Review Pediatrics exam (Samuel merit university)

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Pediatrics exam (Samuel merit university)

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Total Questions : 38

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Question 1:

Aspirin is a part of the treatment for children with Kawasaki disease.

A. True B. False

Answer and Explanation

Choice A:

Aspirin is part of the treatment for Kawasaki disease to reduce inflammation, prevent blood clots, and manage fever. It is typically used in combination with IV immunoglobulin (IVIG) to prevent coronary artery complications.

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Question 2:

A child in compensated shock will which symptoms?

A. Somnolence, hypotension, oliguria B. Irritability, tachypnea, hypotension C. Irritability, capillary refill time > 2 sec, bradycardia D. Irritability, tachycardia, poor peripheral perfusion

Answer and Explanation

Choice A:

Somnolence, hypotension, and oliguria are signs of decompensated shock, not compensated.

Choice B:

While irritability and tachypnea are early signs, hypotension indicates progression to decompensated shock.

Choice C:

Capillary refill time > 2 sec may occur in shock, but bradycardia is a late and ominous sign in pediatrics.

Choice D:

Irritability, tachycardia, and poor peripheral perfusion (e.g., delayed capillary refill, cool extremities) are hallmark signs of compensated shock, where the body is still maintaining blood pressure.

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Question 3:

The primary problem in cystic fibrosis is the production of thin, watery mucus that helps clear airways.

A. True B. False

Answer and Explanation

Choice B:

The primary problem in cystic fibrosis is the production of thick, sticky mucus that obstructs the airways, leading to respiratory issues and infections. It affects various organs, including the lungs and digestive system.

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Question 4:

You are discussing prevention of infective endocarditis with parents of a child with a complex congenital heart defect. A critical teaching point to emphasize includes:

A. Delay dental visits until the child’s heart defect is fully repaired B. High dose IV antibiotics for 2-8 weeks C. Administration of daily prophylactic antibiotics D. Administration of antibiotics one hour prior to all dental procedures

Answer and Explanation

Choice A:

Delaying dental care increases the risk of poor oral hygiene, which can actually increase the risk of endocarditis.

Choice B:

High-dose IV antibiotics are the treatment for infective endocarditis, not prevention.

Choice C:

Daily prophylactic antibiotics are not recommended due to risk of resistance and adverse effects.

Choice D:

Administering antibiotics 1 hour prior to dental procedures is the correct recommendation for preventing infective endocarditis in high-risk children, including those with certain congenital heart defects.

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Question 5:

Which congenital heart disease causes cyanosis when not repaired? (select all that apply)

A. Pulmonary atresia B. Patent ductus arteriosus (PDA) C. Transposition of great arteries D. Tetralogy of Fallot

Answer and Explanation

Choice A:

Pulmonary atresia leads to little or no blood flow to the lungs, resulting in severe cyanosis if not surgically repaired.

Choice B:

PDA typically causes a left-to-right shunt and does not usually result in cyanosis unless other defects are present.

Choice C:

Transposition of the great arteries (TGA) creates parallel circulations, leading to severe cyanosis without mixing of blood.

Choice D:

Tetralogy of Fallot is a classic cyanotic heart defect, especially during "tet spells" due to right-to-left shunting.

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Question 6:

An 18-month-old is admitted to the emergency department in hypovolemic shock. What would be the correct order of nursing interventions (assuming MD orders are written)?

A. Oxygen, IV fluid bolus of 20 ml/kg, medications to support cardiac function B. IV at 2X maintenance, oxygen, medication to support cardiac function C. Oxygen, IV fluid bolus of 10 ml/kg, medication to support cardiac function. D. Oxygen, medication to support cardiac function, IV fluid bolus of 20 ml/kg

Answer and Explanation

Choice A:

This is the correct sequence: oxygen first to improve oxygenation, followed by a rapid IV fluid bolus (20 mL/kg) to restore intravascular volume, and then medications if needed.

Choice B:

Maintenance fluids are inadequate for shock; boluses are required.

Choice C:

A 10 mL/kg bolus is insufficient in pediatric hypovolemic shock; the guideline is 20 mL/kg.

Choice D:

Medications should not be started before volume resuscitation in hypovolemic shock.

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Question 7:

Children with a history of Respiratory syncytial virus (RSV) infection are at an increase risk of developing asthma later in life.

A. True B. False

Answer and Explanation

Choice A:

Children with a history of severe RSV infections are at a higher risk for developing asthma because the infection may damage the airways and increase the susceptibility to wheezing, airway hyperresponsiveness, and inflammation, all of which are features of asthma.

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Question 8:

Which intervention should be included in the plan of care for an infant with the nursing diagnosis Fluid Volume Excess related to congestive heart failure?

A. Administer digoxin as ordered by the physician B. Notify the physician when weight gain exceeds more than 20g/day C. Weight the infant every day on the same scale at the same time D. Put the infant in a car seat to minimize movement

Answer and Explanation

Choice A:

Digoxin improves cardiac contractility but does not directly assess fluid volume status.

Choice B:

A gain of 20g/day is often a normal weight gain in infants; excessive gain is typically considered >50g/day in the context of fluid retention.

Choice C:

Daily weights on the same scale at the same time are the most accurate method to assess fluid volume status in CHF.

Choice D:

Using a car seat may increase energy expenditure in some infants and is not a routine intervention for CHF.

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Question 9:

Which strategy is appropriate when feeding the infant with congestive heart failure?

A. Always bottle feed every 4 hours B. Feed larger volumes of concentrated formula less frequently C. Continue the feeding until a sufficient amount of formula is taken D. Limit feeding to no more than 30 minutes

Answer and Explanation

Choice A:

Feeding frequency should be individualized and may need to be more frequent with smaller volumes.

Choice B:

Larger volumes increase energy expenditure and fatigue; not recommended.

Choice C:

Prolonging feeding times increases fatigue, which can worsen CHF symptoms.

Choice D:

Infants with CHF often tire easily; limiting feeding to 30 minutes reduces energy expenditure and prevents fatigue and fluid overload.

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Question 10:

Which type of respiratory condition is always considered an emergency?

A. Laryngitis B. Laryngotracheobronchitis C. Epiglottitis D. Spasmodic croup

Answer and Explanation

Choice A:

Laryngitis is typically self-limiting and does not require emergency intervention.

Choice B:

Laryngotracheobronchitis (croup) can cause significant respiratory distress but is usually managed with supportive care unless severe.

Choice C:

Epiglottitis is a life-threatening condition that causes airway obstruction and requires immediate emergency intervention, including securing the airway and starting antibiotics.

Choice D:

Spasmodic croup can be distressing but generally resolves with supportive measures and is not an immediate emergency.

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Total Questions : 38

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Pediatrics exam (Samuel merit university)

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