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Peds Practice Final Test ID: 22 Name: ___________________________ Date: _December 13, 2005_ 1. (250). According to Piaget's Theory of Cognitive Development, which substage involves the Intentional behavior of an infant as learned to obtain objects, create sounds, or engage in other pleasurable activity. (A). Primary Circular Reactions (1-4months) (B). Secondary Circular Reactions (4-8months) (C). Use of Reflexes(birth-1month) (D). Coordination of Secondary Schemes (8-12months 2. (220). According to Piaget's Theory of Cognitive Development, which substage begins life with a set of reflexes such as sucking, rooting, and grasping. (A). Primary Circular Reactions(1-4months) (B). Use of Reflexes(birth-1month) (C). Secondary Circular Reactions(4-8months) (D). Coordination of Secondary Schemes(8-12months) 3. (50). What is the leading cause of death in children age 1-14yrs old in the United States? (A). Unintenional Injury (B). Motor Vehicle Accidents (C). Congenital Abnormalities (D). Drowning 4. (370). At what point in life does weight double in 5 months and tripple with in a year (A). It doesn't (B). 1st year of life (C). 2nd year of life (D). 3 yr of life 5. (280). According to Piagets Theory of Cognitive Development, which stage does a child display the ability to think by using words as symbols, but logic is not well developed. (A). Sensorimotor (birth-2yrs) (B). Preoperational (2-7yrs) (C). Concrete Operational (7-11yrs) (D). Formal Operational (11-Adulthood) 6. (80). The definition: is a process established by a health care institution to identify, evaluate and reduce the risk of injury to patients, staff, and visitors, and therby reduce the institutions liablility. This is the definition for what term? (A). Risk Assessment (B). Risk Management (C). Quality Improvement (D). Risk Analisys 7. (60). What is the leading cause of death for children 1-14 yrs old under the unintential injury catagorie? (A). Fires and Burns (B). Drowning (C). Motor Vehicle Accidents (D). Sufforcation 8. (540). When should meats be introduced? (A). 4-6mos (B). 6-8mos (C). 8-10mos (D). 10-12mos 9. (120). Parents or guardians have absolute authority to make choices about their childs health care except? (choose all that apply) (A). When the childs parents are unavailable (B). When the child and parents do not agree on major treatment options (C). When the parents choice of treatment does not permit lifesaving treatment for the child (D). When there is a potential conflict of interest between the child and parents, such as with suspected child abuse or neglect 10. (360). What can a mother due to strive for the best possible outcome in pregnancy? (choose all that apply) (A). Seek early prenatal care (B). avoid drugs, alcohol, tobacco, and excessive caffeine (C). Good nutrition (D). exercise regularly (E). Complete bedrest 11. (30). How does pediatric care differ from that of an adult? (A). The family is more involved in the nursing process (B). The are just smaller adults (C). They are more emotional (D). They can compensate better 12. (150). When begining to examin a child what should one consider? (A). Developmental Level (B). Age (C). Growth (D). Need for Privacy 13. (470). Why do babies recieve a vitamin K injection after birth? (A). Stimulate the immune system (B). Promote adequate clotting (C). Assist in growth and development (D). Stimulate bowel motility 14. (140). The definition: intellectual or thinking processes (A). Growth and Development (B). Cognitive Development (C). Motor Sensory Development (D). Normal Development 15. (180). According to Erickson, what stage of child development does the young child initiate new activities an considers new ideas. the interes in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand leads to feelings of guilt and lack of purpose. (A). Industry vs Inferiority (B). Identity vs Role Confussion (C). Initiative vs Guilt (D). Autonomy vs shame 16. (310). Autosomal chromosomes are all chromosomes except the ones that determine sex. (A). True (B). False 17. (160). Which of the following stages according to Erickson is the following: The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. (A). Trust vs Mistrust (B). Autonomy vs Shame and Doubt (C). Initiative vs Guilt (D). Industry vs Inferiority (E). Identity vs Role Confusion 18. (410). What age group are the following toys/activities appropriate for? Large blocks, teething toys, toys that pop apart and back together, nesting cups and other objects that fit into one another or stack, surprise toys such as jack in the box, social interaction with adults and other children games such as peek aboo, soft balls, push and pull toys. (A). birth-2 months (B). 3-6 months (C). 6-12months (D). 12-18months 19. (70). Standards of Care for the Pediatric Nurse Include: (chose all that apply) (A). Collecting health data (B). Analyzing the assessment data in determining diagnoses (C). Implementing the interventions identified in the care plan (D). Evaluating the childs and familys progress toward attainment of outcomes 20. (350). The maternal use of illicit drugs can cause: (choose all that apply) (A). neonatal addiction (B). convulsions (C). hyperirritability (D). neurological disturbances 21. (210). According to Piaget's Theory of Cognitive Development, Which stage do infants learn about the world by input obtained through the senses and by their motor activity. This stage has 6 substages. (A). Preoperational (2-7yrs) (B). Sensorimotor (birth-1yr) (C). Sensorimotor (birth-2yrs) (D). Concrete Operational (7-11yrs) 22. (440). What is the first sign of puberty in girls? (A). Pubic Hair (B). Breast buds (C). Mensus (D). voice change 23. (260). According to Piaget's Theory of Cognitive Development, which substage does the infant display Curiosity, experimentation, and exploration predominate as the toddler tries out actions to learn results. Objects are turned in every directions, placed in the mouth , used for banging, and inserted in containers as their qualities and uses are explored (A). Primary Circular Reactions (1-4months) (B). Tertiary Circular Reactions (12-18months) (C). Mental Combinations(18-14months) (D). Coordination of Secondary Schemes(8-12months) 24. (290). According to Piaget's Theory of Cognitive Development, which stage does a child display a more accurate understanding of cause and effect. (A). Sensorimotor (birth-2yrs) (B). Preoperational (2-7yrs) (C). Concrete Operational (7-11yrs) (D). Formal Operational (11-Adulthood) 25. (380). How should a nurse help assist parents in preparation for the second year of life (A). Provide anticipatory guidance (B). Provide child development literature (C). Assist them in childproofing their home (D). Suggest toys to play with 26. (420). The term preschool aged refers to a child (A). 1-3yrs (B). 3-6yrs (C). 6-12yrs (D). 12-18yrs 27. (200). According to Erickson, the stage of development where as the body matures and though processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition on self will experience confusion in one or more roles of life. (A). Identity vs Role Confussion (B). Industry vs Inferiority (C). Initiative vs Guilt (D). Autonomy vs Shame and Doubt 28. (550). At what age can a baby have honey? (A). 6mos (B). 8mos (C). 12mos (D). 18mos 29. (90). The definition: is the continuous study and improvement of the process and outcomes of providing health care services to meet the nees of patients, by examining the systems and process of how care and services are delivered (A). Risk Management (B). Quality Improvement (C). Risk Assessment (D). Risk Analisys 30. (130). The definition: directs health care institutions to inform hospitalized patients about their rights, which include expressing a preference for treatment options and making advance directives. (A). Advanced Directives Act (B). Self-Determination Act (C). Good Samaritin Act (D). Informed Consent 31. (520). When should rice cereal be introduced? (A). 4-6mos (B). 3-4mos (C). birth (D). 1-2month 32. (110). When are children 18-21yrs old permitted to give informed consent? (choose all that apply) (A). When they are minor parents of a child (B). When the parents of the child are unavailable (C). When they are emancipated minors (D). When they are adolescents between 16-18yrs of age seeking birth conrtol, mental health counseling, sor substance abuse treatment 33. (450). Who established DRI's and what are they used for (A). established by the board of health. they are to be used to assess and plan intake for individuals of different ages. (B). established by the food and drug administration. they are to be used to assess and plan intake for individuals of different ages. (C). established by the food and nutrition board of the institute of medicine and the national acadamy of science. they are to be used to assess and plan intake for individuals of different ages (D). established by the american acadamy of pediatrics, they are to be used to assess and plan intake for individuals of different ages 34. (170). Which of the following stages according to Erickson follows? The toddlers sense of autonomy or independence is shown by controlling body excretions, saying no when asked to do something, and directing motor activity. Children who are consistently criticized for expressions of autonomy for lack of control. (A). Trust vs Mistrust (B). Autonomy vs Shame and Doubt (C). Industry vs Inveriority (D). Initiative vs Guilt 35. (270). According to Piaget's Theory of Cognitive Development, which substage does language provide a new tool for the toddler to use in understanding the world. language enables the child to think aboiut events and objects before or after they occur. Object permanence is now fully developed as the child actively searches for objects in various locations and out of view. (A). Primary Circular Reactions (1-4months) (B). Mental Combinations (18-24months) (C). Secondary Circular Reactions (4-8months) (D). Tertiary Circular Response (12-18months) 36. (500). When and how much fluoride should be given to a baby? (A). 2 mos 0.25mg (B). 4mos 0.25mg (C). 6mos 0.25mg (D). 8mos 0.25mg 37. (390). The following toys and activities are appropriate for what age Group? Mobiles, black and white patterns, mirrors, music boxes, singing, tape players, soft voices, rocking and cuddling, moving legs and arms while singing and talking, varying stimuli-different rooms, sounds, visual changes (A). birth to 2months (B). 3 to 6 months (C). 6-12 months (D). 12-18months 38. (530). When should fruits and vegitables be introduced? (A). 1-2mos (B). 3-4mos (C). 4-6 mos (D). 6-8mos 39. (480). How many IU of vitamin D is required by an infant? (A). 200 (B). 300 (C). 400 (D). 500 40. (320). The mothers poor nutritional status can effect a baby in many ways, choose all answers that this can result in (A). Low birth weight (B). compromised neurologic performance (C). birth defects (D). slow development (E). impaired immune status 41. (490). At what age does a baby need Iron supplements? (A). 1-2mos (B). 2-4mos (C). 4-6mos (D). 6-8mos 42. (190). According to Erickson, the stage of development that new interest an by involvement in activities develop and the child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority. (A). Initiative vs Guilt (B). Industry vs Inferiority (C). Identity vs Role Confussion (D). Autonomy vs Shame and Doubt 43. (430). The term school aged refers to a child (A). 1-3 yrs (B). 3-6yrs (C). 6-12yrs (D). 12-18yrs 44. (100). The definition: a formal preauthorization for an invasive procedure or participation in research. Consent must be given voluntarily. (A). Implied consent (B). Informed consent (C). Verbal consent (D). Understood consent 45. (230). According to Piaget's Theory of Cognitive Development, which substage does the infant respond relexively, the pleasure gained from that response causes repetition of the behavior. (A). Primary Circular Reactions(1-4months0 (B). Secondary Circular Reactions(4-8months) (C). Use of Reflexes(birth-1month) (D). Coordination of Secondary Schemes(8-12months) 46. (40). What is the leading cause of death in the United States for infants? (A). Motor Vehicle Accidents (B). Congenital Abnormalities (C). Unintential Injury (D). Drowning 47. (10). When age range does the pediatric continum of care encumpus? (A). Birth to 18 (B). Birth to 5 (C). Birth to College (D). Birth to 12 48. (340). The maternal ingestion of alcohol can cause: (A). Low Birth Weight (B). Kidney failure (C). Liver Failure (D). fetal alcohol syndrome 49. (460). During life, at what time is the highest metabolic rate or highest intake requirements? (A). Adolecents (B). Infancy (C). School Aged (D). Teenagers 50. (400). What age group are the following toys/activities appropriate for: Rattles stuffed animals, soft toys with contrasting colors, noise making objects that are easily grasped. (A). Birth-2 months (B). 3-6 months (C). 6-12 months (D). 12-18 months 51. (330). Maternal Smoking can cause: (A). Cancer (B). Low birth weight (C). convulsions (D). hyperirritability 52. (240). According to Piaget's Theory of Cognitive Development, the substage where an infant becomes aware of the environment begins to grow as the infant begins to connect cause and effect. The sounds of bottle preperation will lead to excited behavior. If an object is partially hidden the infant will attempt to retrieve it. (A). Primary Circular Reactions (1-4months) (B). Secondary Circular Reactions(4-8months) (C). Use of Reflexes(birth-1month) (D). Coordination of Secondary Schemes(8-12months) 53. (300). According to Piaget's Theory of Cognitive Development, which stage does a child become fully mature intellectuall thoughs have been attained. (A). Sensorimotor (birth-2yrs) (B). Preoperational (2-7yrs) (C). Concrete Operational (7-11yrs) (D). Formal Operational (11-Adulthood) 54. (20). What four roles does a nurse play in pediatrics? (A). Caring for the patient, teaching the patient, advising the patient, managing their progress (B). Direct Nursing Care, Patient Management, Patient Education, Patient Advocacy (C). Direct Nursing Care, Patient Education, Patient Advocacy, Case Management (D). Giving Care, Patient Education, Client Advocacy, Case Management 55. (510). How are foods introduced? (A). one at a time (B). soft (C). solid (D). liquified 56. (270). What does a toddler understand about death? (A). unable to understand death/separation anxiety (B). may sense caregivers are tense, routines are altered (C). believes it is reversable (D). sleeps more 57. (570). The clinical manifestations of hyponatrimia are: (choose all that apply) (A). anoresia, headache (B). muscle weakness, decreased deep tendon reflexes (C). lethargy, confusion (D). coma/death (E). vomiting 58. (470). Which of the following is an indicator of dehydration (choose all that apply) (A). elevated hematocrit (B). elveated bun (C). edema (D). low specific gravity 59. (400). What effect does a parents pressence have on the outcome? (A). it allows the parents to take part in the care (B). it reduces anxiety associated with pain and hospitalization (C). It makes life easier on the nurse (D). parents get in the way and impede the care 60. (820). What gamma globulin is useful in combating parasitic infections and is part of the allergic response? (A). IGG (B). IGE (C). IGA (D). IGM 61. (480). What is the treatment of mild to moderate dehydration in a child? (choose all that apply) (A). oral rehydration 1-3tsp every 10-15min (B). oral rehydration, 1 tsp every 2-3min even if vomiting (C). iv, 50ml/hr (D). iv, 60ml/hr 62. (490). If soft drinks or juices are used for rehydration how are they given? (A). cold (B). half/half (C). warm (D). flat 63. (240). During the period of bereavement, the nurses goal is to (A). allow the family time to greave (B). provide comfort and support and be physically present (C). provide for privacy (D). contact the mortuary 64. (810). Metabolic alkalosis exist if the HCO3 is (A). >18mmol/L (B). <18mmol/L (C). <25mmol/L (D). >25mmol/L 65. (150). an abnormal elimination pattern characterized by the recurrent soiling or passage of stool at inappropriate times by a child who should have achieved bowel continence is the definition of (A). Stattorea (B). Encopresis (C). Diarrhea (D). Lazzyness 66. (760). Clinical manifestations of hypomagnesemia are: (choose all that apply) (A). tetany, hyperactive reflexes, cramps, twitching, tremors (B). cardiac arrhythmias, seizures (C). vomiting (D). diarrhea 67. (850). How are immunosuppressed children best protected from infection? (choose all that apply) (A). frequent handwashing (B). limit exposure to individuals with upper respiratory infections (C). put them in a bubble (D). vaccines (live viruses should be avoided) 68. (230). When the parents react to a life threatening illness or injury, the stage where parents experience a period of emotions as the child recovers, improves steadily, and prepares for transfer and discharge or dies or remains unresponsive (A). anger and guilt (B). deprivation and loss (C). anticipatory waiting (D). readjustment or mourning 69. (430). How is emla cream applied? (A). 1-2hrs before the first needle stick (B). under suran wrap (C). 20mins before proceedure (D). as needed 70. (320). What approach does hospice take with death? (A). Provide pain relief (B). Provide home care (C). death is just an extension of life. they help patients be comfortable and prepare (D). without death, there would be no life 71. (200). When the parents react to a life threatening illness or injury, the stage where parents become more aware of their childs illness or injury and their anger may be directed toward themselves, each other, health care providers, or other children or parents (A). Anger and Guilt (B). Deprivation and loss (C). shock and disbelief (D). anticipatory waiting 72. (60). What are the risk factors for child abuse? (choose all that apply) (A). History of mental illness, domestic violence, incarceration, or substance abuse in the home (B). Family stresses, Inadequate child care or supervision, Inadequate family social support (C). Use of corporal punishment, Child abuse, Access to firearms, gang membership, exposure to media violence, child hyperactivity (D). bruises on legs, sunburns, scratches on arms 73. (340). What effect does pain have on the body? (A). it lowers the pain threshold (B). it initiates the stress response (C). vital signs increase (D). stimulates constipation 74. (620). hypokalemia exist when the lab values are: (A). >5.8 (B). <5.8 (C). >3.5 (D). <3.5 75. (500). What are the clinical manifestations of extracellular fluid volume excess? (choose all that apply) (A). bounding pulse, distended neck veins (B). hepatomegaly, dyspnea, orthopnea and lung crackles (C). edema (D). weak thready pulse 76. (980). What is the complication that can occur with Mumps? (A). Airway obstruction (B). Orchitis, testicular pain, sterility (C). diarrhea (D). cardiac arrhthmia's 77. (710). How is hypocalcemia treated? (A). oral or iv supplimentation (B). IM injection (C). high calcium diet (D). calcitonin 78. (790). Alkalosis exist if ABG CO2 levels are (A). <27mmHg (B). >27mmHg (C). <41mmHg (D). >41mmHg 79. (560). What are the clinical manifestations of hypernatremia? (choose all that apply) (A). decreased LOC, seizures (B). confusion (C). lethargy (D). coma/death (E). vomiting 80. (390). When using a narcotic to manage pain, what should always be available? (A). Ambu bag (B). Entubation kit (C). Narcan (D). Defibrilator 81. (840). If a mother is known to have aids she is given ZDV after the first trimester, how long is it given to the baby after delivery? (A). 2wks (B). 4wks (C). 6wks (D). 8wks 82. (420). a good way of evaluating the effectiveness of pain control is if the child sleeps. (A). True (B). False 83. (870). What are the clinical manifestations of Systemic Lupus Erythematosus? (choose all that apply) (A). fever, chills, fatiue, malaise and weight loss (B). butterfly rash on the face (C). nausea/vomiting (D). Diarrhea 84. (10). What is a common finding in a child that has been abused? (A). The child is well behaved (B). The child is developmentally delyayed (C). The child has bruses (D). The child runs from parents when they are attempting to get them to stop doing something 85. (550). Treatment for hyponatremia is (A). hypotonic sol. (B). hypertonic sol (C). isotonic sol (D). oral rehydration 86. (590). When is hyperkalemia likely to occur? (A). eatting to many bannana's (B). vitamin overdose (C). massive cell death (crush injury, sickle cell) (D). eating to many green leafy vegies 87. (630). What can cause hypokalemia? (choose all that apply) (A). eating large amounts of black licorice (B). Diarrhea (C). Vomiting (D). not eating bannana's 88. (250). If a child is in a coma the nurse should (A). tell the family to go home and we will call when they wake up (B). encourage the family to communicate (C). tell the family they should make plans to have a vegitable (D). encourage the family to pray 89. (520). Hypernatremia occurs when the sodium level is (A). >148 (B). <148 (C). >135 (D). <135 90. (920). The MMR Vaccine should be given at what ages? (A). 18mos, 4-6yrs (B). 12mos, 4-6yrs (C). Birth, 4-6yrs (D). 6mos, 4-6yrs 91. (210). When the parents react to a life threatening illness or injury, the stage where parents go through the emotions of death before their child dies (A). anger and guilt (B). deprivation and loss (C). anticipatory waiting (D). readjustment or mourning 92. (30). How often should a child engage in moderate physical activity such as bike riding, walking, baseball, or rollerblading? (A). 20 min three times a week (B). 30 min. three times a week (C). 30 min five times a week (D). daily 93. (690). Hypocalcemia exist if lab values are (A). >5.3 (B). <5.3 (C). >4.4 (D). <4.4 94. (90). the deliberate maltreatment of another individual that inflicts pain or injuyr may result in permanent or temporary disfigurement or even death is the definition of: (A). emotional abuse (B). physical abuse (C). physical neglect (D). emotional neglect 95. (1000). A fever isn't considered harmful until it reaches 105.9F (A). True (B). False 96. (40). How often should a child engage in vigorous physical activity? (A). 20 min five times a week (B). 30 min three times a week (C). 20min three times a week (D). 15 min three times a week 97. (640). What are the clinical manifestations of hypokalemia?(choose all that apply) (A). decreased GI Motility, Abd destintion (B). constipation, paralytic illius (C). weakness, respiratory depression, abnormal ekg (D). vomiting 98. (780). Acidosis exist if an ABG CO2 level is: (A). <27mmHg (B). >27mmHg (C). <41mmHg (D). >41mmHg 99. (860). When caring for a child that is immunosuppressed, it is important for the nurse to (A). ensure handwashing is done frequently (B). emphasize the importance of promoting the childs development (C). ensure persons with colds due not have contact with the child (D). ensure the childs meds are taken as perscribed 100. (70). Sahming, ridiculing, embarrassing, or insulting a child is the definition for: (A). Emotional neglect (B). emotional abuse (C). sexual abuse (D). physical neglect 101. (260). What does an infant understand about death? (A). unable to understand the true concept of death (B). aware someone is missing (C). believes death is reversible (D). stops walking or talking 102. (770). How is hypomagnesemia treated (A). Malox (B). Lasix (C). administer magnesium, and treat the cause of the deficency (D). IV solutions 103. (280). What do preschoolers understand about death? (A). unable to understand the concept of death (B). unable to distinguish fact from fantasy (C). believes it is reversible (D). separation anxiety 104. (940). The PCV vaccine should be given at what age? (A). birth, 6mos, 1yr, 4-6yrs (B). 2mos, 6mos 12mos, 18mos (C). Birth, 2mos, 6mos, 12mos (D). 2mos, 4mos, 6mos, 12mos 105. (530). The treatment for hypernatremia is (A). hypotonic sol. (B). hypertonic sol. (C). isotonic sol (D). oral rehydration 106. (700). What are the clinical manifestations of hypocalcemia? (choose all that apply) (A). tetany, twitchingcramping, tingling, carpal spasm, pedal spasm (B). laryngospasm, seizures, cardiac arrhythmias (C). death, chf, spontaneous fractures (D). weak thready pulse 107. (50). How long should television be limited each day? (A). 1hr (B). 2hr (C). 3hr (D). 4hrs 108. (1030). How can a apnic episode be stopped in an infant? (A). Tactile stimulation (B). yelling (C). pinching (D). slapping 109. (740). how is hypermagnesemia managed? (A). Increase urine output, dialysis (B). multivitamins (C). lasix (D). st. johns wart 110. (120). Once a child has been identified as being abused, what is the goal? (A). rehabilitation (B). prevent further abuse (C). treat the injuries and send them home (D). Bitch slap the parents 111. (890). The DTAP vaccine should be given at what ages? (A). Birth, 2mos, 4mos, 6mos, 15mos (B). 2mos, 4mos, 6mos, 15mos, 4-6yrs (C). Birth, 6mos, 12mos, 18mos, 4-6yrs (D). 2mos, 6mos, 15mos, 2yrs, 4-6yrs 112. (160). When a child has encopresis, how should the child be treated? (A). embarrass them in front of their friends (B). praise them when successful, don't punish when not (C). make them wear thier dirty underware (D). make them wear a diaper because it is easier to clean up 113. (370). What drugs should be avoided for pain management in children with chronic conditions? (choose all that apply) (A). Nubain (B). Talwin (C). Stadol (D). morphine 114. (80). deliberate withholding of or failure to provide the necessary and available resources to a child is the definition of: (A). emotinal abuse (B). emotinal neglect (C). sexual abuse (D). physical neglect 115. (100). the caretakers emotional unavailability to the child is the definition of: (A). emotional abuse (B). emotional neglect (C). sexual abuse (D). physical neglect 116. (540). Hyponatremia occurs when the sodium level is (A). >148 (B). <148 (C). >135 (D). <135 117. (140). why may bulimia go unnoticed? (A). they do it in private (B). they may be of normal weight (C). they eat with others (D). Parents are stupid and don't pay attention 118. (440). What is the most significant problem with deep sedation in a child (A). cardiac arrest (B). incontenence (C). respirtory depression (D). bradycardia 119. (460). You know a infant is adequately hydrated when they urinate (A). 2-4ml/kg (B). 1-2ml/kg (C). .5-1ml/kg (D). 4-6ml/kg 120. (660). Hypercalcemia exist if the lab values are (A). >5.3 (B). <5.3 (C). >4.4 (D). <4.4 121. (670). Clinical manifestions of hypercalcemia are: (choose all that apply) (A). constipation, anorexia, nausea, vomiting (B). fatigue, weakness, polyuria, cardiac arrhythmias/arrest (C). confusion, lethargy and decreased attention span (D). hemmorhage 122. (990). Clinical manifestations of Roseola are (A). Nausea (B). sudden high fever that diappears as a pale pink rash appears (C). Vomiting (D). Diarrhea 123. (170). Separation anxiety is likely to be seen in what age groups (A). infant (B). toddler (C). preschooler (D). school aged 124. (580). Hyperkalemia occurs when lab values are: (A). >5.8 (B). <5.8 (C). <3.5 (D). >3.5 125. (1010). What complicatons can occur if a fever rises quickly? (A). seizures (B). lethargy (C). cardiac arrhythmia (D). Diarrhea 126. (330). What is not a reliable indicator of pain? (A). Pain scale (B). patients non-verbal behavior (C). vital signs (D). pictures drawn 127. (960). When can a child begin getting a yearly influenza vaccine? (A). birth (B). 1mo (C). 6mos (D). 18mos 128. (880). The Hepatitis B vaccine should be given at what ages? (A). Birth, 2mos, 6mos (B). Birth, 4mos, 8mos (C). Birth, 6mos, 1yr (D). Birth, 1mo. 2mos 129. (220). When the parents react to a life threatening illness or injury, the stage where parents expierence a life suspended in time, and fear leaving the area because they may miss an important procedure, physician visit, or decisions or changes in treatment. (A). anger and guilt (B). deprivation and loss (C). anticipatory waiting (D). readjustment or mourning 130. (310). What do young children fear more than dying? (A). Pain (B). desertion (C). needles (D). nurses 131. (180). When caring for a child in the hospital you should (A). discuss all treatments with the parents (B). Don't take any lip, tell them they are going to do what you tell them or else. (C). Promote a sense of control, trust, and support (D). tell the child everything you are going to do before you do it 132. (610). What are the treatments for hyperkalemia? (choose all that apply) (A). potassium wasting diuretics (B). kdur (C). dialyisis (D). k tab 133. (510). What is the treatment for extracellular fluid volume excess? (A). compression hose (B). treat the underlying cause (C). diuretics (D). elevation of the extremity 134. (1040). Cystic Fibrosis is definitively diagnosed by a possitive sweat test (A). True (B). False 135. (680). How is hypercalcemia treated? (choose all that apply) (A). lasix, glucocorticoids (B). calcitonin (C). dialysis (D). radiation 136. (350). What is the problem with using the oucher scale to indicate pain? (A). the information may be unreliable (B). the nurse should use nonverbal behaviors to varify the finding (C). the child may point to how they want to feel (D). The child doesn't understand 137. (190). When the parents react to a life threatening illness or injury, the stage where parents experience a loss of control, an inability to regain their bearings, and feelings of immobility is called (A). Anger and guilt (B). deprivation and loss (C). Shock and disbelief (D). anticipatory waiting 138. (380). When managing pain for a child, how should the medications be administered (A). prn (B). around the clock (C). only when they are asked for (D). as directed 139. (20). Signs that may indicate substance abuse in adolescents are: (chose all that apply) (A). Withdrawl from sports activities, nodding off frequently during the day (B). Teachers report a change in school work, Lack of personal hygene, lack of energy (C). consistant classroom performance, occasional weepiness, disheveled look (D). continued, consistent weepiness, red eyes, oral sores, respiratory discomfort 140. (290). What does a school aged child understand about death? (A). lacks understanding (B). unable to distinguish fact from fantasy (C). separation anxiety (D). acquires more realistic understanding of death 141. (730). Clinical manifestations of hypermagnesemia are: (choose all that apply) (A). decreased muscle irritability, hypotension (B). bradycardia, drowsiness, lethargy (C). weak or absent deep tendon reflexes (D). flaccid muscle paralysis, fatal repiratory depression, cardiac arythmias/arrest (E). vomiting 142. (970). Of the following which is a clinical manifestation of Erythema Infectiosum (fifths disease)? (A). nasal drainage (B). firery red rash on the cheeds giving a slapped face appearance (C). fever (D). lesions 143. (110). the exploitation of a child for the sexual gratification of an adult is the definition of: (A). emotional abuse (B). emotional neglect (C). sexual abuse (D). physical neglect 144. (450). A neonate has the highest % of water by weight (A). True (B). False 145. (720). Hypermagnesemia exist if lab values are: (A). >2.4 (B). <2.4 (C). >1.5 (D). <1.5 146. (910). The IPV vaccine should be given at what ages? (A). 2mos, 4mos, 12mos, 4-6yrs (B). Birth, 2mos, 12mos, 4-6yrs (C). 2mos, 6mos, 12mos, 4-6yrs (D). Birth, 6mos, 12mos, 18mos, 4-6yrs 147. (360). What are common side effects to the use of opioids? (choose all that apply) (A). sedation (B). nausea/vomiting (C). constipaton/itching (D). hemorrhage 148. (130). What is the result of bulimia? (A). Weight loss (B). Heart attack (C). Electrolyte imballance (D). Problems with acid base balance 149. (830). How do most children aquire the AIDs Virus? (A). Sexual Contact (B). Blood transfussion (C). perinatal transmittion (D). infected needles 150. (800). Metabolic acidosis occurs if the HCO3 is (A). <18mmol/L (B). >18mmol/L (C). <25mmol/L (D). >25mmol/L 151. (950). When can a child start the Hep A series? (A). 12mos (B). 24mos (C). 18mos (D). 4-6yrs 152. (900). The HIB vaccine should be given at what ages? (A). Birth, 6mos, 1yr, 4-6yrs (B). 1mo, 4mos, 6mos. 18mos (C). 2mos, 4mos, 6mos, 15mos (D). 6mos, 8mos, 12mos, 18mos 153. (750). hypomagnesemia exist when lab values are: (A). >2.4 (B). <2.4 (C). >1.5 (D). <1.5 154. (600). What are the clinical manifestations of hyperkalemia? (choose all that apply) (A). hyperactivity of GI system, abd cramping, diarrhea (B). weak muscles usually in the legs and progress to flaccid paralysis (C). lethargic cardiac arrhythmias, abnormal ekg (D). bradycardia, weak thready pulse, diaphoresis 155. (410). What are nonpharmacologic interventions for pain? (choose all that apply) (A). ASA (asprin) (B). distraction, cutaneous stimulation (C). electroanalgesia, imagery (D). relaxation techniques, hypnosis 156. (650). Treatments of hypokalemia are (A). High potassium diet (B). bannana's (C). IV fluids (D). lasix 157. (1020). What is the treatment for a high fever? (A). antipyretics (B). remove clothing (C). increase fluid intake, tepid baths (D). Ice bath 158. (300). What does a adolescent understand about death? (A). believes death is reversible (B). acquires more realistic understanding (C). nightmares (D). intellectually capable of understanding 159. (930). The varicella vaccine should be given at what age? (A). Birth (B). 2mos (C). 15mos (D). 20mos 160. (1320). Prior to discharge from the hospital for shunt placement for hydrocephalus, what should be taught to the parents?(choose all that apply) (A). signs and syptoms of shunt failure/infection (B). dietary planning (C). The shunt may need to be replaced as the child grows (D). safe activity planning 161. (200). What is the most serous complication of Kawasaki disease? (A). Cerebral involvement (B). Cardiac involvement (C). Spleen involvement (D). Liver involvement 162. (90). How should a nurse monitor a child for impaired tissue perfussion post cardiac catheterization?(choose all that apply) (A). check capillary refill, estremity warmth (B). pedal pulses, level of conciousness (C). urinary output (D). cyanosis 163. (50). After a child undergoes a cardiac catheterization, what should be monitored? (choose all that apply) (A). I&O's, Pedal pulses (B). Capillary refill, sensation (C). Warmth, and color of lower extremities (D). Neurological status 164. (160). Once a client has been diagnosed with infective endocarditis, what should they be taught? (A). They should modify their exercise routine to minimize strain on the heart (B). They should inform physicians and dentist about the history before invassive proceedures (C). They should take antibiotics before invasive proceedures (D). They should perform frequent handwashing 165. (430). bleeding into a joint is refered to as: (A). ecchymosis (B). hemarthrosis (C). intracapsular hemorrhage (D). edematous joint 166. (1010). When should a small child be treated for a UTI if they are unable to tell you their symptoms? (A). if the urine is tea colored (B). if the urine has a foul smell (C). if they were continent after toilet training (D). if bacteria is seen in the urine 167. (100). The combination of what four defects results in Tetralogy of Fallot?(choose all that apply) (A). Pulmonic stenosis, Right ventricular hypertrophy (B). Hyperplastic left heart syndrome, tricuspid atresia (C). Ventricular Septal Defect, Overriding of aorta (D). Ventricular Septal Defect, Truncus Arteriosus 168. (510). What is the goal of treatment for Idiopathic Thrombocytopenic Purpura? (A). Normal clotting factors (B). Normal platelet counts (C). No hemorrhage (D). Prevention of infection 169. (450). What medication is used to treat mild hemophillia? (A). Fibrinogen Acetate (FBA) (B). Desmopressin Acetate (DDAVP) (C). Cologen Acetate (CGA) (D). Methotrexate (MTXA) 170. (1040). What is a common concern of children with generalized edema (A). their appearance (B). their weight gain (C). if they will live (D). Social status change 171. (980). What should be taught to parents after an infant has under gone surgical repair of Hypospadias or Epispadias and a stent is in place (A). Proper wound care techniques (B). Double diaper techniques (C). Proper restraint techniques (D). Weighing Diapers 172. (670). What are the cardinal signs of bone marrow failure? (A). Petechiae (B). Frank bleeding (C). Joint Pain (D). Hypergonadism 173. (170). The most common pathologic tachycardia, is the abrupt onset of a rapid, regular heart rate, often to fast to count. (A). Ventricular (B). Atrial (C). Supraventricular (D). Rock heart 174. (710). How do children aquire Retinoblastoma? (A). exposure to radiation (B). exposure to chemicals (C). inherited by an autosomal dominat gene (D). prolonged exposure to the sun 175. (1270). When is Reye syndrom (encephalopathy) likely to develop? (A). after asprin use (B). after a mild viral illness, or aspirin use (C). after head trauma (D). with prolonged nausea and vomiting 176. (370). When caring for a child with sickle cell anemia, the nurse focuses on?(choose all that apply) (A). increasing tissue perfusion, promoting hydration (B). controling pain, preventing infection (C). administering transfusions and antibiotics (D). ensuring adequate nutrition, preventing complications, providing emotional support 177. (460). When obtaining a history on a child with hemophillia, what information should be obtained? (choose all that apply) (A). Complete history (B). previous episodes (C). dietary habits (D). Family history 178. (310). An exacerbation of the symptoms of sickle cell is termed? (A). hemolytic crisis (B). Sickle cell crisis (C). hypoxic event (D). hypoxic crisis 179. (720). What is the first sign of retinoblastoma? (A). stigmatism (B). white pupil, termed leukokoria or cats eye reflex (C). nastigmus (D). lazy eye 180. (1230). The primary nursing diagnosis for a child with otitis media is:? (A). infection related to presence of pathogens (B). Risk for caregiver role strain related to chronic disease (C). Pain related to inflammation and pressure on the tympanic membrane (D). Risk for infection related to knowledge deficit about infection in children 181. (900). Clinical manifestations of Appendicitis are? (choose all that apply) (A). Rebound tenderness (B). Nausea and vomiting (C). Difficulty ambulating (D). Painful passage of stool 182. (420). Since Iron overload is a major complication of Beta-Thalassemia, what medication should be given? (A). Lasix (furosemide) (B). Dexferol (deferoxamine) (C). Glucophage (metformin) (D). Folic Acid 183. (1280). Signs of hydrocephalus are: (choose all that apply) (A). Rapid head growth, bulging fontanel, split sutures (B). Increased Itracraneal Pressure (C). Diarrhea, hematuria, decreased bowel sounds (D). Promininet scalp veins, translucent skin, increased tone or hyperreflexia 184. (20). What precautions should be taken when diuretics are used? (A). Intake and Output (B). Monitor sodium levels (C). Monitor potassium levels (D). Monitor mental status 185. (1110). What is the time frame from time infected with streptocaccus to the time Acute Postinfectious Glomerulonephritis develops? (A). 1-2 days (B). 4-6 days (C). 8-14 days (D). 3-4 weeks 186. (770). How is an infant with Esophageal atresia hydrated? (A). Orally (B). Periferal IV (C). Umbilical artery catheter (D). Central Line 187. (340). What is the treatment for a child in sickle cell crisis?(choose all that apply) (A). hydration, oxygen, pain management (B). bedrest, blood transfussion (C). apply ice to the joints (D). compression bandages 188. (180). What age does Kawasaki disease occur? (A). 10-15yrs (B). <5yrs (C). >5yrs (D). >10yrs 189. (870). What is the treatment for Hirschsprugs disease? (choose all that apply) (A). surgical removal of the aganglionic bowel and the creation of a colostomy (B). Illiostomy (C). TPN and a lactose free diet (D). Diet high in fiber 190. (1100). What are the common cause of Acute Postinfectious Glomerulonephritis? (A). blockage of urine in the urethera (B). Beta-hemolytic streptococcal infection of the skin or pharynix (C). Staphylococcus (D). Peumococcus, Coxasackie virus 191. (830). Why can't parents place a child with gastroesophageal reflux disease in a infant seat. (A). it will interfere with the healing process (B). it incrases intraabdominal pressure and will worsen the condition (C). it makes the incission site prone to infection (D). it prevents stomach contents from moving through the intestine 192. (1290). What factors can cause a shunt for hydrocephalus to fail? (choose all that apply) (A). blockage at either end (B). kink in the tubing (C). bacterial infection (D). valve breakdown 193. (910). A Diaphragmatic Hernia is life-threatening, Why?, What would you look for? ___________________________________________________ ___________________________________________________ ___________________________________________________ 194. (730). When preparing an infant to feed after a cleft pallet surgery has been performed, how should they be possitioned? (A). Fowlers (setting up) (B). Semi-Fowlers (C). Trendellenburg (D). Left lateral recumbant 195. (750). Medications for an infant after cleft pallet surgery are geared toward? (choose all that apply) (A). Pain Control (B). ensure clotting at the incision (C). Minimize crying (D). ease the parental anxiety 196. (1330). What is the goal of clinical therapy for Cerebral Palsy? (A). Prevention of the advancement of the disease (B). curing the disease (C). helping the child develop to his or her maximum level of independence (D). Teaching the parents to adapt to a stressful environment 197. (590). What are some complications of the treatments for brain tumors? (choose all that apply) (A). impaired cognitive function, emotional or behavioral problems (B). memory deficit, attention deficit (C). nausea, vomiting, diarrhea (D). Diabeties insipidus 198. (740). How should an infant post cleft pallet surgery be possitioned? (A). supine with hands in soft restraints (B). supine or sid-lying with elbows in soft restraints (C). restrained on a papoose board (D). seated possition to avoid aspiration 199. (120). What possition does a child with a cyanotic heart defect assume? (A). Fowlers position (B). Trendellenburg (C). A knee to chest position while squating (D). Left lateral recumbant 200. (250). What side effects of oral iron supplimentation should be taught to the child and parents?(choose all that apply) (A). black stools (B). constipation (C). flatulance (D). foul after taste 201. (10). What medication is most commonly used to improve the hearts ability to contract and therefore increase output? (A). Furosemide (B). Chloraothiazide (C). Digoxin (D). Spironolactone 202. (70). What treatment should be done post cardiac catheterization?(choose all that apply) (A). Encourage fluids (B). apply a sandbag to the operative site (C). Permit quiet play (D). prophalactic antibiotics 203. (800). When treating a child with Pyloric Stenosis, what diet should they be placed on? (A). high fiber (B). TPN (C). High caloric (D). High protein 204. (920). How is Necrotizing Enterocolitis Managed? (choose all that apply) (A). discontinue all enteral feedings (B). Antibiotics (C). strict enteric precautions (D). Monitor I&O's 205. (1210). What increases the incidnence of otitis media? (A). cold air (B). smoking (C). swimming (D). not drying the ears 206. (860). What are the clinical manifestations of Intussusception? (choose all that apply) (A). acute onset of abdominal pain with vomiting and passage of brown stool (B). increase in episodes of pain (C). statorrhea, vomiting, diarrhea, hematochezia (D). stools are red and rsemble currant jelly , palpable mass may be present in the upper right quadrant of the abdomen 207. (650). If a tumor is felt in the abdomen, the nurse should? (A). Palpate the mass to determine size and shape (B). Perform deep palpation to see if the mass moves (C). Don't palpate notify the MD (D). Perform gentle massage to break up the mass 208. (360). What effect does cytotoxic drugs have on someone in a sickle cell crisis? (A). increases the production of normal blood cells (B). decreases the production of abnormal blood cells and leads to less amount of pain (C). destroys the abnormal cells prior to transfussion (D). prevents vaso-occlusion 209. (660). The common initial symptoms of osteosarcoma are: (choose all that apply) (A). Loss of function (B). pain referred to the hip or back (C). Edema (D). Pulmonary metastasis 210. (1180). What causes Amblyopia (lazy eye) ___________________________________________________ ___________________________________________________ ___________________________________________________ 211. (620). an asymptomatic, firm lobulated mass located to one side of the midline in the abdomen is the definition of? (A). Tumor in the lung (B). Wilms' Tumor (Nephroblastoma) (C). Abdominal Aortic Anurisym (D). Necrotic bowel syndrome 212. (220). What are the clinical manifestations of Iron deficiency anemia? (A). Pallor, fatigue, irratability (B). Pale, cool, clammy, cyanosis (C). nailbed deformities, growth retardation, developmental delay (D). tachycardia, systolic heart murmur 213. (810). After a pyloric stenosis repair, what should the parents be taught prior to going home? (A). apply antibacterial ointment to the incission (B). to fold the infants diaper so it does not touch the incission (C). Proper wound care (D). wash their hands frequently 214. (1250). after a tonsilectomy, what should the nurse monitor? (choose all that apply) (A). vital signs, dehydration (B). respiratory distress (C). I&O's (D). hemorrhage 215. (240). How should liquid iron preparations be taken? (A). chilled to increase absorption (B). warmed to increase absorption (C). through a straw (D). immediately after mixing 216. (580). What symptoms are likely to develop in a child with a brain tumor?(choose all that apply) (A). Headache, nausea, vomiting (B). dizziness, change in vision or hearing (C). Halucinations (D). fatigue 217. (1130). What should be taught to the parents before discarge after hospitalization for acute post infectous glomerulonephritis? (A). Report any hematuria to the doctor immediately (B). it may take up to 3 weeks for hypertension and gross hematuria to resolve (C). watch for fever (D). watch for a stone to pass 218. (390). What diet should a child be encouraged to eat while in sickle cell crisis? (A). High Protein (B). High calorie (C). High Folic Acid (D). High B12 219. (760). What possition should an infant be in prior to the repair of a Esophageal atresia? (A). Fowlers (setting up) (B). Semi-Fowlers (45 degrees) (C). Trendellenburg (head slightly lower than body) (D). Left lateral recumbant (left side) 220. (610). What congenital anomalis is associated with Wilms' Tumor (Nephroblastoma)? (choose all that apply) (A). aniridia (absence of the iris) (B). hemihypertropy (abnormal growth of half of the body or body structure) (C). genitourinary anomalies, nevi, and hamartomas (benign nodulelike growths) (D). hypogonadism (enlargement of the gonads) 221. (630). When are Wilms' Tumors (nephroblastomas) discovered commonly? (A). after the child begins complaining of a painful lump in their side (B). during a bath (C). at the doctors office (D). at the swimming pool 222. (1140). What symptoms may an older child complain of with conjunctivitis?(choose all that apply) (A). ithing or burning, photophobia, mucopurulent discharge (B). redness and swelling of the conjunctiva, pink sclera (C). crusty cyelids (D). green drainage 223. (130). What are the clinical manifestations of Rheumatic Fever? (choose all that apply) (A). inflammed and painful joints, Sydenham chorea (aimless movements of the extremities and facial grimacing (B). Fever, painful joints, increased pulse, increased respirations (C). Subcutaneous nodules near joints, fever, anemia (D). Skin rash (pink macules and blanching in the middle of the lesions 224. (990). What complication is common of obstructive uropathy? (A). nephrocalcification (B). Hydronephrosis (C). Kidney failure (D). pylonephritis 225. (260). A child that undergoes a spleenectomy to treat sickle cell anemia is at risk for?(choose all that apply) (A). high rate of infection (B). impaired immunity (C). hemorrhage (D). Death resulting from bacterial infection 226. (840). After the delivery of an infant with a omphalocele, what should be done? (A). ensure airway is open (B). cover the sac with sterile gauze soaked in normal saline (C). monitor vital signs (D). identification of additional problems 227. (1340). The primary nursing diagnosis for a child with cerebral palsy is: (A). impaired physical mobility related to decreased muscle strength and control (B). Sensory perceptual alteration related to cerebral damage (C). altered nutrition less than body requirements related to difficulty in chewing and swallowing and high metobolic needs (D). ineffective management of thereapeutic regimen family related to excessive demands made on family with childs complex care needs 228. (1070). When monitoring the fluid needs of a client with generalized edema, what should be done? (choose all that apply) (A). monitor I&O's, Vital Signs, watch for signs of respiratory distress, hypertension or circulatory overload (B). Urine cultures (C). Daily Weights, (D). Measure abdominal girth 229. (60). When teaching home care to parents of a child after cardiac catheterization, what complications should they be instructed to observe for?(choose all that apply) (A). fever, bleeding or bruising increasing in size at the catheterization site (B). the foot on the side of the proceedure is cooler than the one on the opposite side (C). cyanosis (D). loss of feeling in the extremity the proceedure was performed on 230. (1050). What should be monitored if a client is receiving albumin intravenously?(choose all that apply) (A). elevated heart rate (B). hypertension (C). elevated respirations (D). signs of volume overload 231. (700). What is Rhabdomyosarcoma? (A). a tumor in the spinal cord (B). a cancerous nodule on the skin (C). A soft tissue cancer that is common in children (D). a group of precancerous cells in the gonads 232. (110). What are the clinical manifestations of Tetralogy of Fallot?(choose all that apply) (A). Polycythemia, exercise intollerance (B). Decreased hemoglobin and hematocrit (C). Metabolic Acidosis, poor rowth, clubbing (D). Sickle cell anemia, kidney failure 233. (500). When peforming discharge teaching to a child and family members for hemophillia, what should they be taught?(choose all that apply) (A). Wear an medical identification tage (B). Explain the disease process (C). Teach how to identify internal and external bleeding (D). Teach safety measures to prevent injury 234. (950). In Celiac's disease, the inabilty to digest glutenin and gliadin results in what? ___________________________________________________ ___________________________________________________ ___________________________________________________ 235. (490). When treating a child with hemarthrois, the nurse would: (A). keep the child on bed rest, and pad the hand rails (B). imobilize and elevate the joint and apply ice packs (C). perform daily range of motion exercises (D). ensure adequate pain releif is achieved 236. (330). What prophalactic treatment is recomended for a child with sickle cell? (A). Penicillin (B). Antivirals (C). Quinolones (D). Sulfa drugs 237. (230). When should children be screened for Iron deficiency anemia? (A). at 9 mos and again in adolesence (B). at one year and at 12 yrs (C). at one year and at 5yrs (D). at 18 mos and at menarche 238. (320). What are the two most important steps in avoiding a sickle cell crisis?(choose all that apply) (A). Preventing exposure to infection (B). Isolation in a possitive pressure room (C). maintaining normal hydration (D). frequent blood transfussions 239. (1000). What symptoms are likely to be expiernced if a child has obstructive uropathy? (A). Abdominal Pain (B). Hematuria (C). Same as a UTI (D). Proteinuria 240. (560). What medication is used in combination with methotrexate to protect normal cells? (A). betamethasone (B). Leucovorin (C). epotin (D). procrit 241. (940). A disease characterized by an intolerance for gluten, a protein found in wheat, barley, rye and oats (A). Protein intollerance (B). Grain Intollerance (C). Celiac Disease (D). Gluten Intollerance 242. (1080). What possiton should be maintained if a client has generalized edema? (A). Elevate the HOB (B). Elevate Legs (C). Seated (D). Side lying 243. (350). What does a child with sickle cell gain from an early transfusion while in crisis? (A). regains normal oxygen carring capacity of the blood (B). gains immunity to fight disease (C). Provides more energy to fight the infection (D). relief from ischemia in major organs and body parts 244. (930). What should be monitored in a infant with Necrotizing Enterocolitis? (A). Heart rate (B). Respirations (C). Abdominal Circumference every 4-8 hrs (D). Bloos pressure 245. (40). What are the clinical manifestations of Coarctation of the Aorta?(choose all that apply) (A). Low blood pressure in the legs (B). High blood pressure in the arms (C). Cyanotic Pallor (D). Weak Femoral Pulses 246. (190). What are the clinical manifestations of Kawasaki disease?(choose all that apply) (A). Bilateral conjunctivitis, intesnse erythema of the buccal and pharyngeal surfaces, strawberry tongue, fever (B). fever, conjunctivitis, erythemia, extensive ecchymosis throughout the body (C). Dermatitis of the extremities, palmar and plantar erythema, induration of the hands and feet (D). Dermatitis of the trunk with an erythematous maculopapular rash, Acute cervical lymphadenopathy, an illness not explained by another disease process 247. (820). What complications can occur with gastoesophageal reflux disease (GERD)? (choose all that apply) (A). aspirations, pneumonia (B). reactive airway disease (C). color changes during feeding, apnea, hematemesis (D). statorrhea, flatulence, irritability 248. (690). What effect does leukemic cells have on the testicles? (A). They cause the testies to shrink (B). They cause a painless enlargement (C). The become painful and swollen (D). Elephantitis 249. (570). What clinical manifestations should be reported to the oncologist if the child is recieving chemotherapy? (choose all that apply) (A). Temperature above 101F, any bleeding (B). Pain with urination or defecation, sores in the mouth, vomiting or diarrhea (C). persistent pain, signs of infection, exposure to communicaple disease (D). hair begins to fall out 250. (640). What are some common clinical manifestations of Wilms' Tumors (nephroblastoma)? (A). Hypertension (B). proteinuria (C). Hematuria (D). kidney failure 251. (140). When caring for a child with Sydenham chorea, what should be done? (A). restrain the child to prevent injury (B). increase fluids (C). monitor I&O's (D). provide emotional support, encourage the family to participate in care 252. (30). If a child is having difficulty breathing, what possition should they be kept in? (A). Fowlers (B). Semi-Fowlers (C). Trendellenburg (D). Left lateral recumbant 253. (880). What should be taught to parents prior to discharge of an infant post surgical repair of Hirschsprungs disease? (A). Wound Care (B). Potential complications (C). Skin Care (D). colostomy care and referal to support groups 254. (1090). acute inflammation of the glomeruli of the kidneys is termed (A). hydronephrosis (B). glomerulonepritis (C). glomeruloritis (D). nephritis 255. (680). What are the clinical manifestations of leukemia? (choose all that apply) (A). fever, pallor, overt signs of bleeding (B). Lethargy, malaise, anorexia (C). Nausea, Vomiting, Diarrhea, general pain (D). Joint pain, bone pain, enlargement of the liver and spleen and changes in the lymphnodes 256. (1020). What causes Enuresis?(choose all that apply) (A). neurological or congenital structural disorders (B). illness, stress (C). UTI (D). Family history 257. (960). A early sign of celiac disease is:? (A). Diarrhea (B). Statorrhea (C). Vomiting (D). hematocezia 258. (1030). What are the clinical manifestations of Nephrotic Syndrome? (choose all that apply) (A). Periorbital edema, weight gain, hypertension irritability (B). anorexia, hematuria, malaise, pale shinny skin, veins are prominent, hair becomes brittle (C). foamy or frothy urine, generalized edema, respiratory distress (D). increased heart rate, increased respiratory rate 259. (470). What is the most important nursing diagnosis for a child with hemophillia? (A). Risk for impaired tissue perfusion (B). Risk for injury (C). Risk for hemorrhage (D). Risk for failure to thrive 260. (1190). When working with a visually impaired child, what should the nurse do? (A). call the childs name and identify yourself before touching the child (B). Tell the child you are leaving the room, Describe wht each procedure will feel like (C). Play games with them and try and scare them (D). Let the child touch the equipment to establish familiarity, Describe wht foods are present and their locations on the food tray 261. (970). What should parents be taught about celiac disease? (A). Enema's may help reduce symptoms (B). it is lifelong and will require a life long diet modification (C). it will last up to six months and until then diet modification is needed (D). Frequent diaper changes will be needed to prevent skin irritation 262. (520). What medications are used in the treatment of Idiopathic Thrombocytopenic Purpura?(choose all that apply) (A). Corticosteroids (B). cytotoxic drugs (C). Intravenous immunoglobulins (D). Methotrexate 263. (1200). What can a mother do to protect against otitis media? (A). good personal hygene (B). Breast feeding (C). prophalactic antibiotics (D). good ear care 264. (1220). What should be taught the the child and faimilies after a tympanostomy?(choose all that apply) (A). Encourage the child to drik genrous amounts of fluids, Reestablish a regular diet as tolerated, give pain medication as ordered (B). Place drops in childs ear as instructed, restrict the child to quiet activities, follow instructions on swimming and bathing (C). Qtips may be used to remove wax and drainage from the ear canal (D). Ear plugs can be used, be alert for tubes becoming dislodged, report purulent discharge from the ear 265. (280). In response to the constant formation and destruction of the childs red blood cells how does the body attempt to compensate?(choose all that apply) (A). increases bone marrow spaces (B). respirations increase, heart rate increases (C). increase production of RBC which results in hemolytic anemia (D). blood pressure increases, temperature increases 266. (80). How should the nurse check a pulse in a child post cardiac catheterization? (A). Palpation of the radial artery (B). Apical (C). Palpation of the femoral artery (D). Palpation of the corotid artery 267. (440). The goal of treatment for hemophilia is to (A). control blood loss (B). control bleeding by replacing the missing clotting factor (C). maintain blood pressure (D). increase fluid intake 268. (1300). When is an infection most likely to occur after shunt placement for hydrocephalus? (A). first week (B). first 3 weeks (C). first month (D). first 2 months 269. (850). What can effect the outcome of an infant after omphalocele repair? (choose all that apply) (A). maintenance of normal vital signs, proper intake of fluids (B). infection, pain control (C). ability to pass stool (D). establishment of an intake to support growth patterns 270. (400). What are the clinical manifestations of Beta-Thalassemia? (choose all that apply) (A). Anemia, Skeletal changes (B). heart failure,hepatomegaly, splenomegaly (C). Neurological abnormalities (D). Delayed sexual maturation, Darkening of the skin 271. (300). The clinical manifestations of sickle cell anemia are directly related to? (A). shortened life span of blood cells (B). tissue hypoxia (C). tissue destruction resulting from vaso-occlusion (D). immature RBC's 272. (600). How is Neuroblastoma diagnosed? (choose all that apply) (A). desmopressin (DDAVP) levels (B). Vanillylmandelic acid (VMA) levels (C). Homovanillic acid (HVA) levels (D). Radiographic studies for calcification 273. (270). What can cause a sickle cell crisis?(choose all that apply) (A). hypoxia, high altitude, emotionally stress full event (B). poorly pressurized airplanes, hypoventilation (C). injury (D). vasconstriction due to cold 274. (530). What medications are used to treat the side effects of chemotherapy? (A). Diuretics (B). Antiemetics (C). Beta-Blockers (D). Alpha-Blockers 275. (210). What are the causes of Iron deficiency anemia?(choose all that apply) (A). bleeding in the neonatal period, blood loss from hemophilia (B). parasitic gastrointestinal illness, menorrhagia (C). congenital defects, hemorrhage, sickle cell (D). sickle cell, low iron diet, hemorrhage 276. (1150). What are the common infectous organisms involved with conjunctivitis? (A). Haemophilus influenzae, Streptococcus pneumoniae (B). Staphylococcus aureus (C). E-Coli (D). Viruses 277. (1060). What should be monitored if a client is on diuretic therapy? (A). observe for shock (B). hypotension (C). decreased heart rate (D). decreased respirations 278. (380). What IV fluids are used prior to and after blood transfussion?(choose all the apply) (A). D5W (B). NS (C). None if the child is small (D). LR 279. (480). In the event that a child has a bleeding episode, what treatment should be performed? (choose all that apply) (A). Apply pressure for 15 min. (B). immobilize and elevate the affected area (C). apply clotting agents directly to the wound and apply a tourniquet (D). apply ice packs, and assist with factor replacement therapy 280. (1170). What should be taught to the parents of a child with conjunctivitis? (choose all that apply) (A). the child should not return to school until they have been on an antibiotic for 24hrs (B). how to apply antibiotic ointment to an eye patch and apply it to the affected eye (C). frequent handwashing, avoid sharing towels (D). the child should not rub their eyes, teach how to instill eye medications 281. (1260). What signs indicate increased intracranial pressure? (choose all that apply) (A). Headache, visual disturbances, diplopia (B). Bulging fontanel, Nausea vomiting (C). diarrhea, tachycardia (D). Vertigo, slight change in vital signs, pupils not as reactive or equal, sunsetting eyes, Seizures, change in LOC 282. (1120). What are the clinical manifestations of acute postinfectous glomerulonephritis? (A). microscopic hematuria, headache, costovertebral tenderness (B). periorbital edema, lethargy, fever, abdominal pain (C). Hypertension (D). Nausea and vomiting 283. (890). What clinical manifestations indicate Anorectal malformations? (choose all that apply) (A). UTI's (B). stool in the urine (C). ribbonlike stools (D). blood in the stool 284. (150). How long does Sydenham chorea tipically last? (A). 1-2 weeks (B). 4-6 weeks (C). 5-15 weeks (D). 20-30 weeks 285. (550). What should the nurse try to do when they are caring for a child with thrombocytopenia? (A). use carfull handling when possitioning the client (B). pad the handrails (C). ensure adequate hydration (D). minimize needle sticks and other intrusive proceedures 286. (1240). A child has been perscribed antibiotics for otitis media, what instructions should the parents be given? (A). 5ml is the same as a tsp (B). Notify the md if a rash develops or nausea and vomiting develops (C). notify the md if diarrhea develops (D). use exactly as directed and complete the prescribed course 287. (290). An infant that is born with sickle cell anemia may not become symptomatic until? (A). 2-4mos of age (B). 6-10yrs of age (C). 4-6mos of age (D). 3-6yrs of age 288. (1310). children with venticuloatrial shunts are placed on_____________ to prevent shunt infections (A). plasma infussion (B). prophylactic antibiotics (C). prophylactic antivirals (D). immunoglobulin therapy 289. (790). What are the clinical manifestations of Pyloric Stenosis?(choose all that apply) (A). Projectile vomiting (B). always hugary, irritable, fails to gain weight, fewer and smaller stools (C). vomiting, Diarrhea, fever, macropapular rash (D). Dehydration, alkalosis, hyperbilrubinemia 290. (1160). What comfort measures should be taken with conjunctivitis?(choose all that apply) (A). cleaning drainage away with a warm clean cloth (B). avoiding bright lights, avoiding reading (C). apply an eye patch with opthalmic ointment (D). antihistamines, topical steroids and vasoconstrictors 291. (540). A child who is receiving cranial radiation and intrathecal chemotherapy should be evaluated for:? (A). Anemia (B). Skin irritation (C). Scholastic evaluations (D). neurologic damage 292. (780). What should be done post surgically for Esophageal atresia? (A). maintain gastrostomy drainage (B). Maintain IV fluids and antibiotics (C). Monitor I&O's (D). TPN is administered if needed 293. (410). All of the clinical manifestations of Beta-Thalassemia are the result of (A). tissue hypoxia related to abnormal RBC's (B). Vaso-Occlussion (C). defective synthesis of hemoglobin, structurally impaired RBC'sand the shortened life span of RBC's (D). Abnormal immunity 294. (670). What clinical manifestations are likely to be seen in Autistic spectrum disorder? (A). Mental Retardation (B). repetitive behaviors (head banging, twirling, biting, flapping their hands) (C). Absence Siezures (D). Nausea, Vomiting, Diarrhea, Fever 295. (420). What are the clinical manifestations of Hyperthyroidism? (choose all that apply) (A). Enlarged nontender thyroid gland, prominent or bulging eyes, auditory bruit on auscutation (B). Nausea, Vomiting, Diarrhea, Sweating, Fever (C). eyelid lag, tachycardia, nervousness, emotional lability, heat intolerance, increased sweating (D). restlessness, irritability, increased appetite with weight loss, Insomnia, tremor, muscle weakness 296. (300). When are growth hormone suplimentations stoped? (A). At the age of 19 (B). when the child gets to acceptable height or growth slows to less than one inch/yr (C). When the child reaches the height of their parents (D). At the age of 21 297. (660). What is the key part of behavior modification? (A). Strict environment (B). Consistancy (C). Reward system (D). Stern disapline 298. (50). If bleeding or drainage is noted on a cast what is done? (A). Remove the cast and apply a new one (B). circle the area to determine the extent of drainage (C). notify the MD (D). pack the cast with gauze 299. (480). What is the goal of treatment for a child with congenital adrenal hyperplasia? (A). Increase adrenal secretion of androgens by replacing deficient hormones, which is accomplished by the life long oral administration of glucocorticoids (B). Treating the child for disturbed body image (C). Promoting normal growth and development (D). suppress adrenal secretion of androgens by replacing deficient hormones, which is accomplished by the lifelong oral administration of glucocorticoids 300. (580). A child is more likely to develop eczema if? (A). He lives in the ohio valley (B). is exposed to cigarette smoke (C). there is a family history of allergies or asthma (D). he is allergic to soap 301. (120). What is the treatment for knock-knees? (A). casting (B). surgery (C). braces worn at night (D). braces worn both day and night 302. (270). What complications can arise from a fracture? (choose all that apply) (A). fat embolism (B). Chest Pain (C). decreased circulation (D). SOA, compartment syndrome 303. (490). What are the clinical manifestations of Type one Diabetes Melitus?(choose all that apply) (A). polyuria (B). polydipsia (C). polyphagia, with weight loss (D). Obesity 304. (160). Management of a client with developmental dysplagia of the hip includes? (choose all that apply) (A). maintaining traction, providing cast care, teaching the parents to care for the child at home (B). preventing complications resulting from immobility (C). ROM exercises, and strength building (D). promoting normal growth and development 305. (570). What is the first line treatment for itching (A). calamine lotion (B). cold compress (C). warm moist compress (D). antihistamine 306. (40). After casting is complete, what possition is the extremity left in? (A). Pronated (B). Lower than the heart (C). elevated (D). in a traction device 307. (340). As a result of increased fluid loss through the kidneys in Diabetes Insipidus, what is the normal body response (A). Polydipsia (B). Polyphagia (C). Polyuria (D). Kidney Failure 308. (680). What are the two most common medications to treat ADHD? (A). Ritalin (B). MSIR (C). SSRI's (D). Concerta 309. (370). What is the major complication if hypothyroidism goes untreated in a child? (A). obesity (B). heart problems (C). growth delay/mental retardation (D). neurologic problems 310. (620). What symptoms does the client complain of with lice? (A). pruritus (B). bugs jumping (C). Dandruff (D). hair falling out 311. (390). When testing thyroid function, a TSH and a T4 are drawn, what would indicate a need for supplimentation? (A). low tsh, high t4 (B). high tsh, low t4 (C). high tsh, high t4 (D). low tsh, low t4 312. (290). What is the standard treatment for a child with a growth hormone difficiency? (A). IM injections 3-7 times a week (B). Sub Q Injections 3-7 times a week (C). Oral medications 3-7 times a week (D). IV Injections 3-7 times a week 313. (310). What should be taught to the parents of a child who is recieving growth hormone supplimentation? (A). the child will only have to take the injections for about 6 wks (B). How to identify complications (C). How to administer the injections at home (D). how to provide support for their child 314. (180). When should Legg-Calve-Perthes Disease be suspected (A). if an xray show degeneration of the femoral head (B). any child from 2-12 that complains of hip pain and a limp (C). if there is a family history (D). if there is a history of chemotherapy treatment 315. (240). What is the best exercise for a child that has been diagnosed with Ostogenesis Imperfecta (brittle bone disease)? (A). aerobic (B). calastinics (C). swiming (D). running 316. (500). What is considered to be an abnormal result of a fasting blood glucose test? (A). <100 (B). >100 (C). >126 (D). >140 317. (700). What is the most accurate way to identify Mental Retardation? (A). IQ testing (B). Functional Assessment (C). MRI (D). Testing for Downs syndrome 318. (730). What drug class is typically prescribed to someone with depression? (A). Psycotropics (B). Mood enhancers (C). SSRI's Serotonin Reuptake Inhibitors (D). Beta Blockers 319. (280). What are the clinical manifestations of compartment syndrome?(choose all that apply) (A). Paresthesia, Pain, Pressure (B). Pallor, Paralysis (C). Edema (D). Pulselessness 320. (440). An increased pulse rate in a child with hyperthyroidism would indicate? (A). A complication to the medication (B). The medication needs to be increased (C). The medication needs to be decreased (D). Lab work needs to be done 321. (720). What are the clinical manifestions of schizophrenia? (choose all that apply) (A). social withdrawal, impaired social relationships, flat affect (B). regression, loose associations (C). Suicidal and homicidal tendancies (D). poor judegment, anxiety, delusions, and hallucinations 322. (10). You are caring for a client with a cast, upon inspection of the cast an area seems to be warmer than the rest, what should be suspected? (A). suspect the client wet the bed (B). suspect the use of a heating pad (C). suspect an infection (D). suspect he is trying to avoid going to school for another day 323. (740). ___________________________________________________ ___________________________________________________ ___________________________________________________ 324. (710). What are common characteristics seen in a child with fetal alcohol syndrome?(choose all that apply) (A). flat midface, low nasal bridge, long philtrum with narrow upper lip (B). short upturned nose, poor coordination (C). Mental retardation, Developmental Delays, Delayed Cognitive Development (D). failure to thrive, skeletal and joint abnormalities, hearing loss 325. (400). Once a thyroid deficiency has been identified, what is it usually treated with? (A). humulin (B). synthroid (C). loratadine (D). dexamethazone 326. (190). What are the predisposing factors to a slipped capital femoral epiphysis? (choose all that apply) (A). obesity, recent growth spurt (B). previous injury (C). endocrine disorders (D). family history 327. (140). What is the most common treatment of Developmental Dysplasia of the Hip when the child is under 3mos? (A). Skin traction (B). Pavlik harness (C). bone traction (D). hans device 328. (80). How often is a cast changed? (A). every week (B). only when needed (C). every 3 wks (D). every 1-2 wks 329. (320). What is the most important nursing diagnosis for a teenager diagnosed with hyperpituitarism? (A). Disturbed body image (B). Risk for infection (C). Failure to thrive (D). Developmental delay 330. (470). What symptoms may a child exhibit that would indicate congenital adrenal hyperplasia? (A). recurrent vomiting, dehydration, metabolic acidosis, hypotension, hypoglycemia (B). diarrhea, fluid overload, metabolic alkalosis, hypertension, hyperglycemia (C). polyuria, polidipsia, polyphagia (D). nausea, vomiting, diarrhea, fever 331. (260). Once a fracture has been diagnosed, what is the most important symptom to be managed? (A). swelling (B). drainage (C). pain (D). incision 332. (170). What are the early symptoms of Legg-Calve-Perthes Disease?(choose all that apply) (A). mild pain in the hip or anterior thigh, relieved by bed rest (B). decreased circulation in the affected leg (C). limp (D). neuropathy of the extremity 333. (430). What should be taught to the parents of a child diagnosed with hyperthyroidism? (A). how to promote growth and development (B). how to assess for an increased pulse rate (C). how to increase childs self esteam (D). how to get their child to concentrate 334. (550). A child with PKU should avoid?(choose all that apply) (A). high protein foods (B). Potassium (C). ASA (D). aspartame 335. (650). What is the primary complaint of someone who under goes autografting? (A). Pain at the burn site (B). swelling at the burn site (C). Pain at Donor site (D). Edema at the donor site 336. (380). What is a goiter? (A). The nerd that sat behind you in algebra (B). Small nodule over a joint (C). Painful enlargement of the thyroid (D). Painless enlargement of the thyroid 337. (70). ___________________________________________________ ___________________________________________________ ___________________________________________________ 338. (100). While examining a 18 month old child, you notice the legs are bowed, this finding is? (A). Abnormal, will require surgery (B). Normal, until 2-3yrs of age (C). Abnormal, will require bracing (D). Abnormal, will require casting 339. (90). How long should casting continue (A). 3-6wks (B). 6-8wks (C). 8-12wks (D). 12-14wks 340. (330). In diabetes insipidus, inadequate ADH has what effect on the kidneys resulting in what? (A). retention of water, decreased urinary output (B). release of water, polyuria (C). increased concentration, foul odor (D). decreased urination, UTI 341. (60). The skin around the edges of a cast are checked for? (A). redness/swelling (B). lacerations (C). drainage (D). increased warmth 342. (210). What is the most important assessment on a child who is undergoing treatment for scoliosis? (A). capulary refill (B). Neurvascular checks (C). examine for pressure ulcers (D). Vital signs 343. (540). How is PKU treated? (A). Oral medications (B). Special diet low in phenylalanine (C). Enzyme therapy (D). splenectomy 344. (560). What is the potential result if dietary control of PKU is lost before the age of 6? (A). Developmental Delay (B). Delayed Growth and Development (C). Deminished IQ (D). Exopthalmosis 345. (250). What is the most important thing that should be monitored in a child with Muscular Dystorphies? (A). Vital signs (B). cardiac and respirtory function (C). capulary refill (D). neurologic status 346. (200). How much of a spinal curvature is required before it is considered to be abnormal? (A). <5 degrees (B). <10 degrees (C). >10 degrees (D). >15 degrees 347. (450). What is a major clinical indicator for Congenital Adrenal Hyperplasia in a female? (A). Breast are enlarged (B). clitoris is enlarge and labial fusions (C). clitoris is small and labial detachment (D). clitoris is not present 348. (230). How long should a child recieving antibiotics for osteomylitis continue the treatment? (A). 1 wk (B). 10 days (C). 20 days (D). 6 wks 349. (130). What are the signs and symptoms of developmental dysplasia of the hip (DDH) (choose all that apply) (A). limited abduction of the hip, Limp, (B). asymmetry of the gluteal and thigh fat folds (C). decreased circulation (D). telescoping or pistoning of the thigh 350. (30). When handling a cast, how is it handled?(choose all that apply) (A). With the fingertips (B). With the palms of the hands (C). gentle technique (D). with force 351. (600). What is the treatment for celulitis?(choose all that apply) (A). warm compress QID (B). elevation (C). coumadin (D). bedrest 352. (350). How is a child with precocious puberty identified?(choose all that apply) (A). short stature (B). premature skeletal maturation (C). curiosity of sex (D). secondary sex characteristics 353. (690). What are the side effects of the medications used to treat ADHD? (A). anorexia, insomnia, tachycardia (B). polyphagia, lethargy, bradycardia (C). drooling, incontenence (D). head banging, twirling, absence siezures 354. (220). What is the initial treatment for osteomylitis? (A). oral antibiotics (B). wide spectrum oral antibiotics (C). IV antibiotics (D). Wide spectrum IV antibiotics 355. (410). How long must thyroid replacement be taken? (A). 6 wks (B). 2yrs (C). 10 yrs (D). throughout life 356. (20). How long does it take for a cast to dry? (A). 12 hrs (B). 6 hrs (C). 24-48hrs (D). 48-72hrs 357. (460). What is a major clinical indicator for Congenital Adrenal Hyperplasia in a male? (A). slightly enlarged penis and hyperpigmented scrotum (B). slightly enlarged penis, testicular enlargement (C). small penis, hyperpigmented scrotum (D). small penis, testicular enlargement 358. (510). What is considered to be an abnormal result of a 2hr glucose tollerance test? (A). >100 (B). >150 (C). >200 (D). >250 359. (520). When planning the management of a child with type one diabetes melitus, what should be considered? (A). injections sites (B). disturbed body image (C). developmental level and cognitive abilities (D). Self Esteem 360. (150). What is the most common treatment for a child over 3mos of age with developmental dysplasia of the hip (A). skin traction (B). Pavlick harnes (C). bone traction (D). hans device 361. (360). How is precocious puberty treated? (A). Magnesium Sulfate (B). Gonadotropin-releasing hormone analog (C). Gonadotropin-releasing hormone (D). Estrogen 362. (630). How is lice treated?(choose all that apply) (A). pediculicide shampoo (B). shaving the childs head (C). fine toothed comb (D). retreatment in 7 days 363. (590). How long is Impetigo contageous? (A). 24hrs (B). 48 hrs (C). untill 48 hours after treatment began (D). forever 364. (110). What is the treatment for bowlegs? (A). casting (B). surgery (C). braces worn at night (D). braces worn both day and night 365. (640). Who is most likely to contract Oral Candidiasis (thrush) (A). those that put everything in their mouths (B). those with immune disorders, corticosteroid inhailer, antibiotics (C). children of a woman with STD's (D). Those with a large amout of mushrooms in their diet 366. (530). What are the clinical manifestions of PKU?(choose all that apply) (A). musty or mousey body and urine odor (B). irritability, vomiting, hyperactivty, seizures (C). eczemalike rash, mental retardation (D). nausea, vomiting, diarrhea, fever 367. (610). How is Pediculosis Capitis (lice) Spread?(choose all that apply) (A). the bugs jump from one person to another (B). by contact with dirty people (C). direct contact (D). use of hair accessories shared by another Peds Practice Final Practice Test Answer Details Test ID: 22 1. (250). According to Piaget's Theory of Cognitive Development, which substage involves the Intentional behavior of an infant as learned to obtain objects, create sounds, or engage in other pleasurable activity. Answer: (D). Coordination of Secondary Schemes (8-12months 2. (220). According to Piaget's Theory of Cognitive Development, which substage begins life with a set of reflexes such as sucking, rooting, and grasping. Answer: (B). Use of Reflexes(birth-1month) 3. (50). What is the leading cause of death in children age 1-14yrs old in the United States? Answer: (A). Unintenional Injury 4. (370). At what point in life does weight double in 5 months and tripple with in a year Answer: (B). 1st year of life 5. (280). According to Piagets Theory of Cognitive Development, which stage does a child display the ability to think by using words as symbols, but logic is not well developed. Answer: (B). Preoperational (2-7yrs) 6. (80). The definition: is a process established by a health care institution to identify, evaluate and reduce the risk of injury to patients, staff, and visitors, and therby reduce the institutions liablility. This is the definition for what term? Answer: (B). Risk Management 7. (60). What is the leading cause of death for children 1-14 yrs old under the unintential injury catagorie? Answer: (C). Motor Vehicle Accidents 8. (540). When should meats be introduced? Answer: (C). 8-10mos 9. (120). Parents or guardians have absolute authority to make choices about their childs health care except? (choose all that apply) Answer: (B). When the child and parents do not agree on major treatment options Answer: (C). When the parents choice of treatment does not permit lifesaving treatment for the child Answer: (D). When there is a potential conflict of interest between the child and parents, such as with suspected child abuse or neglect 10. (360). What can a mother due to strive for the best possible outcome in pregnancy? (choose all that apply) Answer: (A). Seek early prenatal care Answer: (B). avoid drugs, alcohol, tobacco, and excessive caffeine Answer: (C). Good nutrition Answer: (D). exercise regularly 11. (30). How does pediatric care differ from that of an adult? Answer: (A). The family is more involved in the nursing process 12. (150). When begining to examin a child what should one consider? Answer: (A). Developmental Level 13. (470). Why do babies recieve a vitamin K injection after birth? Answer: (B). Promote adequate clotting 14. (140). The definition: intellectual or thinking processes Answer: (B). Cognitive Development 15. (180). According to Erickson, what stage of child development does the young child initiate new activities an considers new ideas. the interes in exploring the world creates a child who is involved and busy. Constant criticism, on the other hand leads to feelings of guilt and lack of purpose. Answer: (C). Initiative vs Guilt 16. (310). Autosomal chromosomes are all chromosomes except the ones that determine sex. Answer: (A). True 17. (160). Which of the following stages according to Erickson is the following: The task of the first year of life is to establish trust in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Answer: (A). Trust vs Mistrust 18. (410). What age group are the following toys/activities appropriate for? Large blocks, teething toys, toys that pop apart and back together, nesting cups and other objects that fit into one another or stack, surprise toys such as jack in the box, social interaction with adults and other children games such as peek aboo, soft balls, push and pull toys. Answer: (C). 6-12months 19. (70). Standards of Care for the Pediatric Nurse Include: (chose all that apply) Answer: (A). Collecting health data Answer: (B). Analyzing the assessment data in determining diagnoses Answer: (C). Implementing the interventions identified in the care plan Answer: (D). Evaluating the childs and familys progress toward attainment of outcomes 20. (350). The maternal use of illicit drugs can cause: (choose all that apply) Answer: (A). neonatal addiction Answer: (B). convulsions Answer: (C). hyperirritability Answer: (D). neurological disturbances 21. (210). According to Piaget's Theory of Cognitive Development, Which stage do infants learn about the world by input obtained through the senses and by their motor activity. This stage has 6 substages. Answer: (C). Sensorimotor (birth-2yrs) 22. (440). What is the first sign of puberty in girls? Answer: (B). Breast buds 23. (260). According to Piaget's Theory of Cognitive Development, which substage does the infant display Curiosity, experimentation, and exploration predominate as the toddler tries out actions to learn results. Objects are turned in every directions, placed in the mouth , used for banging, and inserted in containers as their qualities and uses are explored Answer: (B). Tertiary Circular Reactions (12-18months) 24. (290). According to Piaget's Theory of Cognitive Development, which stage does a child display a more accurate understanding of cause and effect. Answer: (C). Concrete Operational (7-11yrs) 25. (380). How should a nurse help assist parents in preparation for the second year of life Answer: (A). Provide anticipatory guidance 26. (420). The term preschool aged refers to a child Answer: (B). 3-6yrs 27. (200). According to Erickson, the stage of development where as the body matures and though processes become more complex, a new sense of identity or self is established. The self, family, peer group, and community are all examined and redefined. The adolescent who is unable to establish a meaningful definition on self will experience confusion in one or more roles of life. Answer: (A). Identity vs Role Confussion 28. (550). At what age can a baby have honey? Answer: (C). 12mos 29. (90). The definition: is the continuous study and improvement of the process and outcomes of providing health care services to meet the nees of patients, by examining the systems and process of how care and services are delivered Answer: (B). Quality Improvement 30. (130). The definition: directs health care institutions to inform hospitalized patients about their rights, which include expressing a preference for treatment options and making advance directives. Answer: (B). Self-Determination Act 31. (520). When should rice cereal be introduced? Answer: (A). 4-6mos 32. (110). When are children 18-21yrs old permitted to give informed consent? (choose all that apply) Answer: (A). When they are minor parents of a child Answer: (C). When they are emancipated minors Answer: (D). When they are adolescents between 16-18yrs of age seeking birth conrtol, mental health counseling, sor substance abuse treatment 33. (450). Who established DRI's and what are they used for Answer: (C). established by the food and nutrition board of the institute of medicine and the national acadamy of science. they are to be used to assess and plan intake for individuals of different ages 34. (170). Which of the following stages according to Erickson follows? The toddlers sense of autonomy or independence is shown by controlling body excretions, saying no when asked to do something, and directing motor activity. Children who are consistently criticized for expressions of autonomy for lack of control. Answer: (B). Autonomy vs Shame and Doubt 35. (270). According to Piaget's Theory of Cognitive Development, which substage does language provide a new tool for the toddler to use in understanding the world. language enables the child to think aboiut events and objects before or after they occur. Object permanence is now fully developed as the child actively searches for objects in various locations and out of view. Answer: (B). Mental Combinations (18-24months) 36. (500). When and how much fluoride should be given to a baby? Answer: (C). 6mos 0.25mg 37. (390). The following toys and activities are appropriate for what age Group? Mobiles, black and white patterns, mirrors, music boxes, singing, tape players, soft voices, rocking and cuddling, moving legs and arms while singing and talking, varying stimuli-different rooms, sounds, visual changes Answer: (A). birth to 2months 38. (530). When should fruits and vegitables be introduced? Answer: (D). 6-8mos 39. (480). How many IU of vitamin D is required by an infant? Answer: (C). 400 40. (320). The mothers poor nutritional status can effect a baby in many ways, choose all answers that this can result in Answer: (A). Low birth weight Answer: (B). compromised neurologic performance Answer: (D). slow development Answer: (E). impaired immune status 41. (490). At what age does a baby need Iron supplements? Answer: (C). 4-6mos 42. (190). According to Erickson, the stage of development that new interest an by involvement in activities develop and the child takes pride in accomplishments in sports, school, home, and community. If the child cannot accomplish what is expected, however, the result will be a sense of inferiority. Answer: (B). Industry vs Inferiority 43. (430). The term school aged refers to a child Answer: (C). 6-12yrs 44. (100). The definition: a formal preauthorization for an invasive procedure or participation in research. Consent must be given voluntarily. Answer: (B). Informed consent 45. (230). According to Piaget's Theory of Cognitive Development, which substage does the infant respond relexively, the pleasure gained from that response causes repetition of the behavior. Answer: (A). Primary Circular Reactions(1-4months0 46. (40). What is the leading cause of death in the United States for infants? Answer: (B). Congenital Abnormalities 47. (10). When age range does the pediatric continum of care encumpus? Answer: (C). Birth to College 48. (340). The maternal ingestion of alcohol can cause: Answer: (D). fetal alcohol syndrome 49. (460). During life, at what time is the highest metabolic rate or highest intake requirements? Answer: (B). Infancy 50. (400). What age group are the following toys/activities appropriate for: Rattles stuffed animals, soft toys with contrasting colors, noise making objects that are easily grasped. Answer: (B). 3-6 months 51. (330). Maternal Smoking can cause: Answer: (B). Low birth weight 52. (240). According to Piaget's Theory of Cognitive Development, the substage where an infant becomes aware of the environment begins to grow as the infant begins to connect cause and effect. The sounds of bottle preperation will lead to excited behavior. If an object is partially hidden the infant will attempt to retrieve it. Answer: (B). Secondary Circular Reactions(4-8months) 53. (300). According to Piaget's Theory of Cognitive Development, which stage does a child become fully mature intellectuall thoughs have been attained. Answer: (D). Formal Operational (11-Adulthood) 54. (20). What four roles does a nurse play in pediatrics? Answer: (C). Direct Nursing Care, Patient Education, Patient Advocacy, Case Management 55. (510). How are foods introduced? Answer: (A). one at a time 56. (270). What does a toddler understand about death? Answer: (A). unable to understand death/separation anxiety 57. (570). The clinical manifestations of hyponatrimia are: (choose all that apply) Answer: (A). anoresia, headache Answer: (B). muscle weakness, decreased deep tendon reflexes Answer: (C). lethargy, confusion Answer: (D). coma/death 58. (470). Which of the following is an indicator of dehydration (choose all that apply) Answer: (A). elevated hematocrit Answer: (D). low specific gravity 59. (400). What effect does a parents pressence have on the outcome? Answer: (B). it reduces anxiety associated with pain and hospitalization 60. (820). What gamma globulin is useful in combating parasitic infections and is part of the allergic response? Answer: (B). IGE 61. (480). What is the treatment of mild to moderate dehydration in a child? (choose all that apply) Answer: (A). oral rehydration 1-3tsp every 10-15min Answer: (B). oral rehydration, 1 tsp every 2-3min even if vomiting 62. (490). If soft drinks or juices are used for rehydration how are they given? Answer: (B). half/half 63. (240). During the period of bereavement, the nurses goal is to Answer: (B). provide comfort and support and be physically present 64. (810). Metabolic alkalosis exist if the HCO3 is Answer: (D). >25mmol/L 65. (150). an abnormal elimination pattern characterized by the recurrent soiling or passage of stool at inappropriate times by a child who should have achieved bowel continence is the definition of Answer: (B). Encopresis 66. (760). Clinical manifestations of hypomagnesemia are: (choose all that apply) Answer: (A). tetany, hyperactive reflexes, cramps, twitching, tremors Answer: (B). cardiac arrhythmias, seizures 67. (850). How are immunosuppressed children best protected from infection? (choose all that apply) Answer: (A). frequent handwashing Answer: (B). limit exposure to individuals with upper respiratory infections Answer: (D). vaccines (live viruses should be avoided) 68. (230). When the parents react to a life threatening illness or injury, the stage where parents experience a period of emotions as the child recovers, improves steadily, and prepares for transfer and discharge or dies or remains unresponsive Answer: (D). readjustment or mourning 69. (430). How is emla cream applied? Answer: (A). 1-2hrs before the first needle stick 70. (320). What approach does hospice take with death? Answer: (C). death is just an extension of life. they help patients be comfortable and prepare 71. (200). When the parents react to a life threatening illness or injury, the stage where parents become more aware of their childs illness or injury and their anger may be directed toward themselves, each other, health care providers, or other children or parents Answer: (A). Anger and Guilt 72. (60). What are the risk factors for child abuse? (choose all that apply) Answer: (A). History of mental illness, domestic violence, incarceration, or substance abuse in the home Answer: (B). Family stresses, Inadequate child care or supervision, Inadequate family social support Answer: (C). Use of corporal punishment, Child abuse, Access to firearms, gang membership, exposure to media violence, child hyperactivity 73. (340). What effect does pain have on the body? Answer: (B). it initiates the stress response 74. (620). hypokalemia exist when the lab values are: Answer: (D). <3.5 75. (500). What are the clinical manifestations of extracellular fluid volume excess? (choose all that apply) Answer: (A). bounding pulse, distended neck veins Answer: (B). hepatomegaly, dyspnea, orthopnea and lung crackles Answer: (C). edema 76. (980). What is the complication that can occur with Mumps? Answer: (B). Orchitis, testicular pain, sterility 77. (710). How is hypocalcemia treated? Answer: (A). oral or iv supplimentation 78. (790). Alkalosis exist if ABG CO2 levels are Answer: (A). <27mmHg 79. (560). What are the clinical manifestations of hypernatremia? (choose all that apply) Answer: (A). decreased LOC, seizures Answer: (B). confusion Answer: (C). lethargy Answer: (D). coma/death 80. (390). When using a narcotic to manage pain, what should always be available? Answer: (C). Narcan 81. (840). If a mother is known to have aids she is given ZDV after the first trimester, how long is it given to the baby after delivery? Answer: (C). 6wks 82. (420). a good way of evaluating the effectiveness of pain control is if the child sleeps. Answer: (B). False 83. (870). What are the clinical manifestations of Systemic Lupus Erythematosus? (choose all that apply) Answer: (A). fever, chills, fatiue, malaise and weight loss Answer: (B). butterfly rash on the face 84. (10). What is a common finding in a child that has been abused? Answer: (B). The child is developmentally delyayed 85. (550). Treatment for hyponatremia is Answer: (B). hypertonic sol 86. (590). When is hyperkalemia likely to occur? Answer: (C). massive cell death (crush injury, sickle cell) 87. (630). What can cause hypokalemia? (choose all that apply) Answer: (A). eating large amounts of black licorice Answer: (B). Diarrhea 88. (250). If a child is in a coma the nurse should Answer: (B). encourage the family to communicate 89. (520). Hypernatremia occurs when the sodium level is Answer: (A). >148 90. (920). The MMR Vaccine should be given at what ages? Answer: (B). 12mos, 4-6yrs 91. (210). When the parents react to a life threatening illness or injury, the stage where parents go through the emotions of death before their child dies Answer: (B). deprivation and loss 92. (30). How often should a child engage in moderate physical activity such as bike riding, walking, baseball, or rollerblading? Answer: (C). 30 min five times a week 93. (690). Hypocalcemia exist if lab values are Answer: (D). <4.4 94. (90). the deliberate maltreatment of another individual that inflicts pain or injuyr may result in permanent or temporary disfigurement or even death is the definition of: Answer: (B). physical abuse 95. (1000). A fever isn't considered harmful until it reaches 105.9F Answer: (A). True 96. (40). How often should a child engage in vigorous physical activity? Answer: (C). 20min three times a week 97. (640). What are the clinical manifestations of hypokalemia?(choose all that apply) Answer: (A). decreased GI Motility, Abd destintion Answer: (B). constipation, paralytic illius Answer: (C). weakness, respiratory depression, abnormal ekg 98. (780). Acidosis exist if an ABG CO2 level is: Answer: (D). >41mmHg 99. (860). When caring for a child that is immunosuppressed, it is important for the nurse to Answer: (B). emphasize the importance of promoting the childs development 100. (70). Sahming, ridiculing, embarrassing, or insulting a child is the definition for: Answer: (B). emotional abuse 101. (260). What does an infant understand about death? Answer: (A). unable to understand the true concept of death 102. (770). How is hypomagnesemia treated Answer: (C). administer magnesium, and treat the cause of the deficency 103. (280). What do preschoolers understand about death? Answer: (C). believes it is reversible 104. (940). The PCV vaccine should be given at what age? Answer: (D). 2mos, 4mos, 6mos, 12mos 105. (530). The treatment for hypernatremia is Answer: (A). hypotonic sol. 106. (700). What are the clinical manifestations of hypocalcemia? (choose all that apply) Answer: (A). tetany, twitchingcramping, tingling, carpal spasm, pedal spasm Answer: (B). laryngospasm, seizures, cardiac arrhythmias Answer: (C). death, chf, spontaneous fractures 107. (50). How long should television be limited each day? Answer: (B). 2hr 108. (1030). How can a apnic episode be stopped in an infant? Answer: (A). Tactile stimulation 109. (740). how is hypermagnesemia managed? Answer: (A). Increase urine output, dialysis 110. (120). Once a child has been identified as being abused, what is the goal? Answer: (B). prevent further abuse 111. (890). The DTAP vaccine should be given at what ages? Answer: (B). 2mos, 4mos, 6mos, 15mos, 4-6yrs 112. (160). When a child has encopresis, how should the child be treated? Answer: (B). praise them when successful, don't punish when not 113. (370). What drugs should be avoided for pain management in children with chronic conditions? (choose all that apply) Answer: (A). Nubain Answer: (B). Talwin Answer: (C). Stadol 114. (80). deliberate withholding of or failure to provide the necessary and available resources to a child is the definition of: 115. (100). the caretakers emotional unavailability to the child is the definition of: Answer: (B). emotional neglect 116. (540). Hyponatremia occurs when the sodium level is Answer: (D). <135 117. (140). why may bulimia go unnoticed? Answer: (B). they may be of normal weight 118. (440). What is the most significant problem with deep sedation in a child Answer: (C). respirtory depression 119. (460). You know a infant is adequately hydrated when they urinate Answer: (B). 1-2ml/kg 120. (660). Hypercalcemia exist if the lab values are Answer: (A). >5.3 121. (670). Clinical manifestions of hypercalcemia are: (choose all that apply) Answer: (A). constipation, anorexia, nausea, vomiting Answer: (B). fatigue, weakness, polyuria, cardiac arrhythmias/arrest Answer: (C). confusion, lethargy and decreased attention span 122. (990). Clinical manifestations of Roseola are Answer: (B). sudden high fever that diappears as a pale pink rash appears 123. (170). Separation anxiety is likely to be seen in what age groups Answer: (A). infant Answer: (B). toddler Answer: (C). preschooler 124. (580). Hyperkalemia occurs when lab values are: Answer: (A). >5.8 125. (1010). What complicatons can occur if a fever rises quickly? Answer: (A). seizures 126. (330). What is not a reliable indicator of pain? Answer: (C). vital signs 127. (960). When can a child begin getting a yearly influenza vaccine? Answer: (C). 6mos 128. (880). The Hepatitis B vaccine should be given at what ages? Answer: (A). Birth, 2mos, 6mos 129. (220). When the parents react to a life threatening illness or injury, the stage where parents expierence a life suspended in time, and fear leaving the area because they may miss an important procedure, physician visit, or decisions or changes in treatment. Answer: (C). anticipatory waiting 130. (310). What do young children fear more than dying? Answer: (B). desertion 131. (180). When caring for a child in the hospital you should Answer: (C). Promote a sense of control, trust, and support 132. (610). What are the treatments for hyperkalemia? (choose all that apply) Answer: (A). potassium wasting diuretics Answer: (C). dialyisis 133. (510). What is the treatment for extracellular fluid volume excess? Answer: (B). treat the underlying cause 134. (1040). Cystic Fibrosis is definitively diagnosed by a possitive sweat test Answer: (A). True 135. (680). How is hypercalcemia treated? (choose all that apply) Answer: (A). lasix, glucocorticoids Answer: (B). calcitonin Answer: (C). dialysis 136. (350). What is the problem with using the oucher scale to indicate pain? Answer: (C). the child may point to how they want to feel 137. (190). When the parents react to a life threatening illness or injury, the stage where parents experience a loss of control, an inability to regain their bearings, and feelings of immobility is called Answer: (C). Shock and disbelief 138. (380). When managing pain for a child, how should the medications be administered Answer: (B). around the clock 139. (20). Signs that may indicate substance abuse in adolescents are: (chose all that apply) Answer: (A). Withdrawl from sports activities, nodding off frequently during the day Answer: (B). Teachers report a change in school work, Lack of personal hygene, lack of energy Answer: (D). continued, consistent weepiness, red eyes, oral sores, respiratory discomfort 140. (290). What does a school aged child understand about death? Answer: (D). acquires more realistic understanding of death 141. (730). Clinical manifestations of hypermagnesemia are: (choose all that apply) Answer: (A). decreased muscle irritability, hypotension Answer: (B). bradycardia, drowsiness, lethargy Answer: (C). weak or absent deep tendon reflexes Answer: (D). flaccid muscle paralysis, fatal repiratory depression, cardiac arythmias/arrest 142. (970). Of the following which is a clinical manifestation of Erythema Infectiosum (fifths disease)? Answer: (B). firery red rash on the cheeds giving a slapped face appearance 143. (110). the exploitation of a child for the sexual gratification of an adult is the definition of: Answer: (C). sexual abuse 144. (450). A neonate has the highest % of water by weight Answer: (A). True 145. (720). Hypermagnesemia exist if lab values are: Answer: (A). >2.4 146. (910). The IPV vaccine should be given at what ages? Answer: (A). 2mos, 4mos, 12mos, 4-6yrs 147. (360). What are common side effects to the use of opioids? (choose all that apply) Answer: (A). sedation Answer: (B). nausea/vomiting Answer: (C). constipaton/itching 148. (130). What is the result of bulimia? Answer: (C). Electrolyte imballance 149. (830). How do most children aquire the AIDs Virus? Answer: (C). perinatal transmittion 150. (800). Metabolic acidosis occurs if the HCO3 is Answer: (A). <18mmol/L 151. (950). When can a child start the Hep A series? Answer: (B). 24mos 152. (900). The HIB vaccine should be given at what ages? Answer: (C). 2mos, 4mos, 6mos, 15mos 153. (750). hypomagnesemia exist when lab values are: Answer: (D). <1.5 154. (600). What are the clinical manifestations of hyperkalemia? (choose all that apply) Answer: (A). hyperactivity of GI system, abd cramping, diarrhea Answer: (B). weak muscles usually in the legs and progress to flaccid paralysis Answer: (C). lethargic cardiac arrhythmias, abnormal ekg 155. (410). What are nonpharmacologic interventions for pain? (choose all that apply) Answer: (B). distraction, cutaneous stimulation Answer: (C). electroanalgesia, imagery Answer: (D). relaxation techniques, hypnosis 156. (650). Treatments of hypokalemia are Answer: (A). High potassium diet 157. (1020). What is the treatment for a high fever? Answer: (A). antipyretics Answer: (B). remove clothing Answer: (C). increase fluid intake, tepid baths 158. (300). What does a adolescent understand about death? Answer: (D). intellectually capable of understanding 159. (930). The varicella vaccine should be given at what age? Answer: (C). 15mos 160. (1320). Prior to discharge from the hospital for shunt placement for hydrocephalus, what should be taught to the parents?(choose all that apply) Answer: (A). signs and syptoms of shunt failure/infection Answer: (C). The shunt may need to be replaced as the child grows 161. (200). What is the most serous complication of Kawasaki disease? Answer: (B). Cardiac involvement 162. (90). How should a nurse monitor a child for impaired tissue perfussion post cardiac catheterization?(choose all that apply) Answer: (A). check capillary refill, estremity warmth Answer: (B). pedal pulses, level of conciousness Answer: (C). urinary output 163. (50). After a child undergoes a cardiac catheterization, what should be monitored? (choose all that apply) Answer: (A). I&O's, Pedal pulses Answer: (B). Capillary refill, sensation Answer: (C). Warmth, and color of lower extremities 164. (160). Once a client has been diagnosed with infective endocarditis, what should they be taught? Answer: (B). They should inform physicians and dentist about the history before invassive proceedures 165. (430). bleeding into a joint is refered to as: Answer: (B). hemarthrosis 166. (1010). When should a small child be treated for a UTI if they are unable to tell you their symptoms? Answer: (C). if they were continent after toilet training 167. (100). The combination of what four defects results in Tetralogy of Fallot?(choose all that apply) Answer: (A). Pulmonic stenosis, Right ventricular hypertrophy Answer: (C). Ventricular Septal Defect, Overriding of aorta 168. (510). What is the goal of treatment for Idiopathic Thrombocytopenic Purpura? Answer: (B). Normal platelet counts 169. (450). What medication is used to treat mild hemophillia? Answer: (B). Desmopressin Acetate (DDAVP) 170. (1040). What is a common concern of children with generalized edema Answer: (A). their appearance 171. (980). What should be taught to parents after an infant has under gone surgical repair of Hypospadias or Epispadias and a stent is in place Answer: (B). Double diaper techniques 172. (670). What are the cardinal signs of bone marrow failure? Answer: (A). Petechiae Answer: (B). Frank bleeding Answer: (C). Joint Pain 173. (170). The most common pathologic tachycardia, is the abrupt onset of a rapid, regular heart rate, often to fast to count. Answer: (C). Supraventricular 174. (710). How do children aquire Retinoblastoma? Answer: (C). inherited by an autosomal dominat gene 175. (1270). When is Reye syndrom (encephalopathy) likely to develop? Answer: (B). after a mild viral illness, or aspirin use 176. (370). When caring for a child with sickle cell anemia, the nurse focuses on?(choose all that apply) Answer: (A). increasing tissue perfusion, promoting hydration Answer: (B). controling pain, preventing infection Answer: (D). ensuring adequate nutrition, preventing complications, providing emotional support 177. (460). When obtaining a history on a child with hemophillia, what information should be obtained? (choose all that apply) Answer: (A). Complete history Answer: (B). previous episodes Answer: (D). Family history 178. (310). An exacerbation of the symptoms of sickle cell is termed? Answer: (B). Sickle cell crisis 179. (720). What is the first sign of retinoblastoma? Answer: (B). white pupil, termed leukokoria or cats eye reflex 180. (1230). The primary nursing diagnosis for a child with otitis media is:? Answer: (C). Pain related to inflammation and pressure on the tympanic membrane 181. (900). Clinical manifestations of Appendicitis are? (choose all that apply) Answer: (A). Rebound tenderness Answer: (C). Difficulty ambulating 182. (420). Since Iron overload is a major complication of Beta-Thalassemia, what medication should be given? Answer: (B). Dexferol (deferoxamine) 183. (1280). Signs of hydrocephalus are: (choose all that apply) Answer: (A). Rapid head growth, bulging fontanel, split sutures Answer: (B). Increased Itracraneal Pressure Answer: (D). Promininet scalp veins, translucent skin, increased tone or hyperreflexia 184. (20). What precautions should be taken when diuretics are used? Answer: (C). Monitor potassium levels 185. (1110). What is the time frame from time infected with streptocaccus to the time Acute Postinfectious Glomerulonephritis develops? Answer: (C). 8-14 days 186. (770). How is an infant with Esophageal atresia hydrated? Answer: (C). Umbilical artery catheter 187. (340). What is the treatment for a child in sickle cell crisis?(choose all that apply) Answer: (A). hydration, oxygen, pain management Answer: (B). bedrest, blood transfussion 188. (180). What age does Kawasaki disease occur? Answer: (B). <5yrs 189. (870). What is the treatment for Hirschsprugs disease? (choose all that apply) Answer: (A). surgical removal of the aganglionic bowel and the creation of a colostomy Answer: (C). TPN and a lactose free diet 190. (1100). What are the common cause of Acute Postinfectious Glomerulonephritis? Answer: (B). Beta-hemolytic streptococcal infection of the skin or pharynix Answer: (C). Staphylococcus Answer: (D). Peumococcus, Coxasackie virus 191. (830). Why can't parents place a child with gastroesophageal reflux disease in a infant seat. Answer: (B). it incrases intraabdominal pressure and will worsen the condition 192. (1290). What factors can cause a shunt for hydrocephalus to fail? (choose all that apply) Answer: (A). blockage at either end Answer: (B). kink in the tubing Answer: (D). valve breakdown 193. (910). A Diaphragmatic Hernia is life-threatening, Why?, What would you look for? Answer: Severe respiratory distress occurs shortly after birth. As the infant cries, abdominal organs extend into the thorax, decreasing the size of the thoracic cavity. the infant becomes dyspneic and cyanotic. Characteristic findings include a barrel shaped chest and sunken abdomen 194. (730). When preparing an infant to feed after a cleft pallet surgery has been performed, how should they be possitioned? Answer: (A). Fowlers (setting up) 195. (750). Medications for an infant after cleft pallet surgery are geared toward? (choose all that apply) Answer: (A). Pain Control Answer: (C). Minimize crying 196. (1330). What is the goal of clinical therapy for Cerebral Palsy? Answer: (C). helping the child develop to his or her maximum level of independence 197. (590). What are some complications of the treatments for brain tumors? (choose all that apply) Answer: (A). impaired cognitive function, emotional or behavioral problems Answer: (B). memory deficit, attention deficit Answer: (D). Diabeties insipidus 198. (740). How should an infant post cleft pallet surgery be possitioned? Answer: (B). supine or sid-lying with elbows in soft restraints 199. (120). What possition does a child with a cyanotic heart defect assume? Answer: (C). A knee to chest position while squating 200. (250). What side effects of oral iron supplimentation should be taught to the child and parents?(choose all that apply) Answer: (A). black stools Answer: (B). constipation Answer: (D). foul after taste 201. (10). What medication is most commonly used to improve the hearts ability to contract and therefore increase output? Answer: (C). Digoxin 202. (70). What treatment should be done post cardiac catheterization?(choose all that apply) Answer: (A). Encourage fluids Answer: (C). Permit quiet play 203. (800). When treating a child with Pyloric Stenosis, what diet should they be placed on? Answer: (B). TPN 204. (920). How is Necrotizing Enterocolitis Managed? (choose all that apply) Answer: (A). discontinue all enteral feedings Answer: (C). strict enteric precautions 205. (1210). What increases the incidnence of otitis media? Answer: (B). smoking 206. (860). What are the clinical manifestations of Intussusception? (choose all that apply) Answer: (A). acute onset of abdominal pain with vomiting and passage of brown stool Answer: (B). increase in episodes of pain Answer: (D). stools are red and rsemble currant jelly , palpable mass may be present in the upper right quadrant of the abdomen 207. (650). If a tumor is felt in the abdomen, the nurse should? Answer: (C). Don't palpate notify the MD 208. (360). What effect does cytotoxic drugs have on someone in a sickle cell crisis? Answer: (B). decreases the production of abnormal blood cells and leads to less amount of pain 209. (660). The common initial symptoms of osteosarcoma are: (choose all that apply) Answer: (B). pain referred to the hip or back Answer: (C). Edema Answer: (D). Pulmonary metastasis 210. (1180). What causes Amblyopia (lazy eye) Answer: visual deprivation to one eye, commonly untreated strabismus, congenital cataract, or visual differences between eyes 211. (620). an asymptomatic, firm lobulated mass located to one side of the midline in the abdomen is the definition of? Answer: (B). Wilms' Tumor (Nephroblastoma) 212. (220). What are the clinical manifestations of Iron deficiency anemia? Answer: (A). Pallor, fatigue, irratability Answer: (C). nailbed deformities, growth retardation, developmental delay Answer: (D). tachycardia, systolic heart murmur 213. (810). After a pyloric stenosis repair, what should the parents be taught prior to going home? Answer: (B). to fold the infants diaper so it does not touch the incission 214. (1250). after a tonsilectomy, what should the nurse monitor? (choose all that apply) Answer: (A). vital signs, dehydration Answer: (B). respiratory distress Answer: (D). hemorrhage 215. (240). How should liquid iron preparations be taken? Answer: (C). through a straw 216. (580). What symptoms are likely to develop in a child with a brain tumor?(choose all that apply) Answer: (A). Headache, nausea, vomiting Answer: (B). dizziness, change in vision or hearing Answer: (D). fatigue 217. (1130). What should be taught to the parents before discarge after hospitalization for acute post infectous glomerulonephritis? Answer: (B). it may take up to 3 weeks for hypertension and gross hematuria to resolve 218. (390). What diet should a child be encouraged to eat while in sickle cell crisis? Answer: (A). High Protein Answer: (B). High calorie Answer: (C). High Folic Acid 219. (760). What possition should an infant be in prior to the repair of a Esophageal atresia? Answer: (C). Trendellenburg (head slightly lower than body) 220. (610). What congenital anomalis is associated with Wilms' Tumor (Nephroblastoma)? (choose all that apply) Answer: (A). aniridia (absence of the iris) Answer: (B). hemihypertropy (abnormal growth of half of the body or body structure) Answer: (C). genitourinary anomalies, nevi, and hamartomas (benign nodulelike growths) 221. (630). When are Wilms' Tumors (nephroblastomas) discovered commonly? Answer: (B). during a bath 222. (1140). What symptoms may an older child complain of with conjunctivitis?(choose all that apply) Answer: (A). ithing or burning, photophobia, mucopurulent discharge Answer: (B). redness and swelling of the conjunctiva, pink sclera Answer: (C). crusty cyelids 223. (130). What are the clinical manifestations of Rheumatic Fever? (choose all that apply) Answer: (A). inflammed and painful joints, Sydenham chorea (aimless movements of the extremities and facial grimacing Answer: (C). Subcutaneous nodules near joints, fever, anemia Answer: (D). Skin rash (pink macules and blanching in the middle of the lesions 224. (990). What complication is common of obstructive uropathy? Answer: (B). Hydronephrosis 225. (260). A child that undergoes a spleenectomy to treat sickle cell anemia is at risk for?(choose all that apply) Answer: (A). high rate of infection Answer: (B). impaired immunity Answer: (D). Death resulting from bacterial infection 226. (840). After the delivery of an infant with a omphalocele, what should be done? Answer: (B). cover the sac with sterile gauze soaked in normal saline 227. (1340). The primary nursing diagnosis for a child with cerebral palsy is: Answer: (A). impaired physical mobility related to decreased muscle strength and control 228. (1070). When monitoring the fluid needs of a client with generalized edema, what should be done? (choose all that apply) Answer: (A). monitor I&O's, Vital Signs, watch for signs of respiratory distress, hypertension or circulatory overload Answer: (C). Daily Weights, Answer: (D). Measure abdominal girth 229. (60). When teaching home care to parents of a child after cardiac catheterization, what complications should they be instructed to observe for?(choose all that apply) Answer: (A). fever, bleeding or bruising increasing in size at the catheterization site Answer: (B). the foot on the side of the proceedure is cooler than the one on the opposite side Answer: (D). loss of feeling in the extremity the proceedure was performed on 230. (1050). What should be monitored if a client is receiving albumin intravenously?(choose all that apply) Answer: (B). hypertension Answer: (D). signs of volume overload 231. (700). What is Rhabdomyosarcoma? Answer: (C). A soft tissue cancer that is common in children 232. (110). What are the clinical manifestations of Tetralogy of Fallot?(choose all that apply) Answer: (A). Polycythemia, exercise intollerance Answer: (C). Metabolic Acidosis, poor rowth, clubbing 233. (500). When peforming discharge teaching to a child and family members for hemophillia, what should they be taught?(choose all that apply) Answer: (A). Wear an medical identification tage Answer: (B). Explain the disease process Answer: (C). Teach how to identify internal and external bleeding 234. (950). In Celiac's disease, the inabilty to digest glutenin and gliadin results in what? Answer: the acccumulation of the amino acid glutamine, which is toxic to mucosal cells in the intestine. Damage to the villi ultimately impairs the absorptive process in the small intestines. 235. (490). When treating a child with hemarthrois, the nurse would: Answer: (B). imobilize and elevate the joint and apply ice packs 236. (330). What prophalactic treatment is recomended for a child with sickle cell? Answer: (A). Penicillin 237. (230). When should children be screened for Iron deficiency anemia? Answer: (A). at 9 mos and again in adolesence 238. (320). What are the two most important steps in avoiding a sickle cell crisis?(choose all that apply) Answer: (A). Preventing exposure to infection Answer: (C). maintaining normal hydration 239. (1000). What symptoms are likely to be expiernced if a child has obstructive uropathy? Answer: (C). Same as a UTI 240. (560). What medication is used in combination with methotrexate to protect normal cells? Answer: (B). Leucovorin 241. (940). A disease characterized by an intolerance for gluten, a protein found in wheat, barley, rye and oats Answer: (C). Celiac Disease 242. (1080). What possiton should be maintained if a client has generalized edema? Answer: (A). Elevate the HOB 243. (350). What does a child with sickle cell gain from an early transfusion while in crisis? Answer: (D). relief from ischemia in major organs and body parts 244. (930). What should be monitored in a infant with Necrotizing Enterocolitis? Answer: (C). Abdominal Circumference every 4-8 hrs 245. (40). What are the clinical manifestations of Coarctation of the Aorta?(choose all that apply) Answer: (A). Low blood pressure in the legs Answer: (B). High blood pressure in the arms Answer: (D). Weak Femoral Pulses 246. (190). What are the clinical manifestations of Kawasaki disease?(choose all that apply) Answer: (A). Bilateral conjunctivitis, intesnse erythema of the buccal and pharyngeal surfaces, strawberry tongue, fever Answer: (C). Dermatitis of the extremities, palmar and plantar erythema, induration of the hands and feet Answer: (D). Dermatitis of the trunk with an erythematous maculopapular rash, Acute cervical lymphadenopathy, an illness not explained by another disease process 247. (820). What complications can occur with gastoesophageal reflux disease (GERD)? (choose all that apply) Answer: (A). aspirations, pneumonia Answer: (B). reactive airway disease Answer: (C). color changes during feeding, apnea, hematemesis 248. (690). What effect does leukemic cells have on the testicles? Answer: (B). They cause a painless enlargement 249. (570). What clinical manifestations should be reported to the oncologist if the child is recieving chemotherapy? (choose all that apply) Answer: (A). Temperature above 101F, any bleeding Answer: (B). Pain with urination or defecation, sores in the mouth, vomiting or diarrhea Answer: (C). persistent pain, signs of infection, exposure to communicaple disease 250. (640). What are some common clinical manifestations of Wilms' Tumors (nephroblastoma)? Answer: (A). Hypertension Answer: (C). Hematuria 251. (140). When caring for a child with Sydenham chorea, what should be done? Answer: (D). provide emotional support, encourage the family to participate in care 252. (30). If a child is having difficulty breathing, what possition should they be kept in? Answer: (B). Semi-Fowlers 253. (880). What should be taught to parents prior to discharge of an infant post surgical repair of Hirschsprungs disease? Answer: (D). colostomy care and referal to support groups 254. (1090). acute inflammation of the glomeruli of the kidneys is termed Answer: (B). glomerulonepritis 255. (680). What are the clinical manifestations of leukemia? (choose all that apply) Answer: (A). fever, pallor, overt signs of bleeding Answer: (B). Lethargy, malaise, anorexia Answer: (D). Joint pain, bone pain, enlargement of the liver and spleen and changes in the lymphnodes 256. (1020). What causes Enuresis?(choose all that apply) Answer: (A). neurological or congenital structural disorders Answer: (B). illness, stress Answer: (D). Family history 257. (960). A early sign of celiac disease is:? Answer: (B). Statorrhea 258. (1030). What are the clinical manifestations of Nephrotic Syndrome? (choose all that apply) Answer: (A). Periorbital edema, weight gain, hypertension irritability Answer: (B). anorexia, hematuria, malaise, pale shinny skin, veins are prominent, hair becomes brittle Answer: (C). foamy or frothy urine, generalized edema, respiratory distress 259. (470). What is the most important nursing diagnosis for a child with hemophillia? Answer: (B). Risk for injury 260. (1190). When working with a visually impaired child, what should the nurse do? Answer: (A). call the childs name and identify yourself before touching the child Answer: (B). Tell the child you are leaving the room, Describe wht each procedure will feel like Answer: (D). Let the child touch the equipment to establish familiarity, Describe wht foods are present and their locations on the food tray 261. (970). What should parents be taught about celiac disease? Answer: (B). it is lifelong and will require a life long diet modification 262. (520). What medications are used in the treatment of Idiopathic Thrombocytopenic Purpura?(choose all that apply) Answer: (A). Corticosteroids Answer: (C). Intravenous immunoglobulins 263. (1200). What can a mother do to protect against otitis media? Answer: (B). Breast feeding 264. (1220). What should be taught the the child and faimilies after a tympanostomy?(choose all that apply) Answer: (A). Encourage the child to drik genrous amounts of fluids, Reestablish a regular diet as tolerated, give pain medication as ordered Answer: (B). Place drops in childs ear as instructed, restrict the child to quiet activities, follow instructions on swimming and bathing Answer: (D). Ear plugs can be used, be alert for tubes becoming dislodged, report purulent discharge from the ear 265. (280). In response to the constant formation and destruction of the childs red blood cells how does the body attempt to compensate?(choose all that apply) Answer: (A). increases bone marrow spaces Answer: (C). increase production of RBC which results in hemolytic anemia 266. (80). How should the nurse check a pulse in a child post cardiac catheterization? Answer: (B). Apical 267. (440). The goal of treatment for hemophilia is to Answer: (B). control bleeding by replacing the missing clotting factor 268. (1300). When is an infection most likely to occur after shunt placement for hydrocephalus? Answer: (D). first 2 months 269. (850). What can effect the outcome of an infant after omphalocele repair? (choose all that apply) Answer: (A). maintenance of normal vital signs, proper intake of fluids Answer: (B). infection, pain control Answer: (D). establishment of an intake to support growth patterns 270. (400). What are the clinical manifestations of Beta-Thalassemia? (choose all that apply) Answer: (A). Anemia, Skeletal changes Answer: (B). heart failure,hepatomegaly, splenomegaly Answer: (D). Delayed sexual maturation, Darkening of the skin 271. (300). The clinical manifestations of sickle cell anemia are directly related to? Answer: (A). shortened life span of blood cells Answer: (C). tissue destruction resulting from vaso-occlusion 272. (600). How is Neuroblastoma diagnosed? (choose all that apply) Answer: (B). Vanillylmandelic acid (VMA) levels Answer: (C). Homovanillic acid (HVA) levels Answer: (D). Radiographic studies for calcification 273. (270). What can cause a sickle cell crisis?(choose all that apply) Answer: (A). hypoxia, high altitude, emotionally stress full event Answer: (B). poorly pressurized airplanes, hypoventilation Answer: (D). vasconstriction due to cold 274. (530). What medications are used to treat the side effects of chemotherapy? Answer: (B). Antiemetics 275. (210). What are the causes of Iron deficiency anemia?(choose all that apply) Answer: (A). bleeding in the neonatal period, blood loss from hemophilia Answer: (B). parasitic gastrointestinal illness, menorrhagia 276. (1150). What are the common infectous organisms involved with conjunctivitis? Answer: (A). Haemophilus influenzae, Streptococcus pneumoniae Answer: (B). Staphylococcus aureus Answer: (D). Viruses 277. (1060). What should be monitored if a client is on diuretic therapy? Answer: (A). observe for shock 278. (380). What IV fluids are used prior to and after blood transfussion?(choose all the apply) Answer: (B). NS Answer: (C). None if the child is small 279. (480). In the event that a child has a bleeding episode, what treatment should be performed? (choose all that apply) Answer: (A). Apply pressure for 15 min. Answer: (B). immobilize and elevate the affected area Answer: (D). apply ice packs, and assist with factor replacement therapy 280. (1170). What should be taught to the parents of a child with conjunctivitis? (choose all that apply) Answer: (A). the child should not return to school until they have been on an antibiotic for 24hrs Answer: (C). frequent handwashing, avoid sharing towels Answer: (D). the child should not rub their eyes, teach how to instill eye medications 281. (1260). What signs indicate increased intracranial pressure? (choose all that apply) Answer: (A). Headache, visual disturbances, diplopia Answer: (B). Bulging fontanel, Nausea vomiting Answer: (D). Vertigo, slight change in vital signs, pupils not as reactive or equal, sunsetting eyes, Seizures, change in LOC 282. (1120). What are the clinical manifestations of acute postinfectous glomerulonephritis? Answer: (A). microscopic hematuria, headache, costovertebral tenderness Answer: (B). periorbital edema, lethargy, fever, abdominal pain Answer: (C). Hypertension 283. (890). What clinical manifestations indicate Anorectal malformations? (choose all that apply) Answer: (B). stool in the urine Answer: (C). ribbonlike stools 284. (150). How long does Sydenham chorea tipically last? Answer: (C). 5-15 weeks 285. (550). What should the nurse try to do when they are caring for a child with thrombocytopenia? Answer: (D). minimize needle sticks and other intrusive proceedures 286. (1240). A child has been perscribed antibiotics for otitis media, what instructions should the parents be given? Answer: (D). use exactly as directed and complete the prescribed course 287. (290). An infant that is born with sickle cell anemia may not become symptomatic until? Answer: (C). 4-6mos of age 288. (1310). children with venticuloatrial shunts are placed on_____________ to prevent shunt infections Answer: (B). prophylactic antibiotics 289. (790). What are the clinical manifestations of Pyloric Stenosis?(choose all that apply) Answer: (A). Projectile vomiting Answer: (B). always hugary, irritable, fails to gain weight, fewer and smaller stools Answer: (D). Dehydration, alkalosis, hyperbilrubinemia 290. (1160). What comfort measures should be taken with conjunctivitis?(choose all that apply) Answer: (A). cleaning drainage away with a warm clean cloth Answer: (B). avoiding bright lights, avoiding reading Answer: (D). antihistamines, topical steroids and vasoconstrictors 291. (540). A child who is receiving cranial radiation and intrathecal chemotherapy should be evaluated for:? Answer: (C). Scholastic evaluations 292. (780). What should be done post surgically for Esophageal atresia? Answer: (A). maintain gastrostomy drainage Answer: (B). Maintain IV fluids and antibiotics Answer: (D). TPN is administered if needed 293. (410). All of the clinical manifestations of Beta-Thalassemia are the result of Answer: (C). defective synthesis of hemoglobin, structurally impaired RBC'sand the shortened life span of RBC's 294. (670). What clinical manifestations are likely to be seen in Autistic spectrum disorder? Answer: (B). repetitive behaviors (head banging, twirling, biting, flapping their hands) 295. (420). What are the clinical manifestations of Hyperthyroidism? (choose all that apply) Answer: (A). Enlarged nontender thyroid gland, prominent or bulging eyes, auditory bruit on auscutation Answer: (C). eyelid lag, tachycardia, nervousness, emotional lability, heat intolerance, increased sweating Answer: (D). restlessness, irritability, increased appetite with weight loss, Insomnia, tremor, muscle weakness 296. (300). When are growth hormone suplimentations stoped? Answer: (B). when the child gets to acceptable height or growth slows to less than one inch/yr 297. (660). What is the key part of behavior modification? Answer: (B). Consistancy 298. (50). If bleeding or drainage is noted on a cast what is done? Answer: (B). circle the area to determine the extent of drainage 299. (480). What is the goal of treatment for a child with congenital adrenal hyperplasia? Answer: (D). suppress adrenal secretion of androgens by replacing deficient hormones, which is accomplished by the lifelong oral administration of glucocorticoids 300. (580). A child is more likely to develop eczema if? Answer: (C). there is a family history of allergies or asthma 301. (120). What is the treatment for knock-knees? Answer: (D). braces worn both day and night 302. (270). What complications can arise from a fracture? (choose all that apply) Answer: (A). fat embolism Answer: (B). Chest Pain Answer: (D). SOA, compartment syndrome 303. (490). What are the clinical manifestations of Type one Diabetes Melitus?(choose all that apply) Answer: (A). polyuria Answer: (B). polydipsia Answer: (C). polyphagia, with weight loss 304. (160). Management of a client with developmental dysplagia of the hip includes? (choose all that apply) Answer: (A). maintaining traction, providing cast care, teaching the parents to care for the child at home Answer: (B). preventing complications resulting from immobility Answer: (D). promoting normal growth and development 305. (570). What is the first line treatment for itching Answer: (B). cold compress 306. (40). After casting is complete, what possition is the extremity left in? Answer: (C). elevated 307. (340). As a result of increased fluid loss through the kidneys in Diabetes Insipidus, what is the normal body response Answer: (A). Polydipsia 308. (680). What are the two most common medications to treat ADHD? Answer: (A). Ritalin Answer: (D). Concerta 309. (370). What is the major complication if hypothyroidism goes untreated in a child? Answer: (C). growth delay/mental retardation 310. (620). What symptoms does the client complain of with lice? Answer: (A). pruritus Answer: (C). Dandruff 311. (390). When testing thyroid function, a TSH and a T4 are drawn, what would indicate a need for supplimentation? Answer: (B). high tsh, low t4 312. (290). What is the standard treatment for a child with a growth hormone difficiency? Answer: (B). Sub Q Injections 3-7 times a week 313. (310). What should be taught to the parents of a child who is recieving growth hormone supplimentation? Answer: (C). How to administer the injections at home 314. (180). When should Legg-Calve-Perthes Disease be suspected Answer: (B). any child from 2-12 that complains of hip pain and a limp 315. (240). What is the best exercise for a child that has been diagnosed with Ostogenesis Imperfecta (brittle bone disease)? Answer: (C). swiming 316. (500). What is considered to be an abnormal result of a fasting blood glucose test? Answer: (C). >126 317. (700). What is the most accurate way to identify Mental Retardation? Answer: (B). Functional Assessment 318. (730). What drug class is typically prescribed to someone with depression? Answer: (C). SSRI's Serotonin Reuptake Inhibitors 319. (280). What are the clinical manifestations of compartment syndrome?(choose all that apply) Answer: (A). Paresthesia, Pain, Pressure Answer: (B). Pallor, Paralysis Answer: (D). Pulselessness 320. (440). An increased pulse rate in a child with hyperthyroidism would indicate? Answer: (B). The medication needs to be increased 321. (720). What are the clinical manifestions of schizophrenia? (choose all that apply) Answer: (A). social withdrawal, impaired social relationships, flat affect Answer: (B). regression, loose associations Answer: (D). poor judegment, anxiety, delusions, and hallucinations 322. (10). You are caring for a client with a cast, upon inspection of the cast an area seems to be warmer than the rest, what should be suspected? Answer: (C). suspect an infection 323. (740). 324. (710). What are common characteristics seen in a child with fetal alcohol syndrome?(choose all that apply) Answer: (A). flat midface, low nasal bridge, long philtrum with narrow upper lip Answer: (B). short upturned nose, poor coordination Answer: (D). failure to thrive, skeletal and joint abnormalities, hearing loss 325. (400). Once a thyroid deficiency has been identified, what is it usually treated with? Answer: (B). synthroid 326. (190). What are the predisposing factors to a slipped capital femoral epiphysis? (choose all that apply) Answer: (A). obesity, recent growth spurt Answer: (C). endocrine disorders Answer: (D). family history 327. (140). What is the most common treatment of Developmental Dysplasia of the Hip when the child is under 3mos? Answer: (B). Pavlik harness 328. (80). How often is a cast changed? Answer: (D). every 1-2 wks 329. (320). What is the most important nursing diagnosis for a teenager diagnosed with hyperpituitarism? Answer: (A). Disturbed body image 330. (470). What symptoms may a child exhibit that would indicate congenital adrenal hyperplasia? Answer: (A). recurrent vomiting, dehydration, metabolic acidosis, hypotension, hypoglycemia 331. (260). Once a fracture has been diagnosed, what is the most important symptom to be managed? Answer: (C). pain 332. (170). What are the early symptoms of Legg-Calve-Perthes Disease?(choose all that apply) Answer: (A). mild pain in the hip or anterior thigh, relieved by bed rest Answer: (C). limp 333. (430). What should be taught to the parents of a child diagnosed with hyperthyroidism? Answer: (B). how to assess for an increased pulse rate 334. (550). A child with PKU should avoid?(choose all that apply) Answer: (A). high protein foods Answer: (D). aspartame 335. (650). What is the primary complaint of someone who under goes autografting? Answer: (C). Pain at Donor site 336. (380). What is a goiter? Answer: (D). Painless enlargement of the thyroid 337. (70). 338. (100). While examining a 18 month old child, you notice the legs are bowed, this finding is? Answer: (B). Normal, until 2-3yrs of age 339. (90). How long should casting continue Answer: (C). 8-12wks 340. (330). In diabetes insipidus, inadequate ADH has what effect on the kidneys resulting in what? Answer: (B). release of water, polyuria 341. (60). The skin around the edges of a cast are checked for? Answer: (A). redness/swelling 342. (210). What is the most important assessment on a child who is undergoing treatment for scoliosis? Answer: (B). Neurvascular checks 343. (540). How is PKU treated? Answer: (B). Special diet low in phenylalanine 344. (560). What is the potential result if dietary control of PKU is lost before the age of 6? Answer: (C). Deminished IQ 345. (250). What is the most important thing that should be monitored in a child with Muscular Dystorphies? Answer: (B). cardiac and respirtory function 346. (200). How much of a spinal curvature is required before it is considered to be abnormal? Answer: (C). >10 degrees 347. (450). What is a major clinical indicator for Congenital Adrenal Hyperplasia in a female? Answer: (B). clitoris is enlarge and labial fusions 348. (230). How long should a child recieving antibiotics for osteomylitis continue the treatment? Answer: (D). 6 wks 349. (130). What are the signs and symptoms of developmental dysplasia of the hip (DDH) (choose all that apply) Answer: (A). limited abduction of the hip, Limp, Answer: (B). asymmetry of the gluteal and thigh fat folds Answer: (D). telescoping or pistoning of the thigh 350. (30). When handling a cast, how is it handled?(choose all that apply) Answer: (B). With the palms of the hands Answer: (C). gentle technique 351. (600). What is the treatment for celulitis?(choose all that apply) Answer: (A). warm compress QID Answer: (B). elevation Answer: (D). bedrest 352. (350). How is a child with precocious puberty identified?(choose all that apply) Answer: (A). short stature Answer: (B). premature skeletal maturation Answer: (D). secondary sex characteristics 353. (690). What are the side effects of the medications used to treat ADHD? Answer: (A). anorexia, insomnia, tachycardia 354. (220). What is the initial treatment for osteomylitis? Answer: (D). Wide spectrum IV antibiotics 355. (410). How long must thyroid replacement be taken? Answer: (D). throughout life 356. (20). How long does it take for a cast to dry? Answer: (C). 24-48hrs 357. (460). What is a major clinical indicator for Congenital Adrenal Hyperplasia in a male? Answer: (A). slightly enlarged penis and hyperpigmented scrotum 358. (510). What is considered to be an abnormal result of a 2hr glucose tollerance test? Answer: (C). >200 359. (520). When planning the management of a child with type one diabetes melitus, what should be considered? Answer: (C). developmental level and cognitive abilities 360. (150). What is the most common treatment for a child over 3mos of age with developmental dysplasia of the hip Answer: (A). skin traction 361. (360). How is precocious puberty treated? Answer: (B). Gonadotropin-releasing hormone analog 362. (630). How is lice treated?(choose all that apply) Answer: (A). pediculicide shampoo Answer: (C). fine toothed comb Answer: (D). retreatment in 7 days 363. (590). How long is Impetigo contageous? Answer: (C). untill 48 hours after treatment began 364. (110). What is the treatment for bowlegs? Answer: (C). braces worn at night 365. (640). Who is most likely to contract Oral Candidiasis (thrush) Answer: (B). those with immune disorders, corticosteroid inhailer, antibiotics 366. (530). What are the clinical manifestions of PKU?(choose all that apply) Answer: (A). musty or mousey body and urine odor Answer: (B). irritability, vomiting, hyperactivty, seizures Answer: (C). eczemalike rash, mental retardation 367. (610). How is Pediculosis Capitis (lice) Spread?(choose all that apply) Answer: (C). direct contact Answer: (D). use of hair accessories shared by another