Tuesday, October 20, 2009

pedia part 1

1. Children with cleft palate are prone to frequent episodes of otitis media owing to which of, the following?
a. Lowered resistance due to malnutrition
b. ineffective functioning of Eustachian tube
c. Plugging of the Eustachian tubes with food particles
d. Constant leaning of the middle ear

2. which of the following assessment would suggest that the child has developed infection under the cast
a. Cold toes
b. Absent pedal pulses
c. " Hot spots' in cast
d. Cyanotic extremities

3. in caring for a child after surgery for cleft repair, the nurse should watch for which of the following immediate postoperative complications?
a. Bleeding and respiratory difficulty
b. Scarring problems and infection
c. infection and respiratory distress
d. pneumonia and infection

4. Which of the following organisms is responsible for the development of rheumatic fever?
a. Streptococcus infection
b. Haemophilus influenza
c. Group A beta hemolytic strptococcus
d. staphylococcus aureus

5. the priority nursing goal for a child with acute lymphocytic leukemia is
a. decrease risk of infection
b. encourage intake of iron rich foods
c. discuss death and dying
d. discourage injection

6. the reason why children with cystic fibrosis receive pancrease
a. to soften their stools
b. to aid in digestion
c. to prevent diabetes
d. to help heal complications like pneumonia

7. which of the ofollowing is the rationale behind the use of croupette (mist tent) for children who has acut larycotracheobronchitis
a. have child bring favourite toy
b. it liquefy secretions
c. it warms respiratory tract
d. it provides reverse isolation

8. in treating a child with developmental dysplasia of the hip, which if the following position should be maintained
a. extended and abducted
b. extended and adducted
c. flexed and abducted
d. flexed and adducted

9. which of the following assessment findings would be noted for a child with pyloric stenosis?
a. Projectile vomiting
b. Choking after feeding
c. Currant jelly stool
d. Vomitus with bile

10. Which of the following structural defects are found in the tetralogy of Fallot?
a. Pulmonary stenosis, ventricular septal defect, overriding of aorta, hypertrophy of the left ventricle
b. Pulmonary stenosis, ventricular septal defect, overriding of aorta, hypertrophy of right ventricle
c. Aortic stenosis, ventricular septal defect, overriding of aorta, hypertrophy of right ventricle
d. Aortic stenosis, ventricular septal defect, overriding of aorta, hypertrophy of left ventricle

11. Among the following positions, the child wihh tetralogy of fallot will assume what?
a. Semi fowlers
b. Tripod/ orthopnic
c. Supine
d. Squatting

12. A 9-year-oirl girl is admitted to the hospital with a diagnosis of rheumatic fever. Which of the following is most likely to be noted in her history?
a. She was treated for pneumonia 3 weeks ago
b. She was born with a congenital heart defect
c. She had chicken pox 1 month ago
d. She had an untreated fever and sore throat 2 weeks ago

13. Nephroblastoma may go unnoticed by parents and the health care team because it does not manifests symptoms in the early stages. Which of the following is the most common symptom noted
a. Abdominal pain
b. Hematuria
c. Hypertension
d. Abdominal mass

14. What would be the most appropriate nursing intervention to a 3- year ol child who arrives in the emergency room with temperature of 105 degrees, inspiratory stridor, restlessness, leaning forward and drooling?
a. Have a thorough physical exam of the respiratory system
b. Put him in semi fowlers position and encourage fluid intake
c. Examine throat and have a throat culture
d. Notify physician immediately and prepared intubation set

15. Aspirin, rectal temperature and intramuscular injections should be avoided in children with
a. Iron deficiency anemia
b. Haemophilia
c. Sickle cell anemia
d. Thalassemia

16. A child with haemophilia complains of a sudden, severe headache. He is confused, lethargic, and vomiting. The nurse should suspect
a. Intracranial bleeding
b. Hemorrhagic shock
c. Medication overdose

17. The teaching plan for a child with sickle cell disease should include the following except
a. Regular aerobic exercise
b. Avoid persons who have infection
c. Well balanced diet
d. Increase fluid intake

18. What is the most common cause of non communicating hydrocephalus?
a. Developmental malformation
b. Meningitis
c. Birth trauma

19. Which of the following phrases best describes the pathophysiology of non-communicating hydrocephalus?
a. Precursor of spina bifida occulta
b. Obstruction of cerebrospinal fluid flow in the ventricular system
c. Hypervolemia
d. Tumor formation in the cerebral hemisphere

20. The most significant prenatal maternal disorder in the development of myelomeningocele
a. IDA
b. Diabetes Mellitus
c. Diabetes Insipidus
d. Folic acid deficiency

21. Which of the following is most characterize cerebral palsy, spastic type
a. Athetosis
b. Dyskenesia
c. Wide base gait
d. Hypertonicity

22. All of the following manifestations are characteristic of all clients with cerebral palsy except
a. Delayed gross motor development
b. Decrease cognitive functioning
c. Abnormal muscle performance
d. Altered muscle tone

23. Characteristics of down’s syndrome include
a. Small tongue
b. Tranverse palmar crease
c. Marked motor delays
d. Inability to walk

24. Passing a soft no. 8 or 10 French catheter through the nares (bilaterally) to confirm diagnosis of this condition is essential
a. Bronchopulmonary dysplasia
b. Tetralogy of fallot
c. Down’s symdrome
d. Choanal atresia