PEDIATRIC NURSING PRACTICE
QUESTIONS AND ANSWERS.1
An 18-Month-Old is discharged from the hospital after having a febrile seizure
secondary to exanthem subitum (Roseola). On discharge, the mother asks the nurse if
her 6-year-old twins will get sick. Which teaching about the transmission of roseola
would be most accurate?
1. The child should be isolated at home until the vesicles have dried.
2. The child does not need to be isolated from the older siblings.
3. Administer acetaminophen to the older siblings to prevent seizures.
4. Monitor older children for seizure development. - Answers-. 2. The route of roseola
transmission is unkown, and the disease is more commonly seen in children 6 months
to 3 years of age, so siblings do not need to be isolated.
Which would be the priority intervention for a child suspected of having varicella
(chickenpox)?
1. Contact Precautions
2. Contact and Droplet Respiratory Precautions?
3. Droplet respiratory precautions?
4. Universal Precautions and standard precautions. - Answers-2. Varicella (Chickenpox)
is highly contagious. Contact & Droplet respiratory precautions should be started
immediately because the primary source of transmission is secretions of the respiratory
tract (droplet) and also by contaminated objects.
Caladryl - Answers-A lotion containing diphenhydramine. Should not be applied if child
has already been given benadryl (diphenhydramine) because it can cause toxicity.
Which s&s would the nurse expect with rheumatic fever?
1. Ankle and Knee Joint Pain.
2. Negative group A beta strep culture.
3. Large, red "bulls eye" - appearing rash.
4. stiff neck with photophobia. - Answers-Ankle and knee joint pain.
The parents of a 12-month old with HIV are concerned about him receiving routine
immunizations. What will the nurse tell them about immunizations? - Answers-"You are
concerned about your child receiving immunizations. Let me explain why your child will
NOT receive routine immunizations today"
,The nurse acknowledges a client's fears and then discusses the concerns to clarify any
misconceptions. Immunizations and influenza vaccine are recommended to prevent
infection. Immunocompromised HIV-infected children should not receive MMR and
varicella live vaccines.
Nursing Assessment suspects the newborn has cystic fibrosis. Which interventions
would the nurse begin.
1. Observe frequency and nature of stools.
2. Provide Chest PT
3. Observe for weight gain.
4. Assess parent's compliance with fluid restrictions.
5. Assess respiratory system frequently. - Answers-1 & 3
Cystic fibrosis is an inherited autsomal trait, causing exocrien gland dysfunction. 7-10%
present meconium ileus, so assessing stool frequency and consistency is important.
Assessing weight is important in newborns because they lose up to 10% of their birth
weight, and can take 2 weeks for them to regain their birth weight.
Assessing the newborn's respiratory system frequently would be monitored as
frequently as other infants if the newborn has no respiratory symptoms. Chest PT would
not be initiated in a newborn without a definitive diagnosis.
Can a mother breastfeed their infant if they have PKU? - Answers-Yes. Breast milk has
low amounts of phenylalanine, so the mother can breast as long as the infants
phenylalanine level is monitored.
Vaccines given routinely at 15 months. - Answers-Hib & DTaP
Which priority intervention for the newborn of a mother positive for hepatitis antigen? -
Answers-The newborn should receive both hepatitis B vaccine and hepatitis B immune
globulin within 12 hours of birth to prevent hepatitis B infection.
signs of intussusception - Answers-bloody stools or "currant jelly stools", diarrhea,
Large palpable sausage shaped mass in the abdomen, abdominal distention, grunting,
dehydration Fever, and pain (legs pulled towards abdomen)!
Flat Ribbon Stools indicate - Answers-Hirschsprung Disease
Treatment for Intussusception - Answers-Barium or air enema
Nursing Care for Intussusception - Answers-Document I & O
Monitor for peritonitis & perforation
Monitor and record stools
, Biggest complications of Intussusception - Answers-Peritonitis and Perforation
Risk factors for intussusception - Answers-Cystic Fibrosis
Ages 3 months to 3 years old.
Complication of Mal-Rotation & Valvolus - Answers-Pain related to rotation of intestines
around the mesenteric artery can cut off circulation, leading to potential septic intestinal
necrosis.
Which pediatric GI disorder presents with green bilious vomiting? - Answers-Mal-
Rotation and Valvolus
GI disorders that present with bloody stools? - Answers-Mal-Rotation/Valvolus &
Intussusception.
Obstructive GI disorders where a palpated sausage shaped mass is felt on the
abdomen. - Answers-Mal-Rotation and Valvolus. Symptoms for these disorders are
similar but Mal-Rotation requires surgical intervention.
Preoperative care for Mal-Rotation/Valvolus - Answers-Hydration, IV antibiotics, NG
tube.
Post-Operative Care for Intussusception - Answers-Bowel sounds should return in four
hours, progressive diet, hydration.
Priority nursing diagnosis for intussusception - Answers-Acute Pain!
Which response about safety measures is the most appropriate advice for the 2 year
old's mother who had her older home remodeled to reduce the lead level? Select all that
apply.
1. Wash & dry the child's hands and face before he eats.
2. it is best to use cold water to prepate the child's food to decrease lead level.
3. diet does not matter in reduce lead levels in the child.
4. Drinking two cups of milk per day helps decrease lead levels. - Answers-1 & 3.
Washing and drying hands and face especially before eating, decreases lead ingestion.
Hot water absorbs more lead readily than hot water. Diet does matter; regular meals,
adequate iron and calcium, and less fat help the child absorb less lead. Drinking 2 cups
of milk per day is important for children but does not help decrease lead level.
Which would the nurse explain to parents about the inheritance of cystic fibrosis?
1. The child of parents who are both carriers of the gene for CF has a 50% chance of
acquiring CF.
2. The child of a mother who has CF and a father who is a carrier of the gene for CF
has a 50% chance of acquiring CF. - Answers-2. If the child is born to a parent with CF
QUESTIONS AND ANSWERS.1
An 18-Month-Old is discharged from the hospital after having a febrile seizure
secondary to exanthem subitum (Roseola). On discharge, the mother asks the nurse if
her 6-year-old twins will get sick. Which teaching about the transmission of roseola
would be most accurate?
1. The child should be isolated at home until the vesicles have dried.
2. The child does not need to be isolated from the older siblings.
3. Administer acetaminophen to the older siblings to prevent seizures.
4. Monitor older children for seizure development. - Answers-. 2. The route of roseola
transmission is unkown, and the disease is more commonly seen in children 6 months
to 3 years of age, so siblings do not need to be isolated.
Which would be the priority intervention for a child suspected of having varicella
(chickenpox)?
1. Contact Precautions
2. Contact and Droplet Respiratory Precautions?
3. Droplet respiratory precautions?
4. Universal Precautions and standard precautions. - Answers-2. Varicella (Chickenpox)
is highly contagious. Contact & Droplet respiratory precautions should be started
immediately because the primary source of transmission is secretions of the respiratory
tract (droplet) and also by contaminated objects.
Caladryl - Answers-A lotion containing diphenhydramine. Should not be applied if child
has already been given benadryl (diphenhydramine) because it can cause toxicity.
Which s&s would the nurse expect with rheumatic fever?
1. Ankle and Knee Joint Pain.
2. Negative group A beta strep culture.
3. Large, red "bulls eye" - appearing rash.
4. stiff neck with photophobia. - Answers-Ankle and knee joint pain.
The parents of a 12-month old with HIV are concerned about him receiving routine
immunizations. What will the nurse tell them about immunizations? - Answers-"You are
concerned about your child receiving immunizations. Let me explain why your child will
NOT receive routine immunizations today"
,The nurse acknowledges a client's fears and then discusses the concerns to clarify any
misconceptions. Immunizations and influenza vaccine are recommended to prevent
infection. Immunocompromised HIV-infected children should not receive MMR and
varicella live vaccines.
Nursing Assessment suspects the newborn has cystic fibrosis. Which interventions
would the nurse begin.
1. Observe frequency and nature of stools.
2. Provide Chest PT
3. Observe for weight gain.
4. Assess parent's compliance with fluid restrictions.
5. Assess respiratory system frequently. - Answers-1 & 3
Cystic fibrosis is an inherited autsomal trait, causing exocrien gland dysfunction. 7-10%
present meconium ileus, so assessing stool frequency and consistency is important.
Assessing weight is important in newborns because they lose up to 10% of their birth
weight, and can take 2 weeks for them to regain their birth weight.
Assessing the newborn's respiratory system frequently would be monitored as
frequently as other infants if the newborn has no respiratory symptoms. Chest PT would
not be initiated in a newborn without a definitive diagnosis.
Can a mother breastfeed their infant if they have PKU? - Answers-Yes. Breast milk has
low amounts of phenylalanine, so the mother can breast as long as the infants
phenylalanine level is monitored.
Vaccines given routinely at 15 months. - Answers-Hib & DTaP
Which priority intervention for the newborn of a mother positive for hepatitis antigen? -
Answers-The newborn should receive both hepatitis B vaccine and hepatitis B immune
globulin within 12 hours of birth to prevent hepatitis B infection.
signs of intussusception - Answers-bloody stools or "currant jelly stools", diarrhea,
Large palpable sausage shaped mass in the abdomen, abdominal distention, grunting,
dehydration Fever, and pain (legs pulled towards abdomen)!
Flat Ribbon Stools indicate - Answers-Hirschsprung Disease
Treatment for Intussusception - Answers-Barium or air enema
Nursing Care for Intussusception - Answers-Document I & O
Monitor for peritonitis & perforation
Monitor and record stools
, Biggest complications of Intussusception - Answers-Peritonitis and Perforation
Risk factors for intussusception - Answers-Cystic Fibrosis
Ages 3 months to 3 years old.
Complication of Mal-Rotation & Valvolus - Answers-Pain related to rotation of intestines
around the mesenteric artery can cut off circulation, leading to potential septic intestinal
necrosis.
Which pediatric GI disorder presents with green bilious vomiting? - Answers-Mal-
Rotation and Valvolus
GI disorders that present with bloody stools? - Answers-Mal-Rotation/Valvolus &
Intussusception.
Obstructive GI disorders where a palpated sausage shaped mass is felt on the
abdomen. - Answers-Mal-Rotation and Valvolus. Symptoms for these disorders are
similar but Mal-Rotation requires surgical intervention.
Preoperative care for Mal-Rotation/Valvolus - Answers-Hydration, IV antibiotics, NG
tube.
Post-Operative Care for Intussusception - Answers-Bowel sounds should return in four
hours, progressive diet, hydration.
Priority nursing diagnosis for intussusception - Answers-Acute Pain!
Which response about safety measures is the most appropriate advice for the 2 year
old's mother who had her older home remodeled to reduce the lead level? Select all that
apply.
1. Wash & dry the child's hands and face before he eats.
2. it is best to use cold water to prepate the child's food to decrease lead level.
3. diet does not matter in reduce lead levels in the child.
4. Drinking two cups of milk per day helps decrease lead levels. - Answers-1 & 3.
Washing and drying hands and face especially before eating, decreases lead ingestion.
Hot water absorbs more lead readily than hot water. Diet does matter; regular meals,
adequate iron and calcium, and less fat help the child absorb less lead. Drinking 2 cups
of milk per day is important for children but does not help decrease lead level.
Which would the nurse explain to parents about the inheritance of cystic fibrosis?
1. The child of parents who are both carriers of the gene for CF has a 50% chance of
acquiring CF.
2. The child of a mother who has CF and a father who is a carrier of the gene for CF
has a 50% chance of acquiring CF. - Answers-2. If the child is born to a parent with CF
