Question

A nurse is assessing an adolescent who has Cushing's syndrome. Which of the following findings should the nurse expect?

Answer 1

Correct Answers:

Hyperglycemia

Rationale :

💎Excess cortisol in Cushing’s promotes hepatic gluconeogenesis, raising serum glucose levels.

💎Glucocorticoids cause peripheral insulin resistance, further contributing to hyperglycemia.

💎Adolescents with Cushing’s often show centripetal adiposity and glucose intolerance, both linked to high cortisol.

💎Protein catabolism from cortisol reduces muscle mass, but its metabolic effect on carbohydrates still drives elevated glucose.

💎Monitoring includes fasting glucose and A1C, as persistent hyperglycemia increases cardiometabolic risk.

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Answer 2

Correct Answers:

Fontanel is level and soft.

Rationale :

🔷A soft, level anterior fontanel reflects adequate hydration and improved intravascular volume in infants.

🔷 With rehydration, interstitial fluid and cerebral perfusion normalize, reversing the sunken fontanel seen in dehydration.

🔷 This finding aligns with improving skin turgor, urine output, and capillary refill, markers of volume status.

🔷 It also indicates better cerebral perfusion pressure, reducing risk for irritability or lethargy related to fluid deficit.

🔷 Nurses reassess fontanel, mucous membranes, and wet diapers to confirm sustained rehydration.

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Answer 3

Correct Answers:

Assign consistent nursing staff to care for the infant.

Rationale :

🔶Failure to thrive often involves psychosocial and feeding-relational components; consistent caregivers build trust and improve intake.

🔶Stable staffing enhances cue recognition (early hunger/satiety cues) and supports responsive feeding techniques.

🔶Attachment security fosters calmer feeds, better suck–swallow–breathe coordination, and caloric adequacy.

🔶Continuity allows tracking of growth velocity, feeding logs, and behavioral patterns to tailor interventions.

🔶It also reduces care fragmentation, supporting interdisciplinary plans (nutrition, lactation, OT) for sustained weight gain.

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Answer 4

Correct Answers:

Infuse feedings using a mechanical pump.

Rationale :

🔵Nasojejunal feedings bypass the stomach; they should be continuous via pump to prevent dumping and osmotic diarrhea.

🔵A controlled rate maintains steady nutrient delivery and reduces risk of aspiration and reflux.

🔵Pumps allow precise mL/hr adjustments, essential for toddler caloric goals and tolerance.

🔵Bolus jejunal feeds can cause cramping, bloating, and hemodynamic shifts due to rapid osmolar loads.

🔵Standard practice includes pump infusion, HOB elevation, and regular flushes per policy to maintain patency.

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Answer 5

Rationale :

The rooting reflex is triggered by lightly stroking the cheek or perioral area, prompting the infant to turn toward the stimulus and open the mouth for feeding.
This reflex is essential for breastfeeding or bottle feeding, helping the infant locate the nipple.
It normally appears at birth and disappears around 4 months as voluntary head control and feeding develop.
Testing other areas like the foot (A) or thigh (C) would instead assess different reflexes such as the Babinski or muscle tone, not rooting.
Accurate assessment of primitive reflexes provides important information about neurologic development in infants.

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Answer 6

Correct Answers:

Monitor for pallor or swelling in the child's affected hand.

Rationale :

🟣 Neurovascular compromise is the priority after cast application; pallor or swelling may indicate ischemia or compartment syndrome.

🟣Early detection via color, temperature, capillary refill, sensation, and movement prevents permanent neuromuscular injury.

🟣Tight casts or swelling can compress arterial inflow/venous outflow, threatening tissue viability.

🟣Nurses educate caregivers to report increasing pain unrelieved by analgesics, numbness/tingling, and coolness.

🟣Prompt action (elevate as ordered, notify provider) preserves perfusion and prevents functional loss.

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Answer 7

Correct Answers:

"Hemodialysis uses an electrolyte solution to clean your child's blood."

Rationale :

🟡Hemodialysis (HD) circulates blood through an extracorporeal circuit across a semipermeable dialyzer membrane.

🟡Diffusion and ultrafiltration remove uremic toxins, correct electrolytes, and manage fluid via controlled transmembrane pressure.

🟡It requires vascular access (e.g., catheter, fistula) and is performed in intermittent sessions several times per week.

🟡The dialysate bath remains outside the body; solutes move along concentration gradients to achieve clearance.

🟡 This contrasts with peritoneal dialysis, which uses the peritoneum as the membrane inside the body.

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Answer 8

Correct Answers:

Shrug their shoulders against mild pressure.

Rationale :

⚫Cranial nerve XI (accessory) innervates trapezius and sternocleidomastoid muscles; shoulder shrug tests trapezius strength.

⚫Applying light resistance assesses motor function and symmetry between sides.

⚫Additional assessment includes head rotation against resistance for sternocleidomastoid evaluation.

⚫Normal findings are strong, symmetric contractions without pain or fasciculations.

⚫Abnormalities suggest lower motor neuron lesions, neuropathy, or central involvement requiring further evaluation.

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Answer 9

Correct Answers:

Wheezing

Rationale :

🔴In infants with GERD, wheezing signals potential aspiration and airway compromise, making it the priority.

🔴Airway findings align with the ABCs, where breathing concerns (bronchospasm, microaspiration) supersede feeding issues.

🔴Refluxate can inflame the lower airways, causing reactive wheeze and hypoxemia if unaddressed.

🔴Immediate actions include airway assessment, pulse oximetry, and strategies to reduce reflux and aspiration risk.

🔴Ongoing management targets positioning, feed modifications, and, when ordered, acid suppression.

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Answer 10

Correct Answers:

"The incubation period is 2 to 3 weeks before symptoms appear."

Rationale :

⭐Varicella-zoster virus has an incubation of ~10–21 days, so symptoms often emerge 2–3 weeks after exposure.

⭐Children can be contagious 1–2 days before rash, meaning exposure can occur without visible lesions.

⭐A 9-month-old typically has not yet received the first varicella vaccine (routine at 12–15 months), so is susceptible.

⭐Anticipatory guidance includes monitoring for prodrome (fever, malaise) followed by vesicular rash in crops.

⭐Post-exposure advice may include contacting the provider about variZIG for high-risk infants or early evaluation if symptoms develop.

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RN Pediatric Nursing 2023 Exam D

No.

1 :
A nurse is assessing an adolescent who has Cushing's syndrome. Which of the following findings should the nurse expect?

2 :
A nurse is caring for an infant who weighs 7.8 kg (17.2 lb) and was admitted yesterday for treatment of moderate dehydration. Which of the following findings indicates to the nurse that the infant's condition is improving?

3 :
A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care?

4 :
A nurse is planning care for a toddler who has a new prescription for enteral feedings via a nasojejunal tube. Which of the following interventions should the nurse plan to include?

5 :
A nurse is assessing a I-month-old infant at a well-child visit. Identify the location the nurse should stroke to elicit the rooting reflex. (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

6 :
A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm. Which of the following information is the priority for the nurse to include?

7 :
A nurse is caring for an 8-year.old child who was recently diagnosed with chronic renal failure. The child's parents ask for information on hemodialysis. Which of the following statements should the nurse make?

8 :
A nurse is assessing a school-age child's cranial nerve function. Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?

9 :
A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding?

10 :
A nurse is providing teaching to the guardian of a 9-month-old infant who was exposed to chickenpox at day care. Which of the following statements by the guardian indicates an understanding of the teaching?

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RN Pediatric Nursing 2023 Exam D

No.

1 : A nurse is assessing an adolescent who has Cushing's syndrome. Which of the following findings should the nurse expect?

2 : A nurse is caring for an infant who weighs 7.8 kg (17.2 lb) and was admitted yesterday for treatment of moderate dehydration. Which of the following findings indicates to the nurse that the infant's condition is improving?

3 : A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care?

4 : A nurse is planning care for a toddler who has a new prescription for enteral feedings via a nasojejunal tube. Which of the following interventions should the nurse plan to include?

5 : A nurse is assessing a I-month-old infant at a well-child visit. Identify the location the nurse should stroke to elicit the rooting reflex. (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

6 : A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm. Which of the following information is the priority for the nurse to include?

7 : A nurse is caring for an 8-year.old child who was recently diagnosed with chronic renal failure. The child's parents ask for information on hemodialysis. Which of the following statements should the nurse make?

8 : A nurse is assessing a school-age child's cranial nerve function. Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?

9 : A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding?

10 : A nurse is providing teaching to the guardian of a 9-month-old infant who was exposed to chickenpox at day care. Which of the following statements by the guardian indicates an understanding of the teaching?

1 :
A nurse is assessing an adolescent who has Cushing's syndrome. Which of the following findings should the nurse expect?

2 :
A nurse is caring for an infant who weighs 7.8 kg (17.2 lb) and was admitted yesterday for treatment of moderate dehydration. Which of the following findings indicates to the nurse that the infant's condition is improving?

3 :
A charge nurse is planning care for an infant who has failure to thrive. Which of the following actions should the nurse include in the plan of care?

4 :
A nurse is planning care for a toddler who has a new prescription for enteral feedings via a nasojejunal tube. Which of the following interventions should the nurse plan to include?

5 :
A nurse is assessing a I-month-old infant at a well-child visit. Identify the location the nurse should stroke to elicit the rooting reflex. (You will find hot spots to select in the artwork below. Select only the hot spot that corresponds to your answer.)

6 :
A nurse is providing discharge teaching to the parents of a school-age child following surgery and cast application to the right forearm. Which of the following information is the priority for the nurse to include?

7 :
A nurse is caring for an 8-year.old child who was recently diagnosed with chronic renal failure. The child's parents ask for information on hemodialysis. Which of the following statements should the nurse make?

8 :
A nurse is assessing a school-age child's cranial nerve function. Which of the following actions should the nurse ask the child to take when assessing the accessory nerve?

9 :
A nurse is admitting an infant who has GERD. Which of the following is the priority assessment finding?

10 :
A nurse is providing teaching to the guardian of a 9-month-old infant who was exposed to chickenpox at day care. Which of the following statements by the guardian indicates an understanding of the teaching?