Family Final Study Guide
What is the normal levels of Digoxin?
0.6-1.2
An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of which of the following complications? a. Air embolism b. Allergic reaction c. Hemolytic reaction d. Circulatory overload
Circulatory overload
A nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which of the following is the most appropriate activity for this child?
Crayons and a coloring book
A 6-month-old infant is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than ______ beat/min A) 60 B) 70 C) 90 to 110 D) 110 to 120
90 to 110
The nurse is counseling the parents of a 12-year-old child with Duchenne Muscular Dystrophy about problems that may develop during adolescence. What body system does the nurse expect may be affected? A) Neurological B) Integumentary C) Gastrointestinal D) Cardiopulmonary
Cardiopulmonary
The physician ordered acetaminophen to be given every 6 hours to a child weighing 66 lbs. The maximum recommended dose for children is 10-15 mg/kg/dose. What is the maximum amount this child can safely receive in 24 hours?
1800 mg/day
A family wants to being oral feeding of their 4-year-old son, who is ventilator-dependent and currently tube-fed. They ask the home health nurse to feed him the baby food orally. The nurse recognizes a high risk of aspiration and an already compromised respiratory status. The most appropriate nursing action is to:
Acknowledge their request, explain the risks, and explore with the family the available options
Probable signs of pregnancy are: A) determined by ultrasound B) observed by the health care provider C) reported by the client D) diagnostic tests
observed by the health care provider
A mother brings her 2-week-old infant to a clinic for treatment after a diagnosis of clubfoot made at birth. Which statement by the mother indicates a need for further teaching regarding this disorder? A) "treatment needs to be started as soon as possible" B) "i realize my infant will require follow-up care until fully grown" C) "i need to bring my infant back to the clinic in 1 month for a new cast" D) "i need to come to the clinic every week with my infant for the casting"
I need to bring my infant back to the clinic in 1 month for a new cast
A nurse is providing instructions to the parents of a child with scoliosis regarding the use of a brace. Which statement by the parents indicates a need for further teaching? A) "I will encourage my child to perform prescribed exercises" B) "I will have my child wear soft fabric clothing under the brace" C) "I should apply lotion under the brace to prevent skin break down" D) "I should avoid the use of powder because it will cake under the brace"
I should apply lotion under the brace to prevent skin breakdown
A father questions the nurse about the immunization schedule for his 15-month-old toddler who is being treated for acute lymphoid leukemia. What vaccine is contraindicated for a child receiving chemotherapy?
MMR (measles, mumps, rubella)
Home care is being considered for a young child who is ventilator dependent. Which factor is most important in deciding whether home care is appropriate?
Preparation and training of family
A nurse is caring for a 10-month-old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development? A) tie colorful latex balloons to the side of the crib B) provide a small electronic toy C) change the infant's diaper as soon as soiling occurs D) allow the infant to stand in the crib
Allow the infant to stand in the crib
The mother brings her child with cerebral palsy in to the clinic and is afraid the child is having seizures as the child has the slow worm like movements in her arms and she drools when this occurs. The nurse explains to the mother that this is not a seizure by what type of activity? A) Athetoid B) Ataxic C) Spastic D) Hypotonic
Athetoid
An 11-year-old child has a recurrence of Ewing Sarcoma and is verbalizing wanting to stop all treatments. This nurse is aware that the best ethical practice would be which of the following plans? A) Tell the parents that they need to force the child to have the treatment as she is too young to decide B) Have the parents discuss treatment with the child and take the child's view into consideration C) Inform the child that she is not allowed to decide the course of treatment D) Plan a meeting with the parents, child, and the medical team to provide an opportunity to discuss the child's concerns
plan a meeting with the parents, child, and the medical team to provide an opportunity to discuss the child's concerns
A 16-year-old boy comes into the office of the school nurse complaining of left hip pain that began when playing basketball in gym class. The boy is in the 85th percentile for height and weight. He complains of increased pain with weight bearing. The nurse observes out-toeing of the left leg with ambulation. Which nursing action is a priority? A) administer ibuprofen and instruct the boy to rest B) apply heat to the hip and elevate the leg C) refer the boy to the emergency department D) apply ice to the hip and immobilize it with a splint
refer the boy to the emergency department
A patient recently came into the Emergency Department with a diagnosis of Guillain-Barre Syndrome (GBS). What is the priority system to initially monitor for this patient? A) musculoskeletal B) neurological C) respiratory D) vascula
respiratory
What do you never give someone with sickle cell anemia?
Demerol (meperidine)
A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? A) calcium B) protein C) vitamin B12 D) folic acid
Vitamin B12
A child is placed in skeletal traction for treatment of a fractured femur. The nurse develops a plan of care for the child and includes which intervention in the plan? A) ensure that all ropes are outside the pulleys B) ensure that the weights are resting lightly on the floor C) restrict diversional and play activities until the child is out of traction D) check the physician's prescriptions for the amount of weight to be applied
Check the physician's prescription for the amount of weight to be applied
A nurse is taking care of a 10-year-old child that weighs 30 kg. The doctor has ordered azithromycin PO 300mg x 1 dose. Azithromycin comes in an oral suspension 100mg/5mL in a 15 mL bottle. According to the drug handbook for children 2-15 years if age, 10mg/kg/day but not to exceed 500mg/day. How many milliliters should be given?
3 mL
A 6-year-old child weighing 55 pounds has otitis media. The physician has ordered Amoxicillin/Clavulanate (Augmentin). The recommended dose is 45 mg/kg/day every 12 hours. The medicine comes as 400mg/5mL. How many mL's will the nurse give per dose? (round to the nearest tenth)
7.0 mL
An 8-year-old child receiving digoxin (Lanoxin). The nurse should notify the practioner and withhold the medication is the apical pulse is less than _____ beats/min A) 60 B) 70 C) 90 D) 100
70
A nurse is caring for a school-aged child who has a concussion. Which of the following manifestations are late indications of increased intracranial pressure (ICP)? (Select all that apply) A) Headache B) Nausea C) Increased sleeping D) Bradycardia E) Decreased motor response
Bradycardia, decreased motor response
A child has a right femur fracture caused by a motor vehicle accident and is placed in skin traction temporarily until surgery can be performed. During assessment, the nurse notes that the dorsalis pedal pulse is absent on the right foot. What action should the nurse take? A) notify the physician B) administer an analgesic C) release the skin traction D) apply ice to the extremity
Notify the physician
A 12-year-old comes into the clinic with left thigh pain and a lump over the distal femur. The nurse is aware that these symptoms can be linked to which of the following medical problems? A) Ewing sarcoma B) Osteosarcoma C) Osteoarthritis D) Osgood Schlatter's Disease
Osteosarcoma
A patient at 24 weeks of gestation contacts the nurse at her obstetric provider's office to complain that she has cravings for dirt and gravel. The nurse is aware that this condition is known as _____ and may indicate anemia
Pica
A nurse carding for a school-age patient who possibly has Reye Syndrome? (Select all that apply) A) Use of aspirin B) A recent infection with Influenza A C) Recent history of bacterial otitis media D) A recent infection of chicken pox E) Recent episode of Haemophilus influenza meningitis
Use of aspirin, a recent infection with influenza a, a recent infection of chicken pox
Which strategies should the school nurse recommended implementing in the classroom for a child with attention deficit hyperactive disorder (ADHD)? (Select all that apply) A) schedule heavier subjects to be taught in the afternoon B) accompany verbal instructions by written format C) limit number of breaks taken during instructional periods D) allow more time for testing E) reduce homework and classroom assignments
accompany verbal instructions by written format, allow more time for testing, reduce homework and classroom assignments
A school-age child is admitted in vasoocclusive sickle cell crises. What should be included in the child's care? A) correction of acidosis B) adequate hydration and pain management C) pain management and administration of heparin D) adequate oxygenation and replacement of factor VIII
adequate hydration and pain management
A woman at 10 weeks of gestation who is seen in the prenatal clinic with presumptive signs and symptoms of pregnancy likely will have: A) Amenorrhea B) positive pregnancy test C) Chadwick's sign D) Hegar's sign
amenorrhea
The nurse is conducting a staff in-service on childhood blood disorders. Which describes the pathology of idiopathic thrombocytopenic purpura? A) bone marrow failure in which all elements are suppressed B) deficiency in the production rate of globulin chains C) diffuse fibrin deposition in the microvasculature D) an excessive destruction of platelets
an excessive destruction of platelets
The child has been complaining of joint pain in the knees and jaw for the last 6 weeks, both joints are swollen and warm to touch, but not red. The physician is ordering blood to rule out Junior Idiopathic Arthritis. Which of the following lab tests would the nurse expect the physician to order? (Select all that apply) A) Antinuclear antibodies B) Sedimentation rate C) CBC with differential D) Electrolytes
antinuclear antibodies, sedimentation rate, CBC with differential
A child with asthma is having pulmonary function tests. Which explains the purpose of the peak expiratory flow rate (PEFR)? A) confirms the diagnosis of asthma B) determines the cause of asthma C) identifies the "triggers" of asthma D) assesses the severity of asthma
assesses the severity of asthma
What is the major concern guiding treatment for the child with Legg-Calve-Perthes disease? A) avoid permanent deformity B) minimize pain C) maintain normal activities D) encourage new hobbies
avoid permanent deformity
a nurse is planning to use an interpreter during a health history interview of a non-english speaking patient and family. Which nursing care guidelines should the nurse include when using an interpreter? (Select all that apply)
elicit one answer at a time, arrange for the family to speak with the same interpreter if possible, introduce the interpreter to the family
Which statement concerning pancreatic enzymes, for a CF client is correct? A) capsules may not be opened B) microcapsules can be crushed C) encourage to eat throughout the day D) enzymes administered at each meal and with snacks
enzymes administered at meals and with snacks
A nurse is caring for a 15-year-old adolescent who is receiving chemotherapy for leukemia. The nurse expects that adolescents with health problems are most concerned about
feeling different regarding changes in body image
The nurse teaches a pregnant woman about the presumptive, probable, and positive signs of pregnancy. The woman demonstrates understanding of the nurse's instructions if she states that a positive sign of pregnancy is: A) a positive pregnancy test B) fetal movement palpated by the nurse-midwife C) Braxton Hicks contractions D) quickening
fetal movement palpated by the nurse-midwife
An adolescent comes to the clinic with an uneven gait and shoulders not even in height. The physician diagnoses the teen with scoliosis. The nurse knows what is the major concern for this person? A) impaired body image B) impaired respiratory C) impaired gastrointestinal D) impaired mobility
impaired body image
A nurse is planning care for a 6-year-old child who has bacterial meningitis. Which of the following nursing interventions should the nurse include in the plan of care? A) assist child in a supine position B) keep the room well lit C) measure head circumference every shift D) implement seizure precautions
implement seizure precautions
The nurse notices that a toddler is more cooperative taking medicine from a small cup than from a large cup. This is an example of which characteristic of preoperational thought? A) Egocentrism B) irreversibilty C) inability to conserve D) transductive reasoning
inability to conserve
The nurse must assess 10-month-old Chad. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which of the following initial actions by the nurse would be most appropriate? A) Initiate a game of peek-a-boo B) ask father to place Chad on the examination table C) talk softly to Chad while taking him from his father D) Undress Chad while he is still sitting on his father's lap
initiate a game of peek-a-boo
The nurse is preparing to administer a dose of digoxin (Lanoxin) to a child in heart failure (HF). What is a beneficial effect of administering digoxin (Lanoxin)? A) It decreases edema B) It decreases cardiac output C) It increases heart size D) It increases venous pressure
it decreases edema
A nurse prepares a list of home care instructions for the parents of a child who has a plaster cast applied to the left forearm. Which instructions would be included on the list? (Select all that apply) A) use fingertips to lift the cast while it is drying B) keep small toys and sharp objects away from the cast C) contact the physician if the child complains of numbness or tingling in the extremity D) use a padded ruler or another padded object to scratch under the cast if it itches E) placing a heating pad on the lower end of the cast and over the fingers if the fingers feel cold F) elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling
keep small toys and sharp objects away from the cast, contact the physician if the child complains of numbness or tingling in the extremity, elevate the extremity on pillows for the first 24 to 48 hours after casting to prevent swelling
What are the nursing interventions post cardiac catheterization?
lie flat, maintain a patent peripheral venous catheter, color and extremity affected by insertions, check pulse distally from insertion point of the catheterization
Which assessment findings should the nurse note in a school-aged child with Duchenne Muscular Dystrophy (DMD) (select all that apply) A) Lordosis B) Gower Sign C) Kyphosis D) Scoliosis E) Waddling Gait
lordosis, gower sign, waddling gait
A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? A) "discontinue all contraception now" B) "lose weight so that you can gain more during pregnancy" C) "you may take any medications you have been regularly taking" D) "make sure you include adequate folic acid in your diet"
make sure you include adequate folic acid in your diet
Why is meperidine (Demerol) not recommended for children in sickle cell crises? A) may induce seizures B) is easily addictive C) not adequate for pain relief D) given by intramuscular injection
may induce seizures
When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. How should the nurse assess this diet? A) indicates they live in poverty B) is lacking in protein C) may provide sufficient amnio acids D) should be enriched with meat and milk
may provide sufficient amino acids
A home health nurse is developing a plan of care for a child who has hemiplegic cerebral palsy. Which of the following goals is the priority for the nurse to include in the plan of care? A) provide respite services for the parents B) improve the client's communication skills C) foster self-care activities D) modify the environment
modify the environment
A nurse educator is preparing to conduct a session to the nursing staff regarding the theories of growth and development and plans to discuss Kohlberg's theory or moral development. Which of the following should the nurse include in the sessions? (Select all that apply)
moral development progresses in relationship to cognitive development, a person's ability to make moral judgements develops over a period of time, the theory provides a framework for understand how individuals determine a moral code to guide their behavior, in stage 2 (instrumental relativist orientation) the children are expected to reason as mature members of society
You are working with a new nurse to give an IM injection. Which principles do you want to include when doing this teaching? (Select all that apply) A) Usually 2 mL is the maximum volume that should be administered in a single site to small children and older adults B) New evidence suggests that immunizations at the ventrogluteal site have been found to have fewer local reactions and fever C) Distraction and prevention of unexpected movement may be more easily achieved by placing the child supine on a parent's lap for ventrogluteal site use D) The deltoid muscle advantages are less pain and fewer side effects from the injectate compared with the vastus lateralis E) Aspiration during intramuscular vaccine administration is always recommended
new evidence suggests that immunizations at the ventrogluteal site have been found to have fewer local reactions and fever, distraction and prevention of unexpected movement may be more easily achieved by placing the child supine on a parent's lap for ventrogluteal site use, the deltoid muscle advantages are less pain and fewer side effects from the injectate compared with the vastus lateralis
A nurse is providing teaching to a parent who has a fracture of an epiphyseal plate. Which of the following statements should the nurse make? A) "the blood supply to the bone is disrupted" B) "normal bone growth can be effected" C) "bone marrow can be lost through the fracture" D) "the younger the child the longer the healing process will take"
normal bone growth can be effected
A 4-year-old is placed in Buck extension traction for Legg-Calve-Perthes disease. He is crying with pain as the nurse assess the skin of his right foot and sees that it is pale with an absence of a pulse. What should the nurse do first? A) reposition the child and notify practitioner B) notify the practitioner of the changes noted C) give the child medication to relieve the pain D) chart the observations and check the extremity again in 15 minutes
notify the practitioner of the changes noted
Which clinical manifestation should the nurse expect when a child with sickle cell anemia experiences an acute vasoocclusive crises? A) circulatory collapse B) cardiomegaly, systolic murmurs C) Hepatomegaly intrahepatic cholestasis D) Painful swelling of hands and feet; painful joints
painful swelling of hands and feet; painful joints
The parents of a young child with heart failure tell the nurse that they are "nervous" about giving digoxin (Lanoxin). The nurse's response should be based on which statement? A) it is a safe, frequently used drug B) it is difficult to either overmedicate or undermedicate with digoxin C) parents lack the expertise necessary to administer digoxin D) parents must learn specific, important guidelines for administration of digoxin
parents must learn specific, important guidelines for administration of digoxin
What is most important for a nurse to teach the parents of a child with Duchenne Muscular Dystrophy to do for their child? A) maintain a high-calorie diet B) institute seizure precautions C) restrict the use of larger muscles D) perform ROM exercises
perform ROM exercises
Precautions for Idiopathic Thrombocytopenic (low platelets) Purpura
restricted from any activity that would be risky to them, keep children inside for recess, cannot participate in sports
Which are characteristics of physical development of a 30-month-old child? (select all that apply)
sphincter control is achieved, primary dentition is complete
A child with cystic fibrosis does not like taking a pancreatic enzyme supplement with meals and snacks. The parent does not like to force it. The most important reasons the child is to take the pancreatic enzyme supplement with meals and snacks is: A) the child will become dehydrated if the supplement is not taken with meals and snacks B) the child needs these pancreatic enzymes to help the digestive system absorb fats, carbs, and proteins C) the child needs the pancreatic enzymes to aid in liquefying mucus to keep the lungs clear D) the child will experience severe diarrhea if the supplement is not taken as prescribed
the child needs these pancreatic enzymes to help the digestive system absorb fats, carbs, and proteins
Which factor is important to include in the teaching plan for parents of a child with Legg-Calve-Perthes disease? A) it is an acute illness lasting 1 to 2 weeks B) it affects primarily adolescents C) there is a disturbance in the blood supply to the femoral epiphysis D) it is caused by a virus
there is a disturbance in the blood supply to the femoral epiphysis
Which screening tests should the school nurse perform for the adolescent? (Select all that apply)
vision, hearing, scoliosis
A 5-year-old child is brought to the emergency department with abrupt onset of sore throat, pain with swallowing, fever, and sitting upright and forward. Acute epiglottitis is suspected. What are the most appropriate nursing interventions? (select all that apply) A) vital signs B) throat culture C) medical history D) assessment of breath sounds E) emergency airway equipment readily available
vital signs, medical history, assessment of breath sounds, emergency airway equipment readily available
The nurse is teaching parents about signs of digoxin (Lanoxin) toxicity. Which is a common sign of digoxin toxicity? A) seizures B) vomiting C) bradypnea D) tachycardia
vomiting
What are the signs and symptoms of Digoxin toxicity?
vomiting , dysrhythmia
