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before a routine check up at ped office, an 8mo old infant is sitting on mother's lap, chewing on a toy. when preparing to examine infant, which action should lvn should do first?
asscultate heart and lung sounds
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which direction is most important when administering immunizations?
properly store vaccine, and follow the recommended procedure for injection
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which immunization should a 4 month old pt should receive?
dtap, haemophilus influenzae type b (HIB), polio
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what is the recommended age to give measles vaccine?
1 year/12months
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which comment by a 7y/o boy to his friends best typifies his developmental age?
"girls are yucky"
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which instruction should the nurse give to those visiting a child on protective (reverse) isolation?
fresh fruits that can not be peeled is prohibited
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a person who is in good health, whose body harbors the specific organisms of a disease is called a...
carrier
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neonates born to women infected with hep b should recieve which tx?
HBIG (hep b immune globulin) and hep b vaccine at birth, 1 month, and 6 months
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which characteristics is commonly seen in a child with pertussis?
whooping cough
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an infant with immune deficiency should receive with type of polio virus
inactivated polio vaccine (IPV)
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an observation on a child's skin, the nurse notes a papular pruritic rash with some vesicles. the rash is profuse on the trunk and sparse on the limbs. which illness does pt have?
chickenpox
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a child was admitted b/c of chickenpox. she was put into airborne precaution, which nursing action is correct when implanting the prescribed isolation precaution?
specimen are sent to the laboratory in a zip closure biohazard bag
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a mother is concern that her 3 y/o daughter has been exposed to fifth's disease. what are the following characteristics?
red rash on face that spreads to the extremities
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a child is seen in ped office for complaints of bones and joint pain. which other finding would suggest leukemia?
petechiae
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a family that recently went camping brings their child to the clinic, with a complaint of a rash after a tick bite. lyme disease is suspected. which findings would be seen with lyme disease?
red papule and becomes a large red round ring
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which period of communicability is indicated with a pt with scarlet fever?
1-7 days
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FILL-IN
the causative of scarlet fever is _________.
beta- hemolytic streptococci group A
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which definition best describes the etiology of SIDS (sudden infant death syndrome)?
unexplained death of a infant
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a 6 week old infant who isnt breathing is brought to the emergency department. a finding of SIDS is made. which intervention should the nurse take initially?
allow them to see their infant
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CALCULATION
therapy for kawasaki disease include IV gamma globulin..
400mg/kg a day
child wt 10 kg
how much is given per dose?
4000 mg
400 x 10 = 4000
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the following route is allowed to take a temp of a leukemia pt except:
rectal
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to prevent trauma to the suture line who a infant who underwent cleft lip repair, the nurse would perform which intervention?
maintain elbow restraints
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after an infant with a cleft lip as a surgical repair and healths, the parents can expect to the following results?
some scarring
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FILL-IN
____________ is the absence of a normal body opening or the abnormal closure of a body passage
esophageal atresia
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which conditions or factor is the major cause for esophageal atresia and tracheoesophageal fistula?
unknown
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FILL-IN
___________ is a protrusion of the intestine through the umbilical ring.
umbilical hernia
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A 38 year old multiparas client gave birth a day ago to a full term newborn with myelomeningocele. Which assessment finding best indicates that the client is grieving over the loss of her “perfect” baby?
The client states that she has not selected a name for her baby.
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Which of the following nursing diagnosis is most relevant in the first 12 hrs of life in a neonatal born with myelomeningocele?
risk for infection
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While assessing a full term neonate, which of the following symptoms would cause the nurse to suspect a neurological impairment?
a weak sucking reflex
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Myelomeningocele requires nearly immediate surgical repair for which of the following purposes?
Decrease the possibility of infection and further cord damage
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_____________ is characterized by an excess of cerebrospinal fluid (CSF) within the ventricular and subarachnoid spaces of the cranial cavity.
Hydrocephalus
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CALCULATION
order: IV 27ml/hr
tubing delivers: 60 ml/hr
how many drops per minute?
27
x - drops per minute the same as how many drops per hour.
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in an infant receiving inadequate tx for congenital hypothyroidism, the nurse would expect to observe which symptom?
fatigue and sleepiness
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the mother with a neonate born with hypospadias is sharing her feelings of guilt about this anomaly. the nurse should explain which about the following defect?
it is congenital
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FILL-IN
__________ is a congenital condition in which the urethra terminates on the ventral surface of the penis instead of the tip.
hypospadias
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the following are considered chromosomal abnormalities. SATA
- down syndrome
- klimefelter syndrome
- turner syndrome
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which define best describe club foot, called talipies varus?
inversion of the foot
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a boy with patent (open) duptus arteriosus, was delivered 6 hrs earlier, and is being held by his mother. as the nurse enters the room to assess the neonate's v/s the mother states that "my baby as a heart murmur, does that mean he has a bad heart?" which response would be appropriate?
"the murmur is caused by actual opening, which can take up to a week or two to close"
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a mother is concern that her 3 y/o has been exposed to 5th diseases. which symptoms are characteristics of the viral infection?
red rash on face that spreads the extremities
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dx of congenital hip dislocation can best be confirmed by which diagnostic techniques?
x-ray
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for coarctation of the aorta, the nurse correctly advices the parents that the optimal time for surgery?
before the child is 2 years old
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CALCULATION
2 y/o child is showing signs of shock, a 10ml/kg bolus of NS is ordered. the child wt 20 kg.
200ml
10 x 20 = 200
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a teenage pt with heart failure is rx digoxin. to which classification does this drug belong?
cardiac glycoside
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a child with congential heart defect is recieveing digoxin, which intervention is most important before giving medication?
check apical pulse for 1 minute
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a toddler is immobilized with tractions to the legs. which activity would appropriate for the child?
pounding board
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which statement about patent duptus arteriosus is correct?
duptus arteriosus normally closes completely by 16 weeks
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the nurse can best facilitate reduction of the heart's work load by which method?
organizing nursing care, so that the infant can have a longer rest period
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the nurse should counsel parents to postponed which action until their son's hypospadius has been repaired?
circumcision
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CALCULATION
0.5 mg/kg per day in 2 divided doses
child wt is 10 kg.
how much is given in each dose?
2.5 mg
0.5 x 10 = 5mg/2 = 2.5
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CALCULATION
aspirin 80mg/kg per day in 4 divided doses
child wt 15kg
how much is given in one dose?
300mg
15 x 80 = 1200/4 = 300mg
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CALCULATION
child has sinus bradycardia-
atropine 0.02mg/kg
wt = 20kg
0.4mg
20 x 0.02 = 0.4
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which intervention would be appropriate for an infant after cardiac catheterization?
apply pressure is oozing or bleeding is present
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which explanation of how to decrease the chances of having a child with spinal bifida is most accurate?
pre-pregnancy intake of 400mcg of folic acid reduces the recurrence rate that it will happen again
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which complication involving leg length is seen with congenital hip dislocation?
decrease leg length on the effected side
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when obtaining a blood specimen for a PKU test, which action by the nurse is incorrect?
apply pressure with a alcohol wipe after the specimen is obtained
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