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146 Cards in this Set
- Front
- Back
1. A 12-month-old girl with sickle cell anemia is admitted in sickle cell crisis. Her symptoms might include: |
b |
|
2. Sickle cell disease is caused by: |
b |
|
3. Treatment for a 6-year-old in sickle cell crisis includes:
A. IV fluids, oxygen, analgesics for pain B. NPO, nasogastric (NG) tube to suction, bed rest C. Bone marrow transplant, IV fluids, oxygen D. Analgesics for pain, pancreatic enzymes, bed rest |
a |
|
4. Treatment of leukemia includes administration of chemotherapy agent to lower the WBC count. This decrease in the WBC count may:
A. Lower the child’s resistance to infection B. Cause joint pain and sores in the mouth C. Lead to a decrease in hemoglobin and increase anemia D. Lead to lethargy, petechiae, and bruising |
a |
|
5. Select all of the correct responses related to iron-deficiency anemia. |
a, b, d, e |
|
6. The medication used to decrease fever and the incidence of coronary artery damage in Kawasaki disease is: |
c |
|
7. The parents of a 4 month old noticed that many bruises were forming on their son’s knees, buttocks and thighs. The blood tests reveal that he has classic hemophilia. The nurse understands that hemophilia is
A. Caused by spontaneous mutation. B. Transmitted by diseased mothers to affected sons on the X chromosome. C. Transmitted by asymptomatic fathers to affected sons on the Y chromosome. D. Transmitted by asymptomatic females to affected sons on the X chromosome. |
d |
|
8. Which information obtained from the visit to a client with hemophilia would cause the most concern? |
a |
|
9. A 4-year-old has been diagnosed as having iron deficiency anemia. A liquid iron preparation has been prescribed. When administering medication the nurse should |
c |
|
10. A 10-year-old has hemophilia A and is admitted to the hospital for hemarthrosis of the right knee. He is in a great deal of pain. Which of the following interventions would aggravate his condition? |
b |
|
11. How could the nurse best evaluate if parents are giving their child with iron deficiency anemia iron as prescribed?
A. Parents state they offer orange juice when they give the medication. B. Parents state the child has greenish black stools. C. Parents state the child experiences nausea with the iron preparation. D. Parents state they are giving the iron as prescribed. |
b |
|
12. A 5-year-old is admitted to the nursing care unit in vaso-occlusive crisis from sickle cell anemia. What is the priority nursing intervention?
A. Teaching the family about sickle cell anemia and home care needs. B. Managing the child’s pain. C. Encouraging a high protein, high calorie diet. D. Administering oxygen via nasal cannula. |
d |
|
13. A child is admitted to the pediatric unit with hemarthrosis secondary to hemophilia. The most appropriate nursing intervention would be
A. Daily bleeding times. B. Prophylactic antibiotic therapy. C. Elevating and immobilizing the affected joint. D. Encouraging active range of motion of affected joint. |
c |
|
14. An example of a cyanotic congenital heart defect is: |
a |
|
15. A 3-month-old infant has unrepaired Tetralogy of Fallot. Which of the following signs and symptoms would the infant be expected to exhibit?
A. Tachycardia, hypertension, decreased femoral pulses B. Circumoral cyanosis, hypoxic spells, feeding fatigue C. Hypotension, bradycardia, dyspnea D. Cyanosis, tachypnea, hypertension in upper extremities |
b |
|
16. Which of the following should be included in the nursing care plan for an infant with congestive heart failure?
A. Increase the calories per ounce of formula. B. Increase the amount of water to be given. C. Let the infant sleep for long periods. D. Increase the amount of formula per feeding. |
a |
|
17. The most accurate assessment of fluid volume imbalance in a child is determined by
A. Measurement of intake and output. B. Daily weighing. C. Assessment of skin turgor. D. Evaluation of areas of edema. |
b |
|
18. An early symptom of congestive heart failure in an infant is |
c |
|
19. The young patient has just been admitted for evaluation. The nurse reports that the physical assessment reveals a finding that may indicate coarctation of the aorta, which is |
a |
|
22. The staff is developing a care plan for a child who is to have a cardiac catheterization. Following the procedure, the plan of care will include |
d |
|
23. When congestive heart failure (CHF) in a 4-year-old child is well controlled, the nurse will evaluate that the |
c |
|
24. A 4-year-old with tetralogy of Fallot is seen in a squatting position near his bed. The nurse should |
b |
|
25. A 10-year-old with a ventricular septal defect (VSD) is going to have a cardiac catheterization. Which of the following needs to be a high priority for the nurse to assess? |
d |
|
26. An infant with congestive heart failure (CHF) is admitted to the hospital. Which goal has the highest priority when planning nursing care? |
a |
|
27. The LVN realizes that additional teaching is not needed when the parents of a child with Kawasaki's syndrome states, "It is a(n):
A. Systemic, acute inflammatory disease, also known as mucocutaneous lymph node syndrome. B. Circulatory deficit with decreased cardiac output. C. Inflammatory disorder caused by group A beta-hemolytic Streptococcus infection. D. Mixed cardiac defect that affects both the systemic and pulmonary circulations. |
a |
|
28. The LVN understands the symptoms of acute lymphoblastic leukemia (ALL) are the results of:
A. A rare inherited sex-linked disorder. B. An overproduction of immature lymphocytes. C. A malignant disorder of the lymphatic system. D. Cancer cells developing in the bone marrow. |
b |
|
29. Which of the following statements indicates that the parents understand the need for their child to receive long-term antibiotic therapy after an episode of rheumatic fever?
A. “It will prevent further streptococcal infections.” B. “It will protect against further joint damage” C. “The inflammation will subside more quickly.” D. “The inflammation will be reduced with future attacks.” |
a |
|
30. A 6-year-old is admitted with a diagnosis of rheumatic fever. Which of the following goals is the most important when caring for her while she is in the hospital?
A. Providing rest. B. Providing a nutritious diet. C. Maintaining contact with school friends. D. Keeping up with schoolwork. |
a |
|
31. A diagnosis of rheumatic fever is being ruled out for a child. The nurse teaches the parents that the lab test to check for a recent streptococcal infection is: |
b |
|
1. In a 2 year old with increased intracranial pressure, which one of the following signs would be cause for alarm? |
d |
|
2. The nurse is at the bedside when a 9 year old has a seizure shortly after admission. The first action during the seizure is to |
c |
|
3. A symptom of meningitis in a young infant is |
c |
|
4. The nurse is caring for a newborn with meningomyelocele. The correct position for the baby to be placed preoperatively is
A. Semi-Fowler’s position. B. Supine position. C. Prone position. D. Side-lying position. |
c |
|
5. Reye’s syndrome has been associated with the use of |
b |
|
6. Reye’s syndrome usually develops following |
d |
|
7. To improve the comfort of a child in the acute stage of meningitis, the nursing intervention is to |
c |
|
8. The leading cause of mental retardation, physical disability, and seizures in children is
A. Cancer. B. Congenital birth defect. C. Head injury. D. Cerebral palsy. |
c |
|
9. When a child with cerebral palsy is admitted to the hospital, the plan of care must include
A. Bed rest to speed recovery. B. The child’s normal exercise program. C. Physical restraints to prevent falls. D. A low-calorie diet because of immobility. |
b |
|
10. When caring for a child who is having a diagnostic workup for meningitis, the primary responsibility of the nurse would be to
A. Tell the parents that this is a very easy test to perform. B. Support the child in a side-lying position with the knees flexed. C. Prepare the child for general anesthesia. D. Reassure the parents that the child will not be uncomfortable. |
b |
|
11. A child with cerebral palsy needs a diet
A. High in calories. B. High in iron. C. Low in calories. D. Low in fiber. |
a |
|
12. An infant is brought to the well-baby clinic. While the nurse is collecting data, which observation would lead the nurse to suspect a diagnosis of meningitis in the infant? |
c |
|
13. To prepare for discharge and home care for the infant who has had a ventriculoperitoneal shunt insertion, the parents are instructed in recognizing shunt malfunction. The nurse will instruct the parents to watch for the frequent complication of |
b |
|
14. The condition in which a child’s eyes are unable to focus and work together and visual acuity is reduced in one eye is called:
A. Strabismus B. Esotropia C. Amblyopia D. Exotropia |
c |
|
15. A nurse caring for an infant that has a head injury because of a fall knows that the infant is at risk for
A. Compression fractures of the lower extremities. B. Brain hemorrhage. C. Cardiac system problems. D. Hyperthermia. |
b |
|
16. The nurse's notes indicate that a child responds to vigorous stimulation only. The nurse caring for this child should assess the child's level of consciousness and |
d |
|
17. The nursing assessment reveals the child's systolic pressure is increased with a widened pulse pressure, the pulse rate has dropped, and respirations have become irregular. The most likely physiological cause is |
d |
|
1. Before discharging a 3-year-old child to home in a hip spica cast, the nurse will want to be sure that the |
d |
|
2. The nurse checks the young patient in Bryant’s traction. Proper body alignment is being maintained if the legs are perpendicular to the trunk and the buttocks are
A. Lower than his head. B. Elevated over the mattress. C. Flat on the mattress. D. Raised on a pillow. |
b |
|
3. The LVN is caring for a client with osteosarcoma. Which symptoms would the nurse expect? |
c |
|
4. When assessing capillary refill on the toe of a casted leg, the original color returned in 2 seconds. The LVN's next action would be to: |
a |
|
5. Based on the knowledge of muscular dystrophy, which activity would a nurse anticipate the client having difficulty with first?
A. Breathing B. Sitting C. Standing D. Swallowing |
c |
|
6. In caring for a 6-year-old child in a full leg cast, which of the following findings should the nurse report to the physician immediately? |
d |
|
7. Which organism is the major cause of osteomyelitis?
A. Haemophilus influenza B. Escherichia coli C. Beta-hemolytic Streptococcus D. Staphylococcus aureus |
d |
|
8. Russell traction, used as a part of the treatment of fractured femur in children, is a type of: |
a |
|
9. Because no cure has been discovered for muscular dystrophy (MD), the primary goal is to: |
b |
|
10. A hereditary musculoskeletal disorder that exhibits symptoms of gradual muscle weakness, a “waddle gait”, and difficulty standing and sitting is known as: |
d |
|
11. Which of the following information found in the infant’s birth history is most indicative of a true club foot condition? |
c |
|
12. A 10-year-old child has juvenile rheumatoid arthritis. Which statement by the child indicates teaching about ibuprofen (Motrin) use has been effective? |
a |
|
13. The nurse advises the parents that, to detect possible complications of JRA, the child will require which periodic evaluation?
A. Chest X-rays B. Dental examinations C. Hearing examinations D. Eye examinations |
d |
|
14. A child with a fracture femur is in skeletal traction. Which assessment finding should the nurse report immediately to the physician or charge nurse? |
d |
|
15. A 9-year-old girl is admitted to the pediatric unit with a fractured right femur. Which intervention is best to prevent complications associated with traction and immobility? |
a |
|
16. Which assessment finding may indicate a serious neurovascular problem that should be reported immediately to the charge nurse or physician? |
c |
|
17. A child is to be fitted for a Milwaukee brace. The adolescent asks if the brace has to be worn when she is at school. The nurse correctly advises the adolescent that the brace has to be worn during which time period? |
a |
|
18. Which of the following statements made by the adolescent best supports the nurse’s suspicion that she has scoliosis?
A. “My friends are getting taller faster than I am.” B. “One of my sleeves is always shorter than the other.” C. “I have a difficult time sleeping on my side at night.” D. “I always roll crooked when I am doing a somersault.” |
b |
|
19. An infant has a clubfoot and initial medical management is serial casting. The nurse caring for the child after the long leg cast has been applied should |
b |
|
20. The nurse providing discharge instructions to parents of a child with a cast should include |
a |
|
21. A 2-month-old infant has been placed in a Pavlik harness for hip reduction. To prevent shin irritation the nurse should instruct the parents to |
b |
|
22. To care for a child that is in Bryant skin traction for dysplasia of the hip the nurse should ensure |
d |
|
Which cardiovascular disorder is considered acyanotic?
|
- Patent ductus arteriosus (does not start with a "T") |
|
A child with sickle cell anemia comes to the ER suspected of being in vaso-occlusive crisis. Which assessment finding would indicate that the client is having a vaso-occlusive crisis? |
- Acute abdominal pain and hand-foot syndrome |
|
A child is prescribed ASA as a part of the therapy for Kawasaki disease. The order is for 80 mg/kg/day orally in four divided doses until the child is afebrile. The child weighs 15kg. How much is given in one dose? |
- 300 mg |
|
To facilitate feeding in an infant that tires when eating, the nurse should:
|
- Hold the infant at a 45 degree angle while feeding |
|
A 4 year old child is diagnosed with acute lymphocytic leukemia (ALL). His WBC count, especially the neutrophil count, is low. Which intervention should the nurse teach the parents? |
|
|
When performing the initial assessment, the nurse found that when the child's head was flexed, his knees and hips are flexed. The nurse should document this finding as? |
- Brudzinski's sign |
|
The child grimaces when the light is on in the room. Which of the following interventions should the nurse implement to minimize photophobia? |
- Avoid using the television |
|
Which of the following vaccines should a nurse administer to protect an infant from bacterial meningitis? (Select all that apply) |
- Pneumococcal conjugate vaccine (PVC) |
|
A child is admitted with possible Reye syndrome. The nurse should recognize that which of the following factors in the child's health history supports this diagnosis? |
- Recent episode of gastroenteritis (viral) |
|
Which of the following manifestations are indicative of stage II of Reye syndrome? (Select all that apply)
|
- Hyperventilation |
|
A child is admitted for a surgical procedure. The child has a seizure disorder and says that he is feeling "odd". The parent says that he thinks the child is about to have a seizure. Which of the following nursing interventions should be implemented for this child? (Select all that apply) |
- Provide privacy |
|
A nurse is caring for a child who has an arm cast. Which of the following is an EARLY sign of altered neurovascular function?
|
- Pain |
|
A nurse is caring for a preschooler who walks but has difficulty keeping up with peers. The nurse is assessing the preschooler for possible right developmental dysplasia of the hip (DDH). Which of the following assessments should the nurse use to assess for DDH?
|
- Trendelenburg sign |
|
A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used. Which of the following responses by the nurse appropriately addresses the mother's question?
|
- "The Pavlik harness is used for infants less than 6 months of age." |
|
A nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? (Select all that apply)
|
- Muscular weakness in lower extremities |
|
The nurse in the newborn nursery is doing the admission assessment on a neonate. Congenital hip dysplasia will be suspected when the nurse observes:
|
- Asymmetry of the gluteal and thigh fat folds |
|
The nurse has completed parent education related to treatment for a child with congenital clubfoot. The nurse knows that parents need further teaching when they state:
|
- "We're happy this is the only cast our baby will need." |
|
An infant has just returned from surgery for correction of bilateral congenital clubfeet. The infant has bilateral long-leg casts. The toes on both feet are edematous, but there is color, sensitivity, and movement to them. Which of the following should the nurse do first? |
- Elevate the legs on pillows |
|
The nurse is teaching a family how to care for their infant in a Pavlik harness to treat congenital developmental dysplasia of the hip (DDH). Which of the following is appropriate for the nurse to include in parental education in relation to the Pavlik harness? |
- Check at least two or three times a day for red areas under the straps. |
|
4 year old with Tetralogy of Fallot in squatting position
|
- Take no action if comfortable but continue to observe |
|
Sickle cell anemia crisis S/S
|
- Abdominal pain, swollen painful joints |
|
Sickle Cell
|
- Inherited defect of hemoglobin |
|
Sickle Cell Tx
|
- IV fluids, Oxygen. analgesics for pain, blood transfusion |
|
Hemophilia safest sport
|
- Swimming |
|
Leukemia - 3 consequences bone marrow dysfunction
|
- Infection, anemia, bleeding |
|
Leukemia Tx
|
- Chemo lowers WBC count which may lower child's resistance to infection |
|
Medication that decreases fever and incidence of CAD in kawasaki |
- IV immune Globin |
|
Example of a cyanotic congentital heart defect is?
|
- Tetrology of Fallot (starts with a "T") - Transition of great arteries
|
|
Cardiac defect in 1 month infant may cause
|
- Poor nutritional intake (failure to thrive) |
|
Cardiovascular disorder that is considered acyanotic |
- PDA (Patent Ductus arteriosus) |
|
CHF intervention |
- Cluster nursing activities |
|
Cardiac Catheterization, significant bleeding, what is nursing action?
|
- Apply direct pressure |
|
Ventricular septal defect - S/S (description)
|
- Failure of septum to develop completely between the ventricles |
|
Observation with Tetrology of Fallot (TOF)? |
- Increased cyanosis with crying or activity (blue baby) |
|
Cancer in children
|
- Leukemia |
|
Cardiac Catheterization
|
- It provides visual of heart and great vessels with radioopaque dye |
|
Diet plan in infant with heart failure
|
- Increase caloric content per ounce (low energy) |
|
1 week infant with hydrocephalus
|
- Increased head size |
|
Nurse Dx first 12 hours neonate with myelomeningocele
|
- Risk for infection |
|
S/S neonate with bacterial meningitis
|
- Hypothermia, irritability, poor feeding |
|
2 year old with bacterial meningitis, intervention measure
|
- Place in respiratory isolation |
|
Bacterial meningitis on Antibiotics, nursing action |
- Wearing a mask while providing care |
|
Bacterial meningitis, what nursing plan
|
- Decreased environmental stimulation |
|
2 month old infant, head circumference at 95th percentile, nursing action
|
- Measure head again |
|
Cerebral Palsy
|
- Cerebral Palsy is a condition that does not get worse |
|
Head injury S/S of most concern |
- Nonreactive pupils (late sign) |
|
19 months palpating fontanels
|
- Both fontanels closed |
|
Acute bacterial meningitis, nurse is looking for |
- Irritability, fever, vomiting |
|
S/S of increased ICP in a 10 month old infant (all that apply)
|
- Bulging Fontanels, high pitched cry, irritability |
|
Increased ICP, cause for concern
|
- Increased lethargy and drowsiness (LOC) |
|
Cerebral Palsy diet
|
- Increase in calories |
|
Early S/S of increased ICP in children |
- Headache |
|
Meningomyelocele newborn going into surgery |
- Keep newborn in prone position pre surgery |
|
Nursing interventions in increased ICP
|
- Suctioning and position changes |
|
Cerebral Palsy goals
|
- Promoting optimum development |
|
Child eyes unable to focus and work together
|
- Amblyopia |
|
9 year old child with head injury
|
- Clear nasal fluid (CSF) |
|
Blow to head instructions
|
- Awaken child ever 4 hours 1st night (every 1-2 hours) |
|
Strabismus
|
- Pretend child is a pirate when eye is patched for treatment |
|
Hydrocephalus |
- Blockage of CSF circulation |
|
Surgery for reduction of myelomeningocele, post-op intervention |
- Daily measurement of the head circumference (risk for infection and increased ICP) |
|
A common hallmark with febrile seizures with young children? |
- With a rise in body temp above 102 degrees |
|
Patient with increased ICP, what intervenions can decrease ICP (all that apply)
|
- HOB at 30 degree angle, supplemental oxygen, IV osmotic diuretics as ordered |
|
Viral meningitis, nurse action (all that apply)
|
- Allow child to assume position for comfort, Tylenol pain, watch child for seizures |
|
Hydrocephalus, early S/S in child
|
- Early morning Headache |
|
3 year old with early Duchenne's muscular dystrophy, assessment seen |
- Difficulty riding a trycycle |
|
Patient needs more instructions with Milwaukee brace
|
- "I understand that I can take off the brace for a few hours to go to party" |
|
Developmental dysplasia of Hip (DDH) in infant
|
- Pavlik harness for 3-4 months |
|
Newly casted leg (all that apply)
|
- Elevate leg on pillow first 24-48 hours, observe drainage on cast, call doctor if numbness or tingling |
|
Osteomyelitis, interventions
|
- Assess for infection, increased fluid intake, IV antibiotics |
|
Skeletal traction, providing care
|
- Clean pinsite with N/S, make sure weights are in the proper position, apply an antibiotic ointment around pin if ordered |
|
Cerebral Palsy, mother understands |
- "Non-progressive, brain damage caused by injury |
|
Duchenne's muscular dystrophy, primary nursing goal |
- Maintaining function of unaffected muscles |
|
Fractured femor check
|
- Pulmonary Emboli |
|
NSAIDS for Juvenile Rheumatoid Arthritis, adverse effects (all that apply)
|
- Abdominal pain, blood in the stool, reduced blood clotting ability |
|
Left thigh swollen, nurse does?
|
- Assess the neurologic status of the toes |
|
Immobilized with traction in legs, play activity?
|
- Pounding Board (to relieve stress and use up energy) |
|
Juvenile Rheumatoid Arthritis (Chronic autoimmune disorder)-10 year old, S/S not associated with the disease |
- Rhinitis Associated (Rash, Fever, Lymphadenopathy) |