Pediatric Nursing Practice Test

P. Hydroxylase converts phenylalanine (an amino acid) to tyrosine. Thus, the direct effect of its absence is the lack of tyrosine. Tyrosine is the precursor of thyroxine, epinephrine and melanin.

Communicating hydrocephalus, also called non-obstructive hydrocephalus, is the functional impairment of arachnoid granulations. It can be caused by diffuse ventricular dilatation from scarring and fibrosis of subarachnoid space following infectious, inflammatory and hemorrhagic events preventing the flow of CSF. Non-communicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor).

Some newborns have developed a twisted foot appearance due to intrauterine position. However, with manipulation the foot can be brought into a straight position. This temporary abnormality is called a pseudo-talipes disorder. A true clubfoot cannot be aligned properly without further intervention. (Letter a) P.Talipes does not need a surgery and traction with ilizarov frame. (Letter b) Tendon replacement is the last corrective treatment for a true talipes. (Letter d) the management is for T.Talipes.

Blood lead level: 10-14 microgram/dl – rescreen to confirm level every year for 6 years 15-19 microgram/dl – retest every 3-4 months for children age 6-35 years old. Remove the child from the environment with lead; cover walls with paneling or MASONITE. 20-44 microgram/dl – retest every 3-4 months; chelating agent SUCCIMER (Chemet) orally for 19 days 45-69 microgram/dl – admit the child; chelation therapy with Dimercaprol (BAL) or Edetate Calcium Disodium (EDTA); EDTA is administered intramuscularly and add 0.5 ml procaine because administration of this drug is painful. >70 microgram/dl – immediate treatment with chelating agent, Dimercaprol (BAL); after BAL, oral Penicillamine (Cuprimine) is given for 3-6 months

Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Subacute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm

DDST is first done at 3 months, repeated at 10 months and again repeated at 3-4 years.

Each toe has 3 phalanges with the exception of the great toe having only 2. Therefore, B,C and D are incorrect.

Non-communicating hydrocephalus, also called obstructive hydrocephalus, is caused by a CSF-flow obstruction ultimately preventing the CSF from flowing into the subarachnoid spaces (e.g. atresia, tumor). Communicating hydrocephalus, also called non-obstructive hydrocephalus, is the functional impairment of arachnoid granulations. Normal Pressure Hydrocephalus (a form of communicating hydrocephalus) is caused by enlarged cerebral ventricles, with only intermittently elevated cerebrospinal fluid pressure.

Procaine (0.5 ml) is added in the solution before administering the IM injection to the client because EDTA is very painful. The syringe should be held by the barrel not the plunger to prevent the escape of prepared medication.

Clamping of the cord that causes decrease blood flow causes the closure of ductus venosus (shunts blood to the fetal liver).

In ASD and VSD an opening or hole is present. To treat the disorder, a patch (Dacron or Silastic) is placed in between the atria (in ASD) and ventricles (in VSD). Ductal ligation is for PDA. Fontan procedure is for tricuspid atresia and Brock procedure is indicated for patients with Tetralogy of Fallot.

Lofenalac is the soy-based formula given to children with PKU. Nutraminogen is given for infants with galactosemia. Similac is given for those who have failure to thrive.

Abciximab is a platelet receptor inhibitor specific for Kawasaki Disease. Ibuprofen is used to decrease the inflammation in Kawasaki Disease. Succimer and Dimercaprol are chelating agents used for the management of lead poisoning.

Chorea is a jerky movement seen in rheumatic fever diazepam should be given.

In the fetal structure, the opening between the two atria is called the foramen ovale.

The weight of the body is carried by the largest tarsal bones, calcaneus (heelbone) and talus (ankle bone). Tarsus, the posterior half of the foot composed of seven tarsal bones: Medial cuneiform, Intermediate cuneiform, Lateral cuneiform, Cuboid, Navicular, Talus and Calcaneus.

Intubation set is used prepared at the bedside for children presenting the signs and symptoms of Epiglotitis. Never used a tongue depressor, manipulation of the throat can cause pulmonary arrest in a child with epiglotitis.

At three years of age you expect the child to be able to ride a tricycle. Bowel control is achieved at about 18 months (bowel before bladder). Sitting unsupported is noted when the child is 8 months old. Tying shoelaces is possible at 4 years old.

Acute Phase: fever of 5 days or more, conjunctivitis, strawberry tongue, red cracked lips, enlarged cervical lymph nodes, abdominal pain, anorexia, joint swelling, diarrhea, polymorphous rash, increase WBC and ESR. Sub acute Phase (after 10 days): desquamation of palms and soles, increase platelet, vascular aneurysm.

High levels of prostaglandin in the uterus cause the opening in the pulmonary artery and aorta which is the ductus arteriosus.

Phenylpyruvic acid is the breakdown product when phenylalanine is metabolized. This ketoacid goes to the urine giving its musty/mousy odor.

Steroids are not given to children with K.Disease as this causes aneurysm that poses danger to the child.

Jone’s criteria are used in the diagnosis is rheumatic fever. There should be 1 major or 2 major symptom plus 2 minor manifestations. Major S/S: carditis, erythema marginatum, polyarthritis, subcutaneous nodules, chorea Minor S/S: fever, history of RF, prolonged PR interval, arthralgia, Increase ESR, leukocytosis

Clamping of the cord causes the closure of the ductus venosus of a newborn. Increase pressure of the left side of a neonate’s heart as well as increase PO2 level help the foramen ovale to close. Decrease prostaglandin level and increase PO2 contribute to the closure of the ductus arteriosus.

Croup or Laryngotracheobronchitis is characterized by the inflammation and infection due of the larynx, trachea and bronchi. The symptoms are marked retractions, inspiratory stridor, and a barking cough.