Peds Exam 2 NCLEX EXAM VERIFIED
SOLUTIONS, SCORED A+
A .12-year-old .child .is .in .the .urgent .care .clinic .with .a .complaint .of .fever,
.headache, .and .sore .throat. .A .diagnosis .of .group .A .beta-hemolytic
.streptococcus .(GABHS) .pharyngitis .is .established .with .a .rapid-strep .test, .and
.oral .penicillin .is .prescribed. .The .nurse .knows .which .of .the .following
.statements .about .GABHS .is .correct?
a. .Children .with .a .GABHS .infection .are .less .likely .to .contract .the .illness .again
.after .the .antibiotic .regimen .is .completed.
b. .A .follow-up .throat .culture .is .recommended .following .the .completion .of
.antibiotic .therapy.
c. .Children .with .a .GABHS .infection .are .at .increased .risk .for .the .development .of
.rheumatic .fever .(RF) .and .glomerulonephritis.
d. .Children .with .a .GABHS .infection .are .at .increased .risk .for .the .development .of
.rheumatoid .arthritis .in .adulthood. .- .CORRECT .ANSWER-C. .Children .with
.GABHS .infection .are .at .increased .risk .for .the .development .of .rheumatic .fever
.(RF) .and .glomerulonephritis
A .5-year-old .is .recovering .from .a .tonsillectomy .and .adenoidectomy .and .is
.being .discharged .home .with .his .mother. .Home .care .instructions .should
.include .which .of .the .following? .Select .all .that .apply.
a. .Observe .the .child .for .continuous .swallowing.
b. .Encourage .the .child .to .take .sips .of .cool, .clear .liquids.
c. .Administer .codeine .elixir .as .necessary .for .throat .pain.
d. .Observe .the .child .for .restlessness .or .difficulty .breathing.
e. .Encourage .the .child .to .cough .every .4 .to .5 .hours .to .prevent .pneumonia.
f. .Administer .an .analgesic .such .as .acetaminophen .for .pain. .- .CORRECT
.ANSWER-A. .Observe .the .child .for .continuous .swallowing
B. .Encourage .the .child .to .take .sips .of .cool, .clear .liquids .
D. .Observe .child .for .restlessness .or .difficulty .breathing
F. .Administer .an .analgesic .such .as .acetaminophen .for .pain
A .3-month-old .infant .is .seen .in .the .clinic .with .the .following .symptoms:
.irritability, .crying, .refusal .to .nurse .for .more .than .2 .to .3 .minutes, .rhinitis, .and .a
.rectal .temperature .of .101.8° .F .(38.8° .C). .The .labor, .delivery, .and .postpartum
.history .for .this .term .infant .is .unremarkable. .The .nurse .anticipates .a .diagnosis
.of:
a. .Acute .otitis .media .(AOM)
, b. .Otitis .media .with .effusion .(OME)
c. .Otitis .externa
d. .Respiratory .syncytial .virus .(RSV) .- .CORRECT .ANSWER-A. .Acute .Otitis .Media
.(AOM)
A .5-year-old .is .seen .in .the .urgent .care .clinic .with .the .following .history .and
.symptoms: .sudden .onset .of .severe .sore .throat .after .going .to .bed, .drooling .and
.difficulty .swallowing, .axillary .temperature .of .102.2° .F .(39.0° .C), .clear .breath
.sounds, .and .absence .of .cough. .The .child .appears .anxious .and .is .flushed.
.Based .on .these .symptoms .and .history, .the .nurse .anticipates .a .diagnosis .of:
a. .Group .A .beta-hemolytic .streptococcus .(GABHS) .pharyngitis
b. .Acute .tracheitis
c. .Acute .epiglottitis
d. .Acute .laryngotracheobronchitis .(LTB) .- .CORRECT .ANSWER-C. .Acute
.epiglottis
A .2-month-old .formerly .healthy .infant .born .at .term .is .seen .in .the .urgent .care
.clinic .with .intercostal .retractions, .respiratory .rate .of .62, .heart .rate .of .128,
.refusal .to .breastfeed, .abundant .nasal .secretions, .and .a .pulse .oximeter .reading
.of .88% .in .room .air. .The .diagnosis .of .respiratory .syncytial .virus .(RSV) .is .made,
.and .a .bronchodilator .is .administered. .The .infant's .oxygen .saturation .(SaO2)
.remains .95% .in .room .air, .and .the .respiratory .rate .is .54, .with .intercostal
.retractions; .heart .rate .is .120 .bpm. .After .2 .hours .of .observation .and .an
.intravenous .(IV) .bolus .of .fluids, .the .infant .is .being .discharged .home. .The .nurse
.provides .which .of .the .following .home .care .instructions .for .this .infant? .Select
.all .that .apply.
a. .Continue .breastfeeding .infant.
b. .Discontinue .breastfeeding .and .administer .Pedialyte .for .24 .hours.
c. .Observe .infant .for .labored .breathing .or .apnea .(cessation .of .breathing).
d. .Instill .normal .saline .drops .in .bot .- .CORRECT .ANSWER-A. .Continue
.breastfeeding .infant .
C. .Observe .infant .for .labored .breathing .or .apnea .(cessation .of .breahting)
D. .Instill .normal .saline .drops .in .both .nares .and .suction .thoroughly .before
.feeding .and .before .placing .to .sleep
F. .Keep .the .infant .out .of .daycare .or .nursery
Which .of .the .following .should .be .used .in .the .care .of .all .pediatric .patients .to
.reduce .the .risk .of .transmission .of .microorganisms .from .both .recognized .and
.unrecognized .sources .of .infection?
a. .Transmission-based .precautions
b. .Airborne .precautions
c. .Standard .precautions
d. .Droplet .precautions .- .CORRECT .ANSWER-C. .Standard .Precautions
Which .childhood .vaccine .provides .some .protection .against .bacterial .meningitis,
.epiglottitis, .and .bacterial .pneumonia?
SOLUTIONS, SCORED A+
A .12-year-old .child .is .in .the .urgent .care .clinic .with .a .complaint .of .fever,
.headache, .and .sore .throat. .A .diagnosis .of .group .A .beta-hemolytic
.streptococcus .(GABHS) .pharyngitis .is .established .with .a .rapid-strep .test, .and
.oral .penicillin .is .prescribed. .The .nurse .knows .which .of .the .following
.statements .about .GABHS .is .correct?
a. .Children .with .a .GABHS .infection .are .less .likely .to .contract .the .illness .again
.after .the .antibiotic .regimen .is .completed.
b. .A .follow-up .throat .culture .is .recommended .following .the .completion .of
.antibiotic .therapy.
c. .Children .with .a .GABHS .infection .are .at .increased .risk .for .the .development .of
.rheumatic .fever .(RF) .and .glomerulonephritis.
d. .Children .with .a .GABHS .infection .are .at .increased .risk .for .the .development .of
.rheumatoid .arthritis .in .adulthood. .- .CORRECT .ANSWER-C. .Children .with
.GABHS .infection .are .at .increased .risk .for .the .development .of .rheumatic .fever
.(RF) .and .glomerulonephritis
A .5-year-old .is .recovering .from .a .tonsillectomy .and .adenoidectomy .and .is
.being .discharged .home .with .his .mother. .Home .care .instructions .should
.include .which .of .the .following? .Select .all .that .apply.
a. .Observe .the .child .for .continuous .swallowing.
b. .Encourage .the .child .to .take .sips .of .cool, .clear .liquids.
c. .Administer .codeine .elixir .as .necessary .for .throat .pain.
d. .Observe .the .child .for .restlessness .or .difficulty .breathing.
e. .Encourage .the .child .to .cough .every .4 .to .5 .hours .to .prevent .pneumonia.
f. .Administer .an .analgesic .such .as .acetaminophen .for .pain. .- .CORRECT
.ANSWER-A. .Observe .the .child .for .continuous .swallowing
B. .Encourage .the .child .to .take .sips .of .cool, .clear .liquids .
D. .Observe .child .for .restlessness .or .difficulty .breathing
F. .Administer .an .analgesic .such .as .acetaminophen .for .pain
A .3-month-old .infant .is .seen .in .the .clinic .with .the .following .symptoms:
.irritability, .crying, .refusal .to .nurse .for .more .than .2 .to .3 .minutes, .rhinitis, .and .a
.rectal .temperature .of .101.8° .F .(38.8° .C). .The .labor, .delivery, .and .postpartum
.history .for .this .term .infant .is .unremarkable. .The .nurse .anticipates .a .diagnosis
.of:
a. .Acute .otitis .media .(AOM)
, b. .Otitis .media .with .effusion .(OME)
c. .Otitis .externa
d. .Respiratory .syncytial .virus .(RSV) .- .CORRECT .ANSWER-A. .Acute .Otitis .Media
.(AOM)
A .5-year-old .is .seen .in .the .urgent .care .clinic .with .the .following .history .and
.symptoms: .sudden .onset .of .severe .sore .throat .after .going .to .bed, .drooling .and
.difficulty .swallowing, .axillary .temperature .of .102.2° .F .(39.0° .C), .clear .breath
.sounds, .and .absence .of .cough. .The .child .appears .anxious .and .is .flushed.
.Based .on .these .symptoms .and .history, .the .nurse .anticipates .a .diagnosis .of:
a. .Group .A .beta-hemolytic .streptococcus .(GABHS) .pharyngitis
b. .Acute .tracheitis
c. .Acute .epiglottitis
d. .Acute .laryngotracheobronchitis .(LTB) .- .CORRECT .ANSWER-C. .Acute
.epiglottis
A .2-month-old .formerly .healthy .infant .born .at .term .is .seen .in .the .urgent .care
.clinic .with .intercostal .retractions, .respiratory .rate .of .62, .heart .rate .of .128,
.refusal .to .breastfeed, .abundant .nasal .secretions, .and .a .pulse .oximeter .reading
.of .88% .in .room .air. .The .diagnosis .of .respiratory .syncytial .virus .(RSV) .is .made,
.and .a .bronchodilator .is .administered. .The .infant's .oxygen .saturation .(SaO2)
.remains .95% .in .room .air, .and .the .respiratory .rate .is .54, .with .intercostal
.retractions; .heart .rate .is .120 .bpm. .After .2 .hours .of .observation .and .an
.intravenous .(IV) .bolus .of .fluids, .the .infant .is .being .discharged .home. .The .nurse
.provides .which .of .the .following .home .care .instructions .for .this .infant? .Select
.all .that .apply.
a. .Continue .breastfeeding .infant.
b. .Discontinue .breastfeeding .and .administer .Pedialyte .for .24 .hours.
c. .Observe .infant .for .labored .breathing .or .apnea .(cessation .of .breathing).
d. .Instill .normal .saline .drops .in .bot .- .CORRECT .ANSWER-A. .Continue
.breastfeeding .infant .
C. .Observe .infant .for .labored .breathing .or .apnea .(cessation .of .breahting)
D. .Instill .normal .saline .drops .in .both .nares .and .suction .thoroughly .before
.feeding .and .before .placing .to .sleep
F. .Keep .the .infant .out .of .daycare .or .nursery
Which .of .the .following .should .be .used .in .the .care .of .all .pediatric .patients .to
.reduce .the .risk .of .transmission .of .microorganisms .from .both .recognized .and
.unrecognized .sources .of .infection?
a. .Transmission-based .precautions
b. .Airborne .precautions
c. .Standard .precautions
d. .Droplet .precautions .- .CORRECT .ANSWER-C. .Standard .Precautions
Which .childhood .vaccine .provides .some .protection .against .bacterial .meningitis,
.epiglottitis, .and .bacterial .pneumonia?
