Essential of Pediatric Nursing Test Bank

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A patient was rushed to the ER because of difficulty in urination. He was diagnosed then as a cse of benign prostate hyperthropy (BPH) and was advised by the doctor to undego transurethral resection of prostate (TURP). Based on the urgency of the surgery, the nurse classifies this condition as:

  • A. emergency
  • B. C.urgent
  • C. elective
  • D. required
Correct Answer: B

Rationale: Transurethral resection of prostate (TURP) is a surgical procedure commonly performed to treat benign prostatic hyperplasia (BPH) that is causing significant symptoms such as difficulty urinating. In this case, the patient was rushed to the ER due to the difficulty in urination, which indicates that the condition is causing acute distress and requires prompt intervention. Since the surgery was advised urgently by the doctor, the nurse classifies this condition as urgent. An urgent procedure is one that is necessary within a relatively short time frame to prevent complications or alleviate acute distress, but it is not an emergency that requires immediate intervention.

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A woman sees her primary care provider because of extreme fatigue for the past 2 months; she difficulty lifting even light objects. Her physician suspects myasthenia gravis. Which of the ff. tests should the nurse anticipate to confirm this diagnosis?

  • A. Mestinon test
  • B. Pulmonary function studies
  • C. Quinine tolerance test
  • D. Tensilon test
Correct Answer: D

Rationale: The Tensilon test is used to confirm the diagnosis of myasthenia gravis, a condition characterized by muscle weakness and fatigue. In this test, the medication Tensilon (also known as edrophonium) is administered intravenously. If the patient has myasthenia gravis, there will be a rapid but temporary improvement in muscle strength after the Tensilon injection. This response helps to differentiate myasthenia gravis from other causes of muscle weakness. The other options mentioned (Mestinon test, pulmonary function studies, and quinine tolerance test) do not specifically confirm the diagnosis of myasthenia gravis.

Regarding the gross motor skills, a 2-year-old child can

  • A. heel-toe walk
  • B. balance on each foot 6 sec
  • C. walk up and down stairs
  • D. balance well on each foot
Correct Answer: C

Rationale: A 2-year-old typically can walk up and down stairs with support.

Which of the following is MOST likely considered a risk factor for extraneural metastasis in primary brain tumors?

  • A. age less than 10 year
  • B. female gender
  • C. ventriculoperitoneal (VP) shunt insertion
  • D. supratentorial tumor
Correct Answer: A

Rationale: Younger age is a significant risk factor for extraneural metastasis in pediatric brain tumors.

Which of the ff. statements, if made by a patient with hypertension, indicates to a nurse a need for more teaching?

  • A. "High BP may affect the kidneys and eyes."
  • B. "Most people with hypertension watch their diet."
  • C. "Medication will no longer be needed when I feel better."
  • D. "Many people do not know when their BP is high."
Correct Answer: C

Rationale: Option C, "Medication will no longer be needed when I feel better," indicates a need for more teaching by the nurse. This statement shows a misunderstanding regarding hypertension management. Hypertension is a chronic condition that often requires long-term treatment with medications even if the patient feels better. The patient should be educated on the importance of continued medication adherence to effectively manage their hypertension and prevent complications. Options A, B, and D demonstrate understanding of hypertension and its management, indicating that more teaching is not necessary in those areas.

The client with epilepsy is taking the prescribed dose of phenytoin (Dilantin) to control seizures. Results of a phenytoin blood level study reveal a level of 35 mcg/ml. Which of the following symptoms would be expected as a result of this laboratory result?

  • A. Nystagmus
  • B. No symptoms, because this is normal
  • C. Tachycardia therapeutic level
  • D. Slurred speech
Correct Answer: A

Rationale: A phenytoin blood level of 35 mcg/ml is considered to be above the therapeutic range (usually 10-20 mcg/ml for phenytoin). At this elevated level, the client is at risk for phenytoin toxicity. Symptoms of phenytoin toxicity include nystagmus (rapid, involuntary eye movements), as well as other symptoms such as confusion, slurred speech, ataxia, and tremors. Tachycardia is not typically associated with phenytoin toxicity. Therefore, the expected symptom in this case would be nystagmus.

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