E3
The mother of a 4-year old boy has contacted the physician's office. She reported her son was expose to someone with chickenpox. She inquired about when her son may show if he has gotten the disease. What information should be provided? 1. The incubation period for the disease is between 10 and 21 days 2. Symptoms of the diseases should show up within 24 to 48 hours of exposure 3. Younger children will have longer periods of incubation 4. The illness should show symptoms in a week if he was exposed
1. The incubation period for the disease is between 10 and 21 days
The nurse is discussing vaccination for Haemophilus influenzae type B (Hib) with the mother of a 6-month-old child. Which comment provides the mother with the most compelling reason to get the vaccination? 1. "You have a choice of two excellent vaccines" 2. " Young children are especially susceptible to these bacteria" 3. "These bacteria live in every human" 4. " Your child needs this final dose for protection"
2. " Young children are especially susceptible to these bacteria"
The nurse is providing care to several children who have been brought to the clinic by the parents reporting cold-like symptoms. Which patient would the nurse most likely suspect is infected with coxsackie? 1. A 5-year-old with nasal congestion, halitosis and sore throat 2. A 7-year-old with 103 F Tempt, drooling and a palmar rash 3. A 2-year-old with thin watery nasal discharge and a cough 4. A 3-year-old with a 100 F Temp, sneezing and coughing
2. A 7-year-old with 103 F Tempt, drooling and a palmar rash
A nurse is reviewing the medical record of a child and finds that the child has a grade III murmur. After auscultating the child's heart sounds, how would the nurse document this murmur? 1. A Loud, audible with a stethoscope 2. A Loud without a thrill 3. A Loud with a precordial thrill 4. A soft and easily heard
2. A Loud without a thrill
A nurse is educating a group of parents about symptoms of Pertussis in under immunized children. What would the nurse include when teaching parents about the respiratory disorder? 1. Incubation is 6-21 days 2. A whooping cough is present 3. Tdap or Dtap for the respiratory disorder is given at age 14 years 4. Signs of airway obstruction is never present
2. A whooping cough is present
A pregnant women is to undergo testing to evaluate for chromosomal abnormalities. Which test would the nurse expect to be done during the early gestation? 1. Fetal nuchal translucency 2. Chorionic villi sampling 3. Triple screen 4. Amniocentesis
2. Chorionic villi sampling
The nurse has just administered medication via a gastric tube. What is the priority nursing action following administration? 1. Check tube placement 2. Flush the tube 3. Re-tape the tube 4. Remove the tube
2. Flush the tube
After assessing a group of children for infection. Which group of children would the nurse determines that it is NOT necessary to implement airborne precautions? 1. Rubella 2. Measles 3. Streptococcus group A 4. Scarlet fever
2. Measles
Nursing Management of Fifth Disease should include which of the following. 1. Do not attempt to visualize the throat. 2. Provide droplet precautions 3. Do not isolate the child 4. Place the child in a supine position
2. Provide droplet precautions
While reviewing a newborn's medical record, the nurse notes that the chest X-ray shows a ground glass pattern. The nurse interprets this as indicative of: 1. Persistent pulmonary hypertension 2. Respiratory distress syndrome 3. Transient tachypnea of the newborn 4. Asphyxia
2. Respiratory distress syndrome
A group of nursing students is reviewing information about childhood infectious diseases. The students demonstrated an understanding of this information when they identified which disease as a common childhood exanthema. 1. Mumps 2. Rubella 3. West Nile virus 4. Rabies
2. Rubella
A nurse is performing resuscitation on a newborn, which action would the nurse do first. 1. Give chest compressions at a rate of 80 times per minute 2. Suction the mouth and then the nose 3. Intubate with an appropriate-size endotracheal tube 4. Administer epinephrine intravenously
2. Suction the mouth and then the nose
What would be most important to include in the teaching plan for parents of a child with pinworm? 1. "Seal the child's clothing in a plastic bag for at least 10 days" 2. "Be sure your child wears shoes at all times" 3. "Make sure the child washes his hands after using the bathroom" 4. "After applying this special cream, I will leave it on for about 8 to 10 hours"
3. "Make sure the child washes his hands after using the bathroom"
A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. What would the nurse include in the child's discharge instructions? 1. "Call your medical provider if he vomits more than five times" 2. "Any watery fluid draining from his ears is normal" 3. "Wake him every 2 hours to check his movement and responses" 4. "Expect his headache to get worse initially and then disappear"
3. "Wake him every 2 hours to check his movement and responses"
After teaching the parents of a child with varicella zoster. The nurse determines that the parents have understood the teaching when they state that their child can return to school at which time 1. After day 5 of the rash 2. Once the rash appears 3. After the lesions have crusted 4. When the rash has healed completely
3. After the lesions have crusted
After teaching a class about hemodynamic characteristics of congenital heart disease, the instructor determines that the teaching has been successful when the class identifies which defect as an example of a disorder involving increased pulmonary blood flow? 1. Tetralogy of Fallot 2. Transposition of the great vessels 3. Atrial septal defect 4. Hypoplastic left heart syndrome
3. Atrial septal defect
A nurse is preparing a presentation for an expectant parent group about neural tube defects and prevention. Which would the nurse emphasize? 1. Smoking cessation 2. Increased calcium intake 3. Folic acid supplementation 4. Aerobic exercise
3. Folic acid supplementation
The nurse is conducting a physical examination of a child with a ventricular septal defect. Which finding would the nurse expect to assess? 1. Right ventricular heave along the left sternal border 2. Fixed split-second heart sound on auscultation 3. Holosystolic harsh murmur along the left sternal border 4. Systolic ejection functional murmur
3. Holosystolic harsh murmur along the left sternal border
A nurse is teaching the student nurse the sequence of performing the assessment techniques during a physical examination. What is the appropriate order? 1. Inspection, percussion, palpation, auscultation 2. Palpation, percussion, inspection, auscultation 3. Inspection, palpation, percussion, auscultation 4. Inspection, auscultation, palpation, percussion
3. Inspection, palpation, percussion, auscultation
During class, a student states, "I didn't think children could have strokes. I thought this only occurred in older adults." When responding to the student, what would be most important for the instructor to integrate into the response? 1. Research has identified specific treatments for children 2. The signs and symptoms in children are different from an adult 3. Ischemic strokes are more common in children than hemorrhagic strokes 4. Strokes in children often have an identification cause
3. Ischemic strokes are more common in children than hemorrhagic strokes
What finding would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? 1. Cheyne-Stokes respirations 2. Bradycardia 3. Projectile vomiting 4. Fixed dilated pupils
3. Projectile vomiting
What is the most important nursing intervention for post op Tonsillectomy care? 1. Place child on the supine or prone position 2. Encourage coughing 3. Promoting airway clearance 4. Limit fluid volume
3. Promoting airway clearance
A 4-year-old boy has a febrile seizure during a well-child visit. What nursing action would be a priority? 1. Loosening the child's clothing to ensure a patent airway 2. Using a tongue blade to pry open the child's jaw 3. Protecting the child from harm during the seizure 4. Hyperextending the child's head while placing him on his side
3. Protecting the child from harm during the seizure
When conducting a physical examination of a child with suspected Kawasaki disease. Which finding would the nurse expect to find? 1. Cafe au lait spots 2. Hirsutism or striae 3. Strawberry tongue 4. Malar rash
3. Strawberry tongue
A nurse inspects the eyes of a child with hydrocephalus and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: 1. Nystagmus 2. Decorticate posturing 3. Sunset eyes 4. Dolls eyes
3. Sunset eyes
The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching? 1. "A family history of alcoholism is a risk factor for substance abuse" 2. "If my husband or I have a substance abuse problem it could increase his risk" 3. "Negative life events are a potential risk factor" 4. "Just because his friends are experimenting does not mean that he will"
4. "Just because his friends are experimenting does not mean that he will"
A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they make what statement? 1. "Having the shunt put in eliminate his risk for developmental problems" 2. "The shunt will help to prevent any further complications and surgeries for his disease" 3. "If he doesn't get an infection in the first week, the risk of brain damage is greatly reduced" 4. "My baby will need more surgeries to replace the shunt as he grows"
4. "My baby will need more surgeries to replace the shunt as he grows"
A school nurse is preparing a program on sexuality and birth control for a class of 16-year-olds. Which behavior will have the most influence on how the information was presented to adolescents? 1. Teens are adjusting to their new body images 2. Teenagers are able to think in the abstract 3. Adolescents understand that actions have consequences 4. Adolescents tend to take risk
4. Adolescents tend to take risk
A nurse is preparing a presentation to a local community group about genetic disorders and the types of congenital anomalies that can occur. What would the nurse include as a major congenital anomaly? 1. Overlapping digits 2. Umbilical hernia 3. Polydactyly 4. Cleft palate
4. Cleft palate
The mother of a child with a recent upper respiratory infection reported that her child might be at risk for Reye syndrome, when teaching the mother about this syndrome the nurse would include all the following symptoms except: 1. Severe and continual vomiting 2. Hyperreflexia and irritability 3. Changes in mental status Lethargy Irritability 4. Hyperactive behavior
4. Hyperactive behavior
The nurse is administering immunizations to children in a neighborhood clinic. What is the most frequent route of administration? 1. Intradermal 2. Topical 3. Oral 4. Intramuscular
4. Intramuscular
Shortly after birth, a newborn is diagnose with a Group B streptococcal infection. The nurse understands that the newborn most likely acquired this infection from which of the following? 1. Improper handwashing 2. Nonsterile catheter insertion 3. Contaminated formula 4. Mother's birth canal
4. Mother's birth canal
While caring for a newborn patient who is in the NICU for meconium aspiration. While caring for the child the nurse would be most concerned with which of the following signs of respiratory distress? 1. Respiratory rate of 58 beats per minute 2. Meconium stained skin 3. Auscultation reveals wheezing and rales 4. Nasal flaring and cyanosis of the hands and feet
4. Nasal flaring and cyanosis of the hands and feet
A mother brings her 3-year-old daughter to the emergency department because the child has been vomiting and having diarrhea for the past 36 hours. When assessing this child's temperature, which method would be least appropriate? 1. Tympanic 2. Axillary 3. Oral 4. Rectal
4. Rectal
The nurse is performing a physical examination on a 9-year-old boy who is suspected of having Lyme disease after he experienced a tick bite on his lower leg. On assessment, which symptoms would the nurse expect to find? 1. Confusion and anxiety 2. Hyper salivation and localized pain 3. Swelling and stiffness in the neck 4. Ring-like rash on lower leg and joint pain
4. Ring-like rash on lower leg and joint pain
A nurse is developing a plan of care for a neonate experiencing symptoms of drug withdrawals. What should be included in this plan? 1. Schedule feedings every 4 to 6 hours 2. Rock horizontally 3. Administer glucose between feedings 4. Swaddle the infant between feedings
4. Swaddle the infant between feedings
A client is experiencing the adverse effects of salicylates used to treat viral illness. Which of the following might show up in the history of a child with Reye syndrome who received aspirin. 1. The child has a history of diphtheria 2. The child had a bacterial conjunctivitis 3. The child had a recent scratch on her hand 4. The child had recent chicken pox
4. The child had recent chicken pox
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? 1. "I can't believe it. We're not unclean, poor people." 2. "That explains his complaints of itching on his neck." 3. "We'll have to get that special shampoo." 4. "Everybody in the house will need to be checked."
1. "I can't believe it. We're not unclean, poor people."
The mother of a 15-month-old child is questioning the nurse about the need for a hepatitis B vaccination. Which statement provides the most persuasive reason for the vaccine? 1. "This is a recombinant vaccine that protects your child from liver disease" 2. "The most common side effects is injection site soreness" 3. "This is a live-attenuated vaccine" 4. "Immunizations are needed to protect the general population"
1. "This is a recombinant vaccine that protects your child from liver disease"
A mother brings her child to the health care clinic because she thinks that the child has conjunctivitis. Which assessment finding would lead the nurse to suspect bacterial conjunctivitis? 1. A pus-filled inflamed conjunctiva with mild pain 2. An itchy watery discharge from the eyes 3. A pus-filled eyelid with Photophobia 4. A Stringy discharge with tearing
1. A pus-filled inflamed conjunctiva with mild pain
After assessing a child's blood pressure. The nurse determines the pulse pressure and finds that it is narrowed. What would the nurse identify as associated with this finding? 1. Aortic stenosis 2. Patent ductus arteriosus 3. Complete heart block 4. Aortic insufficiency
1. Aortic stenosis
A newborn has an Apgar score of 6 at 5 minutes. Which action would be the priority? 1. Beginning resuscitative measures 2. Initiating IV fluid therapy 3. Obtaining a blood culture 4. Promoting kangaroo care
1. Beginning resuscitative measures
A nurse is providing care to a newborn who is receiving phototherapy. Which action would the nurse most likely include in the plan of care? 1. Covering the newborns eyes while under the phototherapy lights 2. Ensuring that the newborn is covered or clothed from head to toe 3. Reducing the amount of fluid intake to 8 ounces daily 4. Keeping the newborn in the supine position with the lights off
1. Covering the newborns eyes while under the phototherapy lights
When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, what would be the priority? 1. Establishing a trusting relationship 2. Teaching the family what to expect 3. Assisting with scheduling follow-up visits 4. Using measures to promote growth and development
1. Establishing a trusting relationship
While auscultating the heart of a 5-year-old child, the nurse notes a murmur that is soft, quiet and present each time the heart is auscultated. What grade murmur should the nurse document? 1. Grade 2 2. Grade 1 3. Grade 4 4. Grade 3
1. Grade 2
A child is diagnosed with Kawasaki disease and is in the acute phase of the disorder. What would the nurse expect the physician to prescribe? 1. Intravenous immunoglobulin and Aspirin 2. Acetaminophen and monitor for blood clots 3. Alprostadil and antibiotics 4. Ibuprofen and an ACE inhibitor
1. Intravenous immunoglobulin and Aspirin
Which information would the nurse include when teaching a new mother about the difference between pathologic and physiologic jaundice? 1. Pathologic jaundice appears within 24 hours after birth 2. All Physiologic jaundice requires transfer to the NICU 3. Both were treated with exchange transfusion of maternal O- blood 4. Physiologic jaundice results in kernicterus
1. Pathologic jaundice appears within 24 hours after birth
The nurse is assessing a 5-year-old girl who is anxious, has a fever, speaks in a whisper, and sits up with her neck thrust forward. Based on these findings, what would be least appropriate intervention for the nurse to perform? 1. Schedule the child for an x ray 2. Auscultating for lung sounds 3. Provide 100% oxygen and support 4. Having the child sit forward
1. Schedule the child for an x ray
The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? 1. Swollen lymph nodes 2. Infected tonsils 3. Strawberry tongue 4. Swollen neck
1. Swollen lymph nodes
The nurse is caring for a 7 year-old male who is under immunized and recently circumcised. The nurse would be alert to the child's increased risk for which of the following? 1. Tetanus 2. Acute otitis media 3. Facial sensitivity 4. Frequent sore throats
1. Tetanus