PEDIATRIC NURSING EXAM REVISION ALL
REVISION QUESTIONS AND CORRECT ANSWERS
(GRADED 100%) (2024 UPDATE)
Wilms' - ANSWER- _____ is the most common intraabdominal and kidney tumor of
childhood; it may manifest unilaterally and localized or bilaterally, sometimes with metastasis to
other organs
3 years - ANSWER- what is the peak incidence of Wilms' tumor?
Nephroblastoma (Wilms' tumor) - ANSWER- occurrence is associated with genetic inheritance
and with several congenital anomalies (type of tumor)
Wilms' tumor - ANSWER- signs and symptoms: swelling or mass within the abdomen (mass
ic characteristically firm, nontender, confined to one side, or deep within the flank), urinary
retention/hematuria, anemia, pallor, anorexia, and lethargy, hypertension (caused by excessive
release of renin from kidney tumor), weight loss and fever, sx: of lung involvement: dyspnea, SOB,
and pain in the chest if metastasis has occurred
Do not palpate abdomen - ANSWER- what is a very specific intervention for Wilms' tumor
Neuroblastoma - ANSWER- _______ is a tumor that originates from the embryonic neural
crest cells that normally give rise to the adrenal medulla and the sympathetic ganglia
In the adrenal gland; other sites may be head, neck, chest, or pelvis - ANSWER- where do most
neuroblastomas develop?
10 - ANSWER- most children present with neuroblastoma before _____ years of age
Neuroblastoma - ANSWER- diagnostic evaluation for this type of tumor is aimed at locating
the primary site of the tumor; analyzing the breakdown products excreted in the urine, namely
vanillylmandelic acid, homovanillic acid, dopamine, and norepinephrine, permits detection of
suspected tumor before and after medical-surgical intervention
Poor - ANSWER- what is the prognosis of neuroblastoma?
Younger - ANSWER- the _____ child is at dx. Of a neuroblastoma, the better the survival rate
Neuroblastoma - ANSWER- s/sx: firm, nontender, irregular mass in teh abdomen that crosses
the midline. Urinary frequency/retention from compression of the kidney, ureter, or bladder,
lymphadenopathy, bone pain if skeletal involvement, supraorbital ecchymosis**, periorbital
edema, and exophthalmos as a result of invasion of retrobulbar soft tissue, other typical cancer
signs
Osteosarcoma; osteogenic sarcoma - ANSWER- _____ is the most common bone cancer in
children; also known as ___ ____
,In the long bones; mostly lower extremities, femur - ANSWER- where does osteosarcoma most
commonly originate?
10-25 years - ANSWER- what is the peak incidence of ____ and _____
1. Surgical resection
2. Chemotherapy - ANSWER- treatment for osteosarcoma
1. Nephrectomy
2. Chemotherapy with or without radiation - ANSWER- treatment for wilms'
1. Extensive external radiation
2. More extensive disease: radiation and multi-drug chemotherapy - ANSWER- treatment for
hodgkin's
Intratentorial (below the tentorium cerebelli) - ANSWER- the most common brain tumor,
located in the posterior third of the brain (primarily in the cerebellum or brainstem) accounts for
the frequency of symptoms resulting from ICP
Supratentorial tumor - ANSWER- located within the anterior two thirds of the brain- mainly
the cerebrum
Total removal of tumor without residual neurological damange - ANSWER- treatment for brain
tumors
Brain tumors - ANSWER- s/sx: headache worse on awakening and improves during the day,
vomiting unreleated to feeding/eating, ataxia, seizures, behavioral changes, clumsiness; awkward
gait or difficulty walking, diplopia, facial weakness
At least every 4 hours - ANSWER- how often to perform a neurological assessment for children
Meningitis - ANSWER- opisthotonos, kernig's, and brudzinski's signs are all signs of what
Flat - ANSWER- in an infratentorial procedure, the child is usually positioned ________ and
on either side
Elevated about hte heart level to facilitate cerebrospinal fluid drainage and to decrease excessive
blood flow to the brain to prevent hemorrhage - ANSWER- in a supratentorial procedure, the
head is usually positioned how
Restrict intake: high protein foods (meats and diary) an dprodcts that contain aspartame -
ANSWER- what are interventions for phenylketonuria
36.4-37 (97.5-98.6) - ANSWER- what is the normal temperature range for a child?
It can cause peripheral vasoconstriction - ANSWER- why do you not use alcohol in fever?
,Extracellular - ANSWER- infants and children are more vulnerable to fluid volume deficit
(dehydration) because more of their body water is in the ___ fluid compartment
NPO - ANSWER- for severe dehydration, maintain ___ status to place the bowel at rest and
provide fluid and electrolyte replacement by the IV route as prescribed; if potassium is prescribed
for IV administration, ensure that the child has voided before administering and has adequate renal
function
Phenylketonuria - ANSWER- this is a genetic autosomal recessive disorder that results in CNS
damage from toxic levels of phenylalanine (an essential amino acid in the blood)
Phenylketonuria - ANSWER- phenylketonuria: characterized by blood levels > ______ mg/dl
(normal is 1.2-3.4 in newborns and 0.8-1.8 thereafter).
True - ANSWER- T/F it is a requirement to be screened for phenylketonuria
Phenylketonuria - ANSWER- s/sx: digestive problems and vomiting, seizures, musty odor of
urine, mental retardation.. In older children: eczema, hypertonia, hypopigmentation of the hair,
skin, irises, and hyperactive behavior
Dehydration - ANSWER- weight loss, high pulse, orthostatic BP, irritability, thirst, dry mucous
membranes, sunken fontanel, ndelayed cap refill, tachypnea, and increased urine specific gravity
are signs of what
Rescreen newborns by 14 days - ANSWER- if a newborn has a positive Phenyl. Test before 48
hours of age, what is protocol?
Candida thrives in hyperglycemic tissues - ANSWER- vaginitis in adolescent girls (caused by
candida) may be indicative of diabetes- why?
Normal meals: no special foods or supplements. Dietary intake should include three well balanced
meals per day, eaten at regular intervals, plus a midafternoon snack and a bedtime snack; a
consistent intake of the prescribed protein, fats, and carbs and a snack is needed (concentrated
sweets are discouraged and fat is reduced to 30% or less of total caloric requirements). - ANSWER-
what is the typical diet plan for a child with diabetes?
10-15 g of carbs for every 30-45 minutes of activity - ANSWER- what is the carb intake rule
with increased activity?
Blood - ANSWER- is blood glucose monitoring or urine testing more accurate for glucose?
Ring finger or thumb - ANSWER- what samples to get a blood sample for glucose
The second voided urine - ANSWER- which urine specimen is most accurate for ketones and
glucose (the first, second, etc.)
, 300 - ANSWER- in diabetic ketoacidosis the blood glucose level greater than ____ mg/dl, and
urine and serum ketone tests positive
Diabetic ketoacidosis - ANSWER- s/sx: hyperglycemia, Kussmaul's respirations, acetone
(fruity breath), increasing lethargy, and decreasing LOC
- BG >200 continually
- moderate/high ketonuria
- child is unable to take foods/fluids
- child vomits more than once
- illness persists
Rules:
- test blood glucose every 4 hours
- test for urinary ketones with each voiding
- follow the child's usual meal plan
- encourage rest
- notify the HCP if vomiting, fruity odor to the breath, deep rapid respirations, decreasing level of
consciousness, or persistent hyperglycemia occurs - ANSWER- instruct parents to notify HCP
when the child has what with DM
Hypokalemia (insulin drives K into the cell) - ANSWER- what to watch for when administering
IV insulin for Diabetic ketoacidosis
Aspirin and ibuprofen (not aspirin due to Reye's syndrome) - ANSWER- most common
antipyretics
Metabolic alkalosis - ANSWER- metabolic disturbance with vomiting
Pyloric stenosis or ICP - ANSWER- what is projectile vomiting caused by in children
Rotavirus - ANSWER- ____ is a cause of serious gastroenteritis and is a nosocomial (hospital-
acquired) pathogen that is most severe in children 3-24 months of age; children younger than 3
months have maternally acquired antibody protection
Metabolic acidosis - ANSWER- diarrhea results in what metabolic disturbance
Cleft lip/palate - ANSWER- causes of __ include hereditary and environmental factors-
exposure to radiation or rubella virus, chromosomal abnormalities, and teratogenic factors
