frontal bones - coronal= aka crown of head - lambdoid = separates the parietal and occipital 67. The nurse observes flaring of nares in a newborn. What should this be interpreted as? - signs of respiratory distress 68. The nurse is assessing the reflexes of a newborn. Stroking the outer sole of the foot assesses which reflex? - babinski REFLEXES: BABINSKI: disappears by 12 mos MORO: disappears by 3-4 mos STARTLE: disappears by 4 mos 69. The nurse quickly dries the newborn after delivery. This is to conserve the newborn’s body heat by preventing heat loss through which method? - evaporation 70. An infant is being discharged at 48 hours of age. The parents ask how the infant should be bathed this first week home. Which is the best recommendation by the nurse? - Bathe 2 - 3 times this week with plain water 71. The stump of the umbilical cord usually drops off in how many days? - 10- 14 days 72. The nurse is teaching a class on breastfeeding to expectant parents. Which is a contraindication for breastfeeding? - maternal cancer therapy 73. What should a nursing intervention to promote parent–infant attachment include? - explaining individual differences among infants to the parents - you can carry them when they are fussy 74. Breastfeeding: plugged ducts: continue breastfeeding every 2 to 3 hours (NOT EVERY 4 hrs) and alternate feeding positions, massage breasts and apply warm compress painful nipples: avoid soaps, oils and lotions, air the nipples as much as possible mastitis: continue breastfeeding to drain breast, even if you take antibiotics, continue breastfeeding engorgement: wear warm compress before feedings and wear a well fitting bra 24/7 a day.!!! 75. When should the nurse expect breastfeeding-associated jaundice to first appear in a normal infant? - 2 to 4 days 76. CLEFT LIP (chapter8) - DO SURGERY ON THIS first (2-3 mos child) - involves the external nose, nasal cartilages, nasal septum - feed the child while sitting up right, slow flow nipple, mom's breast is preferred way of feeding Cleft PALATE - CP surgery only 6-12 mos - CP and CL 9- 15 mos - long term problems include otitis media, possible hearing loss, URI - follow up with audiologist and orthodontist, child will eventually need speech therapy SATA QUESTION FOR CLEFT LIP: An infant with an isolated cleft lip is being bottle fed. Which actions should the nurse plan to implement to assist with the feeding? - use a NUK nipple - use cheek support - position the infant upright - mother's breast preferred way of feeding 77. The nurse suspects that a child has ingested some type of poison. What clinical manifestation would be most suggestive that the poison was a corrosive product? -Edema of the lips, tongue, and pharynx 78. What is the most common form of child maltreatment? - child neglect 79. A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child? - b. Monitoring the parents whenever they are with the child (munchausen syndrome by proxy is when the parents/caregiver pretend that their child has some sort of disease or disability and goes to several different doctors and specialists to get their child treated, some treatments are very invasive and the child suffers from after effects of procedures; this is a form of child abuse) 80. A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but NO external signs of trauma. What should the nurse suspect? - shaken baby syndrome 81. Child ingestion of injurious agents antagonist: