Peds NCLEX final exam questions and answers (Actual test Graded A+)

Peds NCLEX final exam questions and answers (Actual test Graded A+) The nurse is educating the parents of a child with a new diagnosis of Juvenile Idiopathic Arthritis on ways to help with mobility. Which statement by the parents requires the need for further education? A. Gentle movement will help keep joint mobility B. We will make sure to keep the joint bent and resting on a pillow for comfort C. A splint may be needed to keep the joint in correct alignment D. Hot and cold compresses can help decrease inflammation and improve joint mobility - B What is needed to diagnose a child with JIA? (SATA) A. The child must be younger than 16 years old B. The child must have swelling in at least one joint for at least 6 weeks C. The child must test positive with rheumatoid factor D. The child must have 2 or more signs of either decreased range of motion E. All of the above - A, B, D The RN is providing care for a 9yo with JIA, the parents tell the RN that their child has not been eating well, and that they are worried that their child isn't getting enough nutrients. The RN knows that the best diet for a child with JIA is which of the following? A. High fat, high calories, low protein diet B. High carbohydrate, low calcium, low fat diet C. High fiber, high protein and calcium diet D. Low density protein, low fat, high calcium diet - C A child with JIA has uveitis, an associated inflammation of the eye structures in the uveal tract, the RN knows this can lead to what eye condition if not treated? A. Glaucoma B. Vision loss C. Cataracts D. Astigmatism - B Which statement below correctly defines precocious puberty? A. Onset of puberty before 8 years old in girls, and before 9 years old in boys B. Puberty that occurs late in age C. Onset of puberty associated with chronic illness D. Puberty that only affects female gender - A A 7 year old girl presents to the doctors office with acne, moodiness, and onset of axillary hair that started 3 months ago. As the nurse is taking care of her you know all of these signs and symptoms can be indicative of which condition? A. Growth hormone deficiency B. Precocious puberty C. SIADH D. Graves' disease - B What statement by a parent of an 8yo daughter, newly diagnosed with central precocious puberty, alerts the nurse for the need for further teaching? SATA A My daughter has an appointment made next week for birth control. B. We allow her to play on the teenager soccer team, since those players are more her size. C. My daughter is being sent to have an x-ray of her wrist next Tuesday to let us know how progressed this is. D. We made this experience more positive by allowing her to pick out her own body wash and deodorant. - A, B A child comes in for their visit with a new diagnosis of precocious puberty. As a nurse you know that while dealing with this child, it is important to consider: SATA A. The child's level of intellectual development B. If the child is currently taking aspirin C. What psychosocial stage they are in D. If the child currently sees a counselor - A, C, D A 6 year old recently diagnosed with diabetes mellitus type 1 has been administered insulin on a scheduled basis for the last month. She is experiencing hypoglycemic episodes and a decreased need for insulin. Her parents feel that her diabetes is getting better and there is not a need for insulin anymore. How does the RN respond to this? A. Explain to her parents she is in the honeymoon phase B. Inform the parents she is in remission C. Tell the parents they may need to purchase a new glucometer D. Advise the parents this is abnormal - A A 7 year old child is brought into the emergency department and is experiencing hypoglycemia. What signs and symptoms would the RN expect to see? SATA A. Diaphoresis B. Polyuria C. Dyspnea D. Polyphagia E. Tachycardia - A, D, E The Nurse on duty gets asked by a new graduate nurse what the difference is between type 1 and type 2 DM when looking at medications and treatment. The Nurse knows that the main difference concerning diabetes management is: SATA A. Beta cells with type 2 DM do not secrete enough insulin within the body to control BGL B. Beta cells with type 2 DM cannot secrete insulin within the body and insulin is needed to regulate BGL C. The islet cells of the pancreas produce little to none insulin with type 1 DM and insulin replacement is used for long term control of BGL D. Type 1 DM will require lifelong treatment with insulin and cannot be cured with exercise or diet E. Type 2 DM can be controlled with a healthy lifestyle and may not require lifelong medication therapy to control BGL. - A, C, D, E When the RN is teaching a mom with a newly diagnosed child about sick day rules for DM1 the nurse would be sure to teach which of the following? A. Skip insulin injections if the child refuses to eat B. Limit fluid intake to help clear ketones in the blood C. Test blood glucose levels every 4 hours or more often to assess for hyper or hypoglycemia D. Change the meal plan to accommodate for the nausea and sickness - C The nurse is teaching a 5 year old's family about the recent diagnosis of Type 1 diabetes. The nurse knows there is a need for additional teaching when the mother states: A. Treatment will change as he grows older b. When he becomes an adult, he will have diabetes type 2 C. He will always have Type 1 diabetes because his immune system attacks the calls of the pancreas, therefore it cannot produce insulin. D. Injection sites need to be rotated daily, and he may be eligible for an insulin pump - B A 10 year old newly diagnosed with Diabetes Type 1 is devastated with the news and is crying. What statement made by the child shows understanding? A. I'll never be able to play football at my school. I really wanted on the team. B. Everyone will be watching me every time I give myself a shot. C. My sugar level should be between 90-130mg/dL D. I will never need tests other than my sugar levels - C The nurse is assigned a 5 year old with enuresis. The family is concerned because the had been dry for 7 consecutive months prior to this current hospitalization. They are asking the nurse what can be done to help with this problem. What is the nurses best response? A. Desmopressin has been known to help children not wet the bed. B. Thats not good, your daughter probably has a UTI. C. Children often regress to wetting the bed when they are hospitalized. I will preform and assessment to see if there are any other concern, but if it is regression, she should be able to retrain when she returns home. D. Does your child possible have a pinworm infection? - C A school age child has been experiencing enuresis. What are some physical factors that may cause this? SATA A. Decreased bladder capacity B. Sun poisoning C. UTI D. Diabetes mellitus E. Epistaxis - A, C, D The nurse is educating the child and parents about therapeutic management for nocturnal enuresis. Which statement made by the parents of a 5 year old with nocturnal enuresis requires a need for further education? A. We will limit liquids before bedtime B. I know it is important to avoid sugar and caffeine after 4pm C. DDAVP is the best option for all children with nocturnal enuresis D. Our child will continue to use the restroom prior to bedtime - C A nurse is caring for a 6 year old who has been experiencing bedwetting a few times a week. Which physical factor would the nurse know to assess for with enuresis? A. The child has recently moved homes and has a new sibling and has increased stress B. The nurse should assess for any emotional trauma from previous sexual abuse C. The nurse should assess for diabetes mellitus D. Has the child experienced increased pressure to potty train? - C A child is taking Desmopressin for the treatment of enuresis. What lab needs to be monitored with this drug? A. Calcium B. Sodium C. BUN D. Potassium - B A child with Diurnal enuresis should also be assessed for what other medical condition? A. Juvenile Arthritis B. Diabetes C. Congestive heart failure D. Constipation - B What is the priority nursing intervention for a newborn diagnosed with cryptorchidism: A. Asses the parent's education level and knowledge of their child's condition. B. Administering pain medication to the neonate. C. Educating the parents on the child's condition and providing them with resources. D. Consult with the physician about immediate surgical intervention. - C A nurse is examining a newborn postpartum, during the examination the nurse notes that the child has an undescended testis. When the physician examines the child finds both testes in place. What could have happened during the initial exam? A. The testicle spontaneously descended in that time frame. B. Cremasteric reflex, caused a false diagnosis from the child being upset or cold. C. The nurse did not perform the exam D. None of the above. - B At what gestational age do we expect the testes begin to descend in a male fetus? A. 36-40 weeks B. 28-32 weeks C. 32-36 weeks D. 24-28 weeks - C In an infant less than 6 months of age, the most appropriate management of cryptorchidism is by observation rather than surgery. A. True B. False - A Which statement made by the parent of a 4 month old child with cryptorchidism indicates the need for further teaching? A. The testes may descend during my child's first 6 months of life B. The prognosis for cryptorchidism is good with proper diagnosis and treatment C. Treatment should be delayed until my child is 2 years old D. It will be important for my child to start regular testicular self examinations when he is an adolescent - C Which lab values could the nurse expect to see in a child with true absence of the testes? SATA A. Increased FSH B. Decreased FSH C. Normal Testosterone D. Increased LH E. Absent testosterone - A, D, E All of the following are important nursing postop interventions for a child following a hypospadias surgery except: A. Encourage high fluids to maintain hydration and free urine flow B. Remove pressure dressing after the required four days to prevent infection C. Encourage parents to proved environmental stimulation for the child D. Encourage parents to bring the child's favor toy or music to calm them - B The parents of a child with hypospadias need additional information when they state: A. My child will have a problem with urinary continence if not surgically corrected B. This is a congenital anomaly in which the actual urethral opening is below the penis C. My child's activity will be restricted for several days after surgery D. If not surgically corrected, my child may have issues with infertility as an adult - A After surgical repair of hypospadias, the nurse's priority assessment is to... A. Assess the infant's pain using the cries scale B. Ensure the pressure dressing is intact C. Administer 2mg/kg sulfamethoxazole/trimethoprim PO once daily D. Assess the infant's ability to drink - B What kind of graft is used for surgical repair of hypospadias? A. Allograft B. Xenograft C. Preputial skin graft D. Synthetic skin substitute - C