EXAM1, SPRING07, PEDIATRIC, DDST, Dee
Terms
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copy deck
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Developmental Assessment screens:
a) determines if the child is normal
b) screens the cognitive & behavioral level of the child
c) screens what the child can do at the time
d) screens for intelligence quot - screens what the child can do at the time
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The liver is ______ to palpate in a child.
a) difficult
b) easy - easy
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A pediatric assessment on younger children should:
a) start from the most intrusive to the least intrusive
b) begin with the least intrusive to the most intrusive - begin with the least intrusive to the most intrusive
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In an otoscope assessment it is important to:
a) hold with the handle down
b) hold with the handle up - hold with the handle up
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The tempanic membrane:
a) yellowish in color
b) pearly grey
c) pinkish
d) white - pearly grey
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Fluid in the middle ear is:
a) otitis serous
b) otitis media
c) otitis externa - otitis media
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In scoliosis a curvaqture of ______ is when a problem is acknowledged and _______ is when scoliosis is treated.
a) 5% / 10%
b) 5% / 20%
c) 10% / 15%
d) 10% / 20% - 10% / 20%
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A lateral S or C shaped curvature of the spine is:
a) kyphosis
b) lordosis
c) scoliosis - scoliosis
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A disorder of the spine often associated with a rotational deformity of the ribs and spine is called:
a) kyphosis
b) lordosis
c) scoliosis - scoliosis
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The incidence of scoliosis increases during:
a) infancy
b) toddlers
c) puberty
d) 16-20 years - puberty
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The incidence of scoliosis increases during:
a) pre-school to 3rd grade
b) 3rd grade to 6th grade
c) 6th grade to 9th grade
d) 9th grade to 12th grade - 6th grade to 9th grade
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The Burns Classification:
a) a physical assessment framework
b) designed to evaluate IQ
c) emotional & behavioral assessment guide
d) organizes developmental, physiological, & psychosocial data - organizes physiological, psychosocial, & developmental data
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In examining a toddler the nurse should:
a) begin with a head to toe approach
b) foot to head approach - foot to head approach
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In examining the preschooler the nurse should:
a) assess childs willingness to be separated from parent
b) allow to touch & play with equipment
c) offer choices
d) distract by asing to count, name colors, etc - all are correct
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In examining school age children the nurse should:
a) offer a gown
b) explain & give choices
c) let child listen to heart & lungs
d) head to toe exam - all are correct
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Posture presenting a sway back, inward curve of the lower spine, is called:
a) kyphosis
b) lordosis
c) scoliosis - lordosis
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A humpback is called:
a) kyphosis
b) lordosis
c) scoliosis - kyphosis
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A __________ is used to measure the % of curvature in the spine.
a) x-ray
b) MRI
c) Lineaospirometer
d) scoliometer - scoliometer
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Lice is passed by all of the following EXCEPT:
a) combs & brushes
b) head to head contact
c) foot to mouth contact - he he he :)
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Nits are:
a) mounds of lice
b) lice eggs
c) silvery white teardrop shaped close to the scalp
d) B & C - lice eggs & are silvery white teardrop shaped usually found close to the scalp
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DDST-Denver Developmental Screening Test consists of four areas:
a) cultural; academic; socioeconomic; psychosocial
b) academic; physiological; psychosocial; psychological
c) personal; adaptive; motor; social;
d) personal/social; fi - personal/social; fine motor/adaptive; language; gross motor
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Instrument used to visualize the tympanic membrane
a) stethoscope
b) oroscope
c) otoscope
d) otometer - otoscope
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Fluid in the ear, looks like bubbles on the eardrum & may cause muffled hearing, crackling, popping, pressure:
a) otitis media
b) serous otitis
c) otitis externa
d) serous media - serous otitis
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Fluid in the middle ear is:
a) otitis media
b) serous otitis
c) otitis externa
d) serous media - otitis media
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Otitis media:
a) fluid in the middle ear
b) outer ear infection
c) causes muffled hearing
d) outer ear infection - fluid in the middle ear
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Otitis externa is characterized by:
a) fluid in the ear
b) looks like bubbles on the eardrum
c) muffled hearing, crackling, popping, pressure
d) pain when pressure is applied on the tragus -
pain when pressure is applied on the tragus
(outer ear infection) -
An irritation caused by the injection of louse saliva:
a) nits
b) ecchymiosis
c) errythemia
d) pruitis - pruitis
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Symptoms of lice in a child may present:
a) silvery white shapes close to the head
b) pruitis
c) swollen lymph nodes
d) nits behind ears, nape of the neck, crown of the head - all are correct
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Female lice can lay:
a) 50 nits a month
b) 100 nits a month
c) 150 nits a month
d) 500 nits a month - 150 nits a month
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The lifespan of lice is:
a) 3 days
b) 1 week
c) 2 weeks
d) 1 month - 1 month
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Nits hatch in:
a) 1-3 days
b) 1-7 days
c) 8-12 days
d) 1 month - 8-12 days
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Conditions for lice are:
a) feed on blood every three to six hours
b) can survive 15-20 hours without a blood meal
c) lay 3-6 eggs every 24 hours, usually at night
d) need 82 degree and 70% humidity - all are correct
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The female matures & begins to lay eggs:
a) as soon as hatched
b) 1 day after reaching adulthood
c) 2 days after reaching adulthood
d) 1 week after reaching adulthood - 2 days after reaching adulthood
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2 days after reaching adulthood, Lice will lay:
a) 3-6 eggs every hour
b) 3-6 eggs every 8 hours
c) 3-6 eggs every 12 hours
d) 3-6 eggs every 24 hours - 3-6 eggs every 24 hours
- What is the General rule of thumb when planning a pediatric assessment?
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do everything that you can standing, then sitting, then lying
Least intrusive to most !intrusive -
What would you assess first on a toddler?
a) chest auscultation
b) abdominal palpation
c) otoscopic exam
d) oral -
Rationale:
1st- Chest auscultation; the least intrusive choice;
2nd-abdominal is more intrusive
3rd-most intrusive is otoscope and oral examination -
For an ear assessment, if the child is 3 years old or less:
a) pull pinna up
b) pull pinna down - pull pinna down
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For an ear assessment of an adult:
a) pull pinna up
b) pull pinna down - pull pinna up
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If the child is upset or crying during an ear assessment:
a) have parent or child immobilize child to continue exam
b) pre-medicate with short term anesthesia
c) remember the TM may become red due to increase blood flow from crying - remember the TM may become red due to increase blood flow from crying
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During a pediatric ear exam:
a) Look at pinna & palpate for lesions & tenderness
b) palpate lymph nodes preauricular & postauricular for tenderness & enlargement
c) discharge or inflammation
d) wrestler with a he - all are correct
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In an ear assessment:
a) observe placement of pinna
b) observe ear size & position
c) assess while patient is facing you
d) imagine a line between the eye’s outer canthus & ear pinna - all are correct
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In an ear assessment imagine a line between the eye’s outer canthus & the pinna:
a) a deviation should not be observed
b) should not be a deviation of more than 10 degrees
c) should not be a deviation of more than 20 degrees
d) - should not be a deviation of more than 10 degrees
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When conducting an otoscope exam all of the following should be implemented EXCEPT:
a)use smallest speculum possible
b) hold the handle up
c) brace your hand against the head to prevent injury
d) straighten ear canal by pulling -
Choose smallest speculum possible
WRONG !!!
always select the LARGEST speculum that will fit into the canal -
In an otoscope assessment the malleus can be seen at about:
a) 1:00
b) 5:00
c) 7:00
d) 11:00 - 11:00
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Assessment of TM in otoscope exam should reveal:
a) TM appears pearly grey
b) may see a “cone of lightâ€
c) may see a “piece of pieâ€
d) TM in L-ear will be 7:00
e) TM in R-ear will be 5:00 - all are correct
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Relief for acute serous otitis media is all of the following EXCEPT:
a) chew gum
b) yawn
c) swallow w/ nose pinched
d) blow with nose & mouth closed - blow with nose & mouth closed
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During scoliosis exam, the nurse observes 5 Cafe Ole spots on the patient.
a) indicate basal cell carcinoma
b) unusual but not abnormal
c) indicates neurofibromatosis
d) indicates child has excessive intake o - this finding is indicative of neurofibromatosis
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During scoliosis exam, the nurse observes a hairy patch on the spinal cord:
a) basal cell carcinoma
b) indicates heuritism
c) indicates neurofibromatosis
d) indicates spina bifida - indicates spina bifida
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The nurse observes dimpling in a localized area of the spinal cord:
a) indicates subarachnoid hematoma
b) indicates polyomyelitis
c) indicates neurofibromatosis
d) indicates spina bifida - indicates spina bifida
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The nurse observes a 10 degree curve using a scoliometer. The nurse knows:
a) this is an acceptable deviation
b) curvature must be 20 degrees or more for a referral
c) knows a 20 degree curvature is referred & 25 degree is treate - refers patient for reassessment in 1 year
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During a scoliosis exam, the nurse observes freckels under the axilla. The nurse knows:
a) freckles are caused by overexposure to the sun
b) this is not abnormal
c) indicates spina bifida
d) sign of neurofibromatosis - sign of neurofibromatosis
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In assessing an adolescent:
a) provide gown & privacy for changing clothes
b) cover areas of body not being assessed during exam
c) perform exam in private unless adolescent requests parent or sibling
d) provides chaperone when pa - all are correct
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Bruises are common findings in all the following areas except:
a) knees
b) shins
c) shoulders
d) lower arms - shoulders
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When a skin color abnormality is suspected, the nurse should:
a) inspect the soles of feet
b) inspect the sclera of the eyes
c) inspect the buccal mucosa
d) inspect the tongue - inspect inspect the sclera of the eyes, buccal mucosa & the tongue
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The nurse observes the child as excessivly warm when palpated and recognizes this as:
a) normal because the skin should be warm to the touch
b) a sign of fever
c) a sign of inflammation - a sign of fever &/ or a sign of inflammation
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The nurse observes the child as cool when palpated and recognizes this as:
a) normal because the skin should be cool to the touch
b) a sign of cold exposure
c) a sign of hyperthermia
d) a sign of shock - normal because the skin should be cool to the touch
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The nurse observes the child's skin as abnormally cool when palpated & recognizes this as:
a) normal because the skin should be cool to the touch
b) a sign of cold exposure
c) a sign of hyperthermia
d) a sign of shock - sign of cold exposure, a sign of shock
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When palpating the childs skin, the nurse detects an abnormality in texture & knows all of the following are true EXCEPT:
a) this is normal due to hormonal changes taking place
b) abnormalities in texture are associated w/endocrine disorder - this is normal due to hormonal changes taking place
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The nurse observes that the child is sweating excessivly without exertion & knows this indicates:
a) the child is overweight
b) excessive caffiene intake
c) fever
d) uncorrected heart defect
c) the child - fever &/or uncorrected heart defect
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The nurse pinches a small amount of skin on the abdomen of a child & observes poor turgor & knows this:
a) indicates poor nutrition
b) indicates an endocrine disorder
c) is a sign of a potential pulmonary defect
d) dehyd - dehydration
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Acute otitis externa is:
a) inflammation of the pinna
b) infection of the external ear canal
c) inflammation of the external ear canal
d) inflammation of the tempanic membrane - inflammation of the external ear canal
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Dry scaley skin on the external ear or in the auditory canal indicates:
a)endocrine disorders
b) chronic dehydration
c) diabetes
d) psoriases or seborrhea - psoriases or seborrhea
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Hard nodules or calculi on the auricle rim or outside the opening of the external auditory canal is associated with:
a) gouty tophi
b) chronic sinusitis
c) pulmony disorder
d) renal disorder - gouty tophi
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Observation of low set ears is usually associated with:
a) congenital heart disease
b) Down's syndrome
c) renal disorders
d) b & c - Down's syndrome & renal disorders
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If signs of inflammation or obstruction are present before an otoscopic exam:
a) gently pull pinna down & quickly inspect w/otoscope
b) use a Q-tip to manipulate obstruction out of the canal
c)lubricate canal w/water soluble gel - do not insert the otoscope
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When inspecting the TM the "cone of light" is:
a) a triangular reflection visible in the right lower quadrant of the left ear
b) a triangular reflection visible in the left lower quadrant of the left ear -
a triangular reflection visible in the left lower quadrant of the left ear
(and the right lower quadrant of the right ear) -
Reddened tympanic membrane w/ purlulent, foul smelling ear drainage suggets:
a) otitis media
b) otitis interna
c) otitis externa
d) serous otitis - otitis externa
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Bulging, reddened, or perforated TM may be the result of:
a) acute otitis media
b) otitis interna
c) otitis externa
d) acute serous otitis - acute otitis media
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Absence of the cone of light when inspecting the TM may be due to:
a) otitis media
b) otitis interna
c) otitis externa
d) serous otitis - otitis media