‫‪Mohammad sami-0569945982‬‬

‫‪Pediatric‬‬
‫اﻻطﻔﺎل‬

‫ﻻﯾﺼﻞ اﻟﻨﺎس اﻟﻰ ﺣﺪﯾﻘﺔ اﻟﻨﺠﺎح دون أن ﯾﻤﺮوا ﺑﻤﺤﻄﺎت اﻟﺘﻌﺐ واﻟﻔﺸﻞ واﻟﯿﺄس‬

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‫اﻟﻔﺸﻞ ﻟﯿﺲ ﻋﻨﺪ اﻟﺨﺴﺎرة اﻧﻤﺎ اﻟﻔﺸﻞ ﻋﻨﺪ اﻻﻧﺴﺤﺎب‬

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‫‪T. Mohammad Sami‬‬

‫‪sa‬‬

‫‪0569945982‬‬
‫‪ad‬‬
‫‪m‬‬
‫‪a‬‬ ‫‪m‬‬
‫‪oh‬‬
‫‪M‬‬

‫‪2019‬‬
‫‪Prometric Exam Collection‬‬
‫ﻏﯿﺮ ﻣﺴﻤﻮح اﻟﺴﺮﻗﺔ ﻣﻨﮫ – اﻟﻤﻠﻒ ﻟﯿﺲ ﻟﻠﺒﯿﻊ‬

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Mohammad sami-0569945982

INTUSSUSCEPTION

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MAIN PROBLEM: Intussusception is a condition in which one segment of

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intestine "telescopes" inside of another, causing an intestinal obstruction
.(blockage)

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INITIAL MANIFESTATION: a Colicky pain with knees drawn up; sausage-
shaped is common sign

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:OTHER MANIFESTATIONS 56
Paroxysmal abdominal pain
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Currant-jelly stool (bloody and mucoid)
LABORATORY DATA: Barium enema - may reduce intussusception by
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hydrostatic pressure NURSING DIAGNOSIS: Pain

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:INTERVENTIONS
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Prepare the client for surgery

Assess for episodes of currant jelly stool (mucoid)
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QUSHTIONS
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Q1) 5 month-old boy has been vomiting green colored vomit He has
intermittent abdominal pain during which he draws his chest, turns pale
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and cries forcefully. On observation, the in the stool which has a jelly-
like consistency. Abdominal pal along. Tube-like mass. There is no fever,
rash nor diarrhea are hyperactive in all quadrants which is the most
?likely form of initial treatment
A. Manual manipulation
B. Surgical resection
C. Normal saline enema
D. Laparoscopy

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Mohammad sami-0569945982

Q2) a 7-month-old infant seen in the Emergency Department suffering

from episodes of severe abdominal pain, and the infant's stool became
like red jelly. Abdominal examination revealed palpable sausage- shaped
mass in the right upper quadrant. Which of the following is the first line
?of therapeutic management for this infant
A. Non-surgical hydrostatic reduction
B. Surgical simple reduction
C. Pyloromyotomy

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D. Endorectal pull-Through

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Q3) 7month-old infant seen in the Emergency Department suffering from
episodes of severe abdominal pain, and the infant’s stool become like

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red jelly. Abdominal examinassions revealed palpable sausage-shaped
mass in the right upper quadrant which of the following is the best
?diagnosis
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A. Hirschsprung disease
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B. Hypertrophic pyloric stenosis

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C. Infant colic
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D. Intussuception
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Q4) Nurse is preparing to care for a child with a diagnosis of

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intussusception. The nurse reviews the child's record and expects to

?note which sign of this disorder documented
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A. watery diarrhea
a
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B. rib bone-like stools

C. profuse projectile vomiting
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D. Red jelly stool

Q5) 5year-old child was seen to the Emergency Department abdominal

pain, palpable sauge-shaped mass, and Intussusception is suspected
?Which of the following is the best diagnostic evaluation to
A. X-ray
B. endoscopy

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Mohammad sami-0569945982

C. Rectal biopsy
D. Ultrasonography

SICKLE CELL ANEMIA

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MAIN PROBLEM: Severe chronic, hemolytic anemia characterized by

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episodes of pain to the occlusion of small blood vessels by sickled RBC's

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INITIAL MANIFESTATION: Growth retardation
:OTHER MANIFESTATIONS

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Dyspnea on excition
Joint swelling
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Aching bones
Generalized pain
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Leg ulcers
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LABORATORY DATA: Sickle cell Hgb (Hbs)

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NURSING DIAGNOSIS: Altered tissue perfusion

:INTERVENTIONS
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Priorities are hydration and pain relief

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Report signs and symptoms of vaso-occlusion, MI or CVA Refer the parents

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to a geneticist Pattern of transmission: both parents have the trait: 25%

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chance of the children to have the disease. One parent has the trait and
the other has the disease: 50% chance of the children to have the
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disease. If both parents have the disease: 100 % chance of the children
.to have the disease

QUSHTIONS
Q1) both parent have sickle anemia trait the percentage for the child to
?have the disease
A. 100%
.B. 50%

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Mohammad sami-0569945982

.C. 75%
D. 25%

Q2) 25 weeks-pregnant, primary gravid woman is on her first antenatal

visit, completing physical examination and history, the midwife found
out her husband has sickle cell anemia minor
?What should be the most appropriate plan of care
A. Genetic counselling
B. Identify severity of disease

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C. Discuss the chances of transferring
D. Amniocentesis to identify genetic abnormality

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Q3) Mother of a sickle cell anemia child is asking why her child can't go
hiking with his friends. Which of the following complications hiking can
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.leads to
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A. Enhance iron absorption
B. Decrease oxygen consumption
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C. Inhibit hemoglobin production

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D. Precipitate vaso-oclusive crisis

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Q4) 25 year old male is admitted in sickle cell erisis which of the
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folowing intervention would be of highest priority for this client S

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A tacking hourly blood pressure with mechanical cuff

a

B hydration and pain management

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C. position in high fowlers with knee gatch raised

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D none of above

Q5) A 14 year old girl has been hospitalized with Sickle Cell Anemia in
vasoocclusive crisis. Which of these Nursing diagnoses should receive
?priority in the Nursing plan of care
A. Impaired social interaction
B. Alteration in body image
C. Pain

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Mohammad sami-0569945982

D. Alteration in tissue perfusion

Q6) A female teenager was diagnosed with sickle cell anemia informs a
nurse school arranged a hiking activity in nearby mountains. She shows
excitement while informing the nurse about her new water bottle for
?this trip. What is the appropriate initial response by the nurse
"?A. "what do your parents think
B. "you realize that this type of activity might cause you a pain crisis
C. "you need to get approval from your doctor before attending this

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"activity

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D." it is greet that you are hydrating yourself in preparation of this
"activity

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TETRALOGY OF FALLOT (TOF)

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MAIN PROBLEM: Congenital heart defect characterized by the presence

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of four anom alies: pulmonary stenosis, overriding of the aorta, right

ventricular hypertrophy and ventricular septal defect giving rise to a
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boot shaped heart INITIAL MANIFESTATION: CYANOSIS accompanied by

"squatting "tet spell
a
oh

OTHER MANIFESTATIONS: Shortness of breath

Edema
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Cardiomegaly
LABORATORY DATA: Cardiac catheterization to detect abnormalities
NURSING DIAGNOSIS: Altered tissue perfusion
:INTERVENTIONS
Allow the child to squat to decrease venous return to the heart
Prepare the client for surgery (Blalock-Taussig shunt-anastomosis ofthe
aorta pulmonary artery)

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Mohammad sami-0569945982

QUSHTIONS
Q1) the nurse is assessing a child who has Tetralogy of Fallot observed
that the child is having clubbing in his fingernails which of the flowing
?might be the reason for this clubbing
A. Prolonged tissue hypoxia
B. Delayed physical growth
C. Inactive bone marrow
D. Pulmonary fibrosis

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Q2) A child with tetralogy of Fallot may assume which position of comfort

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?during exercise

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Prone .1
Semi-Fowler .2 56
Side-lying .3
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Knee chest position .4

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PYLORIC STENOSIS
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MAIN PROBLEM: Hypertrophy of the pyloric sphincter

INITIAL MANIFESTATION: Non-bile, non-projectile vomiting (which can
progress projectile vomiting)
:OTHER MANIFESTATIONS
Constipation
Dehydration

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Mohammad sami-0569945982

Weight loss
Palpable olive shaped mass
LABORATORY DATA: Barium swallow reveals narrowing of sphincter
NURSING DIAGNOSIS: Altered nutrition
:INTERVENTIONS
Assess for the presence of olive-shaped mass
Provide thickened feeding
Position the client on right side lying position while seated on an infant

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.seat, after meals

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Prepare the client for possible surgery (Fredet-Ramstedt)

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QUSHTIONS 56
Q1) A 1-month-old infant is admitted to the surgical unit with
hypertrophic pyloric stenosis and scheduled for the surgery. Which the
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?following is the findings of abdominal examination

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A-palpable olive-like mass in the left side

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B. palpable olive-like mass in the right side

C-Palpable olive-like mass moved from left to right
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D-Palpable olive-like mass moved from right to left

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?Q2) Where is the location of pyloric

a

The pyloric sphincter is a band of smooth muscle at the junction

oh

between the pylorus of the stomach and the duodenum of the small
intestine. It plays an important role in
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Q3) A 7-week-old infant boy is admitted with projectile vomiting

decreased urine output, decreased bowel movements and weight loss.
He has poor turgor and appears hungry. The nurse observes left-to right
peristaltic waves after he vomits. The nurse would expect to find which
?of the following during the physical assessment
a. Hepato-spleenomegaly
b. A palpable pyloric mass

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Mohammad sami-0569945982

C- Lymphadenopathy
d. Bulging fontanelles

Q4) -Nurse Nancy is assessing a child with pyloric stenosis; she is likely to
?note which of the following
A. “Currant jelly” stools
B. Regurgitation
C. Steatorrhea

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D. Projectile vomiting

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MENINGITIS

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MAIN PROBLEM: Viral or bacterial infection affecting the meninges

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INITIAL MANIFESTATION: Headache with nuchal rigidity

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:OTHER MANIFESTATIONS
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Nuchal rigidity
a

Exaggerated and symmetrical deep tendon reflexes

oh

Opisthotonus
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Positive Brudzinski's sign

Positive Kernig's sign
Fever, chills
Photophobia
LABORATORY DATA: CSF culture
NURSING DIAGNOSIS: Ineffective breathing pattern
:INTERVENTIONS

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Mohammad sami-0569945982

Intravenous Penicillin is the drug of choice

Implement strict isolation until the first 24 hours of antibiotig
.treatment
Referthe parents to anjaudiologist

QUSHTIONS
Q1) nurse receives a telephone call from the admission office of the
hospital and is told that a patient with streptococcal meningitis will be
admitted to the Medical Unit. The nurse is planning to apply infection

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control measures For the patient which type of isolation precaution the

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?nurse must observe
A. Droplet precautions

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B. Contact precautions

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C. Airborne precautions
D. Standard precautions
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Q2) A 33-year-old man with meningitis present Department. Healthcare
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providers plan to precautions what is the best nursing practice for this
?case
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A. Use N95 mask all the time

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B. Monitor the negative air pressure

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C-Use respiratory protective equipment all the

D. Keep the patients with the same diagnosis admitted to the Emergency
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Q3) The nurse observes the client csf,Which of the following of csf color
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?indication for patient with bacterial meningitis

a

A-Cloudy
oh

B-Clear
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C-Red
D-Brown

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Mohammad sami-0569945982

Q4) a nurse is putting together a presentation Meningitis. on Which of

?the following has not been linked to Meningitis in humans
A-S.Pneumonia
B-H. Influenza
C-n. Meningitis
D-CL difficile

CLEFT LIP

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MAIN PROBLEM: Cleft lip is a birth defect that results in a unilateral or
.bilateral opening in the upper lip between the mouth and nose
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INITIAL MANIFESTATION: Unilateral or bilateral tear on the upper

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OTHER MANIFESTATION: Gap on one or both sides of the upper lip

LABORATORY DATA: No specific
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NURSING DIAGNOSES: Altered nutrition, Ineffective airway clearance

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:INTERVENTIONS
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Prepare the client for surgery

a

Teach the parents how to apply elbow restraints, which will be used
oh

.postoperatively to prevent the child from touching the surgical site

.Apply logan bow to reduce tension on the suture line
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Use large soft nipples, breck feeder (syringe with rubber tubing) or
.dropper when feeding the client
.Keep the client on supine or sidelying position, never on the abdomen

CLEFT PALATE



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Mohammad sami-0569945982

MAIN PROBLEM: Cleft palate is a birth defect

characterized by an opening in the roof of the
.mouth caused by lack of tissue development
INITIAL MANIFESTATION: Defect in both hard and
soft palate
:OTHER MANIFESTATIONS
Feeding difficulties
Impaired sucking and swallowing
LABORATORY DATA: No specific

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NURSING DIAGNOSES: Altered nutrition, Ineffective airway clearance

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:INTERVENTIONS

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.Prepare the client for surgery
Teach the parents how to apply elbow restraints, which will be used

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.postoperatively to prevent the child from touching the surgical site
.Position the client on the abdomen
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.Maintain soft diet until palate is healed
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.Use a cup when feeding the child postopera- tively

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Refer the parents to a nutritionist, dentist, speech therapist, audiolo gist

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.and psy- chologist to enable them to cope with the child's special needs
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QUSHTIONS
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Q1) 2-day-old newborn is admitted to the nursery. While the nurse is

administrating oral feeding, the milk returns through the child's nose and
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mouth and the infant become cyanotic.Which of the following condition

a

?the newborn should have

oh

A. Anorectal malformation
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B. Tracheoesophageal fistula
C. Cleft lip and palate
D. Cardiac condition

Q2) A 2-month-old infant with cleft lip is seen in the primary health care
to get the regular vaccine of 2 months. The mother asked proper time
for the corrective cleft lip surgery of her infant. Which of following is the
?best nurse response

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Mohammad sami-0569945982

A. No specific age for repair of cleft lip

B. It is too late, repair should be done immediate after delivery
C. The age of 2 months old is the time for repair
D. The proper time for repair after the age of one year

Q3) The nurse have been teaching a new mother how to feed was born
with a cleft lip and palate before surgical repair of Which of the following
?action from the mother indicate teaching has been successful
A. burping the baby frequently

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B. Prevent the infant from crying
C. Placing the baby flat during feeding

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D. Keep the infant prone following feedings

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Q4) Mother came to the Outpatient Department with an infant having
cleft and palate. The infant was underweight, so the nurse has to
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consider ching the proper way of feeding the child in the treatment plan.
Which of the following is the proper way of feeding
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A. Use a non-squeezable bottle during feeding

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B. Feed infant in an upright, sitting position

C. Enlarge nipple holes of bottle to allow more milk to pass through
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D. Feed infant longer than 45 minutes to allow more food to be

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Q5) A 40-year-old women is a gravida 2, para 2 and is current conceive.

a

Her previous pregnancy resulted in the birth of a cleft lip and palate.
oh

The patient is anxious and concerned pregnancies and the nurse

provides genetic counseling and Which foods would most effectively
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?prevent recurrence a palate

A. Green vegetables and citrus fruit
B. Eggs, milk and dairy products
C. Wheat, corn, rice, oats and rye
D. Beef, chicken and yellow vegetables

Q6) A nurse is caring for a newborn with cleft lip. At which age would the
?nurse expect the doctor to perform

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Mohammad sami-0569945982

A. 3-6 months
B. 6-10 months
C. 11-14 months
D. more than 14 months
Q7) Describe the nipples on bottles used to feed babies with cleft lip
Large holed, soft nipples
______ Q8) the infant with cleft lip/cleft palate needs more frequent
Burping after every 15-30 ml

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Q9) children with cleft lip and palate should be fed in what position

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Almost upright

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Q10) what position is contraindicated after cleft lip repair

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Never let them lay on their abdomen
Q11) children with cleft lip and cleft palate have long term problems
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____with ____and___ and
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Hearing, example otis media speech
Q12) after a cleft lip repair, what device will the baby wear
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A logan bow
a

?Q13) what is the purpose of a logan bow

oh

To prevent stress on the suture line

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APPENDICITIS

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Mohammad sami-0569945982

MAIN PROBLEM: Inflammation of the appendix due to obstruction of

:lumen. INITIAL MANIFESTATION
.Right lower quadrant abdominal pain with rebound ten- derness
.Lessening of the pain indicates rupture of the appendix
:OTHER MANIFESTATIONS
Periumbilical pain
Rebound abdominal tenderness
Anorexia

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Nausea and vomiting

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Low grade fever

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LABORATORY DATA: Elevated WBC
NURSING DIAGNOSIS: Pain

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INTERVENTIONS: Place the client in any position of comfort if the
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appendix has not yet ruptured. it has ruptured, position the client in
.high-Fowler's to prevent the upward spread of infection
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Avoid applying hot compress on the R.L.Q

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.Administer antibiotics as ordered

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Prepare the client for surgery

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QUSHIONS
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Q1) 53 year-old child was admitted with suspected appendicitis. A nurse

was evaluating the child’s condition and the mother stated that the child
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did have his bowel movement for the past two days and requested for
a

?natives. What is the risk of giving laxative to patient with appendicitis

oh

A. Pain
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B. Fever
C. Rupture
D. Diarrhea
Q2) A man is to be discharged from the General appendectomy. The
precautionary measures, plans are discussed with him. What is the most
?important desired outcome after discharge
A. Remain free of post-surgical complications
B. Report fever, redness or drainage from the wound site

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Mohammad sami-0569945982

C. Use pain management techniques approp

D. Resume gradual activities and avoid weight

Q3) A 17 year-old arrived to the Emergency Room complaining abdominal

pain on right lower quadrant. Pain was rated as 9 numeric scale with
positive rebound tenderness over the pain
Blood pressure 120/70 MMHG
Heart rate 95 /MIN
Respiratory rate 20/MIN

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Temperature 39.2
?Which of the following interventions has the highest priority

45
A. Keep NPO

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B. Secure an IV access
C. Prepare for ultrasound
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D. Prepare for abdominal surgery
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Q4) The nurse would increase the comfort of the patient with ‫؟‬
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appendicitis by
A. Having the patient lie prone
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B. Flexing the patient's right knee

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C. Sitting the patient upright in a chair

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D. Turning the patient onto his or her left side

a
oh

Q5) 18-year-old man college student was rushed fainted at the school.
He complained of severe quadrant. Upon palpation, he jerks even with
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?sample was obtained. What is the most likely diagnosis of this patient
A. Appendicitis
B. Liver Cirrhosis
C. Kidney stones
D. Duodenal ulcer

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Mohammad sami-0569945982

Q6) a nurse in male surgical word assigned to different tasks all at the
same time. The nurse managing 4 patients all with different needs and
concerns of varying urgency, which of the following considering critical
.and need the priority of care
A- patient diabetic with right leg pressure ulcer
B-patient with left diabetic foot
C-patient after appendectomy
D-patient has dressing for a head injury

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Q7) year-old child was admitted with suspected appendicitis. A nurse

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evaluating the child's condition and the mother stated that the child did
have his bowel movement for the past two days and requested for

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?natives. What is the risk of giving laxative to patient with appendicitis

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A. Pain
B. Fever 56
C. Rupture
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D. Diarrhea
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