Jersey College Peds Exam 2-Final Questions and Answer

Jersey College Peds Exam 2-Final Questions and Answer A child is brought to the emergency department after experiencing a series of continuous seizures. The nurse is reviewing the orders for care and treatment. Which order would be of the highest priority? serum glucose level The nurse cares for a 7-year-old child with new-onset seizure disorder. Which prescription will the nurse anticipate for this client? use of anticonvulsant medications To detect complications as early as possible in a child with meningitis who's receiving IV fluids, monitoring for which condition should be the nurse's priority? Cerebral edema Dexamethasone is often prescribed for the child who has sustained a severe head injury. Dexamethasone is a(n): steroid While in a pediatric client's room, the nurse notes that the client is beginning to have a tonic-clonic seizure. Which nursing action is priority? Protect the child from hitting the arms against the bed The nurse is caring for a child with a suspected head injury. The nurse observes for what response to the child's eye reflex examination that would indicate potential increased intracranial pressure (ICP)? While assessing the child's pupils, there is no change in diameter in response to a light Absence seizures are marked by what clinical manifestation? Loss of motor activity accompanied by a blank stare The nurse is caring for a 6-year-old child who has a history of febrile seizures and is admitted with a temperature of 102.2°F (39°C). What is the nurse's highest priority? Institute safety precautions The parent of a 12-year-old child with Reye syndrome approaches the nurse wanting to know how this happened to the child, saying, "I never give my children aspirin!" What could the nurse say to begin educating the parent? Sometimes it is hard to tell what products may contain aspirin Which of these age groups has the highest actual rate of death from drowning? Toddlers The nurse and an adolescent are reviewing the adolescent's record of her headaches and activities surrounding them. What activity would the nurse identify as a possible trigger? drinking three cans of diet cola The nurse is caring for a 3-year-old child who experienced a febrile seizure for the first time. What statements by the parents of the child should the nurse address further? I am afraid that our 10-year-old will start having febrile seizures, It is so scary to think that our child will likely develop epilepsy now A mother has just given birth to an infant born with anencephaly. The mother states, "With all of the technological advances in medicine, I am hopeful of a good prognosis for my baby." How should the nurse respond? It must be very difficult to deal with this diagnosis. Tell me what you know about the prognosis A 9-year-old client who suffered a head injury has strabismus. The nurse assesses the client for intracranial pressure (ICP). Which additional intervention is most important for the nurse to perform? Assess the level of consciousness (LOC) A nurse is assessing a 3-year-old child for possible bacterial meningitis. Which sign would indicate irritation of the meninges? Positive Kernig sign Preterm infants have more fragile capillaries in the periventricular area than term infants. This put these infants at risk for which problem? intracranial hemorrhaging A 1-year-old infant has just undergone surgery to correct craniosynostosis. Which comment is the best psychosocial intervention for the parents? The surgery was successful. Do you have any questions? A pregnant client asks if there is any danger to the development of her fetus in the first few weeks of her pregnancy. How should the nurse respond? During the first 3 to 4 weeks of pregnancy, brain and spinal cord development occur and are affected by nutrition, drugs, infection, or trauma A child with a seizure disorder is being admitted to the inpatient unit. When preparing the room for the child, what should be included? oxygen gauge and tubing, suction at bedside, padding for side rails The parents of a 17-year-old adolescent diagnosed with bacterial meningitis tell the nurse, "We just do not understand how this could have happened. Our adolescent has always been healthy and just received a booster vaccine last year." How should the nurse respond? I understand your frustration. Unfortunately, immunizations are not 100% effective in preventing the infection Antibiotic therapy to treat meningitis should be instituted immediately after which event? Collection of cerebrospinal fluid (CSF) and blood for culture A nurse on the neurology unit is monitoring an 8-year-old child admitted with seizures. The child experiences a prolonged tonic-clonic seizure. What should the nurse do next? The nurse should first ensure proper oxygenation followed by administer intravenous (IV) or intramuscular (IM) benzodiazepine A 6-year-old has had a viral infection for the past 5 days and is having severe vomiting, confusion, and irritability, although he is now afebrile. During the assessment, the nurse should ask the parent which question? Did you use any medications, like aspirin, for the fever? A child has been diagnosed with a basilar skull fracture. The nurse identifies ecchymosis behind the child's ear. This would be documented as: Battle sign The mother of a toddler tells the nurse during a routine well-child appointment that she is concerned because, "It seems like my son is falling and hitting his head all of the time." What is the best response by the nurse? Due to the size of their heads and immature neck muscles falling is common, but I will let the physician know your concerns The nurse is collecting data from a child who may have a seizure disorder. Which nursing observations suggest an absence seizure? Minimal or no alteration in muscle tone, with a brief loss of responsiveness or attention The nurse is educating the family of a 7-year-old with epilepsy about care and safety for this child. What comment will be most valuable in helping the parent and the child cope? Use this information to teach family and friends The nurse is preparing a child experiencing new-onset seizures for an electroencephalogram (EEG) test. How can the nurse best explain this procedure to the child? Use a doll with electrodes attached to the head Any individual taking phenobarbital for a seizure disorder should be taught: never to discontinue the drug abruptly Which nursing action should be included in the care plan to promote comfort in a 4-year-old child hospitalized with meningitis? Avoid making noise when in the child's room The nurse is interviewing the caregivers of a child brought to the emergency unit. The caregiver states, "She has a history of seizures but this time it lasted more than 30 minutes and she just keeps having them." The most accurate description of this child's condition would be: The child is in status epilepticus A group of nursing students are reviewing cerebral vascular disorders and risk factors in children. The students demonstrate understanding of the material when they identify which as a risk factor for hemorrhagic stroke? arteriovenous malformations (AVMs) The nurse helps position a child for a lumbar puncture. Which statement describes the correct positioning for this procedure? For a lumbar puncture, the child will be placed in a side-lying position with knees bent and neck flexed to assist with arching the back A 9-year-old boy is suffering from headaches but has no signs of physical or neurologic illness. Which intervention would be most appropriate? Teach the child and his parents to keep a headache diary During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanels (fontanelles) are not palpable. What action would the nurse take? Report the findings to the pediatric healthcare provider The nurse is educating parents of a male infant with Chiari type II malformation. Which statement about their child's condition is most accurate? Take your time feeding your baby The nurse is educating the parents of a 7-year-old girl with epilepsy about managing treatment of the disorder at home. Which intervention is most effective for eliminating breakthrough seizures? Understanding the side effects of medications A preschool-age child has just been admitted to the pediatric unit with a diagnosis of bacterial meningitis. The nurse would include which recommendation in the nursing plan? Decrease environmental stimulation After teaching a group of students about neural tube disorders, the instructor determines that additional teaching is needed when the students identify which condition as a neural tube defect? Hydrocephalus The nurse knows that the heads of infants and toddlers are large in proportion to their bodies, placing them at risk for what problem? head trauma The nurse is caring for a child diagnosed with hydrocephalus following ventriculoperitoneal shunt placement. The child is currently on a ventilator. Which nursing action is priority? Assess the client's respiratory status During the trial period to determine the efficacy of an anticonvulsant drug, which caution should be explained to the parents? The child shouldn't participate in activities that could be hazardous if a seizure occurs The nurse is using the pediatric Glasgow Coma Scale to assess a child's level of consciousness. What would the nurse assess? eye opening, verbal response, motor response The nurse caring for an infant with craniosynostosis, specifically positional plagiocephaly, should prioritize which activity? moving the infant's head every 2 hours The nurse is caring for a child who has suffered a febrile seizure. While speaking with the child's parents, which statement by a parent indicates a need for further education? I hate to think that I will need to be worried about my child having seizures for the rest of his life A 7-year-old client has been complaining of headache, coughing, and an aching chest. The care provider makes a diagnosis of a viral infection. The child's mother tells the nurse that when she first said she had a headache, the child's father gave her half of an adult aspirin. The mother has heard of Reye syndrome and asks the nurse if her child could get this. Which statement would be the best response by the nurse? This might or might not be a problem. Watch your daughter for signs of lethargy, unusual irritability, confusion, or vomiting. If you notice any of these, bring her to the emergency room immediately so she can be checked for Reye syndrome. What is a true statement regarding status epilepticus? It is a common neurologic emergency in children. In caring for a child with meningitis, the nurse recognizes which nursing diagnosis would be most important to include in this child's plan of care? Risk for injury related to seizure activity A child is hospitalized and diagnosed with bacterial meningitis. What can the nurse anticipate will be included in the plan of care and treatment? Acetaminophen, tepid baths as needed, antibiotic therapy The nurse is providing teaching to the parents of a child recently prescribed carbamazepine for a seizure disorder. Which statement by a parent indicates successful teaching? I need to watch for any new bruises or bleeding and let my healthcare provider know about it The student nurse is discussing the plan of care for a child admitted to the hospital for treatment of an infection. Which action should be taken first? Obtain blood cultures The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? Encourage rest and relaxation A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings? Koplik spots A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as: fifth disease The nurse is caring for a child whose family recently emigrated from a developing country. While completing the admission history, the parents report all the child's immunizations are up to date. Which nursing action is most appropriate? Ask parents which immunizations have been given A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? Mumps An adolescent comes to the emergency room with high fevers, chills, rigors and sweats. Malaria is suspected. When taking the health history, what question should the nurse ask first? Have you traveled outside North America? Which collaborative intervention will the nurse provide when caring for an infant diagnosed with pertussis? Have suction available in the room, Encourage small, frequent feedings, Administer erythromycin for 10 days, Utilize droplet and standard precautions A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders? Eosinophils What is the leading cause of neonatal sepsis and death? Group B streptococcus The rash in roseola is pruritic. Which measure would you teach the parent to provide comfort? Apply cool compresses to the skin to stop local itching The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38°C (100.4°F). The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 ml." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38°C (100.4°F)? 7.5 mL Which child will the nurse identify as at greatest risk for developing a urinary tract infection? an 8-month-old bottle-fed female with HIV A nurse is preparing a presentation for parents about common childhood infectious diseases. What conditions would the nurse include as being caused by a tick bite? Lyme disease, Rocky Mountain spotted fever The nurse is providing teaching to the parents of a child with varicella. Which statement by the parents indicates the teaching was successful? We need to make sure that our child washes their hands frequently The nurse is triaging a child diagnosed with poliomyelitis. After ensuring appropriate precautions are in place, what will the nurse do next? Auscultate the child's lungs The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: bacteria The nurse is discussing fever with the parents of a child who is in the emergency department with a temperature of 101°F (38.3°C). Which statement by a parent indicates an understanding of fevers and their management in the ill child? Fevers can be beneficial because they can slow down the growth of the bacteria or virus that may be causing the infection A 6-month-old infant develops roseola. When obtaining information from the parent, what would the nurse expect the parent to report? The infant's temperature fell when the rash appeared When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate? Herpes zoster is a reactivation of a previous varicella zoster infection The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? Puncturing a vein on the dorsal side of the hand Nursing students are learning about the infectious process. They correctly identify the first stage of an infectious disease to be which period? Incubation period A child has been having episodes of diarrhea. The health care provider prescribes stool collection to assess for parasites. Before obtaining the stool specimen, what question should the nurse ask? Have you given your child any antidiarrheal medication containing bismuth? The public health nurse is discussing immunizations with a group of caregivers of infants. One of the mothers asks the nurse why the child will need immunizations. Which statement would be the most appropriate for the nurse to make to this mother? The infant is born with immunity to some diseases, but those immunities decrease over the first year of life Parents bring their 9-year-old child to the clinic for a well-child visit. They are concerned because several children in the neighborhood have developed Lyme disease and ask for suggestions on what to do to reduce their child's risk. What would be appropriate for the nurse to suggest? Wearing protective clothing when playing in wooded areas, Inspecting the skin closely for ticks after the child plays in wooded areas, Contacting the health care provider if there is any area of inflammation that might be a bite The nurse is assessing a child who presents with a history of fever, malaise, fatigue, and headache. The nurse notes a bulls-eye rash on the child's right leg. Which action will the nurse take? Notify the primary health care provider A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence. Incubation, Prodrome, Illness, Convalescence The nurse is attempting to control the infectious process while caring for a client. The nurse changes the client's wound dressing when the dressing becomes soiled. Which link of the chain of infection is the nurse interrupting with this intervention? Reservoir When caring for a child diagnosed with West Nile virus, the nurse will question which prescription from the primary health care provider? amoxicillin 40 mg/kg/day orally every 8 hours The parents state they are afraid to have their child vaccinated and ask the nurse for more information. Which response by the nurse is most appropriate? Vaccinations are very effective at preventing serious disease and infection A 10-year-old child has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To assure that the sensitivity results are accurate, which step is most important? Obtain specimen before antibiotics are given After teaching nursing students about childhood exanthems, the instructor determines that the teaching was successful when the students identify what as the primary cause? Viruses A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent? Your child may return to school when all of the lesions have crusted over The mother of an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse? While immunizations are highly effective they aren't 100% effective at preventing infectious diseases The trigger of prostaglandins to increase the body's temperature set point is caused by what? Pyrogens Monocytes use what as means to eliminate pathogens? Phagocytosis B cells use what to attack specific foreign substances Antibodies Fever can increase the production of what and slow the growth of bacteria and viruses? Neutrophils Acetaminophen and what administered at the appropriate dose and interval, are safe and effective for reducing fever in children? Ibuprofen A 10-year-old girl with long hair is brought to the emergency room because she began acting irritable, reported a headache, and was very sleepy. Which question is most appropriate for the nurse to ask the parents? What were you doing before she began to feel sick? A 6-year-old boy is suspected of having late-stage Lyme disease. Which assessment should the nurse use to produce findings supporting this concern? Asking the child if his knees hurt The nurse is preparing to administer acetaminophen to a 4-year-old girl to provide comfort to the child. Which precaution is specific to antipyretics? Ensure proper dose and interval A 10-year-old boy has an unknown infection and will need to provide a urine specimen for culture and sensitivity. To ensure that the sensitivity results are accurate, which step is most important? Obtain a specimen before antibiotics are given The nurse at an outpatient facility is obtaining a blood specimen from a 9-year-old girl. Which technique would most likely be used? Puncturing a vein on the dorsal side of the hand