NUR 106 Exam #2 Midterm: Pediatric Nursing Essentials Study Guide | 2024 Edition

NUR 106 Exam #2 Midterm: Pediatric Nursing Essentials Study Guide | 2024 Edition Withholding a dose if the apical heart rate is less than 100 beats/min - 32. Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant? Counting the apical rate for 30 seconds before administering the medication Withholding a dose if the apical heart rate is less than 100 beats/min Repeating a dose if the child vomits within 30 minutes of the previous dose Checking respiratory rate and blood pressure before each dose Inflammation weakens blood vessels, leading to aneurysm - 33. The nurse is caring for a child with a diagnosis of Kawasaki disease. The child's parent asks the nurse, "How does Kawasaki disease affect my child's heart and blood vessels?" On what understanding is the nurse's response based? Inflammation weakens blood vessels, leading to aneurysm Increased lipid levels lead to the development of atherosclerosis Untreated diseases causes mitral valve stenosis Altered blood flow increases cardiac workload with resulting heart failure "If the baby turns blue, I will hold him against my shoulder with his knees bent up towards his chest" - 34. The nurse explained how to position an infant with tetralogy of Fallot if the infant suddenly becomes cyanotic. Which statement by the father leads the nurse to determine he understood the instructions? "If the baby turns blue, I will hold him against my shoulder with his knees bent up towards his chest" "If the baby turns blue, I will lay him down on a firm surface with his head lower than the rest of his body" "If the baby turns blue, I will immediately put the baby upright in an infant seat" "If the baby turns blue, I will put the baby in supine position with his head elevated" Painful, tender joints and carditis - 35. A child has an elevated antistreptolysin O (ASO) titer. Which combination of symptoms, in conjunction with this finding, would confirm a diagnosis of rheumatic fever? Subcutaneous nodules and fever Painful, tender joints and carditis Erythema marginatum and arthralgia Chorea and elevated sedimentation rate An atrial septal defect - 36. Through what does the infant born with hypoplastic left heart syndrome acquire oxygenated blood? The patent ductus arteriosus A ventricular septal defect The closure of the foramen ovale An atrial septal defect Sydenham's chorea - 37. A child with rheumatic fever begins involuntary, purposeless movements of her limbs. What does the nurse recognize that this indicates? Seizure activity Hypoxia Sydenham's chorea Decreasing level of consciousness They have little cholesterol - 38. What is accurate about the characteristics of high-density lipoproteins (HDLs)? They have high amounts of triglycerides They have only small amounts of protein They have little cholesterol They aid in steroid production A fat intake reduction of 25-35% of total calories - 39. What should the school nurse recommend when encouraging a heart-healthy diet for a child with high cholesterol? A fat intake reduction of 5-10% of total calories A fat intake reduction of 10-15% of total calories A fat intake reduction of 15-20% of total calories A fat intake reduction of 25-35% of total calories Echocardiogram - 40. A pediatric patient is scheduled for a noninvasive procedure to determine if his heart is structurally normal and to localize a murmur. What diagnostic test does the nurse anticipate? Barium swallow Chest x ray Electrocardiogram Echocardiogram Nonsteroidal anti-inflammatory drug - 1. A nurse is caring for a preschooler who is experiencing mild pain. Which of the following types of medication should the nurse administer first? Opioid analgesic Antianxiety medication Nonsteroidal anti-inflammatory drug Sedative Administer analgesics on a schedule - 2. A nurse is contributing to the plan of care for a child following a surgical procedure. Which of the following interventions should the nurse recommend? Administer NSAIDS for pain greater than 7 on a scale of 0 to 10 Administer intranasal analgesics PRN Administer IM analgesics for pain Administer analgesics on a schedule Loud cry Lowered eyebrows Rigid body - 3. A nurse is collecting data from an infant. The nurse should identify that which of the following findings indicates that the infant is experiencing pain? (Select all) Pursed lips Loud cry Lowered eyebrows Rigid body Pushes away stimulus Offer a pacifier Use swaddling Encourage kangaroo care - 4. A nurse is contributing to the plan of care for an infant who is experiencing pain. Which of the following interventions should the nurse recommend? (Select all) Offer a pacifier Use guided imagery Use swaddling Initiate a behavioral contract Encourage kangaroo care Explain the procedure using the child's favorite toy Allow the child to make one choice regarding the procedure Apply lidocaine cream to three potential insertion sites - 5. A nurse is preparing a toddler for insertion of an IV catheter. Using atraumatic care, which of the following actions should the nurse take? (Select all) Explain the procedure using the child's favorite toy Ask the parents to leave during the procedure Plan to assist with the procedure with the child in his bed Allow the child to make one choice regarding the procedure Apply lidocaine cream to three potential insertion sites b. Diapers and wipes are stacked at the foot of the crib. - 13. Which observation on entering the hospital room let's the nurse know that there is a need for the parents to receive safety education to prevent unintentional injury? a. The blanket is not tucked into the mattress b. Diapers and wipes are stacked at the foot of the crib. c. The crib is side locked in the up position. d. Pillows are stacked on the bedside table. d. On your side with the knees bent and the head close to the knees. - 14. A 9 year old child is preparing for a lumbar puncture. What position will the nurse explain the child will assume for this position? a. On your stomach with your head turned to the side b. On your side, keeping the legs bent and the head arched back c. On your back with your legs extended straight out d. On your side with the knees bent and the head close to the knees. d. Egg yolks - 15. The nurse instructs the mother of a 2 year old who is taking iron supplements for anemia that some foods reduce the absorption of iron. What would be the best example provided by the nurse? a. Red meat b. Green, leafy vegetables c. Acidic fruit juices d. Egg yolks b. Oral penicillin for 10 days - 16. What will the nurse tell the parents of a child with a positive throat culture for group A hemolytic streptococcus that the treatment is most likely to be? a. Acetaminophen and plenty of fluids b. Oral penicillin for 10 days c. Penicillin until his sore throat is gone d. Streptococcus immunizations c. Take the child to the bathroom and turn on a hot shower - 17. Which initial intervention will the nurse suggest to the parents of a child experiencing laryngeal spasm? a. Take the child outside in the cool air b. Bring the child directly to the emergency department c. Take the child to the bathroom and turn on a hot shower d. Have the child drink plenty of fluids c. Quiet chest from previous assessment of wheezing - 18. When auscultating breathe sounds of an infant with respiratory syncytial virus, which assessment would the nurse immediately report? a. Respiration rate decrease from 40 to 32 breathes/min b. Heart rate decrease from 110 to 100 beats/min c. Quiet chest from previous assessment of wheezing d. Oxygen saturation of 90% a. Mummy - 6. Which restraint is most appropriate for the insertion of an intravenous line in a scalp vein of an infant? a. Mummy b. Clove hitch C.Jacket D.Elbow A.Hourly - 7. How often should a child who has a continuous intravenous infusion should be assessed? A.Hourly B.Every 2 hours C.Every 3 hours D.Every 4 hours a. 1.25 - 8.The prescription for a 4-month-old is penicillin G 150,000 units intramuscularly bid. The drug is supplied as a unit dose of 600,000 units in a 5-mL vial. How many milliliters (mL) should the nurse provide? a. 1.25 B.1.4 C.1.6 d. 1.8 C.Apply suction for no more than 15 seconds. - 9. Which intervention will the nurse implement when suctioning a tracheostomy? A.Suction for two to three breaths. B.Clear the catheter with water after suctioning for reuse. C.Apply suction for no more than 15 seconds. D.Establish a regular schedule for suctioning. B."Yes. It will sting a little." - 10. A 4-year-old asks tearfully if the IM injection will hurt. What is the nurse's most effective response? A."No. It is over before you know it." B."Yes. It will sting a little." C."No. Would you like to see the syringe?" D."Yes. Your mom and I are going to hold you to help you be still." D.Vastus lateralis muscle - 11.Where is the best site for giving an IM injection to a 15-month-old child? A.Ventrogluteal muscle b. Dorsogluteal muscle C.Deltoid muscle D.Vastus lateralis muscle C.Apply a cloth diaper. - 12.What intervention should the nurse implement after topical administration of hydrocortisone cream to the buttocks and abdomen of an infant? A.Diaper the infant snugly with a disposable diaper. B.Cover the area with a transparent dressing. C.Apply a cloth diaper. D.Place the infant on a plastic pad, undiapered. candidiasis - 26. The teaching plan for the use of a dry powder inhaler for the treatment of asthma should include the warning to rinse the mouth after inhaling the powder. What does this prevent? Discoloration of tooth enamel Halitosis Irritation of oral membranes candidiasis 72 hours - 27. The nurse is caring for a 3-year-old who suffered a smoke inhalation injury. How long is this patient at the highest risk for pulmonary after exposure? 2 hours 4 hours 18 hours 72 hours Ensure high-protein, high- calorie diet. - is the most appropriate nursing action when planning care for a child with cystic fibrosis? Provide chest physiotherapy before meals every day. Assess weight monthly. Administer pancrease with protein food at mealtime Ensure high-protein, high- calorie diet. Blood to shunt left to right, causing increased pulmonary flow and no cyanosis - 29. What does the nurse explain that a ventricular septal defect will allow? Blood to shunt left to right, causing increased pulmonary flow and no cyanosis Blood to shunt right to left, causing decreased pulmonary flow and cyanosis No shunting because of high pressure in left ventricle increased pressure in the left atrium, impeding circulation of oxygenated blood in the circulating volume Blood pressure lower in the legs than in the arms - 30. What finding would the nurse expect when measuring blood pressure on all four extremities of a child with coarctation of the aorta? Blood pressure higher on the right side Blood pressure higher on the left side Blood pressure lower in the arms than in the legs Blood pressure lower in the legs than in the arms Squatting increases the return of venous blood back to the heart. - 31. A father asks why his with tetralogy of Fallot seems to favor a squatting position. What is the nurse's best response? Squatting increases the return of venous blood back to the heart. Squatting decreasing the return of venous blood back to the heart Squatting is a common resting position when a child is tachycardic. Squatting increasing the workload of the heart B. Apical - What is the best pulse location for the nurse to use when assessing the pulse rate on a 12-month-old infant? A. Brachial B. Apical C. Radial D. Femoral Confirm the identity with the charge nurse, make a new bracelet, and give the medicine. - The nurse is preparing to administer medication to a 2-month-old infant discovers there is no ID bracelet on the child. What should be the next action by the nurse? Give the medication after confirming the child's name from the foot of the crib. Ask the charge nurse to give the medicine. Confirm the identity with the charge nurse, make a new bracelet, and give the medicine. Delay the medication until the admissions office can supply a new ID bracelet. "I clean the perineum from front to back with an antiseptic wipe before I urinate." - 3. The nurse instructed an adolesent female about collecting a clean catch urine specimen. What statement made by the adolescent led the nurse to determine she understood the instructions? "I should wash my perineum with soap and water, the begin to urinate." "I clean the perineum from front to back with an antiseptic wipe before I urinate." "I'll collect the first stream of urine in a sterile comtainer." "I will discard the first void and collect a freshly voided specimen 30 minuntes later." Use an oral syringe and placing the medication on the side of the infants mouth. - 4. A parent tell the nurse, "I'm bot sure how to give this medicae to my infant." How would the nurse teach the parent to best administer an oral suspention? Pour the medication into a small cup and allowing the infant to drink it. Place the medication in a nipple and having the infant suck the nipple. Use an oral syringe and placing the medication on the side of the infants mouth. Administer the medication with a dropper onto the back of the infants tongue. Position the child on the right side after a feeding. - 5. Which intervention is correct when the nurse is administering a gastrostomy feeding by gravity? Discard the residual and increase the volume of feeding by the amount of residual. Flush the gatrostomy tube with 2 to 4 ounces of water before the feeding. Refill the syringe with formula after it has been completely empty. Position the child on the right side after a feeding. Position the child with arms resting on the overbed table. - 19. What is the best intervention for the nurse caring for a child experiencing an acute asthma attack? Offer plenty of fluids, particularly carbonated beverages. Place the child in a humidified cool mist tent with oxygen. Administer sedatives as ordered to decrease anxiety. Position the child with arms resting on the overbed table. Before exercise to prevent attacks - 20. What should the nurse explain to the parent of a child with exercise-induced asthma about when to inhale Cromolyn? Before exercise to prevent attacks At the initial onset of the attack During the attack to relieve symptoms As often as 4 times a day Both parents are carriers of the CF gene. - 21. The parents of a 3 month old infant with cystic fibrosis (CF) want to know how their child got this disease, because no one in either family has CF. What is the nurse's best response based on the understanding of CF? Only one of the parents carry the CF gene. Both parents are carriers of the CF gene. The inheritance pattern is multifactorial. The result is probably a genetic mutation. " We give the aerosol followed by postural drainage before meals." - 22. Which statement indicates that the child's parents understand how to perform respiratory therapy? " We do her postural drainage before the aerosol therapy." " We give her respiratory treatments when she is coughing a lot." " We give the aerosol followed by postural drainage before meals." " She needs respiratory therapy everyday when she has an infection." Remove nasal secretions with bulb syringe. - 23. How would a nurse advise a mother to clear the nostrils when her infant has a cold? Clear the nostril passage after the infant has a feeding. Use over the counter nose drops to clear passages. Remove nasal secretions with bulb syringe. Instill saline nose drops after clearing away secretions. Room temperature water - 24. The nurse offers a variety of fluids to a 5 year old asthmatic child to compensate for the fluid loss through dyspnea. Which fluids are most appropriate? Room temperature water Carbonated beverages Iced fruit juice Cold milk Placing infants on their backs or sides to sleep - 25. The nurse is planning to teach parents about preventing sudden infant death syndrome (SIDS). What significant information would the nurse include? Wrapping the infant snugly for rest periods Positioning the infant prone for sleep Sitting the infant up in an infant seat Placing infants on their backs or sides to sleep Relating fears to magical thinking - A nurse is caring for a preschooler. Which of the following should the nurse identify as an expected behavior for preschoolers? Describing manifestations of illness Relating fears to magical thinking Understanding cause of illness Awareness of body functioning Experiences separation anxiety Displays intense emotions Exhibits regressive behaviors - 2. A nurse on a pediatric unit is caring for a toddler. The nurse should identify which of the following behaviors as expected effects of hospitalization of a toddler? ( SATA) Believes the experiences is punishment. Experiences separation anxiety Displays intense emotions Exhibits regressive behaviors Manifests disturbance in body image "The child plays independently when in a group." - 3. A nurse is reinforcing teaching with a parent about parallel play in children. Which of the following statements should the nurse include. "The child sits and observers others playing." "The child exhibits organized play when in a group." "The child plays independently when in a group." "The child plays independently when in a group." The child might kick health care staff during the protest stage of separation anxiety. - 4. A nurse is reinforcing teaching with a group of parents about separation anxiety. Which of the following information should the nurse include? Separation anxiety is commonly observed in the school age child. The detachment stage of separation anxiety is expected during hospitalization. Separation anxiety begins with the child withdrawing from others. The child might kick health care staff during the protest stage of separation anxiety.