Respiratory
Respiratory
Cardiac
Cardiac
GI/GU
Renal
Extra
100
Which of the following is correct about a child with croup?
A skilled nursing assistant should accompany the child to all tests
A child with croup who is no longer coughing, but has a hard time swallowing is getting better
A child vomiting after an episode is abnormal and should be documented
Emergency equipment should be available in the room
Emergency equipment should be available in the room
100
Your patient is a 5 year old who has come in with ear pain. He recently had a cold and now has pain when you pull on his ear. What do you the nurse suspect?
Pain when you pull on the ear? Otitis Media. Pain when you press on the Tragus? Otitis Externa
100
How would you pick up this baby?
Not under the arms! If they just had open hear surgery move them very carefully
100
An extremely easy way that nurses can decrease stress and O2 demands in babes with cardiac conditions is....
Cluster care!
100
You have a 12 month old who weighs 9 kg. How much uo should you expect in a 12 hour shift
18-27 mL
100-250 mL
216- 324mL
800- 100 mL
216- 324mL
9x 2x 12= 216
9x 3 x 12= 324
100
Mcburney's point?
LRQ
100
1 Aortic
2 Pulmonic
3 Erbs
4 Tricuspid
5 Mitral
200
Prioritize the following patients.
A 2 year old with croup that is drooling
A 9 year old who used their inhaler 1 hours prior with symptoms resolved
A child with CF who is due for their routine postural drainage
A child post tonsillectomy due for pain medication
A 2 year old with croup that is drooling
Epiglottis! Airway is shutting down
200
causes of otitis media
Strep Pneumonia, H. Influenza and M. Catarrhalis; Viruses: RSV and influenza
200
Your patient who is in heart failure is on digoxin. Their vitals are 37.72, 80, 16, 98/68. Which vital sign would be the reason to hold this medication? If a patient were to vomit the medication, would you give them another dose?
HR of 80
No!
hold if HR <100bpm
200
Kawasaki
200
Your patient is ordered K in their IV fluids to treat their hypokalemia. What do you want to check prior to administering K?
Can they pee it out?
200
Which order for a child in DKA would be questioned?
Lactated ringers
Insulin drip
Normal saline
D 50 in 1/2 normal saline
D 50 in 1/2 normal saline
200
What position should a child with Gastrochesis be placed in?
right lateral decubitus position
300
What does 50% or lower of lung function signify?
Upper respiratory infection
Narrowing of the airway
Lower respiratory infection
Croup
Narrowing of the airway
signals a medical alert. Severe airway narrowing may be occurring. A short acting bronchodilator (rescue med) should be given. Call HCP
300
Which of the following can administer Ribivirin?
Skilled nursing assistant
Resident wearing contacts
Nurse who is pregnant
Nurse who has been floated to the peds floor from nicu
Nurse who has been floated to the peds floor from nicu
300
Which of the following is NOT true about Hypoplastic left heart syndrome?
There is a loud systolic murmur at the Left sternal border
It is an obstructive heart defect that may result in pallor, pulmonary edema, delayed cap refill, etc.
After birth the child will be on prostaglandin to keep the ductus arteriosis open
Care of the child may include palliative care if the caregivers chose
There is a loud systolic murmur at the Left sternal border
there is actually no real murmur on assessment
300
Which of the following are interventions for a TET spell? Select all.
Place in a knee-chest position
Place the child in prone trendelenburg
Administer oxygen
Administer Morphine
Administer Nitroglycerin
Administer Aspirin
Place in a knee-chest position
Older children will squat down
Administer oxygen
Administer Morphine if needed to calm child
300
True or false? Intususseption diagnosis is made by barium enema-which, incidentally, fixes the issue
True!
300
Which of the following vital signs in an 8 year old would be related to glomerular nephritis?
100.4, 88, 24 108/70
98.6, 140, 18, 122/ 84
98.6, 110, 16, 64/p
99.6, 74, 16, 146/92
99.6, 74, 16, 146/92
Hypertension!
300
What intervention is appropriate for a child with Omphalocele?
Push it back in
Cover it with a dressing moist with sterile saline
Clean the area with alcohol prep pad
Moisturize the area with lotion
Cover it with a dressing moist with sterile saline
400
A child with asthma had brief exacerbations of asthma on Monday and Thursday this week. What classification of asthma would this be?
Mild intermittent
Mild persistent
Moderate persistent
Severe persistent
Mild intermittent: brief exacerbations with daytime and nighttime symptoms 2xweek or less
Mild persistent: exacerbations more than twice a week but less than once a day. Nighttime symptoms more than twice a month
Moderate persistent: daily symptoms and nighttime symptoms more than once a week
Severe persistent: continuous daytime symptoms with limited physical activity and frequent nighttime symptoms.
400
Which of the following would be an appropriate patient teaching for a patient with strep. Select all.
Replace tooth brush after diagnosis
Call doctor immediately if child starts drooling or has difficulty swallowing
Save leftover antibiotics for future strep
Return to school after at least 24 hours
Gargle salt water
Replace tooth brush after 24 hours of antibiotics
Call doctor immediately if child starts drooling or has difficulty swallowing
Finish entire course of antibiotics
Return to school after at least 24 hours
Gargle salt water
400
Which of the following symptoms are associated with left sided heart failure? Select all
Weight gain
tachypnea
cough/ wheezes
hepatomegaly
edema
jugular vein distension
dyspnea
Tachypnea, dyspnea, cough, wheezes
400
Which of the following increase pulmonary blood flow? Select all
Ventricular septal defect
Hypoplastic left heart
Tetrology of Fallot
Atrial septal defect
Atrial septal defect
Ventricular septal defect
Expect to see Tachypnea, tachycardia, murmur, congestive heart failure, poor weight gain, diaphoresis, edema, frequent respiratory infections
400
A patient is in for a cleft palate correction surgery. Which of the following teachings would be appropriate?
Proper breast feeding technique
Do not lay the child prone
Using a cup for liquids
Give popsicles for pain
Using a cup for liquids
400
A 6 year old patient came in to the doctor's office after a strep infection. The mother now believes that her 6 year old has a UTI. The patient has cola colored urine. The urine has a specific gravity is 1.040, + for protein, + for blood. What would you, the nurse suspect?
Nephrotic syndrome
Diabetes
Appendicitis
Glomerular nephritis
Glomerular nephritis
400
A child is suffering from tracheoesophageal fistula which of the following teaching would be important? Select all
CPR
Aspiration precaution
Taking full dose of antibiotics
Lay the child flat after feedings
CPR
Aspiration precaution
Taking full dose of antibiotics
500
A 4 year old child was decorating gingerbread houses last night after playing outside when his mom started to notice he has nasal drainage. She is worried that he is coming down with a cold and wants to get him treated before his symptoms get worse. Upon investigation he has nasal drainage from the right nostril that is slightly pink in color. What would the nurse suspect?
Kids like to shove stuff up their nose, those little red candies look fun!
500
Parents of a 9 month old call the on call nurse practitioner for the pediatrician's office answers the phone. The child went to bed fine, but has now woken up with a barky cough, difficult to consul. When questioned the child has no fever. What condition does this child have
Acute spasmodic laryngitis
Laryngotracheobronchitis
RSV
Epiglotitis
Acute spasmodic laryngitis
500
Symptoms of endocarditis include... select all
Low grade fever
malaise
headache
high fever
new heart murmur
splenomegaly
Osler nodes
Splinter hemorrhages
All of the above
Low grade fever, malaise, headache, or rapid onset with high fever and ill appearing child, new heart murmur and SPLENOMEGALY
Osler nodes (red painful nodes with white centers found on pads of phalanges)
Splinter hemorrhages
500
Which of the following symptoms are consistent with tetrology of Fallot?
cyanosis
tachycardia
poor weight gain
pulmonary edema
polycythemia
cyanosis
poor weight gain
polycythemia
Decrease pulmonary blood flow!
500
What considerations should be taken for Hirschprung’s disease? Select all
Rectal temps every 4 hours
enemas with mineral oil or saline pre-op
Assess abdominal girths
Nutrition (failure to thrive)
Babies will have retracted bellies
watch for ribbon- like, palpable stools
enemas with mineral oil or saline pre-op
Assess abdominal girths
Nutrition (failure to thrive)
watch for ribbon- like, palpable stools
500
Which of the following would be an inappropriate instruction for a nurse to a 8 year old with nephrotic syndrome. Select all that apply.
Lets get up and do a lap around the hall, you can't watch cartoons all day
Before you can have another juice, I need to check the amount of liquid you've had today
Instead of canned vegetables, let's aim for fresh!
Once you get out of the hospital you should feel much better and this won't happen again
Lets get up and do a lap around the hall, you can't watch cartoons all day
Once you get out of the hospital you should feel much better and this won't happen again
500
Which is which cleft lip vs palate
Repaired at 6 months vs 18 months
increased frequency of otitis media
After surgery avoid prone position
NO pacifiers, NO straws, NO utensils, NO popsicles
Corrective surgery can possibly be done in utero
Lip- Repaired at 6 months, Corrective surgery can possibly be done in utero
Palate-
18 months
increased frequency of otitis media
After surgery avoid prone position
NO pacifiers, NO straws, NO utensils, NO popsicles