practicepeds exam 1

Practice Exam #1Ped Fundamentals/Respiratory Disorders

1. A 2-year-old child comes to the emergency room with an inspiratory stridor and barking cough. A preliminary diagnosis of croup has been made. Which action should be the initial intervention?

A. Administer IV antibiotics B. Provide oxygen by face mask C. Establish and maintain the airway D. Ask the mother to go to the waiting room

2. Place the following steps to the grieving process in the correct order. (1) Depression(2) Shock and disbelief(3) Bargaining(4) Acceptance(5) AngerSelect the answer that places them in order.

A. 1, 3, 2, 4, 5B. 3, 4, 5, 2, 1C. 2, 1, 5, 3, 4D. 2, 5, 3, 1, 4

3. "Sally aged 12 months weighs 21 pounds. The nurse reviews the child’s record and finds out that her birth weight was 7 pounds. In planning care, the nurse knows that the child"

A. Has not gained the expected weight related to the birth weight B. Weighs more than expected C. Falls within normal weight gain range related to the birth weight. D. Should be referred to Protective services immediately for being severely underweight.

4. A nurse plans to offer an infant a pacifier during the period he is NPO. The rationale for this intervention is based on which theorist?

A. Piaget B. Erikson C. Freud D. Kohlberg

5. Which of the following should the nurse do next after noting that an 8-month-old’s posterior fontanel is slightly open?

A. Check the child’s head circumference B. Document this as a normal finding C. Question the mother about the child’s delivery D. Schedule an x-ray of the child’s head

6. "When discussing a 7-month-old’s motor skill development with the mother, the nurse should explain that by 7 months, an infant most likely be able to do the following"

A. Walk with one hand held B. Eat successfully with a spoon C. Stand while holding on to furniture D. Sit alone using hands for support

7. "When discussing adolescent behavior with the parents, the nurse would incorporate information about an adolescent’s need to develop a sense of which of the following?"

A. Identity B. Industry C. Initiative D. Intimacy

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8. "A woman brings her daughter to the pediatric clinic because she is concerned that the child has otitis media. On examination, the nurse would recognize which of the following findings as the most common positive sign of otitis media?"

A. Temperature of 39 degrees C and loss of appetite. B. Pearly gray tympanic membrane and rhinorrhea. C. Pain on pressure on the tragus and edema within the canal. D. Feeling of fullness in the ear and a popping sensation during swallowing.

9. A 6-year-old is admitted with a diagnosis of asthma. An early sign of respiratory distress would be:A. An increased pulse rate B. An increased temperature C. Intercostal and sternal retractions D. An increased respiratory rate

10. Chest physiotherapy in cystic fibrosis is extremely important because it mobilizes secretions in the pulmonary tree and

A. Stimulates the child to breathe more deeply. B. Decreases the child’s need for bronchodilators. C. Increases the level of carbon dioxide in the alveoli. D. Helps prevent respiratory infections.

11. "A child is 5 years old and has recently been admitted to the hospital. According to Erickson, which of the follow stages is the child in?"

A. Trust vs. Mistrust B. Initiative vs. Guilt C. Autonomy vs. Shame D. Intimacy vs. Isolation

12. A nurse is making rounds taking vital signs. Which of the following vital signs is abnormal?A. "11-year-old male- HR=90 bpm, RR=22/min, BP= 120/70mmHg” B. "13-year-old female- HR=130 bpm, RR=22/min, BP= 105/60mmHg” C. "5-year-old male- HR=102 bpm, RR= 24/min, BP= 90/65mmHg " D. "6-year old female- HR= 100bpm, RR=26/min, BP 90/70mmHg "

13. "In terms of cognitive development, which of the following would a 4-year-old be expected to do?"A. Use magical thinking B. Think abstractly C. Understand conversation about matter D. Comprehend another person’s perspective

14. "Which of the following vital signs, obtained from a 2-year-old male, would require the nurse to report the findings?"

A. "P 150, R 60 " B. "P 120, R 35 " C. "P 125, R 38 " D. "P 120, R 24 "

15. A 10-month-old child was admitted to the pediatric unit with newly diagnosed cystic fibrosis. The nurse would expect this child to respond to the staff with which one of the following behaviors?

A. outward hostility B. fear of strangers C. frequent negativism D. occasional jealousy

16. Which intervention is best to help a 2-year-old child adapt to a mist tent?A. Tape the tent closed B. Place the child’s favorite toy in the tent C. Allow the child to play with the tent first D. Ask one or both parents to stay with the child

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17. The nurse is assessing a 9-month-old boy for a well-baby check up. Which of the following observations would be of most concern?

A. "The baby cannot say "mama" when he wants his mother” B. The mother has not given him finger foods C. The child does not sit unsupported D. The baby cries whenever the mother goes out

18. "The new mother asks the nurse whether or not she should pick up the baby when he cries. According to Erikson’s theory of psychosocial development, the nurse’s most appropriate reply should take into consideration his developmental task, which is:"

A. Trust vs. mistrust B. Intimacy vs. isolation C. Autonomy vs. doubt and shame D. Identity vs. role and confusion

19. "Karen the mother of an 11-month-old girl, Shannon, is in the clinic for her daughter’s immunizations. She expresses concern to the nurse that Shannon cannot yet walk. The nurse correctly replies that, according to the Denver Developmental Screen, the median age for walking is:"

A. 12 months B. 15 months C. 10 months D. 4 months

20. "The nurse is assisting with the care of a 2-day-old, full-term newborn that has an apnea monitor. The infant’s apnea monitor alarm sounds and the nurse observes that the newborn has normal skin color with abdominal movements during respiration. The nurse should next:"

A. Stimulate the bottom of the newborn’s foot B. Silence the alarm C. Turn the newborn onto the left side D. Call for help

21. The nurse is checking the vital signs of a 2-day-old client. The nurse should recognize that which of the following vital signs is within the age-based normal range?

A. "Blood pressure, 120/58 mm Hg" B. "Axillary temperature, 37.8’ C (100’F)" C. "apical pulse, 140" D. "respirations, 16"

22. The nurse is preparing a 6-month-old infant for a well-child examination. The infant was born at 38 weeks gestation. Which of the following observations should the nurse recognize as an age-based normal variant?

A. Closed posterior fontanel B. Persistent crossed eyes when looking at objects C. Unable to hold the head upright while on the abdomen D. A large tongue

23. The nurse has weighed a newborn in preparation for the newborn’s discharge. The nurse informs the parents that the newborn weighs 3.2 kg which is equivalent to approximately:

A. 6 lb B. 7 lb C. 8 lb D. 9 lb

24. The nurse is checking a 2-year-old child before the well-child examination is completed. Which of the following is within the age-based normal range?

A. Height 101.6 cm (40 in) B. Weight 22.7 kg (50 lb) C. Respirations 20 D. Apical pulse 144

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25. "Jason, a 6-month-old, is brought to the emergency room with a fever of unknown origin and projectile vomiting. According to Piaget’s Theory of Cognitive development, which of the following should Jason be demonstrating?"

A. Beginning of object permanence B. Memory of events C. "Understanding the concepts of past, present, future" D. Concrete thought

26. "When performing a physical assessment on an 18-month-old child, which of the following would be best?"A. Have the mother hold the toddler on her lap B. Assess the ears and mouth first C. Carry out the assessment from head to toe D. Assess motor function by having the child run and walk

27. Which sign is considered normal in a neonate?A. Doll eyes B. Sunset eyes C. Positive Babinski’s reflex D. Pupils that don’t react to light

28. Which assessment finding would the nurse consider normal for a 3-month-old infant?A. Able to hold a bottle B. Able to lift head and shoulders C. Able to roll from back to abdomen D. Able to sit with support

29. "When examining a 2-year-old, which of the following should the nurse perform last?"A. Chest auscultation B. Examination of the genitals C. Take apical pulse D. Take blood pressure

30. A 14-month-old is admitted to the pediatric floor with a diagnosis of croup. Which characteristics would the nurse expect the toddler to demonstrate if he is developing normally?

A. Strong hand grasp B. Tendency to hold one object while looking for another C. Recognition of familiar voices (smiles) D. Presence of Moro reflex E. Weight that is triple his birth weight F. Closed anterior fontanel

31. Which is the best intervention for parent to take if their child is experiencing an episode of ’midnight croup’ or acute spasmodic laryngitis?

A. Give warm liquids B. Raise the heat on the thermostat C. Provide humidified air with cool mist D. "Take the child to the bathroom with a cool, running shower"

32. Which clinical observation would lead the nurse to suspect epiglottitis?A. Decreased secretions B. Drooling C. Low-grade fever D. Barking cough

33. The most appropriate nursing intervention for a child in an oxygen tent is:A. Changing linens frequently B. Allowing the child to enter and exit the tent at will C. Providing several stuffed animals for the child to play with. D. Providing the child with a fan to assist with lowering the temperature

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34. "The nurse caring for a child in the post operative period following a tonsillectomy. When assessing the child, the nurse recognizes which of the following as signs and symptoms of postoperative bleeding?"

A. Hemoglobin of 11.6 B. Inflamed and reddened throat C. Frequent swallowing and clearing of the throat D. Blood-tinged mucous

35. Which of the following would the nurse expect to find initially in a 2-year-old child with croup suffering respiratory distress?

A. Capillary refill time less than 3 seconds B. Low temperature C. Grunting or head bobbing D. Respiratory rate of 28 breaths /minute

36. A 7-month old child is diagnosed with otitis media; the physician orders amoxicillin (Augmentin ES-600) 40mg/kg/day to be administered three times per day. The child weighs 9 kg. How much amoxicillin should the child receive per dose?

A. 120 mg B. 180 mg C. 200 mg D. 360 mg

37. A child is diagnosed with chronic otitis media. Which statement made by the mother indicates an understanding of this condition?

A. ’I need to be sure the baby is dressed warmly. B. I must be sure he gets all of his DTaP. C. I’ll tell my relatives they can’t smoke around the baby. D. I’ll give him Tylenol once a day every week.

38. "A 2-year-old child with status asthmaticus is admitted to the pediatric unit and begins to receive continuous treatment with albuterol (Proventil), given by nebulizer. The nurse should observe for which adverse reaction?"

A. Bradycardia B. Lethargy C. Tachycardia D. Tachypnea

39. Which nursing intervention is appropriate to correct dehydration for a 2-year-old client with asthma?A. Give warm liquids B. Give cold juice or ice pops C. Provide three meals and three snacks D. "Provide small, frequent meals and snacks"

40. Which test positively diagnoses respiratory syncytial virus (RSV)?A. Blood test B. Nasopharyngeal washings C. Sputum culture D. Throat culture

41. Which medication is an antiviral agent used to treat bronchiolitis caused by respiratory syncytial virus (RSV)?A. Albuterol (Proventil) B. Aminophylline C. Cromolyn sodium (Nasalcrom) D. Ribavirin (Virazole)

42. Which intervention is most important when monitoring dehydration in an infant with bronchiolitis?A. Measurement of intake and output B. Blood levels every 4 hours C. Urinalysis every 8 hours D. Weighing each diaper

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43. Which clinical feature would be found in a child with cystic fibrosis?A. Increase in pancreatic secretions of bicarbonate and chloride B. Decrease in sodium and chloride in both saliva and sweat C. Increased viscosity of mucous gland secretions D. Decreased viscosity of mucous gland secretions

44. Which tool is most commonly used to diagnose cystic fibrosis?A. Chest X-ray B. Pulmonary function test (PFT) C. Stool culture D. Sweat test

45. The nurse is caring for client with cystic fibrosis. Ranitidine (Zantac) 4 mg/kg/day every 12 hours is ordered. The child weighs 20 kg. How many milligrams are given per dose?

A. 16 mg B. 20 mg C. 40 mg D. 80 mg

46. Which intervention is appropriate for care of the child with cystic fibrosis?A. Decrease exercise and limit physical activity B. Administer cough suppressants and antihistamines C. Administer chest physiotherapy two to four times a day D. Administer bronchodilator or nebulizer treatments after chest physiotherapy

47. A nurse is caring for a 17-year-old female child with cystic fibrosis who had been admitted to the hospital for treatment of a recurrent lung infection. The adolescent has many questions about her future and the consequences of her disease. Which statements about the course of cystic fibrosis are accurate? Select all that apply:

A. Breast Development is frequently delayed B. The adolescent is at risk of diabetes C. Pregnancy and child bearing are not affected D. Normal sexual relationships can be expected E. Only males carry the gene for the disease

48. A 2-year-old child is being examined in the emergency room for epiglottitis. Which assessment finding supports this diagnosis?

A. Mild fever B. Clear speech C. Tripod position D. Gradual onset of symptoms

49. A nurse working in the triage area of an emergency department sees that several pediatric patients arrive simultaneously. Which client should be treated first?

A. A crying 4-year-old child with a laceration on his scalp B. A 3-year-old child with a barking cough and a flushed appearance C. A 3-year-old child with Down’s syndrome who’s pale and asleep in his mother’s arms D. "A 2-month-old infant with stridorous breath sounds, sitting up in his mother’s arms and drooling”

50. The recommended site for IM injections in infants and children less than 2 years old is theA. Ventrogluteal B. Deltoid C. Vastus Lateralis D. Dorsogluteal

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practicepeds exam 1

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