Pediatrics Final Exam Questions and Answers All Correct
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Pediatrics
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Pediatrics
Pediatrics Final Exam Questions and Answers All Correct
The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert but has dry mucous membranes. Which other sign indicates the infant is still in the early or mild stage of dehydration?
1. Tachycardia
2. Bradycar...
Pediatrics Final Exam Questions
and Answers All Correct
The nurse is assessing an infant brought to the clinic with diarrhea. The infant is alert
but has dry mucous membranes. Which other sign indicates the infant is still in the early
or mild stage of dehydration?
Explanation: Tachycardia is a sign that indicates mild dehydration. Bradycardia and
increased blood pressure are not signs of dehydration. Decreased blood pressure is not
a sign of mild dehydration. Decreased blood pressure indicates moderate to severe
dehydration.
Page Ref: 411
A 1-month-old client is admitted to the emergency room with severe diarrhea. Which
assessment suggests the client is severely dehydrated?
1. Skin moist and flushed; mucous membranes dry
2. Low specific gravity of urine; skin color pale
3. Fontanels depressed; capillary refill greater than three seconds
4. High specific gravity of urine; moist mucous membranes - Answer-Answer: 3
Explanation: Two signs of severe dehydration are depressed fontanels and capillary
refill time greater than three seconds. Moist, flushed skin; moist mucous membranes;
and low specific gravity of urine are not signs of dehydration. Dry mucous membranes
and pale skin color are signs of mild dehydration, not severe.
Page Ref: 410
The nurse is expecting the admission of a child with severe isotonic dehydration. Which
intravenous fluid should the nurse anticipate the practitioner to order initially to replace
fluids?
1. D5W
2. 0.9 percent Normal Saline (NS)
,3. Albumin
4. D5 0.2 percent (1/4) Normal Saline - Answer-Answer: 2
Explanation: 0.9 percent Normal Saline (NS) maintains Na and chloride at present
levels. D5W can lower sodium levels so would not be used to initially replace fluids in
severe isotonic dehydration. Albumin is used to restore plasma proteins. D5 0.2 percent
(1/4) Normal Saline would not be used initially but later, as maintenance fluids.
Page Ref: 413
The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency
anemia. Which finding indicates that the infant is not tolerating activity?
1. Heart rate of 138
2. Increased alertness
3. Respiratory rate less than 40 with activity
4. Muscle weakness - Answer-Answer: 4
Explanation: Iron deficiency anemia can result in less oxygen reaching the cells and
tissues, causing activity intolerance. An indication that a 9-month-old child is not
tolerating activity and that iron deficiency anemia is worsening would be the presence of
muscle weakness during activity. A heart rate of 138, increased alertness, and a
respiratory rate of less than 40 with activity are all signs that iron deficiency anemia is
resolving and activity tolerance is improving.
Page Ref: 592
Which action by the parents demonstrates an understanding of the nurse's teaching
with regard to prevention of iron-deficient anemia?
1. Feeding their infant with a formula that is not iron fortified
2. Starting iron-fortified infant cereal at 4 to 6 months of age
3. Introducing cow's milk at 6 months of age
4. Limiting vitamin C consumption after 1 year of age - Answer-Answer: 2
Explanation: Starting iron-fortified infant cereal at 4 to 6 months of age is recommended
for prevention of iron deficiency in children. Infants who are not breast-fed should get
iron-fortified formula. Cow's milk should not be introduced until 12 months of age.
Vitamin C should be started at 6 to 9 months of age and continued, because foods rich
in vitamin C improve iron absorption.
Page Ref: 593
A child is diagnosed with sickle cell disease. The parents are unsure how their child
contracted the disease. Which explanation by the nurse is the most appropriate?
,1. "Both the mother and the father have the sickle cell trait."
2. "The mother has the trait, but the father doesn't."
3. "The father has the trait, but the mother doesn't."
4. "The mother has sickle cell disease, but the father doesn't have the disease or the
trait." - Answer-Answer: 1
Explanation: 1. Sickle cell disease is an autosomal recessive disorder; both parents
must have the trait in order for a child to have the disease.
Page Ref: 594
The charge nurse on a pediatric unit is making a room assignment for a school-age
child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which
room assignment is most appropriate for this client?
Explanation: Splenic sequestration can be life-threatening, and there is profound
anemia. The child does not need an isolation room but should not be placed in a room
with any child who may have an infectious illness. The private room is appropriate for
this child.
Page Ref: 596
The nurse is providing care for an adolescent client who is experiencing pain related to
a sickle cell crisis. Which medication does the nurse prepare to administer to this client?
Explanation: The pain during a sickling crisis is severe, and morphine is needed for pain
control around the clock or by patient-controlled analgesia (PCA). Meperidine is not
used for pain control for clients with sickle cell pain crisis because it could cause
seizures. Acetaminophen or ibuprofen is used for mild pain and would not be effective
for the severe pain experienced by a child in sickle cell pain crisis.
Page Ref: 598
The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle
cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the
explanation?
Explanation: Fever, dehydration, and altitude are precipitating factors contributing to a
sickle cell crisis. Regular exercise and increased fluid intake are recommended
activities for a child with sickle cell disease and will not contribute to a sickle cell crisis.
Page Ref: 598
The nurse is administering packed RBCs to a child with sickle cell disease (SCD). The
nurse is monitoring for a transfusion reaction and knows it is most likely to occur during
which time frame?
1. Six hours after the transfusion is given
2. Within the first 20 minutes of administration of the transfusion
3. At the end of the administration of the transfusion
4. Never; children with SCD do not have reactions. - Answer-Answer: 2
Explanation: Blood reactions can occur as soon as the blood transfusion begins or
within the first 20 minutes. The nurse should remain with the child for the first 20
minutes of the transfusion.
Page Ref: 598
A child who has beta-thalassemia is receiving numerous blood transfusions. The child is
also receiving deferoxamine (Desferal) therapy. The parents ask how the deferoxamine
will help their child. Which rationale does the nurse use when responding to the
parents?
1. It prevents blood transfusion reactions.
2. It stimulates RBC production.
3. It provides vitamin supplementation.
4. It prevents iron overload. - Answer-Answer: 4
Explanation: Iron overload can be a side effect of a hypertransfusion therapy.
Deferoxamine (Desferal) is an iron-chelating drug, which binds excess iron so it can be
excreted by the kidneys. It does not prevent blood-transfusion reactions, stimulate RBC
production, or provide vitamin supplementation.
Page Ref: 602
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