PEDIA ( ABNORMALITIES)

1.) A child diagnosed with tetratology of Fallot becomes upset, crying and thrashing around when a blood specimen is obtained. The childs color becomes blue and the respiratory rate increases to 44 breaths/minute. Which of the ff. action would the nur se do first? a. Obtain an order for sedation of the child. b. Assess for an irregular heart rate and rhythm. c. Explain to the child that it will only hurt for a short time. D. Place the child in a knee-to-chest position. 2.) Immediately on return to the nursing unit after surgical repair of a cleft palate, in w/c of the ff. positions would the nurse place the child? a. on the back with the head in apposition of comfort. b. In low Fowlers position with the head turned to the side. c. Lying on the abdomen with the head turned to the side. d. In reverse Tredelenburg with the head tilted forward. 3.) A 4-week-old infant admitted with the diagnosis of hypertrophic pyloric stenosis presents with a history of vomiting. The nurse would anticipate that the infants vomitus would contain gastric contents and which o f the ff? a. Bile and streaks of blood. b. Mucus and bile. c. Mucus and streaks of blood. d. stool and bile. 4.) an infant is admitted to the pediatric unit with a diagnosis of hypertonic pyloric stenosis after vomiting for several days. Which of the ff. nursing diagnoses would be the priority? a. Deficient Fluid volume related to prolonged vomiting. b. Ineffective Airway Clearance to impaired swallowing c. Imbalanced nutrition: Less than body requirements related to prolonged vomiting d. Bowel Incontinence related to abdominal pain. 5.)When an infant with pyloric stenosis is admitted to the hospital, W/c of the ff. would the nurse do first? a. Weigh the infant. b. Begin an intravenous infusion. c. Switch the infant to an oral electrolyte solution. d. Orient the mother to the hospital unit. 6.) After teaching the mother of an infant with pyloric stenosis about the disease, w/c of the ff, if stated by the mother as a cause, indicates effective teaching? a. An enlarged muscle below the stomach sphincter b. A telescoping of the large bowel into the smaller bowel c. A result of giving the baby more formula than is necessary d. My baby taking the formula quickly 7.) When developing the plan of care for an infant with pyloric stenosis, the nurse identifies a nursing diagnosis of Deficient Fluid Volume related to prolonged vomiting. Which of the ff. parameters would the nurse expect to use when evaluating the client outcome? a. Abdominal distention.

b. Weight loss. c. Vomiting. d. Respiratory effort. 8.) When obtaining the nursing history from the mother of an infant with suspected intussusceptions, w/c of the ff. Questions would be most helpful? a. What do the stools look like? b.When was the last time your child urinated? c. Is your child eating normally? d.Has your child any episodes of vomiting?

9.) After teaching the parents of an infant diagnosed with Hirschsprungs disease, the nurse determines that the parents understand the diagnosis when the father states which of the ff.? a.There is no rectal opening for schools to pass b. There is a tube between the trachea and esophagus c. The nerves at the end of large colon are missing d.The muscle below the stomach is too tight 10.) Erythromycin and tetracycline ophthalmic ointments given to newborns are used to provide protection against. a. b. c. d. Neisseria gonorrhea and Chlamydia trachomatis Vibrio Cholera and Haemophilus aegypticus Hepatitis A and B Congenital Syphilis

11.) An adolescent male client scheduled for an emergency appendectomy is to be transferred directly from the emergency room to the operating room. Which of the ff. statements by the client would the nurse interpret as most significant? a. All of a sudden it doesnt hurt at all b.The pain is centered around my navel c.I feel like Im going to throw up d. It hurts when you press on my stomach 12.) When assessing a newborn admitted to the pediatric unit with upper lumbar myelomeningocele, w/c of the ff. would the nurse anticipate finding? a. Minimal movement of the lower extremities. b. Upper extremity paralysis. c. Urinary bladder prolapsed. d. Respiratory problems. 13.) When developing the plan of care for an infant diagnosed with myeomeningocele and the parents who have just been informed of the infants diagnosis, which of the ff. would the nurse include as the priority when the parents visit the infan t for the first time? a. Emphasizing the infants normal and positive features. b. Encouraging the parents to discuss their fears and concerns. c. Reinforcing the doctors explanation of the defect. d. Having the parents feed their infant. 14.)When positioning the neonate with an unrepaired myelomeningocele, w/c of the ff. positions would be most appropriate? a. Supine with the hips at 90- degree flexion. b. Right side lying position with the knees flexed. c. Prone hips in abduction.

d. Semi-Fowlers position with chest and abdomen abduction. 15.) Which of the ff. would alert the nurse initially to suspect hydrocephalus in an infant who has undergone surgical repair of a myelomeningocele? a. Seizures and vomiting. b. Frontal bossing and sunset eyes. c. Increased head circumference and bulging fontanel. d. Irritability and shrill cry. 16.) The nurse discusses with the parents how best to raise the IQ of their child with down syndrome. Which of the ff. would be most appropriate? a. Serving hearty, nutritious meals. b. Giving vasodilator medications as prescribed. c. Letting the child play with more able children. d. Providing stimulating, nonthreatening life experience. 17.) During the acute stage of meningitis, a 3-yr old child is restless and irritable. Which of the ff. would be most appropriate to institute? a. Limiting conversations with the child. b. Keeping extraneous noise to a minimum. c. Allowing the child to play in the bathtub. d. Performing treatments quickly. 18.) Autism can usually be diagnosed when the child is about: a. 2years of age b. 6years of age c. 6 months of age d. 1 to 3months of age 19.) The treatment of choice for an autistic child probably will include: a. Psychoanalysis b. Behavior modification c. d. Play therapy Group therapy

20.) Primary treatment to goals to facilitate recovery of an autistic child should include all of the ff. except: a. Developing self-concept. b. Accepting healthy nurturance. c. Maintaining contact with reality. d. Encouraging the child to play with a ball. 21.) The nurse is aware that scores between 69 and 65 on standardized intelligent quotient (IQ) assessment test indicative of w/c degree of intellectual impairment: a. Mild b. Moderate c. Severe

d. Profound 22.) when a child is diagnosed as being moderately retarded, it would be most helpful for the nurse to suggest that the parents: a. Offer simple, repetitive tasks b. Offer challenging, competitive situations c. Provide complete and detailed directions at the beginning of the task to be carried out d. none

23.) Which nursing diagnosis is most applicable for a child with ADHD? a. Ineffective family coping related to ineffective parenting. b. Potential for injury related to impulsivity. c. Impaired verbal communication related to autism. d.Altered thought processes related to impaired reality.

24.) A 7-year old child has ADHD. The child is most likely to exhibit which of the following symptoms? a. restlessness,decreased attention span, and distractibility b. hyperactivity, somatic complaints, and distractibility c. impulsiveness,anhedonia, and shyness d. poor concentration, decreased attention span and somatic complaints

Situation: Baby boy Alfred, 7 days old, is admitted to the hospital with a diagnosis of Down syndrome. 25. In caring for baby boy Alfred, the nurse recognizes that he will have: a. A developmental lag after 1 or 2 years of age b. High incidence of circulatory problem c. Proneness to respiratory tract infections d. Difficulty in hearing 26. The symptom of Down Syndrome most evident to the nursery nurse during the initial newborn assessment would be: a. Asymmetric gluteal fold b. Hypotonicity of the skeletal muscles c. A rounded occiput d. A transverse palmar (simian) crease

27. Which among the following is not part of the characteristics of tetralogy of fallot? a. b. c. d. Hypertrophy the right ventricle Overriding of the aorta Pulmonary stenosis Hypertrophy of the left ventricle

28. When to bathe a newborn child? a. As soon as possible b. 1 hour after c. within 24 hours d. 6 hours after

1.

29. Heat loss by evaporation in the newborn is prevented by

a. b. c. d.

closing the doors and windows of the room drying the baby with a warm blanket placing the baby on warm padded surface taking the babys temperature every hour