Peds Exam 2 Study

A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions should the nurse take?
A. Place the client on NPO status.
B. Prepare the client for a liver biopsy.
C. Position the client dorsal recumbent.
D. Put the client in a protective environment.
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A nurse is caring for a client who has suspected meningitis and a decreased level of consciousness. Which of the following actions should the nurse take?
A. Place the client on NPO status.
B. Prepare the client for a liver biopsy.
C. Position the client dorsal recumbent.
D. Put the client in a protective environment.
A. CORRECT: Place the client on NPO status due to the client's decreased level of consciousness to prevent aspiration.
B. Expect a client who has Reyes syndrome to require a liver biopsy.
C. Position the client without a pillow and slightly elevate the head of the bed to
prevent increasing intracranial pressure.
D. Clients who are immunocompromised require a protective environment. Place a
client who has suspected meningitis on droplet precautions for at least 24 hours after the initiation of antibiotic therapy.
A nurse is reviewing cerebrospinal fluid analysis for a client who has suspected meningitis. Which of the following findings should the nurse identify as indicating viral meningitis? (Select all that apply)
A. Negative Gram stain
B. Normal glucose content
C. Cloudy color
D. Decreased WBC count
E. Normal protein content
A. CORRECT: Expect a client who has viral meningitis to have a negative Gram stain.
B. CORRECT: Expect a client who has viral meningitis to have a glucose level within the expected reference range.
C. Expect a clear color for a client who has viral meningitis.
D. Expect a slightly elevated WBC count for a client who has viral meningitis.
E. CORRECT: Expect a client who has viral meningitis to have a protein level within
the expected reference range.
A nurse is assessing a 4-month-old infant who has meningitis. Which of the following manifestations should the nurse expect?
A. Depressed anterior fontanel
B. Constipation
C. Presence of the rooting reflex
D. High-pitched cry
A. Expect a 4-month-old infant who has meningitis to have a bulging anterior fontanel.
B. Identify vomiting as an expected finding of meningitis.
C. Identify the rooting reflex as an expected finding in infants until the age of 3 to 4
months and can remain until the age of 12 months.
D. CORRECT: Identify a high-pitched cry as a finding associated with meningitis
between ages 3 months to 2 years.
A nurse is reviewing the medical record of a client who has Reyes Syndrome. Which of the following findings should the nurse identify as a risk factor for Reye Syndrome?
A. Recent history of infectious cystitis caused by Candida
B. Recent history of bacterial otitis media
C. Recent episode of gastroenteritis
D. Recent episode of Haemophilus influenzae meningitis
A. Identify that Candida is a fungus and is therefore not a risk factor for Reye Syndrome.
B. Identify that a bacterial infection is not a risk factor for Reye Syndrome.
C. CORRECT: Identify that gastroenteritis is a viral illness, which is a risk factor for
developing Reye syndrome. Reye syndrome typically follows a viral illness
(influenza, gastroenteritis, or varicella).
D. Identify that Haemophilus influenzae is a bacteria and is therefore not a risk
factor for Reye syndrome.
A nurse is developing an educational program about viral and bacterial meningitis. The nurse should include that the introduction of which of the following immunizations decreased the incidence of bacterial meningitis in children? (Select all that apply)
A. Inactivated polio vaccine (IPV)
B. Pneumococcal conjugate vaccine (PCV)
C. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)
D. Haemophilus influenzae type B (Hib) vaccine
E. Trivalent inactivate influenza vaccine (TIV)
A. Do not include the IPV because it does not decrease the incidence of bacterial meningitis.
B. CORRECT: The introduction of the PCV decreased the incidence of bacterial meningitis in children, as it provides immunity against bacteria that causes the illness.
C. Do not include DTaP vaccine because it does not decrease the incidence of bacterial meningitis.
D. CORRECT: The introduction of the Hib vaccine decreased the incidence of bacterial meningitis in children, as it provides immunity against bacterium that cause the illness.
E. Do not include the TIV because it does not decrease the incidence of bacterial meningitis.
A nurse is caring for a child who has absence seizures. Which of the following findings should the nurse expect? (Select all that apply)
A. Loss of consciousness
B. Appearance of daydreaming
C. Dropping held objects
D. Falling to the floor
E. Having a piercing cry
A. CORRECT: Loss of consciousness for 5 to 10 seconds is a manifestation of an absence seizure.
B. CORRECT: Behavior that resembles daydreaming is a manifestation of an absence seizure.
C. CORRECT: A child who is having absence seizures might drop a held object.
D. Falling to the floor is a manifestation of a tonic-clonic seizure.
E. A piercing cry is a manifestation of a tonic-clonic seizure.
A nurse is caring for a child who just experienced a generalized seizure. Which of the following is the priority action for the nurse to take?
A. Position the child in a side-lying position.
B. Try to determine the seizure trigger.
C. Reorient the child to the environment.
D. Note the time of the postictal period.
A. CORRECT: Following a seizure, children often experience vomiting. Using the airway, breathing, circulation priority-setting framework, the first action to take is to place the child in a side-lying position to maintain a patent airway and prevent aspiration of secretions.
B. Determining the seizure trigger can help prevent future seizure episodes. However, it is not the priority action.
C. Reorienting the child to the environment following a generalized seizure is an appropriate action. However, it is not the priority action.
D. Noting the timing of the postictal period can assist with planning seizure management. However, it is not the priority action.
A nurse is providing teaching to the guardians of a child who is to have an electroencephalogram (EEG). Which of the following statements by the guardian indicates teaching was effective?
A. "My child should remain quiet and still during this procedure."
B. "I cannot wash my child's hair prior to the procedure."
C. "I should not give my child anything to eat prior to the procedure."
D. "This procedure will be very painful for my child."
A. CORRECT: The child should remain still and quiet during the test. Excessive movements can cause false-positive results.
B. The child's hair should be washed to remove oils that prohibit adherence of the EEG electrodes.
C. Foods are not withheld prior to an EEG.
D. The procedure is not painful; however, it can cause anxiety for the child.
A nurse is teaching a group of caregivers about the risk factors for seizures. Which of the following factors should the nurse include in the teaching? (Select all that apply)
A. Febrile episodes
B. Hypoglycemia
C. Sodium imbalances
D. Low blood lead levels
E. Presence of diphtheria
A. CORRECT: Febrile episodes can cause general tonic-clonic seizures in infants and young children.
B. CORRECT: Seizure activity is a late manifestation of hypoglycemia.
C. CORRECT: Seizure activity is a manifestation of hyponatremia and
hypernatremia.
D. High blood lead levels are a risk factor for seizure activity.
E. Diphtheria is a respiratory illness causing difficulty breathing and is not a risk
factor for seizures.
A nurse is reviewing treatment options with the guardian of a child who has worsening seizures. Which of the following treatment options should the nurse include in the discussion? (Select all that apply)
A. Vagal nerve stimulator
B. Additional antiepileptic medications
C. Corpus callosotomy
D. Focal resection
E. Radiation therapy
A. CORRECT: The implantation of a vagal nerve stimulator is an option to provide seizure control.
B. CORRECT: Additional antiepileptic medication can be added to the current medication regime to control seizures.
C. CORRECT: A corpus callosotomy can be performed for uncontrolled seizures.
D. CORRECT: A focal resection can be performed for uncontrolled seizures.
E. Radiation therapy is used in cancer treatment and is not used to control seizures.