Pedia Drill-001

1).Which achievement best characterizes the physical development of a 3-month-old infant?

A.) A strong Moro reflexB.) A strong tonic-neck reflexC.) The ability to roll over intentionallyD.) The ability to lift the head and chest from a prone position

2. When assessing a 2 year-old child brought by his mother to the clinic for a routine check-up, which of the following would the nurse expect the child to be able to do?

a) ride a tricycleb) tie his shoelacesc) kick a ball forwardd) use blunt scissors

3. After having blood sample drawn, a 5 year-old child insists that the site be covered with an adhesive bandage strip. When the mother tries to remove the bandage before leaving the office, the child screams that all the blood will come out. The nurse interprets this behavior as indicating a fear of which of the following?

a) injuryb) compromised body integrityc) paind) loss of control

4. After teaching a group of mothers about temper tantrums, the nurse knows the teaching has been effective when one of the mothers states which of the following?

a) I will ignore the temper tantrumsb) I should pick up the child during the tantrumsc) I'll talk to my daughter during the tantrumsd) I would put my child in time out

5. After teaching the parents of a preschooler who has undergone T and A (Tonsillectomy and Adenoidectomy) about appropriate foods to give the child after discharge, which of the following, if stated by the parents as appropriate foods, indicates successful teaching?

a) meatloaf and uncooked carrots

b) pork and noodle casserolec) cream of chicken soup and orange sherbetd) hot dog and potato chips

6. When teaching the parents of an older infant with CF (cystic fibrosis) about the type of diet the child should consume, which of the following would be most appropriate?

a) low protein dietb) high fat dietc) low carbohydrate dietd) high calorie diet

7. a school-age child with CF asks the nurse what sports she can be involved in as she becomes older. Which of the following activities would be most appropriate for the nurse to suggest?

a) swimmingb) trackc) baseballd) javelin throwing

8. A child diagnosed with tetralogy of fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The child's color becomes blue and respiratory rate increases to 44 bpm. Which of the following actions would the nurse do first?

a) obtain an order for sedation for the childb) assess for an irregular heart rate and rhythmc) explain to the child that it will only hurt for a short timed) place the child in knee-to-chest position

9. Which of the following would the nurse perform to help alleviate a child's joint pain associated with rheumatic fever?

a) maintaining the joints in an extended positionb) applying gentle traction to the child's affected jointsc) supporting proper alignment with rolled pillowsd) using a bed cradle to avoid the weight of bed lines on the joints

10. A 16 month old child diagnosed with Kawasaki Disease (KD) is very irritable, refuses to eat, and exhibits peeling skin on the hands and feet. Which of the following would the nurse interpret as the priority?

a) applying lotions to the hands and feetb) offering foods the toddler likes

c) placing the toddler in a quiet environmentd) encouraging the parents to get some rest

11. Which of the following foods would the nurse encourage the mother to offer to her child with iron-deficiency anemia?

a) rice cereal, whole milk, and yellow vegetablesb) potato, peas, and chickenc) macaroni, cheese and hamd) pudding, green vegetables and rice

12. Because of the risks associated with administration of factor VIII concentrate, the nurse would report which of the following?

a) yellowing of the skinb) constipationc) abdominal distentiond) puffiness around the eye

13. When teaching the mother of an infant who has undergone surgical repair of a cleft lip how to care for the suture line, the nurse demonstrates how to remove formula and drainage. Which of the following solutions would the nurse use?

a) mouthwashb) providone - iodine (betadine) solutionc) a mild antiseptic solutiond) half-strength hydrogen peroxide

14. Which of the following nursing diagnosis would the nurse identify as a priority for the infant with tracheoesophageal fistula (TEF)?

a) impaired parenting related to newborn's illnessb) risk of injury related to increased potential for aspirationc) ineffective nutrition: less than body requirements, related to poor sucking abilityd) ineffective breathing pattern related to a weak diaphragm

15. When the infant returns to the unit after imperforate anus repair, the nurse places the infant in which of the following position?

a) on the abdomen, with legs pulled up under the bodyb) on the back, with legs extended straight outc) lying on the side with hips elevatedd) lying on the back in a position of comfort

16. A child presents to the emergency room with the history of ingesting a large amount of acetaminophen. For which of the following would the nurse assess?

a) hypertensionb) frequent urinationc) right upper quadrant paind) headache

17. Which of the following statements by the mother of an !8 month old would indicate to the nurse that the child needs laboratory testing for lead levels?

a) my child does not always wash after playing outsideb) my child drinks 2 cups of milk everydayc) my child has more temper tantrums than other kidsd) my child is smaller than other kids of the same age

18. An adolescent with a history of surgical repair for undescended testes comes to the clinic for a sport physical. Anticipatory guidance for the parents and adolescent would focus on which of the following as most important?

a) the adolescent sterilityb) the adolescent future plansc) technique for monthly testicular self-examinationsd) need for a lot of psychosocial support

19. When developing the teaching plan for the parents of a 12 month old infant with hypospadias and chordee repair, which of the following would the nurse expect to include as most important?

a) assisting the child to become familiar with his dressing so he will leave them aloneb) encouraging the child to ambulate as soon as possible by using a favorite push toyc) forcing fluids to at least 250 ml/day by offering his favorite juicesd) preventing the child from disrupting the catheter by using soft restraints

20. A school-aged client admitted to the hospital because of decreased urine output and periorbital edema is diagnosed with glomerulonephritis. Which of the following interventions would receive the highest priority?

a) assessing vital signs every four hoursb) monitoring intake and output every 12 hoursc) obtaining daily weight measurementsd) obtaining serum electrolyte levels daily

21. When assessing a 12 year old child with Wilm's tumor, the nurse should keep in mind that it most important to avoid which of the following?

a) measuring the child's chest circumferenceb) palpating the child's abdomenc) placing the child in an uprignt positiond) measuring the child's occipitofrontal circumference

22. When positioning the neonate with an unrepaired myelomeningocele, which of the following positions would be most appropriate?

a) supine the hip at 90 degree flexionb) right side-lying position with knees flexedc) prone with hips in abductiond) semi-fowler's position with chest and abdomen elevated

23. A 4 year old with hydrocephalus is scheduled to have a ventroperitoneal shunt in the right side of the head. When developing the child's postoperative plan of care, the nurse would expect to place the preschooler in which of the following positions immediately after surgery?

a) on the right side, with the foot of the bed elevatedb) on the left side, with the head of the bed elevatedc) prone with the head of the bed elevatedd) supine, with the head of the bed flat

24. After talking with the parents of a child with Down Syndrome, which of the following would the nurse identify as an appropriate goal of care of the child?

a) encouraging self-care skills in the childb) teaching the child something new each dayc) encouraging more lenient behavior limits for the childd) achieving age-appropriate social skills

25. When teaching an adolescent with a seizure disorder who is receiving Valproic acid (Depakene), which of the following would the nurse instruct the client to report the health care provider?

a) three episodes of diarrheab) loss of appetitec) jaundiced) sore throat

26. A hospitalized preschooler with meningitis who is to be discharged becomes angry when the discharge is delayed. Which of the following play activities would be most appropriate at this time?

a) reading the child a storyb) painting with water colorsc) pounding on a pegboardd) stacking a tower of blocks

27. The parents of a child tell the nurse they feel guilty because their child almost drowned. Which of the following remarks by the nurse would be most appropriate?

a) I can understand why you feel guilty, but these things happenb) tell me a bit more about your feelings of guiltc) you should not have taken your eyes off your childd) you really shouldn't fell guilty; you're lucky because your child will be alright

28. The nurse teaches the parents of an infant with developmental dysplasia of the hip how to handle their child in a Pavlik harness. Which of the following interventions would be most appropriate?

a) fitting the diaper under the strapsb) leaving the harness off while the infant sleepsc) checking for the skin redness under straps every other dayd) putting powder on the skin under the straps every day

29. When assessing the development of a 15 month old child with cerebral palsy, which of the following milestones would the nurse expect a toddler of this age to have achieved?

a) walking up stepsb) using a spoonc) copying a circled) putting a block in cup

30. The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and its management. Which of the following statements by the mother indicates successful teaching?

a) my son will probably be unable to walk independently by the time he is 9 to 11 years oldb) muscle relaxants are effective for some children; I hope they can help my sonc) when my son is a little bit older, he can have surgery to improve his ability to walkd) I need to help my son be as active as possible to prevent progression of the disease

31. A 9 month infant is having severe diarrhea and is experiencing dehydration and metabolic acidosis. Which of the following signs and symptoms will the nurse assess?

a) reduced white blood cell countb) reduced platelet countc) shallow respirationd) tachypnea

32. Which of the following behavior of a preschooler indicates that the child is in the stage of initiative?

a) the child wants to finish his game of Candyland before his dressing is changedb) the child cries and has a temper tantrum when he is sent to bed to go to sleepc) the child ignores his parents and continues to watch television with other childd) the child talks to his friends on the telephone and arranges for them to visit

33. A 3 year old child had undergone surgery. Which finding best indicates that the child is no longer experiencing pain?

34. A 2 month old infant undergoes repair of a cleft lip. After surgery, which equipment should the nurse teach the parents to use to feed their infant?

a) cross-cut nippleb) plastic spoonc) paper cupd) rubber dropper

35. A 7 month old child has had recurrent middle-ear infections since she was 4 months old. Which of the following is most important to

assess?

a) how well the clients eatsb) the client's weight gain since her last visitc) whether the client received all her prescribed antibiotics at the time of the last infectiond) the client's temperature

36. Which of the following is appropriate toy for an 8 month old infant?

a) finger paintb) jack-in-the-boxc) small rubber balld) play gym strung across the crib

37. The nurse is teaching new parents before discharge to home. The nurse explains that the anterior fontanel closes between ages

a) 2 and 3 monthsb) 12 and 18 monthsc) 3 and 6 monthsd) 1 and 9 months

38. Which of the following are characteristics of an adolescent? Select all that apply.

a) egocentricityb) abstract thinkingc) high-risk behaviorsd) sense of moralitye) hand dominance developmentf) secondary sex characteristics development

39. In which child would you suspect child abuse?

a) a 2 year old child with bruises on both shinsb) a 2 year old child who won't make eye contact with the nursec) a 3 year old child who acts withdrawn and has bruises on his backd) a 10 year old child who comes to the emergency department with a broken wrist

40. Which drug is used as an antidote for acetaminophen poisoning?

a) vitamin Kb) acetylsalicylic acid (ASA)c) acetylcysteine

d) ethlenediaminetetraacetic acid (EDTA)

43. Which of the following is expected finding in a child with idiophatic thrombocytopenic purpura?

a) petechiaeb) nose bleedingc) dark, concentrated urined) fever

44. AN 8 year old child has been diagnosed to have iron deficiency anemia. Which of the following activities is most appropriate for the child to decrease oxygen demands on the body?

a) dancingb) playing video gamesc) reading a bookd) riding a bicycle

45. Which of the following nursing actions are appropriate for a child with hemophilia who is bleeding? Select all that apply

a) apply pressureb) apply warm packs on the sitec) administer aspirin for paind) apply cold compresses to the sitee) elevate the injured partf) perform range-of-motion exercises to the injured area immediately after bleeding stops

46. Which of the following medications for allergic rhinitis will not cause sedation?

a) brompheniramine and pseudoephedrine (dimetapp)b) diphenhydramine (benadryl)c) pseudoephedrine (triaminic)d) loratadine (claritin)

47. A 6 month old infant is diagnosed to have bacterial meningitis. Which of the following is not a sign of meningeal irritation?

a) marked irritabilityb) nuchal rigidityc) depressed anterior fontaneld) vomiting

48. Which assessment finding would lead the nurse to suspect Down syndrome in a newborn?

a) prominent scalp veins and high-pitched cryb) single palmar crease and hypotoniac) flat maxillary area and short papebral tissuesd) microcephaly, persistent postnatal growth lag

49. Which of the following nutrients decreases the incidence of neural tube defects (NTD's)?

a) vitamin Cb) vitamin Kc) vitamin B12d) folic acid

50. Which instructions about preventing sudden infant death syndrome (SIDS) should the nurse include when teaching parents of infants? Select all that apply

a) place the infant in prone positionb) place the infant in a firm mattressc) place the infant on his back to sleepd) bottle feed the infant instead of breastfeedinge) use soft mattress for the infant during the nightf) encourage breastfeeding of the infant

51. Who among these clients is prone to hepatitis C?

a) the client undergoing hemodialysisb) the client who has diabetes mellitusc) the client who has hypertensiond) the client who has Cushing's disease

52. Which of the following should the nurse assess in a client receiving steroid?

a) hyponatremiab) hyperkalemiac) hyperglycemiad) weight loss

53. The nurse is assessing a newborn who had undergone vaginal delivery. Which of the following findings is least likely to be observed in

a normal newborn?

a) uneven head shapeb) respiration are irregular, abdominal, 30-60/minc) (+) moro reflexd) heart rate is 80 bpm

54. The nurse is caring for several infants who are 2 day old. Who among these infants should be given highest priority by the nurse?

a) a bottlefed infant who takes 1 ounce of milk every 3 to 5 hoursb) a breastfed infant who lost 0.5 ounce of his weightc) a bottlefed infant who takes 2 to 3 ounces of milk every 2 to 4 hoursd) a breastfed infant who feeds every 2 to 4 hours

55. The nurse evaluates that Zofran (Ondasetron) is effective in a client undergoing chemotherapy if which of the following is observed?

a) urine output is 1,500 ml/dayb) the client can tolerate mechanically soft dietc) the client's anxiety is relievedd) the client was able to sleep

56. Which of the following is most important to monitor in the client after surgery for abdominal aortic aneurysm?

a) intake and output measurement every shiftb) blood pressure every 4 hoursc) body temperature every 4 hoursd) abdominal girth

57. The client had been diagnosed to have complete intestinal obstruction. Which of the following assessment findings will the nurse expect?

a) medium pitched gurgling soundsb) high-pitched tinkling bowel soundsc) absence of bowel soundsd) increased bowel sound

58. A mother tells the nurse that she is very worried because her 2 year old child does not finish his meals. What should the nurse advise the mother?

a) make the child seat with the family in the dining room until finishes his meal

b) provide quiet environment for the child few minutes before mealsc) do not give snacks to the child before mealsd) put the child on a chair and feed him

59. A nurse is caring for a client with colostomy created 3 days earlier. The client is beginning to pass malodorous flatus from the stoma. The nurse interprets that:

a) this is normal, expected eventb) this indicates inadequate preoperative bowel obstructionc) the client is experiencing early signs of impaired circulationd) the client should not have the nasogastric tube removed

60. A client does not respond when called by name. The next nursing action would be:

a) open the airway by head-tilt, chin-lift maneuverb) provide rescue breathingc) start external chest compressiond) tap the client by the shoulder

61. The nurse is teaching the parents of a young client how to handle poisoning. If the client ingests poison, what should the parents do first?

a) administer ipecac syrup b) call an ambulance immediately c) call the poison control center d) inspect the home foe other potential poisons

62. The nurse will administer an oral medication to a 3 year old client. What is the best way for the nurse to proceed?

a) it's time for you to take your medicine right now b) if you take your medicine now, you'll go home sooner c) here's your medicine. Would you like apple juice or grape drink after? d) see how Jerome took his medicine? He's a good boy. Now, be a good boy too

63. The nurse performs Guthrie screening test by drawing blood from the heel of an infant. The screening test is done to diagnose which of the following inborn error of metabolism?

a) glucose-6-phosphate dehydrogenase deficiency b) phenylketonuria

c) galactosemia d) hypothyroidism

64. The nurse is giving health teachings to a mother of a child with diabetes on signs and symptoms of hypoglycemia. The nurse should inform the mother that which of the following are manifestations of hypoglycemia?

a) behavioral changes, increased heart rate, sweating and tremors b) nausea, fruity breath odor, headache, and fatigue c) polydipsia, polyuria, polyphagia, and weight loss d) enlarged tongue, hypotonia, easy weight gain, and cool skin temperature.

65. Which of the following foods are allowed for a child with galactosemia? Select all that apply

a) instant potatoes b) chicken c) lima foods d) whole wheat bread e) apples f) 2% cow's milk

66. Which of the following statements indicate that the adolescent is having an early sign of anorexia nervosa?

a) I have my menses every month b) I go out to eat with my friends c) I run three times a day for a total of 5 hours per day d) I try to maintain my weight around 115 lbs. for my height of 5 feet

67. A client and her husband are positive for the sickle cell trait. The client asks the nurse about chances of her children having sickle cell disease. Which of the following is appropriate response by the nurse?

a) one of her children will have sickle cell disease b) only the male children will be affected c) each pregnancy carries a 25% chance of the child being affected d) if she had four children, one of them would have the disease

68. Which of the following health teachings regarding sickle cell crisis should be included by the nurse?

a) it results from altered metabolism and dehydration b) tissue hypoxia and vascular occlusion cause the primary problems

c) increased bilirubin levels will cause hypertension d) there are decreased clotting factors with an increase in white blood cells

69. A child with leukemia is being discharged after beginning chemotherapy. Which of the following instructions will the nurse include when teaching the parents of this child?

a) provide a diet low in protein and high carbohydrates b) avoid fresh vegetables that are not cooked or peeled c) notify the doctor if the child's temperature exceeds 101 F (39C) d) increase the use of humidifiers throughout the house

70. A client with hemophilia has a very swollen knee after falling from bicycle riding. Which of the following is the first nursing action?

a) initiate an IV site to begin administration of cryoprecipitate b) type and cross-match for possible transfusion c) monitor the client's vital signs for the first 5 minutes d) apply ice pack and compression dressings to the knee