Children NCLEX Questions
A mother reports that her school-age child has suddenly begun wetting the bed. Which action should the nurse take? - Ask about recent psychological changes - Tell the parent that this is a normal behavior - Obtain a urine sample for urinalysis
Obtain a urine sample for urinalysis. Explanation: In this situation, the nurse needs more information before proceeding. Physical causes of the enuresis need to be ruled out before psychosocial problems are addressed. Enuresis is not a normal finding in a school age child.
The nurse is admitting a 4-year old with a possible meningococcal infection. Which type of isolation is indicated? - Airborne - Contact - Droplet
droplet precautions Explanation: Meningococcal infections are spread through close mucous membrane or respiratory contact with large respiratory droplets. Meningococcal infections are not spread by small airborne organisms or contact with a person's skin or contaminated items. Standard precautions, used when touching body fluids, are not sufficient to prevent the spread of meningitis.
Which toy is appropriate for a 3-year-old child? - Bicycle - Computer game - Pull toy - A puzzle with large pieces
A puzzle with large pieces Explanation: A puzzle is the most appropriate toy because, at age 3, children like to color, draw, and put together puzzles. A bicycle is appropriate for a 5- or 6-year-old child; a pull toy, for a toddler; and a computer game, for a school-age child.
To decrease the likelihood of bradyarrhythmias in children during endotracheal intubation, succinylcholine is used with which agent? - Lidocaine - Epinephrine - Atropine - Isoproterenol
Atropine Explanation: Succinylcholine is an ultra-short-acting depolarizing agent used for rapid-sequence intubation. Bradycardia can occur, especially in children. Atropine is the drug of choice in treating or preventing succinylcholine-induced bradycardia. Lidocaine is used in adults only. Epinephrine bolus and isoproterenol aren't used in rapid-sequence intubation because of their profound cardiac effects.
A nurse is caring for a toddler who has just been immunized. When teaching the child's parents about potential adverse effects, the nurse should instruct the parents to immediately report: - Local swelling at the injection site - Generalized urticaria - Pain at the injection site - Mild temperature elecation
Generalized Urticaria. Explanation: The nurse should instruct parents to immediately report generalized urticaria because it can herald the onset of a life-threatening episode. A child may experience some pain, redness at the sight, localized swelling, or mild temperature elevation; however, these reactions can be treated symptomatically and aren't life-threatening.
A 2-year-old child has just been admitted to the floor and is displaying fear related to separation from his parents. What additional measures should the nurse implement to alleviate fear? - Offer lots of toys for distraction - Allow frequent visitors - Leave a small light on at night
Leave a small light on at night. Explanation: Toddlers show fear of separation from their parents, the dark, loud or sudden noises, injury, strangers, certain persons, certain situations, animals, large objects or machines, and change in environment
The nurse is assessing a child's skeletal traction and notices that the weights are on the floor. What should the nurse do next? - Notify the HCP immediately - Raise the weights - Move the child up in bed - Put the foot of the bed on blocks
Move the child up in bed. Explanation: The traction weights should be hanging freely to maintain pull. The child needs to be moved up in bed with the weights left untouched to continue countertraction. Then the nurse can determine whether blocks are necessary to maintain the child in the correct position. Raising the weights is inappropriate because doing so interferes with countertraction. The HCP does not need to be notified. The nurse can easily correct the problem by moving the child up in bed.
When assessing the child with asthma for allergic rhinitis, what is an expected finding? - Nasal crease - Mouth breathing - Abdominal pain - Fever
Nasal crease Explanation: In the child with asthma and allergic rhinitis, the allergic reaction to inhaled particles generally causes frequent nose rubbing, subsequently leading to a nasal crease. The child also may exhibit allergic shiners, which are dark circles under the eyes caused by nasal congestion
Which foods would the nurse teach the parents of a child with phenylketonuria (PKU) to avoid? Select all that apply. - Cereal - Hot dog - Hamburger - Fruit - Ice cream
hamburger, hot dog, & ice cream Explanation: Children with PKU lack an enzyme to metabolize phenylalanine and convert it to tyrosine. Treatment is dietary management to control the amount of phenylalanine ingested. Foods with low phenylalanine levels include fruits, most vegetables, and cereals. High-protein foods have high levels of phenylalanine and include meats and dairy products.
A toddler is admitted to the facility with nephrotic syndrome. The nurse carefully monitors the toddler's fluid intake and output and checks urine specimens regularly with a reagent strip. Which finding is the nurse most likely to see? - Glycosuria - Ketonuria - Proteinuria - Polyuria
Proteinuria Explanation: In nephrotic syndrome, the glomerular membrane of the kidneys becomes permeable to proteins, resulting in massive proteinuria. Nephrotic syndrome typically doesn't cause glycosuria or ketonuria. Because the syndrome causes fluids to shift from plasma to interstitial spaces, it's more likely to decrease urine output than to cause polyuria (excessive urine output).
Which approach by a nurse is the best for trying to take a crying toddler's temperature? - Tell the mother not to hold the child - Bring extra help so it can be done quickly - Talk to the mother first and then the toddler - Ignore the crying and screaming
Talk to the mother first and then to the toddler. Explanation: When dealing with a crying toddler, the best approach is to talk to the mother first then to the toddler. This approach helps the toddler get used to the nurse before she attempts any procedures. It also gives the toddler an opportunity to see that the mother trusts the nurse. Ignoring the crying and screaming may be the second step. The nurse should encourage the mother to hold the toddler because it will likely help the situation. The last resort is to bring in assistance so the procedure can be completed quickly.
