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Pediatric Disorders NCLEX Exam
Question and Answer| Latest Update
The parents of a pediatric client who has sickle cell anemia ask about the cause of the disorder. Which response by the nurse would best describe the cause? A. "It is caused by a recessive trait the primarily affects African-Americans." B. "It is a rare, malignant disorder of the lymphatic system." C. "It is an inherited disorder caused by the abnormal hemoglobin synthesis." D. "It is caused by an increased demand for iron in the blood stream." - Answer -A. "It is caused by a recessive trait the primarily affects African-Americans." When reviewing the management of sickle cell anemia with a parent, the nurse understands further teaching would be needed if the parent said that which of the following circumstances contributed to a crisis? A. Excessive vomiting B. Fever C. Foods that are low in iron D. Emotional stress - Answer -C. Foods that are low in iron The nurse is caring for a child whose parents are both African Americans. The child exhibits swelling of their hands and feet, fever, and signs of blocked capillaries. What is the likely cause?
A. Hodgkin's disease B. Diabetic ketoacidosis C. Hyperthyroidism D. Sickle cell anemia - Answer -D. Sickle cell anemia A community health nurse is conducting an educational session with community members regarding tuberculosis. The nurse tells the group that one of the first symptoms associated with tuberculosis is: a. Dyspnea b. Chest pain c. A bloody, productive cough d. A cough with the expectoration of mucoid sputum - Answer -d. A cough with the expectoration of mucoid sputum A nurse performs an admission assessment on a female client with a diagnosis of tuberculosis. The nurse reviews the results of which diagnostic test that will confirm this diagnosis? a. Bronchoscopy b. Sputum culture c. Chest x-ray d. Tuberculin skin test - Answer -b. Sputum culture The parent of a child with TB asks a nurse to explain how the TB is transmitted to others. What is the most appropriate response by the nurse: a. Hand and mouth b. The airborne route c. The fecal-oral route
A nurse is caring for a child who has bronchiolitis. Which of the following are appropriate actions for the nurse to take? (Select all that apply). A. Administer oral prednisone B. Initiate chest percussion and postural drainage. C. Administer humidified oxygen D. Suction the nasopharynx as needed E. Administer oral penicillin - Answer -C-humidified oxygen provides moisture to the airway and is an appropriate action for the nurse to take D-Suctioning that nasopharynx will assist the client to clear secretions and is an appropriate action for the nurse to take. The nurse should include which of the following facts when teaching parents about handling a child with recurrent urinary tract infections? a. Antibiotics should be discontinued 48 hours after symptoms subside. b. Recurrent symptoms should be treated by renewing the antibiotics prescription. c. Complicated urinary tract infections are related to poor perineal hygiene practice. d. Follow-up urine cultures are necessary to detect recurrent infections and antibiotics effectiveness. - Answer -d. Follow-up urine cultures are necessary to detect recurrent infections and antibiotics effectiveness. When reviewing the results of a clean-voided urine specimen, which of the following results would indicate to the nurse that the child may have a urinary tract infection?
a. A specific gravity of 1. b. Cloudy color without odor c. A large amount of casts present d. 100,000 bacterial colonies per milliliter - Answer -d. 100,000 bacterial colonies per milliliter Which of the following factors should the nurse recognize as predisposing the urinary tract to infections in males or females? a. Increased fluid intake b. Short urethra in young females c. Ingestion of highly acidic juices d. Frequent emptying od the bladder - Answer -b. Short urethra in young females A client with advanced cirrhosis has been diagnosed with hepatic encephalopathy. The nurse expects to assess for: A. Malaise B. Hand tremors C. Weight loss D. Stomatitis - Answer -B. Hand tremors A client diagnosed with chronic cirrhosis who has ascites and pitting peripheral edema also has hepatic encephalopathy. Which of the following nursing interventions are appropriate to prevent skin breakdown? Select all that apply. A. Alternating air pressure mattress B. Turn and reposition every 2 hours C. Abdominal and foot massages every 2 hours D. Sit in chair for 30 minutes each shift
A. Restrain the child as necessary. B. Discourage parents from holding the child. C. Adjust activities to child's tolerance level. D. Perform passive range-of-motion exercises daily. - Answer -C. Adjust activities to child's tolerance level. A new mother has some questions about (PKU). Which of the following statements made by a nurse is not correct regarding PKU? A. A Guthrie test can check the necessary lab values. B. The urine has a high concentration of phenylpyruvic acid C. Mental deficits are often present with PKU. D. The effects of PKU are reversible. - Answer -D. The effects of PKU are reversible.
- An infant's PKU test is positive. The nurse's priority is to: A. Provide PKU education to the family members B. Change the infant's formula to Lofenlac C. Obtain an order for packed red cells D. Monitor vital signs every 30 minutes - Answer -B. Change the infant's formula to Lofenlac
- When newborns have been on formula for 36-48 hours, they should have a: A. Screening for PKU B. Vitamin K injection C. Test for necrotizing enterocolitis D. Heel stick for blood glucose level - Answer -A. Screening for PKU
Prevention of Rheumatic Fever can best be accomplished by: a. Keeping children with a fever home from school b. Sending children with sore throats home from school c. Having sore throats cultured as soon as possible d. Treating all colds with antibiotics - Answer -c. Having sore throats cultured as soon as possible A child is admitted to the hospital with suspected Rheumatic Fever. Which of the following does NOT confirm the diagnosis? a. Reddened rash visible over trunk and extremities b. History of sore throat that is self-limiting in the past c. A negative antistreptolysin O titer d. An unexplained fever - Answer -c. A negative antistreptolysin O titer Which of the following orgnaisms is responsible for the development of Rheumatic Fever? a. Streptococeal pneumonia b. Haemophilus Influenza c. Group A B-Hemolytic Streptococcus d. Staphylococcus aureus - Answer -c. Group A B- Hemolytic Streptococcus What is one of the major precipitating factors in the development of Irritable Bowel Syndrome? a. Stress b. Ulcers c. GERD
a. Lesion appear in crops b. Koplik Spots c. Petechiae on soft palate d. Abdominal cramps - Answer -a. Lesion appear in crops
- Which of the following is NOT a risk factor for shingles? a. History of chickenpox b. Age over 20 c. Being treated for cancer d. Weakened immune system - Answer -b. Age over 20 What is the most common type of CAH: a) Low serum levels b) Ambiguous genitalia c) Salt water crisis d) Increased sodium levels - Answer -c) Salt water crisis
- What occurs in salt water crisis a) Hypervolemia b) Hypovolemia c) Hyperkalemia d) hypokalemia - Answer -b) Hypovolemia
- What type of gene is CAH: a) Autosomal recessive gene b) Autosomal Dominate gene - Answer -a) Autosomal recessive gene A nurse is caring for a child who has Muscular Dystrophy. For which of the following findings should the nurse asses? (select all that apply)
a. Purposeless, involuntary, abnormal movements b. Spinal defect and saclike protrusion c. Muscular weakness in lower extremities d. Unsteady, wide-based gait or waddling gait e. Upward slant to the eyes - Answer -c. Muscular weakness in lower extremities d. Unsteady, wide-based gait or waddling gait The nurse teaches the mother of a young child with Duchenne's muscular dystrophy about the disease and it's management. Which of the following statements by the mother indicates successful teaching? a. My son will probably be unable to walk independently by the time he is 9 to 11 years old. b. Muscle relaxants are effective for some children; I hope they help my son. c. When my son is a little bit older, he can have surgery to improve his ability to walk. d. I need to help my son be as active as possible to prevent progression of the disease. - Answer -a. My son will probably be unable to walk independently by the time he is 9 to 11 years old. When trying to stand the child puts hands on knees and moves the hands up the legs until in a standing position. The name for this is? a. limb girdle b. myotonic c. Becker d. Growers maneuver - Answer -d. Growers maneuver
Which diagnostic test(s) is/are performed to assist in the diagnosis of Non-Hodgkin Lymphoma? A) Physical exam and angiography B) Laparotomy C) Blood and urine cultures D) EKG - Answer -C) Blood and urine cultures Which cell is the site of origin for Non-Hodgkin Lymphoma? A) B or T lymphocyte B) Erythrocyte C) Epithelial cell D) Monocyte - Answer -A) B or T lymphocyte What is the primary treatment for children with Non- Hodgkin Lymphoma? A) Radiation B) Multiagent Chemotherapy C) Stem Cell Transplant D) Hyperthermia therapy Correct Answer : B - Answer -B) Multiagent Chemotherapy What food is appropriate for a lactose-free diet? a. Yogurt b. Ice cream c. Broccoli d. Pancakes - Answer -c. Broccoli Which is NOT an expected outcome for person with lactose intolerance? a. The child will be free from abdominal pain
b. The child will have soft, formed stools c. The child will state foods to be avoided or provided in diet and appropriate lactase products d. The child would contain a diet that includes dairy products - Answer -d. The child would contain a diet that includes dairy products What is the major source of nutrients in the basic American diet that correlates with lactose intolerance? a. Milk and dairy b. Fiber and sodium c. Potassium and bananas d. Iron and red meats - Answer -a. Milk and dairy You are the nurse caring for a 3 year old patient with Kawasaki Disease. What medications should you expect to find? a. methotrexate b. aspirin and intravenous immune globulin c. digoxin d. IV tetracycline and furosemide - Answer -b. aspirin and intravenous immune globulin The nursing care plan for a toddler diagnosed with Kawasaki Disease should be based on the high risk for development of which problem? a. hypertension b. seizures c. coronary artery aneurysms d. stroke - Answer -c. coronary artery aneurysms
tympanic membrane has an orange discoloration and decreased movement. Which of the following is an appropriate statement for the nurse to make? A. "your child has an ear infection that requires antibiotics" B. "your child could experience transient hearing loss" C. "your child will need to be on a decongestant until this clears up" D. "your child will need to have a myringotomy" - Answer - B. "your child could experience transient hearing loss" The nurse is planning a diet for an eight-year old with cystic fibrosis (CF). which of the following dietary requirements should be considered? a. High protein, high fat and high calories. b. High protein, low fat and high calories. c. Low protein, low fat and low carbohydrates. d. High protein, high fat and low carbohydrates. - Answer - b. High protein, low fat and high calories. You are assessing a 5-year-old who has been admitted with an acute respiratory infection. You review the chart and see the child has cystic fibrosis. What is the priority for assessment? a. Opening and maintain a patent airway b. Giving antibiotics to the child c. Checking levels of pancreatic enzymes d. Modifying the child's diet - Answer -a. Opening and maintain a patent airway The most important measure to include in the nursing management for a child with cystic fibrosis would be to?
a. Promote optimal nutrition with a high-protein, low-fat diet b. Administer only water-soluble vitamins c. Administer pancreatic enzymes before each meal d. Encourage lots of fluids, especially fruit juices - Answer -c. Administer pancreatic enzymes before each meal A nurse is caring for a child who has cerebral palsy. Which of the following medications should the nurse expect to administer to treat painful muscle spasms? Select all that apply. A. Baclofen (Lioresal) B. Diazepam (Valium) C. Oxybutynin chloride (Ditropan) D. Methotrexate (Rheumatrex) E. Prednisone (Deltasone) - Answer -A. Baclofen (Lioresal) B. Diazepam (Valium) When assessing the development of a 15 month old child with cerebral palsy, which of the following milestones would the nurse expect a toddler of this age to have achieved? A. Walking up steps B. Using a spoon C. Coping a circle D. Putting a block in a cup - Answer -D. Putting a block in a cup
B. Fear related to the possibility of seizures C. Ineffective individual coping related to stresses imposed by epilepsy D. Deficient knowledge related to epilepsy and its control - Answer -A. Risk for injury related to seizure activity A client is admitted to the unit to determine if his symptoms are being caused by a brain tumor. He is scheduled to have an MRI. Which question by the nurse is most important in preparing the client for the MRI? A. "Have you had anything to eat or drink today?" B. "Are you afraid of the dark?" C. "When was the last time you had a bowel movement?" D. "Do you have a pacemaker?" - Answer -D. "Do you have a pacemaker?" A male client with a cerebellar brain tumor is admitted to an acute care facility. The nurse formulates a nursing diagnosis of Risk for injury. Which "related-to" phrase should the nurse add to complete the nursing diagnosis statement? A. Related to visual field deficits B. Related to difficulty swallowing C. Related to impaired balance D. Related to psychomotor seizures - Answer -C. Related to impaired balance When caring for a male client diagnosed with a brain tumor of the parietal lobe, the nurse expects to assess: A. short-term memory impairment. B. tactile agnosia.
C. seizures. D. contralateral homonymous hemianopia. - Answer -B. tactile agnosia Which of the following symptoms is seen in a child with bronchopulmonary dysplasia? a. Minimal work of breathing b. Tachypnea and dyspnea c. Easily consolable d. Hypotension - Answer -b. Tachypnea and dyspnea Which of the following interventions is most appropriate for helping parents to cope with a child newly diagnosed with bronchopulmonary dysplasia? a. Teach cardiopulmonary resuscitation b. Refer them to support groups c. Help parents identify necessary lifestyle changes d. Evaluate and assess parents; stress and anxiety levels
- Answer -a. Teach cardiopulmonary resuscitation Infants with bronchopulmonary dysplasia are commonly treated with bronchodilators such as theophylline. Which of the following adverse effects is common with this drug? a. Lethargy b. Decreased calcium level c. Increased heart rate d. Decreased serum potassium level - Answer -c. Increased heart rate
