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Peds Exam 1
Peds Exam 1
Total Questions : 63
Showing 10 questions Sign up for moreWhich immunization will the nurse teach to the mothers that can assist in preventing the life-threatening disease epiglottitis?
Explanation
a) Measles, mumps, rubella (MMR): Does not directly protect against epiglottitis.
b) Diphtheria, tetanus, pertussis (DTaP): While important for other diseases, does not directly prevent epiglottitis.
c) Hepatitis B: Provides immunity against hepatitis B, not epiglottitis.
d) Hemophilus influenzae type B (Hib): The Hib vaccine specifically targets Haemophilus influenzae type B bacteria, which is the main cause of epiglottitis. Immunization with the Hib vaccine has dramatically reduced the incidence of epiglottitis and other serious infections caused by Hib.
A newborn is suspected of having cystic fibrosis. As the child is being prepared for transfer to the pediatric hospital, the mother asks the nurse which symptoms made the practitioner suspect cystic fibrosis. Which response by the nurse is most appropriate?
Explanation
a) Constipation: Not typically a primary symptom of cystic fibrosis.
b) Meconium ileus: Meconium ileus is a bowel obstruction that occurs shortly after birth due to abnormally thick meconium. It is a classic early sign of cystic fibrosis in newborns. Other symptoms such as failure to thrive, persistent cough, salty-tasting skin, and recurrent respiratory infections may also manifest later.
c) Rectal prolapse: Can be related to cystic fibrosis but is not as specific as other symptoms.
d) Steatorrhea stools: Frequent fatty stools are symptoms of the disease but not specific to cystic fibrosis.
Which breath sounds indicate the infant is experiencing respiratory distress? (Select All That Apply: SATA)
Explanation
a) Eupnea: Normal breathing rate and pattern, not indicative of distress.
b) Apnea: Cessation of breathing, a sign of significant distress.
c) Tachypnea: Rapid breathing, often seen in respiratory distress.
d) Wheezing: High-pitched, musical sounds during expiration, suggesting airway obstruction.
e) Grunting: Heard during expiration, a sign of the body's attempt to keep air in the lungs, indicating distress.
f) Retractions: Visible sinking of tissues between ribs or at the sternum, indicating increased effort to breathe, a sign of distress.
An infant has had recurrent respiratory infections. The mother of the child expresses concern that the infant seems to be at increased risk for complications from respiratory infections in comparison with her older children. Which response by the nurse would be most appropriate?
Explanation
a) The younger child’s airways are smaller and more easily occluded: Children, especially infants, have smaller airways, making them more susceptible to blockage during infections.
b) You are incorrect in your assessment: This response dismisses the mother's concern without providing information.
c) Air passages are more likely to become blocked with mucus due to increased mucus production in young children: While increased mucus production can be a factor, the size of airways is a more critical consideration.
d) Infants are not able to breathe deeply: Not an accurate statement; infants have a different breathing pattern but can breathe adequately.
A 4-year-old girl is brought to the emergency department. She has a ‘frog-like’ croaking sound on inspiration, is agitated, and drooling. She insists on sitting upright. The nurse should do which of the following?
Explanation
a) Make her lie down and rest quietly: Inappropriate as the symptoms suggest potential airway obstruction.
b) Examine her oral pharynx and report to the physician: Important action, but immediate airway management is the priority.
c) Auscultate her lungs and prepare for placement in a warm mist tent: Less critical than ensuring an open airway.
d) Defer an oral assessment and be prepared to assist with a tracheostomy or intubation: The child's symptoms (stridor, agitation, drooling) indicate potential upper airway obstruction, and immediate readiness for airway intervention is essential.
A 3-year-old with bacterial pneumonia is crying and says it hurts when he coughs. The nurse would teach the child to do which of the following?
Explanation
a) Hug his teddy bear when he coughs: Splinting the chest while coughing can reduce discomfort.
b) Blow bubbles to prevent coughing episodes: Not effective for reducing cough-induced pain.
c) Take a sip of apple juice before coughing: Drinking before coughing may not significantly alleviate the discomfort.
d) Ask for codeine cough syrup when he coughs: Medication should be given based on medical advice and prescription, not as a self-request by a child.
A nurse delegates the task of neonatal vital sign assessment to a nurse technician. Which instruction will the nurse give to the technician prior to assigning care?
Explanation
A. Do not report any pause in respiration unless it's greater than 20 seconds.Any pause in respiration can be significant in neonates. A pause in breathing, even if less than 20 seconds, should be reported, as it could indicate a potential problem. This option downplays the importance of monitoring respiratory patterns.
B. Report any neonate with nasal flaring.Nasal flaring in a neonate is a sign of respiratory distress. This instruction is essential because nasal flaring indicates the infant is working harder to breathe and may require further evaluation and intervention.
C. Report any pause in respiration greater than 10 seconds.While this is important, nasal flaring is a more immediate and visible sign of respiratory distress that should be reported.
D. Report any respiratory rate of 40 or greater.A respiratory rate of 40 breaths per minute is within the normal range for neonates. Reporting a normal rate would not be necessary and could create unnecessary concern.
An anxious and irritable preschooler arrives in the ER, refusing to lie down to be examined. The child sits, leans forward in onto the hand, and drools saliva. The child is warm to the touch, is using accessory muscles to breath, and pale in color. The nurse should: Place in the correct order from highest to lowest priority (assume you can only do one at a time).
Explanation
1. Prepare for intubation
2. Notify the physician
3. Start an IV
4. Draw blood gasses
5. Take the child's vital signs
An adolescent was diagnosed with cystic fibrosis as an infant, at this time, the nurse anticipates that the adolescent will need additional teaching related to which of the following?
Explanation
a) Obtaining a sweat chloride test: Likely already part of routine monitoring for cystic fibrosis.
b) Reproductive ability: Adolescents with cystic fibrosis may need education regarding how their condition can affect fertility.
c) The effect of pancreatic enzymes on sex hormones: Not a commonly discussed aspect in cystic fibrosis care.
d) Increased need for weight reduction diet: Weight maintenance or specific diets to promote weight gain are more commonly addressed in cystic fibrosis care.
Which of the following are characteristics seen in bronchiolitis and RSV? (Select All That Apply . )
Explanation
a) Airway swelling: Seen in both bronchiolitis and RSV due to inflammation.
b) Barking cough: More commonly associated with croup, not typically a prominent feature in bronchiolitis or RSV.
c) Increased mucus: Both conditions involve increased mucus production.
d) Bronchospasm: Present in both bronchiolitis and RSV due to airway irritation.
e) Air trapping: Can occur in both conditions due to the airway obstruction and inflammation
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