PEDIA UWORLD DRILLS - child was exposed to measles 2 days ago during ...

PEDIA UWORLD DRILLS

• The parent of an 11-month-old child calls the pediatric outpatient clinic and tells the nurse that the

child was exposed to measles 2 days ago during a family trip to a theme park. What is the best response by the nurse?

• Bring the baby into the clinic for the measles, mumps, rubella (MMR) vaccine
• Check the baby's temperature twice a day
• Do not allow the child to have contact with other children.
• Does your child have a fever or rash?

• A nurse is discussing the fine motor abilities of a 10-month-old infant with the infant's parent. Which

are developmentally appropriate skills for an infant of this age? Select all that apply.

• Grasps a small doll by the arm
• Stacks 3 wooden blocks
• Transfers small objects from hand to hand
• Turns single pages in a book
• Uses a basic pincer grasp

• The parent of a 21-day-old male infant reports that the infant is "throwing up a lot." Which

assessments should the nurse make to help determine if pyloric stenosis is an issue? SATA

• Assess the parent's feeding technique

Check for family history of gluten enteropathy

• Check for history of physiological hyperbilirubinemia
• Check if the vomiting is projectile
• Compare current weight to birth weight

• A 1-year-old child who goes to day care is recovering from an episode of otitis media. Which

intervention is most important for the nurse to recommend to the parents in order to prevent recurrence?

• Exclusive breastfeeding
• Not sending the child to day care
• Preventing water from entering the ear
• Smoking cessation by the parents.

• A 3-month-old child with developmental dysplasia of the hip (DDH) is being fitted for a Pavlik

harness. Which statement made by the parent indicates a need for further instruction?

• . "I should leave the harness on during diaper changes."
• "I will adjust the harness straps every 3-5 days."
• "I will inspect the skin under the straps 2-3 times daily”
• "The harness should keep my baby's legs bent and spread apart."

• The school nurse is conducting an educational session for middle school teachers that is designed to

heighten awareness of school bullying. The nurse recognizes that further instruction is needed when one of the teachers makes which comment?

• "Bullying is a normal part of childhood growth and development."
• "Children with physical disabilities are more vulnerable to bullying."
• "Most children who are victims of a school bully do not tell an adult about it."
• "The most common form of bullying is verbal aggression, such as insults and intimidation."

• The nurse is caring for a 2-year-old who is receiving a saline enema for treatment of intussusception.

Reporting which client finding to the health care provider (HCP) is most important?

• Passed a normal brown stool
• Passed a stool mixed with blood
• Stopped crying
• Vomited a third time

• A 2-year-old child is brought to the emergency department for a severe sore throat and fever of

102.9 F (39.4 C). The nurse notes that the child is drooling with distressed respirations and inspiratory stridor. What action should the nurse take first?

• Assess an accurate temperature with a rectal thermometer
• . Directly examine the throat for the presence of exudates
• . Obtain intravenous access for anticipated steroid administration
• Position the child in tripod position on the parent's lap

• A nurse in a clinic is talking with a parent about the onset of puberty in boys. What is the first sign of

pubertal change that occurs?

• Appearance of upper lip hair
• Increase in height
• Presence of axillary hair
• Testicular enlargement.

• The nurse is caring for a child newly diagnosed with cystic fibrosis. Which of the following

interventions are appropriate to include in the child's plan of care? Select all that apply.

• Aerobic exercise
• Chest physiotherapy
• Low-calorie diet
• Oral fluid restriction
• Social support services

• The nurse assesses 4 infants. Which assessment finding would require follow-up by the health care

provider?

• 3-week-old whose anterior fontanelle bulges with crying
• 4-week-old whose posterior fontanelle is soft
• 6-month-old with birth weight of 7 lb 3 oz (3.3 kg) who now weighs 12 lb (5.4 kg)
• 12-month-old with birth weight of 6 lb 4 oz (2.8 kg) who now weighs 20 lb (9.1 kg)

• The nurse is providing discharge instructions to the parent of a child with Kawasaki disease. The

nurse informs the parent that the presence of which symptom should be immediately reported to the health care provider?

• Fever
• Irritability
• Knee pain
• Skin peeling

• The nurse is reviewing discharge teaching with the parent of a child with acute myelogenous

leukemia who was admitted with varicella-zoster virus. The client has multiple lesions that have not crusted. Which of the following instructions should the nurse include? Select all that apply.

• "Apply diphenhydramine cream sparingly to lesions after bathing your child."
• "Keep giving your child the acyclovir at home as prescribed to fight the virus."
• "You can give your child acetaminophen for pain and fever."
• "Your child should receive the varicella virus vaccine in 30 days."
• "Your child will no longer be infectious after all the lesions have crusted over."

• The nurse is assessing an infant with intussusception. Which of the following clinical findings should

the nurse expect? Select all that apply.

• Palpable olive-shaped mass in epigastrium
• Palpable sausage-shaped abdominal mass
• Projectile vomiting without visualized blood
• Screaming and drawing of the knees up to the chest
• Stool mixed with blood and mucus

• A newborn has a large myelomeningocele. What nursing intervention is priority?
• Assess the anus for muscle tone
• Cover the area with a sterile, moist dressing
• Measure the occipital frontal circumference
• Place the newborn supine with the head of the bed elevated

• The nurse is assessing a 4-year-old boy in a pediatric clinic. Which behaviors by the client would

concern the nurse for possible Duchenne muscular dystrophy? Select all that apply.

• Frequently trips and falls at home
• Has painful knees and elbows in the morning
• Places hands on the thighs to push up to stand
• Suddenly rigidly extends the arms and legs
• Walks on tiptoes and has disproportionately large calves

• A child in the emergency department had a cast placed on the right arm for a nondisplaced fracture.

The client is being discharged home with pain medications. Which statement by the parent indicates that additional teaching is required?

• "A tingling or burning sensation within the first 24-48 hours is not a concern."
• "An itching sensation under the cast for the first 24-48 hours is not a concern."
• "I will call the doctor if pain is severe despite medications for the first 24 hours."
• "My child should elevate the arm for the first 24-48 hours."

• When monitoring an infant with a left-to-right-sided heart shunt, which findings would the nurse

expect during the physical assessment? Select all that apply.

• Clubbing of fingertips
• Cyanosis when crying
• Diaphoresis during feedings
• Heart murmur
• Poor weight gain

• The nurse reinforces teaching for the parents of a child with impetigo. Which of the following

statements by a parent indicates correct understanding of teaching? Select all that apply.

• "I should wash my hands before and after touching the infected area."
• "I will clean the infected area with alcohol before applying the antibiotic ointment."
• "I will separate my child's towels from other laundry and wash them with hot water."
• "My child's fingernails should be kept short and well-filed."
• "The infection could easily spread to other children who come in contact with my child."

• The parents of a hospitalized preschooler are concerned because their toilet- trained child has

started wetting the bed. Which response by the nurse is most helpful?

• "Discipline your child by taking away playroom privileges."
• "It is normal for your child to regress while hospitalized."
• "Restricting fluids at nighttime will solve this problem."
• "Your child is acting out due to the hospitalization."

• A nurse is teaching the parents of an infant with tetralogy of Fallot. Which of the following actions

should the nurse include to reduce the incidence of hypercyanotic spells? Select all that apply.

• Encourage smaller, frequent feedings
• Offer a pacifier when the infant begins to cry
• Promote a quiet period upon waking in the morning
• Swaddle the infant during procedures
• Turn the infant frequently during sleep

• A nurse is caring for a 3-month-old infant who has bacterial meningitis. Which clinical findings

support this diagnosis? Select all that apply.

• Depressed anterior fontanelle
• Frequent seizures
• High-pitched cry
• Poor feeding
• Presence of the Babinski sign
• Vomiting

• The nurse is reviewing anticipatory guidance with the parents of a 6-month-old infant with

phenylketonuria. Which statements by the nurse are appropriate? Select all that apply.

• "A low-phenylalanine diet is required."
• "Meat and dairy products should not be introduced into the diet."
• "Phenylketonuria is self-limiting and usually resolves by adulthood."
• "Special infant formula is required."
• "Tyrosine should be removed from the diet."

• The nurse is caring for a 7-year-old client diagnosed with nephrotic syndrome who will be

discharged soon. Which statement by the parent indicates the need for further teaching?

• "I'll provide a healthy diet without added salt for my child."
• "I'll organize playdates to keep my child's spirits up during relapses."
• "I'll restrict my child's fluids if I notice swelling or rapid weight gain."
• "I'll test for protein in my child's urine every day."