Test Prep for Nursing Exam about Pediatric Nursing (56-60)

56. A nurse on the pediatric unit is caring for four clients and is preparing to do rounds. Which client should the nurse see first?

a) a client being discharged who needs to receive an immunization
b) a client who has returned from the recovery room and is restless
c) a client scheduled for an upper GI series
d) a client with ear tubes that came out spontaneously

57. A nurse in a newborn nursery is monitoring a preterm newborn infant for respiratory distress syndrome. Which assessment signs, if noted in the newborn infant, would alert the nurse to the possibility of this syndrome?

a) tachypnea and retractions
b) acrocyanosis and grunting
c) hypotension and bradycardia
d) presence of a barrel chest with acrocyanosis  

58. A nurse in a newborn nursery is caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring, and grunting. Respiratory distress syndrome is diagnosed, and the physician prescribes surfactant replacement therapy. The nurse prepares to administer this therapy by:

a) intravenous injection
b) subcutaneous injection
c) intramuscular injection
d) instillation of the preparation into the lung through an endotracheal tube

59. A nurse is assessing a newborn infant who was born to a mother who is addicted to drugs. Which of the following assessment findings would the nurse expect to note during the assessment of this newborn?

a) lethargy
b) sleepiness
c) incessant crying
d) cuddles when being held

60. A nurse notes hypotonia, irritability, and a poor sucking reflex in a full-term newborn infant on admission to the nursery. The nurse suspects fetal alcohol syndrome and is aware that which additional sign would be consistent with fetal alcohol syndrome?

a) length of 19 inches
b) abnormal palmar creases
c) birth weight of 6 lb. 14 oz
d) head circumference appropriate for gestational age




ANSWERS AND RATIONALE
56) B
- the client with unstable condition should be given first priority by the nurse. Restlessness after surgery may indicate bleeding, shock, or hypoxia.

57) A
- the newborn infant with respiratory distress syndrome may present with clinical signs of cyanosis, tachypnea or apnea, nasal flaring, chest wall retractions, or audible grunts. Acrocyanosis is the bluish discoloration of the hands and feet, is associated with immature peripheral circulation, and is not uncommon in the first few hours of life. Options B, C, and D do not indicate clinical signs of respiratory distress syndrome.

58) D
- the aim of therapy in respiratory distress syndrome is to support the disease until the disease runs its course, with the subsequent development of surfactant. The infant may benefit from surfactant replacement therapy. In this therapy, an exogenous surfactant preparation is instilled into the lungs through an endotracheal tube. Option A, B, and C identify incorrect methods of administering surfactant.

59) C
- a newborn infant born to a woman using drugs is irritable. The infant is overloaded easily by sensory stimulation. The infant may cry incessantly and be difficult to console. The infant would hyperextend and posture rather than cuddle when being held.

60) B
- features of newborn infants diagnosed with fetal alcohol syndrome include craniofacial abnormalities, intrauterine growth retardation, cardiac abnormalities, abnormal palmar creases, and respiratory distress. Option A, C, and D are normal assessment findings in the full-term newborn infant.


Related Topics:

• Test Prep for Nursing Exam about Pediatric Nursing (61-65) 
• Or go back to Test Prep for Nursing Exam about Pediatric Nursing (1-5) to start the practice test from the beginning.