PEDS EXAM 1 AND 2 STUDY GUIDE EXAM
LATEST UPDATE
1. When assessing an adolescent for scoliosis, what should the nurse ask the client to do?
A. Bend at the waist with arm hanging freely
B. Lie flat on the floor and extend the legs straight from the trunk
C. Sit in a chair while lifting the feet and legs to a right angle with the trunk
D. Stand against the wall while pressing the length of the back against the wall
Rationale:
Scoliosis, a lateral deviation of the spine, is assessed by having the client bend forward
at the waist with arms hanging freely and then looking for lateral curvature of the spine
and a rib hump. The other positions will not reveal the deviation of the spine.
2. The nurse performing an admission assessment on a 2 year old who has been diagnosed
with nephrotic syndrome notes that which most common characteristic is associated with
this syndrome?
A. Hypertension
B. Generalized edema
C. Increased urinary output
D. Frank, bright red blood in the urine
Rationale:
Nephrotic syndrome is defined as a massive proteinuria, hypoalbuminemia, hyperlipemia and
edema. Other manifestation is weight gain, preorbital and facial edema that is most prominent
in the morning. Leg, ankle, labial or scrotal edema, decreased urine output and urine that is
dark and frothy. Abdominal swelling and blood pressure that is normal or slightly decreased.
3. After teaching the parents of an infant with clubfoot requiring application of a plaster cast how
to care for the cast, which statement would indicate that the parents have understood the
teaching?
A. “if the cast becomes soiled, we will clean it with soap and water.”
B. “we will elevate the leg with the cast on pillows so the leg is above heart level.”
C. “we will check the color and temperature of the toes of the casted leg frequently.” D.
“the petals on the edge of the cast can be removed after the first 24 hours.”
Rationale:
A cast that is too tight can cause a tourniquet effect, compromising the neurovascular
integrity of the extremity. Manifestations of neurovascular impairment include pain, edema,
pulselessness, coolness, altered sensation, and inability ito move the distal exposed
extremity. The toes of the casted extremity should be assessed frequently to evaluate for
changes in neurovascular integrity. Wetting a plaster cast with water and soap softens the
, plaster, which may alter the cast’s effectiveness. There is no reason to elevate the casted
extremities when a child with clubfoot is being treated with nonsurgical measures. The legs
would be elevated if swelling were present. Petals, which are applied to cover the rough
edges of the cast, are to be left in place to minimize the risk for skin irritation from the cast
edges.
4. The nurse is taking the blood pressure of a 3 year old child admitted to the hospital for
mild dehydration from vomiting and diarrhea and obtains a reading of 90/50 mmhg. The
nurse interprets this as indicating which finding?
A. A normal finding
B. A elevated finding
C. A decreased finding based on the age of the child
D. Significant, indicating possible fluid volume deficit
Rationale :
A normal blood pressure of a 3 year old child is ranges from 72 to 110 mm hg systolic and 4073
mm hg diastolic. The blood pressure obtained is a normal finding.
5. A toddler receiving chemotherapy after surgery for a wilms tumor has developed
neutropenia. The parents are trying to encourage the child to eat by bringing extra foods to
the room. Which foods would the nurse discourage this child from eating?
A. Fudge
B. French fries
C. Fresh strawberries
D. Milk shakes rationale:
When a client receiving chemotherapy develops neutropenia, eating uncooked fruits and
vegetables may pose a health risk due to possible bacterial contamination. All other foods are
either cooked or pasteurized and would not produce a health risk.
6. A nurse is assessing a 3 year old at a routine wellness checkup. Which of the following findings
should the nurse expect?
A. Skips and hops on one foot
B. Has a vocabulary of 1,500 words
C. Walks backwards heel to toe d. Stands on one foot for few
Seconds rationale: page 210, 230 of the pediatric
textbook.
7. The nurse prepares a list of home care instructions for the parents of a child who has a cast
applied to the left forearm. Which instructions should the nurse include in the list? Select all
that apply?
A. Use fingertips to lift the cast while it is drying
B. Keep small toys and sharp objects away from the cast
, C. Use a padded ruler or another padded object to scratch the skin underneath the
cast if it itches
D. Place the heating pad on the lower end of the cast and over the fingers if the
fingers feel cold
E. Elevate the extremities on the pillow for the first 24 to 48 hours after casting to
prevent swelling
F. Contact the primary health care provider (phcp) if the child complains of
numbness and tingling in the extremities.
Rationale:
While the cast is drying, the palms of the hands are used to lift the cast. If the fingertips are used,
indentation in the cast could occur and cause constant pressure on the underlying skin. Small toys and
sharp objects should be kept away from the cast and no objects (included padded objects) are to be
placed inside the cast because of the risk of altered skin integrity. The extremity is elevated to prevent
swelling and the phcp is notified immediately if any signs of neurovascular impairment develops. A
heating pad is not applied to the cast or fingers. Cold fingers could indicate neurovascular impairment
and the phcp should be notified.
8. When teaching the child with scoliosis being treated with a brace about exercises, the nurse
explains that the exercises are performed primarily for what reason?
A. To decrease back muscle spams
B. To improve the brace’s traction effort
C. To prevent spiral contractures
D. To strengthen the back and the abdominal muscles
Rationale:
Exercises are prescribed for the child with sclerosis wearing a boston brace to help strengthen spinal and
abdominal muscles and provide support. Typically, children wearing a boston brace do not complain of
muscle spasms. Performing exercise provides no effect on the braces’ traction ability. Spiral contracture
do not occur when a boston brace is worn.
9. The mother of a 6 year old arrives at the clinic because the child has been experiencing itchy,
red swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the
laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis
the nurse determines that which requires further investigation?
A. Possible trauma
B. Possible sexual abuse
C. Presence of an allergy
D. Presence of respiratory infection
Rationale:
Conjunctivitis is an inflammation of the conjunctiva. A diagnosis of chlamydial conjunctivitis is a child
who is not sexually active should signal the health care provider to assess the child for possible sexual
abuse. Trauma, allergy, and infection can cause conjunctivitis but the causative organism is not likely to
be chlamydial.
10. A nurse is caring for a 4 year old child who has a new diagnosis of diabetes mellitus and is
distressed after an insulin injection. Which of the following play activities should the nurse
recognize is therapeutic in helping the child deal with the injection?
, A. A story book about a child who has diabetes
B. A needless syringe and a doll
C. A video game
D. A period pf play in the playroom
11. A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the
infant in which of the following positions following feedings?
A. Prone
B. In car seat or infant seat
C. Left side
D. Right side
12. A nurse in an emergency department is caring for an infant who has a 2 day history of
vomiting and an elevated temperature. Which of the following should the nurse recognize as
the most reliable indicator of fluid loss?
A. Body weight
B. Skin integrity
C. Blood pressure
D. Respiratory rate
13. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands
which result will most likely be abnormal in this child?
A. Platelet count
B. Hematocrit level
C. Hemoglobin level
D. Partial thromboplastin time rationale:
Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific coagulation
proteins. Results of that measure platelet function are normal; results of test that measure clotting
factor function may be abnormal. Abnormal laboratory results in hemophilia indicate a prolonged partial
thromboplastin time. The platelet count, hemoglobin level and hematocrit level are normal in
hemophilia.
14. The nurse conducts a developmental screening of a 15 month old child with cerebral palsy.
Which milestones would the nurse expect a typically developing toddler of this age to have
achieved?
A. Walking up steps
B. Using a spoon
C. Copying a circle
D. Putting a block in a cup rationale:
Delay in achieving developmental milestones is a characteristic of children with cerebral palsy. Ninety
percent of typically developing 15-month-old children can put a block in a cup. Walking up steps
typically is accomplished at 18 to 24 months. A child usually is able to use a spoon at 18 months. The
ability to copy a circle is achieved at approximately 3 to 4 years of age.
15. The parents of a child just diagnosed with juvenile idiopathic arthritis(ja) tell the nurse that
the diagnosis frightens them because they know nothing about the prognosis. What
information should the nurse include when teaching the parents about the disease?
LATEST UPDATE
1. When assessing an adolescent for scoliosis, what should the nurse ask the client to do?
A. Bend at the waist with arm hanging freely
B. Lie flat on the floor and extend the legs straight from the trunk
C. Sit in a chair while lifting the feet and legs to a right angle with the trunk
D. Stand against the wall while pressing the length of the back against the wall
Rationale:
Scoliosis, a lateral deviation of the spine, is assessed by having the client bend forward
at the waist with arms hanging freely and then looking for lateral curvature of the spine
and a rib hump. The other positions will not reveal the deviation of the spine.
2. The nurse performing an admission assessment on a 2 year old who has been diagnosed
with nephrotic syndrome notes that which most common characteristic is associated with
this syndrome?
A. Hypertension
B. Generalized edema
C. Increased urinary output
D. Frank, bright red blood in the urine
Rationale:
Nephrotic syndrome is defined as a massive proteinuria, hypoalbuminemia, hyperlipemia and
edema. Other manifestation is weight gain, preorbital and facial edema that is most prominent
in the morning. Leg, ankle, labial or scrotal edema, decreased urine output and urine that is
dark and frothy. Abdominal swelling and blood pressure that is normal or slightly decreased.
3. After teaching the parents of an infant with clubfoot requiring application of a plaster cast how
to care for the cast, which statement would indicate that the parents have understood the
teaching?
A. “if the cast becomes soiled, we will clean it with soap and water.”
B. “we will elevate the leg with the cast on pillows so the leg is above heart level.”
C. “we will check the color and temperature of the toes of the casted leg frequently.” D.
“the petals on the edge of the cast can be removed after the first 24 hours.”
Rationale:
A cast that is too tight can cause a tourniquet effect, compromising the neurovascular
integrity of the extremity. Manifestations of neurovascular impairment include pain, edema,
pulselessness, coolness, altered sensation, and inability ito move the distal exposed
extremity. The toes of the casted extremity should be assessed frequently to evaluate for
changes in neurovascular integrity. Wetting a plaster cast with water and soap softens the
, plaster, which may alter the cast’s effectiveness. There is no reason to elevate the casted
extremities when a child with clubfoot is being treated with nonsurgical measures. The legs
would be elevated if swelling were present. Petals, which are applied to cover the rough
edges of the cast, are to be left in place to minimize the risk for skin irritation from the cast
edges.
4. The nurse is taking the blood pressure of a 3 year old child admitted to the hospital for
mild dehydration from vomiting and diarrhea and obtains a reading of 90/50 mmhg. The
nurse interprets this as indicating which finding?
A. A normal finding
B. A elevated finding
C. A decreased finding based on the age of the child
D. Significant, indicating possible fluid volume deficit
Rationale :
A normal blood pressure of a 3 year old child is ranges from 72 to 110 mm hg systolic and 4073
mm hg diastolic. The blood pressure obtained is a normal finding.
5. A toddler receiving chemotherapy after surgery for a wilms tumor has developed
neutropenia. The parents are trying to encourage the child to eat by bringing extra foods to
the room. Which foods would the nurse discourage this child from eating?
A. Fudge
B. French fries
C. Fresh strawberries
D. Milk shakes rationale:
When a client receiving chemotherapy develops neutropenia, eating uncooked fruits and
vegetables may pose a health risk due to possible bacterial contamination. All other foods are
either cooked or pasteurized and would not produce a health risk.
6. A nurse is assessing a 3 year old at a routine wellness checkup. Which of the following findings
should the nurse expect?
A. Skips and hops on one foot
B. Has a vocabulary of 1,500 words
C. Walks backwards heel to toe d. Stands on one foot for few
Seconds rationale: page 210, 230 of the pediatric
textbook.
7. The nurse prepares a list of home care instructions for the parents of a child who has a cast
applied to the left forearm. Which instructions should the nurse include in the list? Select all
that apply?
A. Use fingertips to lift the cast while it is drying
B. Keep small toys and sharp objects away from the cast
, C. Use a padded ruler or another padded object to scratch the skin underneath the
cast if it itches
D. Place the heating pad on the lower end of the cast and over the fingers if the
fingers feel cold
E. Elevate the extremities on the pillow for the first 24 to 48 hours after casting to
prevent swelling
F. Contact the primary health care provider (phcp) if the child complains of
numbness and tingling in the extremities.
Rationale:
While the cast is drying, the palms of the hands are used to lift the cast. If the fingertips are used,
indentation in the cast could occur and cause constant pressure on the underlying skin. Small toys and
sharp objects should be kept away from the cast and no objects (included padded objects) are to be
placed inside the cast because of the risk of altered skin integrity. The extremity is elevated to prevent
swelling and the phcp is notified immediately if any signs of neurovascular impairment develops. A
heating pad is not applied to the cast or fingers. Cold fingers could indicate neurovascular impairment
and the phcp should be notified.
8. When teaching the child with scoliosis being treated with a brace about exercises, the nurse
explains that the exercises are performed primarily for what reason?
A. To decrease back muscle spams
B. To improve the brace’s traction effort
C. To prevent spiral contractures
D. To strengthen the back and the abdominal muscles
Rationale:
Exercises are prescribed for the child with sclerosis wearing a boston brace to help strengthen spinal and
abdominal muscles and provide support. Typically, children wearing a boston brace do not complain of
muscle spasms. Performing exercise provides no effect on the braces’ traction ability. Spiral contracture
do not occur when a boston brace is worn.
9. The mother of a 6 year old arrives at the clinic because the child has been experiencing itchy,
red swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the
laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis
the nurse determines that which requires further investigation?
A. Possible trauma
B. Possible sexual abuse
C. Presence of an allergy
D. Presence of respiratory infection
Rationale:
Conjunctivitis is an inflammation of the conjunctiva. A diagnosis of chlamydial conjunctivitis is a child
who is not sexually active should signal the health care provider to assess the child for possible sexual
abuse. Trauma, allergy, and infection can cause conjunctivitis but the causative organism is not likely to
be chlamydial.
10. A nurse is caring for a 4 year old child who has a new diagnosis of diabetes mellitus and is
distressed after an insulin injection. Which of the following play activities should the nurse
recognize is therapeutic in helping the child deal with the injection?
, A. A story book about a child who has diabetes
B. A needless syringe and a doll
C. A video game
D. A period pf play in the playroom
11. A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the
infant in which of the following positions following feedings?
A. Prone
B. In car seat or infant seat
C. Left side
D. Right side
12. A nurse in an emergency department is caring for an infant who has a 2 day history of
vomiting and an elevated temperature. Which of the following should the nurse recognize as
the most reliable indicator of fluid loss?
A. Body weight
B. Skin integrity
C. Blood pressure
D. Respiratory rate
13. The nurse analyzes the laboratory results of a child with hemophilia. The nurse understands
which result will most likely be abnormal in this child?
A. Platelet count
B. Hematocrit level
C. Hemoglobin level
D. Partial thromboplastin time rationale:
Hemophilia refers to a group of bleeding disorders resulting from a deficiency of specific coagulation
proteins. Results of that measure platelet function are normal; results of test that measure clotting
factor function may be abnormal. Abnormal laboratory results in hemophilia indicate a prolonged partial
thromboplastin time. The platelet count, hemoglobin level and hematocrit level are normal in
hemophilia.
14. The nurse conducts a developmental screening of a 15 month old child with cerebral palsy.
Which milestones would the nurse expect a typically developing toddler of this age to have
achieved?
A. Walking up steps
B. Using a spoon
C. Copying a circle
D. Putting a block in a cup rationale:
Delay in achieving developmental milestones is a characteristic of children with cerebral palsy. Ninety
percent of typically developing 15-month-old children can put a block in a cup. Walking up steps
typically is accomplished at 18 to 24 months. A child usually is able to use a spoon at 18 months. The
ability to copy a circle is achieved at approximately 3 to 4 years of age.
15. The parents of a child just diagnosed with juvenile idiopathic arthritis(ja) tell the nurse that
the diagnosis frightens them because they know nothing about the prognosis. What
information should the nurse include when teaching the parents about the disease?
