Exam 1 Practice

A child is scheduled for a tonsillectomy in a day-stay surgical unit. On the day following surgery, the mother calls the surgical unit and expresses concern because the child has a very bad mouth odor. Which of the following responses is most appropriate?

"Bad mouth odor is normal and may be relieved by drinking more liquids."

A mother of a 16-year old tells a nurse that she is concerned because the child sleeps about 8 hours every night and until noontime every weekend. The most appropriate nursing response is which of the following?

"Adolescents need that amount of sleep every night."

A nurse is performing an assessment of a 7-year old child who is suspected of having episodes of absence seizures. Which of the following assessment questions to the mother will assist in providing information that will identify the symptoms associated with this type of seizure?

"Does the child have a blank expression during these episodes?"

The mother of a child who underwent a myringotomy with insertion of pressure equalizing tubes (PE Tubes) calls a nurse and reports that the child is complaining of discomfort. Which of the following is the most appropriate response?

"Give the child acetaminophen (Tylenol) for the discomfort."

A student nurse is caring for a 2-year old child diagnosed with croup. A nursing instructor asks the student about the clinical manifestations associated with croup. Which statement by the student indicates a need for further research?

"Symptoms usually worsen during the day and are relieved during sleep."

A 2-year old child is treated in the emergency room for a burn to the chest and abdomen. The child sustained the burn by grabbing a cup of hot coffee that was left on the kitchen counter. The nurse reviews safety principles with the parents prior to discharge. Which statement, if made by the parents, indicates an understanding of the measures to provide safety in the home?

"We will be sure not to leave hot liquids unattended."

A 15-year old girl is grounded for 2 weeks by her parents for smoking in school. The adolescent tells the school nurse, "It's not fair that I get punished when my friends get away with doing the same thing." The nurse's most appropriate response would be:

"When errors in judgment are made, people must be prepared to take the consequences of their actions."

A physician has prescribed phenobarbital sodium, 25 mg po BID, for a child with febrile seizures. The medication label reads: phenobarbital sodium, 20 mg per 5 mL. A nurse has determined that the dosage prescribed is a safe dose for the child. The nurse prepares to administer how many milliliters per dose to the child?

6.25 mL

An 8-year old has a tonsillectomy. During the immediate postoperative period it is most important for the nurse to ensure that the child maintains:

Airway patency by placing the child in a side-lying position

The nurse recognizes that behaviors typical of an 9-month old include:

Being shy with strangers, playing peek-a-boo, and standing holding on to furniture

A mother brings her 4-month old infant to a well baby clinic for immunizations. A nurse would prepare to administer which of the following immunizations to this infant?

DTaP, Hib, IPV

A 10-year old child with asthma is treated for acute exacerbation in the emergency room. A nure reports which of the following, knowing that it is not an indication that the condition is improving?

Decreased wheezing

To bring about effective communication with any child, the nurse must first take into consideration the child's:

Developmental level

A nurse assesses the vital signs of a 12-month old infant with a respiratory infection. The respiratory rate is 35 breaths per minute. On the basis of this finding, which action is most appropriate?

Document the findings

The mother of an 8-year old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that the acetaminophen (Tylenol) is not very effective. The nurse most apprpriately tells the mother to:

Encourage the child to lie on the right side

A 4-year old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention would be most appropriate to alleviate the child's fears?

Encouraging the chld's parents to stay with the child

A young baby has an open repair of a fractured sternum and has a chest tube. The nurse explains to the baby's mother that the chest tube:

Is left in to drain the air from the chest cavity that entered during surgery

A 15 months old come into the clinic for a well-child check-up. The child was last seen at 9 months and was up to date for his immunizations at his 9 month check-up. What immunization should the 15 month old recieve today (if we only give one shot)?

Measles, mumps, rubella vaccine

An appropriate toy for a 3-month old infant would be a:

Metallic mirror

The social development of a 9-month old infant is best promoted by having the infant:

Play peek-a-boo and bye-bye

Before giving a 2-month old child the first DTaP immunization, the nurse discusses with the mother the possible reactions that may occur because these reactions are:

Quite common and may be either local or systemic

When teaching parents to instill eardrops in an 18-month-old child, the nurse shows them how to:

Straighten the auditory canal by pulling the pinna down and back

A clinic nurse prepares to administer an MMR (measles, mumps, rubella) vaccine to a 5-year old child. The nurse administers the vaccine:

Subcutaneously in the outer aspect of the upper arm

A nurse is assigned to care for an 8-year old child with a diagnosis of a basilar skull fracture. The nurse reviews the physician's orders and contacts the physician to question which order?

Suction PRN

A child who was found face down in a water-filled ditch is brought to the emergency room. The child, who has a pulse of 50 beats per minute but no spontaneous respirations, is intubated and bagged with 100% oxygen. The most important nursing measure at this time is to:

Suction the endotracheal tube, mouth, and nasal passages

A 3-month old infant has a ventriculoperitoneal shunt inserted. The nurse plans to:

Teach the parents the signs of increased intracranial pressure

An emergency room nurse is caring for a child diagnosed with epliglottitis. Assessing the child, the nurse monitors for which indication that the child may be experiencing airway obstruction?

The child is leaning forward with the chin thrust out

Penicillin V, 250 mg po every 8 hours, is prescribed for a child with a respiratory infection. The child's weight is 45 pounds. The safe pediatric dosage is 25 ot 50 mg/kg/day. The nurse determines that:

The dose is in safe range

The abnormal finding that a nurse would expect to observe during an assessment of a 1-month old infant admitted to the hospital with hydrocephalus would be that:

The infant's anterior fontanel is tense on palpation

The parents of a 2-year old arrive at a hospital to visit their child. The child is in the playroom when the parents arrive. When the parents enter the playroom, the child does not readily approach the parents. The nurse interprets this behavior as indicating that:

This is a normal pattern