Peds Capstone Review Exam Questions And
Correct Answers
cleft palate post op care - ANSWER post surgery:
-avoid having baby suck on nipple or pacifier
-place baby laterally or on stomach to help prevent aspiration and facilitate drainage
-apply restraints to prevent baby from disturbing operative site
-Keep the infant pain-free to decrease crying and stress on repair
-Feed w/ cups, Avoid sucking on nipple or pacifier
-monitor I/O's daily
Change position frequently to facilitate breathing & place on abdomen in immediate
post-op period
Maintain IV fluids until infant able to eat & drink
meningitis care - ANSWER-institute droplet precautions immediately
-maintain for at least 24 hours after initial abx administration
-keep pt npo if there is a decrease in LOC (r/t aspiration)
-dark quiet environment (photophobia)
-admx medications (abx, corticosteroids)
-mx for signs of increase ICP
Place the client in a position without a pillow and with the head of the bed slightly
elevated. The client can also be placed side-lying to decrease discomfort of the neck.
keep room cool
-onset of petechial or purpuric-type rash is considered a medical emergency
,A nurse is providing care for a child who has suffered a closed head injury. What clinical
manifestations would indicate worsening of this client's condition? - ANSWER -changes
in vital signs
-altered mental status
-increased intracranial pressure
alterations of pupillary response
posturing
bradycardia
decreased motor response
decreased sensory response
Cheyne-Stokes respirations
coma
The pediatric client is admitted to the emergency department with a diagnosis of a
closed head injury. Choose the laboratory and diagnostic tests that will be ordered. -
ANSWER -ABGs,
-blood alcohol and toxicology screening,
-CBC with differential
-liver function tests;
-cervical spine x-rays to rule out cervical spine injury,
Imaging Studies: -CT and/or MRI of head and/or neck may be done with and without
contrast if indicated-measurement of ICP A child is admitted to the emergency
department with a closed head injury. What medications can the nurse expect the
provider to order and why? - ANSWER -Mannitol for the treatment of cerebral edema
-Antibiotics: Utilize r/t CSF leakage, laceration, or penetration injuries
-Analgesics: Used of HA/pain management
-Corticosteroids: Used to decrease cerebral edema
Antiepileptics: Used to prevent/treat seizures
A nurse is examining for strabismus in a pediatric client. Identify three 3 clinical findings
, noted with strabismus. - ANSWER -Eyes that appear crossed or an eye that seems to
wander
-Uncoordinated eye movements
-Asymmetric corneal light reflex
misaligned eyes,
inward deviation of eye
frowning or squinting
trouble seeing print clearly
one eye shut to allow for improved vision
head leaning to one side
headache, dizziness
diplopia
photophobia
crossed eyes.
What is a Wilm's tumor and what are manifestations of this type of cancer? - ANSWER a
Wilm's tumor or nephroblastoma (kidney cancer) is a malignancy that occurs in the
kidneys or abdomen.
Manifestations
-firm, nontender abdominal swelling or mass
-fatigue, malaise, weight loss
-fever
-hematuria
-hypertension
-avoid abdominal palpation or manipulation
Correct Answers
cleft palate post op care - ANSWER post surgery:
-avoid having baby suck on nipple or pacifier
-place baby laterally or on stomach to help prevent aspiration and facilitate drainage
-apply restraints to prevent baby from disturbing operative site
-Keep the infant pain-free to decrease crying and stress on repair
-Feed w/ cups, Avoid sucking on nipple or pacifier
-monitor I/O's daily
Change position frequently to facilitate breathing & place on abdomen in immediate
post-op period
Maintain IV fluids until infant able to eat & drink
meningitis care - ANSWER-institute droplet precautions immediately
-maintain for at least 24 hours after initial abx administration
-keep pt npo if there is a decrease in LOC (r/t aspiration)
-dark quiet environment (photophobia)
-admx medications (abx, corticosteroids)
-mx for signs of increase ICP
Place the client in a position without a pillow and with the head of the bed slightly
elevated. The client can also be placed side-lying to decrease discomfort of the neck.
keep room cool
-onset of petechial or purpuric-type rash is considered a medical emergency
,A nurse is providing care for a child who has suffered a closed head injury. What clinical
manifestations would indicate worsening of this client's condition? - ANSWER -changes
in vital signs
-altered mental status
-increased intracranial pressure
alterations of pupillary response
posturing
bradycardia
decreased motor response
decreased sensory response
Cheyne-Stokes respirations
coma
The pediatric client is admitted to the emergency department with a diagnosis of a
closed head injury. Choose the laboratory and diagnostic tests that will be ordered. -
ANSWER -ABGs,
-blood alcohol and toxicology screening,
-CBC with differential
-liver function tests;
-cervical spine x-rays to rule out cervical spine injury,
Imaging Studies: -CT and/or MRI of head and/or neck may be done with and without
contrast if indicated-measurement of ICP A child is admitted to the emergency
department with a closed head injury. What medications can the nurse expect the
provider to order and why? - ANSWER -Mannitol for the treatment of cerebral edema
-Antibiotics: Utilize r/t CSF leakage, laceration, or penetration injuries
-Analgesics: Used of HA/pain management
-Corticosteroids: Used to decrease cerebral edema
Antiepileptics: Used to prevent/treat seizures
A nurse is examining for strabismus in a pediatric client. Identify three 3 clinical findings
, noted with strabismus. - ANSWER -Eyes that appear crossed or an eye that seems to
wander
-Uncoordinated eye movements
-Asymmetric corneal light reflex
misaligned eyes,
inward deviation of eye
frowning or squinting
trouble seeing print clearly
one eye shut to allow for improved vision
head leaning to one side
headache, dizziness
diplopia
photophobia
crossed eyes.
What is a Wilm's tumor and what are manifestations of this type of cancer? - ANSWER a
Wilm's tumor or nephroblastoma (kidney cancer) is a malignancy that occurs in the
kidneys or abdomen.
Manifestations
-firm, nontender abdominal swelling or mass
-fatigue, malaise, weight loss
-fever
-hematuria
-hypertension
-avoid abdominal palpation or manipulation
