Pediatrics: Study Guide ALL Chapters

The American Association on Intellectual and Developmental Disabilities definition of intellectual disability includes: a. significant limitations in intellectual functioning and adaptive behavior. b. an emphasis on function. c. only intelligence and no other criteria. d. an age limit of 16.

A

The Visual Analog Scale (VAS): a. is a highly subjective evaluation of pain. b. is recommended for children who understand the value of numbers. c. does not offer an option for "no pain." d. is recommended for children under 3 years of age.

A

The best example of adequate documentation of a child's food intake would be: a. "Child ate one bowl of cereal with 6 ounces of milk." b. "Child ate an adequate breakfast." c. "Child ate 80% of the breakfast served." d. "Parent states that child ate an adequate breakfast."

A

The heart transplant procedure in which the recipient's own heart is left in place is the: a. heterotopic heart transplantation. b. orthotopic heart transplantation.

A

The nurse knows that the etiology of CP is most commonly related to which of the following? a. Static brain injury b. Maternal asphyxia c. Childhood meningitis d. Preeclampsia

A

For which of the following populations is pertussis vaccine currently recommended? i. All children from 6 weeks to the seventh birthday ii. Children ages 11 to 12 years who have completed the DTaP/DTP childhood series iii. A second booster for previously immunized adolescents and adults iv. Children ages 7 through 10 years who are not fully vaccinated for pertussis (i.e., did not receive five doses of DTaP, or who received four doses of DTaP with the fourth dose being administered on or after the fourth birthday) v. Pregnant adolescents between 27 and 36 weeks' gestation, if not previously protected a. i, ii, iv, and v b. i, iii, and iv c. ii, iii, and v e. i, ii, iii, and iv

A

In assessing a child for the development of a hearing impairment, the nurse would look for: a. a loud monotone voice. b. stuttering. c. unusual shyness. d. attentiveness, especially when someone is talking.

A

In the United States, most human fatalities associated with rabies occur in people who: a. are unaware of their exposure. b. have not been immunized. c. live near raccoons and bats. d. provoke an unvaccinated dog.

A

Indications for the nurse to conduct a comprehensive family assessment include which of the following? i. Children with developmental delays ii. Children with history of repeated accidental injuries iii. Children with behavioral problems iv. Children receiving comprehensive well-child care a. i, ii, iii, and iv b. ii, iii, and iv c. i, ii, and iii d. ii and iii

A

Infantile spinal muscular atrophy (SMA type 1): a. may be diagnosed prenatally by genetic analysis of circulating fetal cells in maternal blood or amniotic fluid. b. can be cured with surgery performed in utero. c. is associated with nutritional failure to thrive, the most serious complication, often leading to the infant's early death. d. is associated with children who are intellectually delayed.

A

A common presenting manifestation of inflammatory bowel diseases (IBD) in pediatric patients is: a. growth failure. b. chronic constipation. c. obstruction. d. burning epigastric pain.

A

Al, age 5 months, is suspected of having intussusception. What clinical manifestations would he most likely have? a. Crampy abdominal pain, inconsolable crying, a drawing up of the knees to the chest, and passage of red, currant jelly-like stools b. Fever; diarrhea; vomiting; lowered white blood cell count; and tender, distended abdomen c. Weight gain, constipation, refusal to eat, and rebound tenderness d. Abdominal distention, periodic pain, hypotension, and lethargy

A

Although an uncommon disease, the type of encephalitis that is responsible for 30% of cases in children is caused by: a. herpes simplex. b. measles. c. mumps. d. rubella.

A

An early indication of hemorrhage in a child who has had a tonsillectomy is: a. frequent swallowing. b. decreasing blood pressure. c. restlessness. d. bradycardia.

A

An emancipated minor is permitted to consent for: a. treatment for any kind of health problem. b. routine physical examinations only. c. treatment for sexually transmitted infections. d. minor surgery.

A

An infant is receiving Lanoxin elixir 28 mcg once daily. Lanoxin is available in an elixir concentration of 50 mcg/ml. The correct dose to draw up and administer is: a. 0.56 ml. b. 0.28 ml. c. 0.84 ml. d. 1.12 ml.

A

Care for the hearing-impaired child who is hospitalized should include: a. supplementing verbal explanations with tactile and visual aids. b. communicating only with parents to ensure accuracy. c. discouraging parents from rooming in. d. sending nonvocal communication devices home to avoid loss.

A

Cerebral blood flow, oxygen consumption, and brain growth are all: a. less in adults than in children. b. greater in adults than in children. c. greater in adults than in infants. d. less in infants than in children.

A

Common antiinfective agents used for urinary tract infections in children include all of the following except: a. quinolones. b. penicillins. c. sulfonamides. d. cephalosporins.

A

Rubella vaccine administration: a. is given as protection for the unborn child rather than for the recipient of the immunization. b. is recommended for all children beginning at 4 to 6 years of age. c. is given to all pregnant women if not previously immunized. d. is not given to children whose mother is currently pregnant.

A

Sandy, age 2 years, is brought to the clinic by her mother because a toddler who attends Sandy's daycare center has been diagnosed with hepatitis A. Sandy's mother is concerned that Sandy might develop the disease. Which of the following serum laboratory tests would indicate to the nurse that Sandy has immunity to hepatitis A? a. Anti-HAV IgG b. Anti-HAV IgM c. HAsAg d. HAcAg

A

A 2-month-old infant who is being exclusively breastfed should optimally receive a daily supplement of: a. vitamin D. b. folic acid. c. vitamin A. d. vitamin B12.

A

A common cause of respiratory failure in the pediatric population after severe burns is: a. bacterial pneumonia. b. pneumothorax. c. pulmonary edema. d. restriction of chest wall as a result of edema and inelastic eschar formation.

A

A drug used to treat children diagnosed with giardiasis is: a. metronidazole (Flagyl). b. amoxicillin. c. erythromycin. d. tetracycline.

A

A toddler is most likely to react to short-term hospitalization with feelings of loss of control that are manifested by: a. regression. b. withdrawal. c. formation of new superficial relationships. d. self-assertion and anger.

A

Because of the ability of the skull to expand, very young children may tolerate which of the following neurologic conditions better than an adult? a. Intracranial pressure b. Hypoxic brain damage c. Epilepsy d. Subdural hemorrhage

A

Clinical manifestations of influenza usually include all of the following except: a. nausea and vomiting. b. fever and chills. c. sore throat and dry mucous membranes. d. photophobia and myalgia.

A

Most cases of hydrocephalus are a result of: a. developmental malformations. b. neoplasm. c. infection. d. trauma.

A

The purpose of nonnutritive sucking is to: a. satisfy the basic sucking urge. b. take in food. c. collect food and propel it into the esophagus. d. provide an efficient way to process fluids.

A

Which of the following minority groups experience the highest income gap in the United States? a. African American b. Latino c. Asian d. Native American

A

Which of the following would indicate the patient has been immunized with HBV vaccine? a. Anti-HBs b. Anti-HBs and anti-HBc c. HBsAg d. Anti-HBc

A

A 4-month-old infant who does not express vocalization such as cooing, gurgling, or laughing should be evaluated for: a. tongue-tie (ankyloglossia). b. hearing impairment. c. cleft palate. d. vocal cord paralysis.

B

A limb salvage procedure is the treatment of choice with which bone cancer? a. Ewing sarcoma b. Osteosarcoma

B

Acute diarrhea: a. can be caused by celiac disease. b. can be related to hyperthyroidism. c. can be caused by viral, bacterial, and parasitic pathogens. d. is an increase in stool frequency and increased water content with a duration of more than 14 days.

C

An example of atraumatic care would be to: a. eliminate all traumatic procedures. b. restrict visiting hours to adults only. c. encouraging parents to "room in" with the child. d. remove parents from the room during painful procedures.

C

Health concerns consistent with middle adolescence include: a. school performance. b. emotional health issues. c. physical appearance. d. future career or employment.

C

Rapid fluid replacement is contraindicated in which of the following types of dehydration? a. Isotonic b. Hypotonic c. Hypertonic

C

Which of the following physical exam findings is suggestive of self-induced vomiting? a. Presence of distinctive lesions on the hands (Russell sign) b. Hypertension, weakness, and cool skin c. Elevated potassium, magnesium, and erythrocyte sedimentation rate d. A heart murmur diagnosed as mitral valve prolapse

A

Which of the following regarding palliative care is false? a. Serves to hasten death b. Provides pain and symptom management c. Promotes optimal functioning and quality of life d. Addresses issues faced by the family regarding death and dying

A

An informed consent is required for: a. an emergency appendectomy. b. a cutdown for intravenous medications. c. release of medical information. d. all of the above.

D

Corticosteroid administration in muscular dystrophy has been shown to do all of the following except: a. increase muscle bulk and muscle power. b. preserve pulmonary function. c. prolong ambulation. d. increase incidence of scoliosis.

D

Current recommendations for cholesterol screening in children include: a. all children over 2 years of age. b. children over 2 years of age with a family history of elevated cholesterol. c. children with congenital heart disease. d. all children.

D

Diagnostic evaluation is important for early recognition of scoliosis. Which of the following is the correct procedure for the school nurse conducting this examination? a. View the child, who is standing and walking fully clothed, to look for uneven hanging of clothing. b. View all children from the left and right side to look mainly for asymmetry of the hip height. c. Completely undress all children before the examination. d. View the child, who is wearing underpants/shorts, from behind when the child bends forward at the waist.

D

In a child with hypopituitarism, growth hormones are often: a. elevated with accelerated growth. b. elevated with normal growth. c. lower than normal with normal growth. d. lower than normal with stunted growth.

D

In addition to acute pain, the clinical manifestations of otitis media include: a. purulent discharge in the external auditory canal. b. clear discharge in the external auditory canal. c. enlarged axillary lymph nodes. d. enlarged cervical lymph nodes.

D

Increased obesity among children is related to: a. high birth weight. b. underlying disease. c. enzyme abnormalities and metabolic defects. d. overeating.

D

Management of the genitourinary function in the patient with myelomeningocele includes clean intermittent catheterization (CIC) and anticholinergic medication. Which of the following statements about their use is correct? i. CIC is used to prevent spontaneous voiding. ii. Parents are taught to catheterize the infant every 4 hours during the day and once at night. iii. Anticholinergic medications enhance sphincter competence. iv. Anticholinergic medications reduce detrusor muscle tone and reduce bladder pressure. a. i and iii b. i and iv c. ii and iii d. ii and iv

D

Nursing considerations aimed at parental support for the infant with botulism include: a. teaching the parents the importance of administering enemas and cathartics for bowel function after discharge. b. preparing the parents for the fact that the child will have muscular disability after the illness. c. teaching the parents the proper administration of antibiotics to continue treatment after discharge. d. teaching parents that the child will fatigue easily when muscular action is sustained and that timing of feedings after discharge is important.

D

Overproduction of the anterior pituitary hormones can result in: a. hyperthyroidism. b. gigantism c. precocious puberty. d. all of the above.

D

The Wong-Baker FACES Pain Rating Scale: a. is easy to use but less reliable than other methods. b. is a rating of how children are feeling. c. has a coding system from 0.4 to 0.97. d. consists of six cartoon faces.

D

List three factors that contribute to increasing morbidity of any disorder in children.

Homelessness, poverty, low birth weight, chronic illnesses, foreign-born adoption, daycare attendance

What is the most important consideration when evaluating a child's growth charts?

The most reliable evaluation lies in comparing growth measurements over time

List the five assessment components to be evaluated in the analysis of the symptom of pain.

Type, location, severity, duration, and influencing factors

Describe how to measure recumbent length in a 14-month-old child.

With the child in a supine position, fully extend the body by holding the head in midline position, grasping the knees together gently, and pushing down on the knees until the legs are fully extended and flat against the table. Using a length board, place the head firmly at the top of the board and the heels of the feet firmly against the footboard.

Adolescent egocentrism may lead to a pattern of personal fable. An example of a personal fable is: a. "Everyone is coming to the play just to see me." b. "Mary Sue got pregnant, but it won't happen to me." c. "I hate taking my clothes off for gym class because everyone stares at me." d. "Mary is very envious of how I dress."

B

Amy, age 14 years, is scheduled to receive hemodialysis. She will need to have a vein and artery surgically connected for blood access. Which of the following is the correct name for this type of blood access? a. Graft b. Fistula c. Percutaneous catheter

B

Billy has been stung by a bee. A small reaction has occurred at the site. What is the most appropriate action at this time? a. Wait until Billy is at home to completely remove the stinger with forceps. b. Remove the stinger as soon as possible by scraping it off the skin. c. Wash the area with hot water and soap. d. Arrange for Billy to undergo skin testing.

B

Edema formation can be caused by which of the following? a. Decreased venous pressure b. Alteration in capillary permeability c. Increased plasma proteins d. Increased tissue tension

B

Erythema migrans is associated with which of the following conditions? a. Contact dermatitis b. Lyme disease c. Cat scratch disease d. Stevens-Johnson syndrome

B

Glycosylated hemoglobin is an acceptable method used to: a. assess for ketoacidosis. b. assess the control of diabetes. c. assess oxygen saturation of the hemoglobin. d. accurately determine blood glucose levels.

B

In the first few days after a major thermal burn injury, the nurse observes oliguria. What is the most likely cause for this finding? a. Acute renal failure b. Inadequate fluid replacement c. BUN and creatinine elevations d. All of the above

B

Infant botulism usually manifests with symptoms of: a. diarrhea and vomiting. b. constipation and generalized weakness. c. high fever and decrease in spontaneous movement. d. failure to thrive.

B

Infants under the age of 6 months who are diagnosed with pertussis are more likely to present with: a. severe cough. b. apnea. c. tachypnea. d. sore throat.

B

Major aims of skin treatment include all of the following except: a. eliminate the cause. b. obtain an accurate account of child's symptoms. c. effective treatment and symptom relief. d. prevent complications.

B

Accidental poisonings in toddlers can be best prevented by: a. consistently using safety caps. b. storing poisonous substances in a locked cabinet. c. keeping ipecac syrup in the home. d. storing poisonous substances out of reach.

B

Pica should be considered in which of the following children coming to the health clinic? a. 7-year-old with nausea and vomiting for the past 3 days b. 4-year-old with history of celiac disease being seen with anemia and abdominal pain c. 2-year-old who is still drinking from a bottle and is seen with anemia d. 4-month-old who is crying, is irritable, and has reddish stools

B

The clinical manifestation that indicates a progression from minor head injury to severe head injury is: a. irritability b. mounting agitation. c. an episode of vomiting. d. pallor.

B

The clinical manifestations of the main types of congenital heart disease fall into which of the following two categories? a. Decreased cardiac output and low blood pressure b. Congestive heart failure and hypoxemia c. Increased blood pressure and pulse

B

The factor that is likely to have the greatest impact on the outcome and recovery of the unconscious child is the: a. gradual reduction in intracranial pressure. b. level of nursing care and observation skills. c. emotional response of the parents. d. level of discomfort the child experiences.

B

The major nursing consideration in assisting the family of a child with nocturnal enuresis is to prevent the child from developing alterations in: a. body image. b. self-esteem. c. autonomy. d. peer acceptance.

B

The most frequently used site for bone marrow aspiration in children is the: a. femur. b. sternum. c. tibia. d. iliac crest.

B

The nurse knows that with drug reaction rashes, which of the following is true? a. It is usually localized. b. It may be delayed or immediate. c. It is more common with oral drugs. d. It usually has no associated symptoms.

B

A nurse is about to present facts to parents about the possible death of their child. In this case, which of the following techniques would be most effective in promoting communication? a. Acknowledging denial in the parents whenever it occurs b. Using only medical terms for all explanations c. Using body language to communicate caring d. Recognizing feelings and reactions but not acknowledging them

C

A visit to the intensive care unit (ICU) before open-heart surgery for a young child should take place: a. 1 week before the surgery. b. at a busy time with a lot to see and hear. c. the day before surgery. d. several weeks before the surgery.

C

Adolescent girls of low socioeconomic status are particularly at risk for dietary deficiencies of: i. calories. ii. sodium. iii. calcium. iv. folic acid. v. iron. a. i, ii, and iii b. ii, iii, iv, and v c. iii, iv, and v d. i, iii, and v

C

Decreased muscle tone in the infant with Down syndrome: a. indicates inadequate parenting. b. is a sign of infant detachment. c. compromises respiratory expansion. d. predisposes the infant to diarrhea.

C

Definitive treatment for pheochromocytoma consists of: a. surgical removal of the thyroid. b. administration of potassium. c. surgical removal of the tumor. d. administration of beta blockers.

C

Delaying vaccinations is usually recommended in the immunosuppressed child because the immune response is likely to be suboptimal; however, it is considered safe to administer: a. any vaccines. b. any live attenuated vaccines. c. any inactivated vaccines. d. the varicella vaccine.

C

Topical antimicrobial agents in burn therapy: a. eliminate organisms from the wound. b. effectively inhibit bacterial growth. c. encourage strains of resistant bacteria. d. are not used because they diffuse through eschar.

B

Treatment for Ewing sarcoma usually involves: a. radiation alone. b. radiation and chemotherapy. c. amputation and chemotherapy. d. chemotherapy alone.

B

Treatment for Wilms tumor is based on clinical stage and histologic pattern and includes: a. chemotherapy and radiation. b. radiation alone. c. surgery, chemotherapy, and radiation. d. surgery alone.

B

What period begins toward the end of middle childhood and ends at age 13? a. Puberty b. Preadolescence c. Early maturation d. All of the above

B

Which of the following skills is not necessary for the toddler to acquire before separation and individuation can be achieved? a. Object permanence b. Lack of concern about parental whereabouts c. Delayed gratification d. Ability to tolerate a moderate amount of frustration

B

Reye syndrome is widely believed to be linked to: a. administration of nonsteroidal medications for fever during an acute viral infection. b. encephalitis. c. administration of aspirin for fever in children with varicella or influenza. d. bacterial infections.

C

Stimulation of the sympathetic nervous system results in release of epinephrine and norepinephrine from: a. adrenal medulla. b. sympathetic nerves. c. adrenal medulla and sympathetic nerves.

C

The HBsAg negative mother of Daniella, a premature infant weighing 4 pounds and born 6 hours ago, asks, "Have you already given Daniella her hepatitis B vaccine?" What is your correct response? a. "Don't worry, we will give it before she leaves the hospital." b. "Daniella is sleeping right now. I will give it as soon as she wakes up." c. "Because Daniella only weighs 4 pounds, she will not receive her vaccine until she is 1 month of age." d. "Because Daniella is premature and weighs only 4 pounds, she will be given one vaccine dose now and then she will need another in 2 months."

C

The ________________ is the most immature of all the gastrointestinal organs throughout infancy. a. large intestine b. pylorus c. liver d. lower esophageal sphincter

C

The best positioning to use when performing venipuncture on the arm of a toddler is to: a. give simple instructions for the child to hold still. b. mummy restrain the toddler. c. place the child in parent's lap in straddle position. d. hold the child's upper body to prevent movement.

C

The calories are usually increased for an infant with heart failure by: a. increasing the number of feedings. b. introducing solids into the diet. c. increasing the caloric density of the formula. d. gastrostomy feeding.

C

The disease that continues to be a leading cause of death in all age-groups of children is: a. type 1 diabetes mellitus. b. acquired immunodeficiency syndrome (AIDS). c. cancer. d. infectious disease.

C

The primary reason for introducing solid food to infants is to: a. increase their overall caloric intake. b. provide a substitute for the milk source. c. introduce a taste and chewing experience. d. increase their weight.

C

To instill eye drops in an infant whose eyelids are clenched shut, the nurse should: a. apply finger pressure to the lacrimal punctum. b. place the drops in the nasal corner where the lids meet and wait until the infant opens the lid. c. administer the eye drops before nap time. d. use any of the above techniques.

C

To practice cultural humility with children and their families, the nurse should: a. disregard one's own cultural values. b. identify behavior that is abnormal. c. recognize characteristic behaviors of certain cultures. d. rely on one's own feelings and experiences for guidance.

C

Transfer from the intensive care unit to the regular pediatric unit can be best facilitated by: a. discussing the details of the transfer at the bedside, where the child can listen. b. establishing a schedule that mimics the child's home schedule. c. assigning a primary nurse from the regular unit who visits the child before the transfer. d. explaining to the family that there are fewer nurses on the regular unit.

C

Which of the following reactions to surgery is most typical of an adolescent's reaction of fear of bodily injury? a. Concern about the pain b. Concern about the procedure itself c. Concern about the scar d. Understanding explanations literally

C

Which of the following signs is used to evaluate increased intracranial pressure in the infant but not in the older child? a. Projectile vomiting b. Headache c. Tense or bulging fontanel d. Fatigue

C

The initial treatment for the child with hyperthyroidism is: a. subtotal thyroidectomy. b. total thyroidectomy. c. ablation with radioactive iodide. d. administration of antithyroid medication.

D

The nurse would expect which of the following conditions to produce an increased fluid requirement? a. Heart failure b. High intracranial pressure c. Mechanical ventilation d. Tachypnea

D

The sibling of a dying child may feel: a. displaced. b. isolated. c. resentful. d. all of the above.

D

Which of the following techniques is recommended to provide atraumatic care for immunization administration to infants? a. Select a 1 inch needle to deposit vaccine deep into the vastus lateralis. b. Use an air bubble to clear the needle before injection. c. Use the deltoid muscle. d. Use the EMLA patch before administration.

A

Which of the following usually indicates that the intussusception has reduced itself? a. Passage of a normal brown stool b. Increase in appetite c. Hyperactive bowel sounds d. Normal complete blood count

A

Which of the following would be an inappropriate method to help a toddler adjust to the initial dental checkup? a. Explain to the child that a checkup will not hurt. b. Have the child observe his or her sibling's examination. c. Have the child perform a checkup on a doll. d. Ask the dentist to reserve a thorough examination for another visit.

A

Which one of the following is a correct interpretation in the use of reasoning as a form of discipline? a. Used for older children when moral issues are involved. b. Used for younger children to "see the other side" of an issue. c. Used only in combination with scolding and criticism. d. Used to allow children to obtain lengthy explanations and a greater degree of attention from parents.

A

Which one of the following is an expected finding in the child's eye examination? a. Bilateral red reflex of the eye b. Ophthalmoscopic examination revealing a black optic disc c. Strabismus in the 12-month-old infant d. A 5-year-old child who reads the Snellen eye chart at the 20/40 level

A

Which one of the following is not a description of the use of time-out as a discipline? a. Allows the reinforcer to be maintained. b. Involves no physical punishment. c. Offers both parents and child "cooling off" time. d. Facilitates the parent's ability to consistently apply the punishment.

A

Which one of the following statements is false? a. Most reporting of abuse has been from the middle socioeconomic population. b. One child is usually the victim in an abusive family; removal of this child often places the other sibling(s) at risk. c. The abusive family environment is often one of chronic stress, including problems of divorce, poverty, unemployment, and poor housing. d. Child abuse is a problem of all socioeconomic groups.

A

Which symptom suggests pyelonephritis in a 3-year-old child? a. Flank pain and tenderness b. Foul-smelling urine c. Dysuria or urgency d. Enuresis or daytime incontinence

A

With the concept of atraumatic care in mind, preoperative sedation in children is administered by: a. intramuscular route. b. intradermal route. c. subcutaneous route. d. oral route.

A

Zac, a 16-year-old football star at the local high school, is at the school nurse practitioner's office for acne that is not clearing with the over-the-counter medications. During the physical examination, the nurse notes that Zac has achieved a marked increase in muscle and strength in a very short time. Which of the following would the nurse suspect caused these changes? a. Use of an ergogenic aid, anabolic steroids b. More frequent and more strenuous workouts in the gym c. Increased protein and vitamins in the diet d. Use of methylphenidate (Ritalin) or phenmetrazine (Preludin)

A

Bruce, a full-term newborn, has symptomatic hypoglycemia and inability to tolerate oral feedings. An intravenous glucose infusion has been ordered. Which of the following does the nurse recognize as correct? a. Too rapid infusion of the hypertonic solution can cause intracellular overload. b. An initial bolus infusion of 10% dextrose will be given over a 10-minute interval, followed by continuous dextrose infusion for 24 hours. c. The infusion is maintained at the ordered flow rate via an intravenous pump with hourly intake charting to decrease the risk of circulatory overload. d. Termination of the glucose solution should be rapid to prevent hyperinsulinism.

A

Changes in family structure and parent employment have resulted in: a. adolescents having more time unsupervised by adults. b. adolescents having more time for communication and intimacy with parents. c. adolescents having less time to spend with peers. d. adolescents requiring more supervision by outside family members.

A

Child misbehavior requires parental implementation of appropriate disciplinary action. Identify which one of the following would not be an appropriate guideline for implementing discipline. a. Focus on the child and the misbehavior by using "you" messages rather than "I" messages. b. Maintain consistency with disciplinary action. c. Make sure all caregivers maintain unity by agreeing on the plan and being familiar with details before implementation. d. Maintain flexibility by planning disciplinary actions appropriate to the child's age, temperament, and severity of misbehavior.

A

Children 12 years of age and older who are victims of homicide tend to be killed by: a. firearms. b. family members. c. stabbing. d. poor safety devices on firearms.

A

Children who will undergo cardiac surgery should be informed about: a. the location of the intravenous lines. b. the pain at the intravenous insertion sites. c. the need to lie still at all times after surgery. d. all of the above.

A

Children with CP often have manifestations that include alterations of muscle tone. Which of the following is an example of a finding in a child with altered muscle tone? a. Demonstrates increased or decreased resistance to passive movements b. Develops hand dominance by the age of 5 months c. Has an asymmetric crawl d. When placed in prone position, maintains hips higher than trunk, with legs and arms flexed or drawn under the body

A

Children with pinworm infections are seen with the principal symptom of: a. perianal itching. b. diarrhea with blood. c. evidence of small, ricelike worms in their stool and urine. d. abdominal pain.

A

Chronic glomerulonephritis (CGN) describes a variety of different disease processes that may be distinguished from one another by: a. renal biopsy. b. cystoscopy. c. blood cultures. d. serologic tests, including ASO titers.

A

Cindy is 12 years old and is brought to the clinic because of a bald spot developing on her head. Cindy wears her hair tightly braided with beads. Which of the following should the nurse suspect? a. Alopecia from trauma b. Tinea capitis c. Psoriasis d. Urticaria

A

Cindy, age 16 years, reports that she has been sexually abused by her uncle. The nurse knows that the adolescent who has been a victim of sexual abuse: a. should be informed about the steps in the reporting process before information is disclosed to local authorities. b. is more likely to become a runaway. c. is more likely to remain in school and form ties with less-threatening families. d. will usually attempt suicide within 1 month of reporting the incident.

A

Clinical manifestations differentiate bacterial conjunctivitis from viral conjunctivitis. Which of the following is present with bacterial conjunctivitis but not usually found with viral conjunctivitis? a. Child awakens with crusting of eyelids. b. Child has increase in watery drainage from eyes. c. Child has inflamed conjunctiva. d. Child has swollen eyelids.

A

Coarctation of the aorta should be suspected when: a. the blood pressure in the arms is different from the blood pressure in the legs. b. the blood pressure in the right arm is different from the blood pressure in the left arm. c. apical pulse is stronger than the radial pulse. d. point of maximum impulse is shifted to the left.

A

Commotio cordis: a. occurs after a blunt, nonpenetrating blow to the chest, which produces ventricular fibrillation. b. rarely causes death. c. occurs almost exclusively in athletes with hypertrophic cardiomyopathy. d. occurs in athletes who have a history of sudden death in a relative under the age of 50 years.

A

Compared with childhood peer groups, adolescent peer groups are: a. more likely to include peers from the opposite sex. b. less autonomous. c. less likely to influence members' socialization roles. d. more likely to require parental supervision.

A

Congenital lactase deficiency is: a. a rare form of lactose intolerance. b. the form of lactose intolerance associated with giardiasis. c. an intolerance that is manifested later in life. d. a form of lactose intolerance caused by intestinal damage.

A

Conversion reaction: a. is a psychophysiologic disorder associated with sudden onset. b. is more common in girls during childhood and adolescence. c. has an organic cause. d. is diagnosed on the basis of seizures and abnormal electroencephalogram.

A

Current research supports the notion that: a. involvement in the experiences of the dying sibling is beneficial. b. siblings of children who died in the hospital reported readiness for the death. c. protecting the sibling of the dying child from the death rituals is beneficial. d. it is better for the sibling to remember the dying child as he or she was when alive.

A

Diagnostic evaluation results for hemolytic uremic syndrome include which of the following? a. Anemia, thrombocytopenia, and renal failure b. High potassium, low sodium, high hemoglobin and hematocrit, and proteinuria c. High number of urinary casts, low serum BUN and creatinine, and decreased sedimentary rates d. Urine negative for protein but positive for red blood cells, normal hemoglobin and hematocrit, and elevated serum BUN and creatinine levels

A

Diagnostic evaluations for lead poisoning include: a. lead concentration from a venous blood specimen to confirm diagnosis. b. recommended universal screening for all children, with those ages 6 years or older given priority. c. identifying children at high risk for anemia, since these children will most likely have higher lead levels. d. understanding that a blood level for lead in the 3 to 5 mcg/dl range is normal and the child should be rescreened in 1 year unless exposure status changes.

A

Discharge planning for children with lead poisoning includes: a. confirmation that the child will be discharged to a home without lead hazards. b. immediate referral for development and speech therapy. c. visiting nurse care for continuation of intravenous treatment at home. d. explanation that there is little need for follow-up, because lead levels have returned to normal.

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Drug side effects associated with cyclophosphamide (Cytoxan) are: i. neutropenia. ii. infection. iii. gonadal toxicity. iv. hypertension. v. cognitive impairment. a. i, ii, and iii b. i, iv, and v c. ii, iii, and v d. i, ii, iii, iv, and v

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During wound healing, immature connective tissue cells migrate to the healing site and begin to secrete collagen into the meshwork spaces. What is this phase called? a. Fibroplasia b. Scar contracture c. Inflammation d. Scar maturation

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Emergency treatment of a child with a head injury would generally not include: a. administering analgesics. b. checking pupils' reaction to light. c. stabilizing the neck and spine. d. checking level of consciousness.

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Epidural hemorrhage is less common in children under 2 years of age than in adults because: a. the dura is closely attached to the skull in fancy, slowing the spread of blood. b. fractures are less likely to lacerate the middle meningeal artery in children under 2 years of age. c. separation of the dura from bleeding is more likely to occur in children than in adults. d. there is an increased tendency for the skull to fracture in children under 2 years of age.

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Etiology of a nonrecurrent acute seizure includes which of the following? a. Febrile episodes b. Idiopathic epilepsy c. Epilepsy secondary to hemorrhage d. Hypoglycemic status hypopituitarism

A

Factors that best promote adolescent health and well-being include: a. connections with adults outside the family, with the school, or other supportive groups. b. the ability of the adolescent to have universal access to the Internet. c. interventions that focus the responsibility for adolescent health to one person or setting d. health promotion efforts aimed at identification of adolescent needs.

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Fragile X syndrome is: a. the most common inherited cause of cognitive impairment. b. the most common inherited cause of cognitive impairment next to Down syndrome. c. caused by an abnormal gene on chromosome 21. d. caused by a missing gene on the X chromosome.

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Gastric lavage for pediatric poison ingestions: a. can be associated with serious complications of gastrointestinal perforation, hypoxia, and aspiration. b. is recommended in the emergency department for all cases of ingestion. c. has been proven to decrease morbidity. d. is most useful when the child comes to the emergency department within 3 hours of ingestion of the toxin.

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Growth and development during middle adolescence includes which of the following? a. Characterized by a transition to a dominant peer orientation b. Characterized by the changes of puberty and the responses to those changes c. Characterized by the taking on of adult roles d. Characterized by excellent conflict resolution over parental control

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Hereditary retinoblastomas are a result of: a. a germline mutation. b. a somatic mutation. c. a chromosomal aberration. d. an autosomal recessive trait.

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Home management for children with nasopharyngitis may include: a. antipyretics. b. antihistamines. c. expectorants. d. cough suppressants.

A

Identified characteristics of parents who are at higher risk for abusing their children do not include: a. older parents who waited until their mid-30s before having their first child. b. isolated parents with few supportive relationships. c. parents who grew up with poor role models. d. single-parent family.

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Identify four populations at risk for vitamin D deficiency or rickets. a. b. c. d.

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If cow's milk intolerance is suspected as the cause of an infant's colic, the parents should: a. try substituting hydrolyzed formula. b. try substituting soy formula. c. be reassured that the symptoms will disappear spontaneously at about 3 months of age. d. be assessed for areas of improper feeding techniques.

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If failure to thrive has been a long-standing problem, the infant will show evidence of: a. both weight and height being decreased. b. weight restriction only. c. height restriction only. d. increased head circumference.

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If parents are concerned about the fact that their 14-month-old infant is not walking, the nurse should evaluate the cephalocaudal gross motor skill patterns and particularly evaluate whether the infant: a. pulls up to furniture. b. uses a pincer grasp. c. transfers objects. d. has developed object permanence.

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If the patient has an increase in intracranial pressure, one test that is contraindicated is the: a. LP. b. subdural tap. c. CT. d. DSA.

A

Immediate treatment of sprains and strains includes: a. rest and cold application. b. disregarding the pain and "working out" the sprain or strain. c. rest, elevation, and pain medication. d. compression of the area and heat application.

A

In assessing pain in children, the nurse understands that: a. an important aspect is forming a trusting relationship with the child and the family. b. the most important aspect is the relationship that develops between the parents and the nurse. c. the assessment should occur when the child is in pain. d. the assessment should occur when the child is pain free.

A

In evaluation of the child with possible renal trauma, which of the following is usually indicative of kidney damage? a. Flank pain and hematuria b. Dysuria, proteinuria, and nausea c. Abdominal ascites, nausea, and hematuria d. Proteinuria and bladder spasms

A

In fetal circulation the majority of the oxygenated blood is pumped through the: a. foramen ovale. b. lungs. c. liver. d. coronary sinus.

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In hospitals, which of the following is the most significant source of methicillin-resistant Staphylococcus aureus (MRSA) and the major mode of transport? a. Patient to patient via the hands of the health care provider b. Patients coming in direct contact with other patients c. Failure of hospital personnel to wear face masks when working with patients in an airborne infection isolation room d. Indirect contact transmission from hospital equipment

A

In preparing the nursing care plan for the infant born with craniofacial abnormalities, the nurse recognizes which of the following as true? a. Children with this deformity always have some cognitive impairment. b. Abnormalities include deformities involving the skull, facial bones, and neck. c. A helmet is often required after surgery to protect the operative site and bone grafts for 5 years. d. Surgical correction involves peeling the patient's face away from the skull and remolding the understructures.

A

In the child taking digoxin, ECG signs that the drug is having the intended effect are: a. prolonged P-R interval and slowed ventricular rate. b. shortened P-R interval and slowed ventricular rate. c. prolonged P-R interval and faster ventricular rate. d. shortened P-R interval and faster ventricular rate.

A

In the child who is suspected of having epiglottitis, the nurse should: a. have intubation equipment available. b. prepare to immunize the child for H. influenzae. c. obtain a throat culture. d. do all of the above.

A

In the infant who is admitted with possible RSV, the nurse would expect the laboratory to perform: a. enzyme-linked immunosorbent assay test on nasal secretions. b. a viral culture of nasal secretions. c. a bacterial culture of nasal secretions. d. a culture of the blood.

A

Internet chatrooms and social networking: a. have allowed adolescents a more public arena for developing interpersonal skills. b. have decreased the amount of bullying in the school setting. c. have increased the development of multitasking and longer attention spans in the adolescent. d. have decreased adolescents' risk-taking behaviors.

A

Jerry, a 4-year-old, is brought to the emergency department by his parents, who say he vomited a large amount of bright red blood. Jerry is pale, is cool to the touch, and has increased respiratory rate and heart rate. The nurse expects priority care at this time to include: a. administration of intravenous fluids, usually normal saline or lactated Ringer solution. b. stool testing for blood by hemoccult. c. insertion of a nasogastric tube for ice-water lavage. d. preparation for tracheostomy.

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Johnny, a 12-year-old with fracture of the femur, has developed sudden chest pain and shortness of breath. The astute nurse suspects: a. pulmonary embolism. b. compartment syndrome. c. myocardial infarction. d. pneumonia.

A

Of the four infants described, which one should the nurse recognize as being least likely to develop jaundice? a. An infant with subgaleal hemorrhage that is now resolving b. An infant with cephalhematoma that is now resolving c. An infant who has feedings started early, which will stimulate peristalsis and rapid passage of meconium d. An infant who is of Native American descent

A

On palpation of 3-year-old Jennifer's apical impulse, where would the nurse expect to place the fingers? a. At the left midclavicular line and fourth intercostal space b. Lateral to the left midclavicular line and fifth intercostal space c. Over the pulmonic valve d. Over the aortic valve

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One of the most common causes of thyroid disease in children and adolescents is: a. Hashimoto disease. b. Graves disease. c. goiter. d. thyrotoxicosis.

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One of the most important factors in preventing bacterial endocarditis (BE) in high-risk patients is: a. administration of prophylactic antibiotic therapy. b. surgical repair of the defect. c. administration of routine childhood immunizations. d. administration of antibiotics after dental work.

A

One recommended method to foster language development in the toddler is to: a. read books together. b. watch an educational program on the television. c. increase the toddler's exposure to a large number of adults and older children. d. encourage the toddler to watch at least 2 hours of children's television shows per day.

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Osteomyelitis resulting from a bloodborne bacterium that could have developed from an infected lesion is termed: a. acute hematogenous osteomyelitis. b. exogenous osteomyelitis. c. subacute osteomyelitis. d. chronic osteomyelitis.

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Other terms for failure to thrive include: a. growth faltering and pediatric undernutrition. b. growth faltering and organic failure to thrive. c. pediatric undernutrition and nonorganic failure to thrive. d. organic failure to thrive and nonorganic failure to thrive.

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Piaget's theory of cognitive development depicts the toddler as a child who: a. repeatedly explores the same object each time it appears in a new place. b. is able to transfer information from one situation to another. c. has a persistent negative response to any request. d. has the rudimentary beginning of a superego.

A

Preoperative instructions to prepare parents of a child who is scheduled for eye enucleation should include which of the following? a. "There will be a cavity in the skull where the eye was." b. "The child's face may be edematous and ecchymotic." c. "The eyelids will be open and the surgical site will be sunken."

A

Primary prevention of communicable disease is best accomplished by: a. immunization. b. control of the disease spread. c. adequate water supply. d. implementing good hand-washing practices among hospital personnel.

A

Recommended diagnostic evaluation for infants at risk for CP includes: a. magnetic resonance imaging of the brain. b. computed tomographic scan of the brain. c. laboratory testing. d. metabolic and genetic testing when structural abnormality is identified.

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Research has shown that maternal supplementation of folic acid can reduce the recurrence rates of spina bifida, anencephaly, or encephalocele. How should this supplement be administered? a. Daily folic acid dose of 4 mg beginning 1 month before conception and during the first trimester b. Daily folic acid dose of 0.4 mg as soon as pregnancy is confirmed c. Daily folic acid dose of 4 mg given through the use of multivitamin preparations beginning 1 month before conception and throughout the first trimester d. Daily folic acid dose of 4 mg beginning with the confirmation of pregnancy and continuing throughout pregnancy

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Separation is one of the greatest threats to seriously ill children of which age-group? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

A

Seven-year-old Andy was caught taking a playmate's toy. Which of the following is an important understanding of this behavior? a. At this age, Andy's sense of property rights is limited, and he took the item simply because he was attracted to it. b. If Andy is caught and punished and promises "not to do it again," he will keep his promise. c. This stealing act is an indication that something is seriously lacking in Andy's life. d. Andy will learn the importance of respecting others' property if the parents unexpectedly give away an item of Andy's.

A

Sleep problems in the school-age child are often demonstrated by: a. delaying tactics because the child does not wish to go to bed. b. night terrors that awaken the child during the night. c. the development of somatic illness that awakens the child during the night. d. the increasing need for larger amounts of sleep compared with preschool and adolescent children.

A

Slipped capital femoral epiphysis is suspected when: a. an adolescent or preadolescent begins to limp and complains of continuous or intermittent pain in the hip. b. an examination reveals no restriction on internal rotation or adduction but restriction on external rotation. c. referred pain goes into the sacral and lumbar areas. d. all of the above occur.

A

Strategies to prevent ventilator-associated pneumonia in infants and children include all of the following except: a. endotracheal suctioning every 2 hours. b. elevation of the head of the bed (30-35 degrees). c. oral care every 4 hours. d. closed suctioning system.

A

Studies in adults, which presumably may apply to children as well, indicate that benefits of an adequate intake of dietary fiber: i. decrease constipation. ii. increase body weight. iii. decrease body weight. iv. prevent type 2 diabetes mellitus. v. prevent type 1 diabetes mellitus. a. i, iii, and iv b. i, iii, and v c. ii and iv d. iii, iv, and v

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Surgical shunts are often required to provide drainage in the treatment of hydrocephalus. What is the preferred shunt for infants? a. Ventriculoperitoneal shunt b. Ventriculoatrial shunt c. Ventricular bypass d. Ventriculopleural shunt

A

Susan, age 15 years, comes to the school-based clinic and complains to the provider about a vaginal discharge. After the nurse has established a trusting and confidential relationship, Susan confides that she has been sexually active with three different partners within the past 6 months. She thinks they used condoms every time, but she is not sure. Susan's last period was 4 weeks ago, and she has never had a Pap test. What tests would the nurse assisting the provider expect to prepare for? i. Pap test ii. Gonorrhea test iii. Chlamydia test iv. Human immunodeficiency virus test v. Pregnancy test vi. Syphilis test a. ii, iii, iv, v, and vi b. i, ii, iii, iv, v, and vi c. ii, iii, iv, and vi d. i and v

A

Symptoms in celiac disease include stools that are: a. fatty, frothy, bulky, and foul smelling. b. currant jelly-appearing. c. small, frothy, and dark green. d. white with an ammonia-like smell.

A

Symptoms that are similar to those of Reye syndrome have occurred during viral illnesses when the child was given an: a. antiemetic drug. b. analgesic drug. c. antiepileptic drug. d. antiarrhythmic drug.

A

Tammy, age 13 years, is diagnosed with myasthenia gravis. The nurse, in preparing a teaching plan for the family, includes which of the following as a priority? a. Observing for signs of overmedication of anticholinesterase drugs, which include salivation, vomiting, and weakness of respiratory muscles b. Encouraging Tammy to be involved in strenuous activity and sports c. Suggesting to Tammy and her parents that they limit Tammy's scholastic activities in school to allow for adequate rest d. Reducing Tammy's weight to reduce symptom occurrence

A

The American Academy of Pediatrics has recommended vitamin A supplements for certain pediatric patients with measles. Correct dosage of vitamin A and instructions to parents of these children include: i. single oral dose of 200,000 international units in children 1 year old. ii. single oral dose of 100,000 international units in children 6 to 12 months old. iii. dosage may be associated with vomiting and headache for a few hours. iv. safe storage of the drug to prevent accidental overdose. a. i, ii, iii, and iv b. i, ii, and iv c. i, iii, and iv d. ii and iv

A

The adolescent with body art: a. seeks body art as an expression of personal identity and style and to mark significant life events. b. is at lower risk for scarring if the piercing was done on the ear or nose because of the poor blood supply. c. should be advised to have the professional use a piercing gun for all piercings. d. should be advised that complications of piercing include infection and bleeding, but rarely keloid formation, which occurs most often with tattoos.

A

The adolescent with testicular torsion is most likely to be initially seen with which of the following signs and symptoms? a. Tender, painful swelling of the testes b. A mass in the posterior aspect of the scrotum that can be transilluminated c. A heavy, hard, painless mass palpable on the anterior or lateral surface of the testicle d. An asymptomatic scrotal mass that aches, especially after exercise or penile erection

A

The anesthetic EMLA is used: a. before procedures involving skin puncture. b. as preoperative oral sedation. c. for chronic cancer pain. d. postoperatively.

A

The assessment method that the nurse expects to provide the most reliable evaluation about the physical growth pattern of a preschool-age child is: a. recording height and weight measurements of the child and comparing growth measurements over time. b. keeping a flow sheet for height, weight, and head circumference increases. c. obtaining a history of sibling growth patterns. d. measuring the height, weight, and head circumference of the child.

A

The best approach to the management of obesity in children and adolescents is: a. prevention. b. pharmacologic agents sibutramine and orlistat. c. bariatric surgery. d. behavior modification.

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The best way for parents to respond to a child's questions about sexuality is to give the child: a. an honest answer and find out what the child thinks. b. one or two sentences that answer specific questions only. c. an honest, short, and to-the-point answer. d. an honest answer but a little less information than the child expects.

A

The child who receives a stem cell transplant will require: a. meticulous personal hygiene. b. multiple peripheral sites for intravenous therapy. c. less chemotherapy before the transplant. d. a room with laminar air flow.

A

The child with irritable bowel syndrome is most likely to present with: a. history of alternating diarrhea and constipation, recurrent abdominal pain, and bloating. b. alternating patterns of constipation and bloody diarrhea with little flatulence. c. history of parasitic infections, poor nutrition, and low abdominal pain. d. history of colic, laxative abuse, and growth retardation.

A

The condition recognized in the infant with limited neck motion, in which the neck is flexed and turned to the affected side as a result of shortening of the sternocleidomastoid muscle, is: a. torticollis. b. brachial plexus palsy. c. lordosis. d. kyphosis.

A

The embryologic development of the heart results in a heartbeat by the: a. fourth week. b. fifth week. c. sixth week. d. eighth week.

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The expected predominant symptom of a superficial burn is: a. pain. b. significant tissue damage. c. absence of protective functions of the skin. d. blister formation.

A

The factor that best determines the quality of the infant's formulation of trust is the: a. parental attachment. b. degree of mothering skill. c. quantity of the mother's breast milk. d. length of suckling time.

A

The goal of the physical assessment for child physical abuse: a. is to identify all injuries. b. always begins with rapid assessment of airway, breathing, circulation, and neurologic systems. c. should recognize that all forms of physical abuse have obvious signs. d. should occur only after legal authorities have been notified.

A

The hormone in the female that causes growth and development of the vagina, uterus, fallopian tubes, and breasts is: a. estrogen. b. progesterone. c. follicle-stimulating hormone (FSH). d. luteinizing hormone (LH).

A

The infant is predisposed to a more rapid loss of total body fluid and dehydration because: a. of a high proportion of extracellular fluid. b. of a high proportion of intracellular fluid. c. total body water is at about 40%. d. extracellular fluid is 20% of the total.

A

The infant is predisposed to developing otitis media because the eustachian tubes: a. lie in a relatively horizontal plane. b. have a limited amount of lymphoid tissue. c. are long and narrow. d. are underdeveloped.

A

The infant's posterior fontanel usually closes by: a. 6 to 8 weeks. b. 3 to 6 months. c. 12 to 18 months. d. 9 to 12 months.

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The intravenous medication that is used to treat seizures and may be given in either saline or glucose is: a. fosphenytoin. b. phenytoin. c. valproic acid. d. felbamate.

A

The major determinant of neonatal death in technologically developed countries is: a. birth weight. b. short gestation. c. long gestation. d. human immunodeficiency virus (HIV) infection.

A

The major pulmonary changes that occur in submersion injury are directly related to: a. duration of submersion and severity of the hypoxia. b. amount of fluid aspirated and the type of fluid aspirated. c. the amount of blood shunted away from the lungs and the amount of water swallowed. d. the victim's physiologic response and amount of fluid aspirated.

A

The medications that are controversial in the management of increased intracranial pressure are: a. barbiturates. b. paralyzing agents. c. sedatives. d. antiepileptics.

A

The method of communication used with combined auditory and visual impairments that involves spelling into the child's hand is called: a. finger spelling. b. the Tadoma method. c. blindism. d. the tapping method.

A

The most common bone cancer is most likely to occur in which age-group? a. Infancy b. Preschool age c. School age d. Adolescence

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The most common mode of transmission for bacterial meningitis is: a. vascular dissemination of an infection elsewhere. b. direct implantation from an invasive procedure. c. direct extension from an infection in the mastoid sinuses. d. direct extension from an infection in the nasal sinuses.

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The most common type of cardiomyopathy found in children is: a. dilated cardiomyopathy. b. hypertrophic cardiomyopathy. c. restrictive cardiomyopathy. d. secondary cardiomyopathy.

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The most effective intervention for the treatment of fever in a 4-year-old child is to administer: a. a tepid sponge bath. b. aspirin. c. an alcohol sponge bath. d. acetaminophen.

A

The most effective method for tick removal in a child is to: a. use tweezers and grasp close to the point of attachment; then pull straight out using steady, even pressure. b. apply mineral oil to the back of the tick and wait for it to back out. c. use the fingers to pull the tick out with a straight, steady, even pressure. d. place a hot match on the back of the tick and pick it up with gloved hands when the tick falls off.

A

The most efficient rotation pattern for insulin injections involves giving injections in: a. one area of the body 1 inch apart, and moving to different area after 4 to 6 injections. b. different areas of the body each day.

A

The most ideal way to support parents when they first visit the child in the intensive care unit is: a. for the nurse to accompany them to the bedside. b. to use picture books of the unit in the waiting area. c. to limit the visiting hours so that parents are encouraged to rest. d. to expect parents to stay with their child continuously.

A

The most immediate threat to the life of the child with acute kidney injury is: a. hyperkalemia. b. anemia. c. hypertension crisis. d. cardiac failure from hypovolemia.

A

The most painful part of cardiac surgery for the child is usually the: a. thoracotomy incision site. b. graft site on the leg. c. sternotomy incision site. d. intravenous insertion site.

A

The nurse can expect that an infant will begin to respond discriminately to others, particularly the mother, and respond by crying, smiling, and vocalizing at about _________ of age: a. 2 to 3 months b. 4 to 5 months c. 6 to 7 months d. 8 to 9 months

A

The nurse is assessing the mouth and throat of 7-month-old Alex. Which of the following is recognized as a normal finding? a. Membranes are bright pink, smooth, and glistening. b. White curdy plaques are located on the tongue. c. Redness and puffiness are present along the gum line. d. Tip of the tongue extends to the gum line.

A

The nurse is preparing Dottie, age 7, for an upper GI endoscopy. Which of the following does the nurse recognize as not being an appropriate preparation for this test? a. Bowel cleansing with magnesium citrate or GoLYTELY b. Keeping Dottie NPO (nothing by mouth) for 8 hours before the procedure c. Giving Dottie sedation before the procedure is begun d. Explaining to Dottie in advance about the procedure by use of pictures or play with dolls and demonstration

A

The nurse knows that sleepwalking in childhood can best be described by which of the following statements? a. During sleepwalking, the movements are clumsy and repetitive. b. Sleepwalking occurs in the first 1 to 2 hours of sleep. c. During sleepwalking, speech is comprehensible. d. The child remembers the episode in the morning.

A

The nurse observes frothy saliva in the mouth and nose of the neonate, as well as frequent drooling. When fed, the infant swallows normally, but suddenly the fluid returns through the infant's nose and mouth. The nurse should suspect what medical condition? a. Esophageal atresia b. Cleft palate c. Anorectal malformation d. Biliary atresia

A

The nurse plans to conduct a sex education class for 10-year-olds. Which of the following does the nurse recognize as most appropriate for this age-group? a. Present sex information as a normal part of growth and development. b. Discourage question-and-answer sessions. c. Because sexual information supplied by parents usually produces feelings of guilt and anxiety in children, avoid parental assistance in conducting the program. d. Segregate boys from girls and include information related only to same sex in the discussion.

A

The nurse recognizes which of the following individuals as having the least water content in relation to weight? a. Obese adolescent female b. Thin adolescent female c. Obese adolescent male d. Thin adolescent male

A

The nurse, caring for a pediatric patient with septic shock, knows that therapeutic goals associated with tissue perfusion include: i. capillary refill <2 seconds ii. arterial pressure 65-70 mm Hg iii. urinary output >0.5 ml/kg/hr iv. CVP 8-12 mm Hg a. i, ii, iii, and iv b. i, ii, and iii c. i and iii d. ii, iii, and iv

A

The nurse, in preparing the child for a diagnostic test, explains that which of the following tests provides direct visualization of the bladder through a small scope? a. Cystoscopy b. Voiding cystourethrogram c. Intravenous pyelogram d. Renal biopsy

A

The nursing intervention that would be most helpful for the child who has stomatitis from cancer chemotherapy would be: a. an anesthetic preparation without alcohol. b. viscous lidocaine (Xylocaine). c. lemon glycerin swabs. d. a mild sedative.

A

The observation periods for establishing brain death in children: a. differ from age to age. b. are the same at all ages. c. require an observation period of at least 7 days. d. require an observation period of at least 48 hours.

A

The practitioner has prescribed tretinoin cream (Retin-A) for Nancy's acne. Nancy has been using the cream for 2 weeks and is concerned she is not improving. Nancy tells the nurse that she has "done everything" that she was told to do and asks, "Why is my acne no better?" The nurse's best reply is: a. "It is normal for it to take weeks to months to see improvement with acne medications." b. "You must not be using the medication right. Show me how you apply it to your face." c. "Acne is caused by dirt or oil on the surface of the skin. You will need to increase the number of times you wash these areas each day." d. "You will probably need to ask the practitioner about changing your medicine as soon as possible."

A

The primary diagnostic tool for detecting hydrocephalus in older infants and children is: a. computed tomography or magnetic resonance imaging. b. measuring head circumference. c. echoencephalography. d. ultrasonography.

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The primary goal of nursing care for the adolescent rape victim is: a. not to inflict further stress on the victim. b. obtaining a complete history of the incident. c. assisting in the physical examination. d. notifying the police and the parents of the victim before proceeding with assessment.

A

The primary therapeutic regimen for moderate to severe acute laryngotracheobronchitis usually includes: a. vigilant assessment, cool mist, racemic epinephrine, and corticosteroids. b. vigilant assessment, cool mist, racemic epinephrine, and antibiotics. c. intubation, cool mist, racemic epinephrine, and corticosteroids. d. intubation, nebulized epinephrine, and antibiotics.

A

The priority nursing consideration for the child in the acute phase of GBS is: a. careful observation for difficulty in swallowing and respiratory involvement. b. prevention of contractures. c. prevention of bowel and bladder complications. d. prevention of sensory impairment.

A

The recommended treatment for the child who has clinically active tuberculosis includes a 6-month regimen of: i. isoniazid (INH). ii. rifampin. iii. pyrazinamide (PZA). iv. ethambutol. v. rocephin. a. i, ii, and iv b. iv and v c. i, ii, iii, and iv d. i, ii, and iii

A

The resolution of the Oedipus/Electra complex occurs when the child: a. identifies with the same-sex parent. b. realizes that the same-sex parent is more powerful. c. wishes that the same-sex parent were dead. d. notices physical sexual differences.

A

The standard adult "rule of nines" cannot be used to determine the total body surface area of a burn in a child because: a. the child has different body proportions than the adult. b. the child has different fluid body weight than the adult. c. the child's trunk and arm proportions are larger than the adult's. d. as the infant grows, the percentage allotted for the head increases while the percentages for the arms decrease.

A

The standard treatment for Kawasaki disease is: a. aspirin and immune globulin. b. aspirin and cryoprecipitate. c. meperidine hydrochloride and immune globulin. d. meperidine hydrochloride and cryoprecipitate.

A

The temporary treatment for hyperaldosteronism before surgery usually involves administration of: a. spironolactone and potassium. b. phentolamine and sodium. c. furosemide and phosphorus. d. phenoxybenzamine.

A

The therapy for infantile spasms is likely to include: a. adrenocorticotropic hormone. b. valproic acid and vigabatrin. c. ethosuximide only. d. felbamate only.

A

Therapeutic management for chlamydia includes: a. doxycycline. b. intramuscular injection of ceftriaxone (Rocephin). c. intramuscular injection of penicillin. d. clarithromycin.

A

To best effect adolescent health promotion activity, the nurse should incorporate which of the following in the plan? a. The adolescent's definition of health b. The adolescent's past health promotion activities c. A complete assessment of the adolescent's past medical treatment d. A complete physical examination

A

To help alleviate the discomfort and fever of acute otitis media, the parents are advised to administer: i. acetaminophen or ibuprofen (as age permits). ii. antihistamines (as age permits). iii. benzocaine ear drops. iv. decongestants (as age permits). a. i and iii b. ii and iv c. ii, iii, and iv d. i and iv

A

To maintain adequate nutrition and promote healing in the child with a major burn injury, the nurse would recommend which of the following nutrition plans? a. Diet high in proteins and calories b. Diet high in calories and low in proteins c. Diet high in fats and carbohydrates d. Diet high in vitamins A and D

A

To obtain a sputum specimen to test for tuberculosis in an infant, the nurse may need to: a. stimulate the infant's cough reflex. b. obtain mucus from the throat. c. insert a suction catheter into the back of the throat. d. perform gastric lavage.

A

To obtain relevant information from the parents of a child with fluid and electrolyte disturbances, the nurse should question the parents about: a. the type and amount of the child's intake and output. b. the child's general appearance. c. the child's weight over the past month. d. whether they have taken the child's temperature within the past 24 hours.

A

To prepare a breastfed infant physically for surgery, the nurse would expect to: a. permit breastfeeding up to 4 hours before surgery. b. withhold breastfeeding from midnight the night before surgery. c. permit breastfeeding up to 6 hours before surgery. d. replace breast milk with formula and permit feeding up to 2 hours before surgery.

A

To prepare a toddler for an invasive procedure, the best strategy for the nurse to use would be to: a. explain what the child will see, hear, taste, smell, and feel. b. prepare the child a day in advance. c. set up the equipment while the child watches. d. expect the child to sit still and cooperate.

A

To prevent a child with diarrhea from becoming dehydrated the nurse should: a. use gentle persuasion. b. force fluids. c. awaken the child to offer fluids. d. allow only high-quality, nutritious liquids.

A

To prevent an ostomy pouch from being pulled off, a young child may need to: a. wear one-piece outfits. b. use an alcohol-based skin sealant. c. use a rubber band to help the appliance fit.

A

To safely administer 1 teaspoon of medication at home, the parent should use the: a. household soup spoon. b. disposable calibrated syringe. c. hospital's molded plastic cup. d. household teaspoon.

A

To understand and deal effectively with families in a multicultural community, nurses should: a. be aware of their own attitudes and values. b. learn about different cultural beliefs to manipulate them. c. learn how to change longstanding health beliefs. d. recognize that all cultures are very similar to one another.

A

Tommy is brought in by his father for his yearly physical. On examination, the nurse notes that since last year Tommy has developed pubic hair, testicular enlargement, and related scrotal changes. In planning anticipatory guidance, the nurse recognizes that which of the following subjects would best be discussed with Tommy as soon as possible? a. Nocturnal emission b. Sexually transmitted infection prevention c. Pregnancy prevention d. Hygiene needs

A

Treatment of choice for the child with idiopathic hypopituitarism may include: a. biosynthetic growth hormone. b. human growth hormone. c. chemotherapy. d. administration of clonidine.

A

Two basic concepts in the philosophy of family-centered pediatric nursing care are: a. enabling and empowerment. b. empowerment and bias. c. enabling and curing. d. empowerment and self-control.

A

Typical treatment of poison ivy contact dermatitis to the arm does not include which of the following? a. Oral corticosteroids b. Calamine lotion c. Aveeno baths d. Topical corticosteroid gel

A

Using present treatment protocols, prognosis for Hodgkin disease may be estimated with: a. the Ann Arbor Staging Classification. b. histologic staging. c. degree of tumor burden. d. initial leukocyte count.

A

What assessment finding is the nurse most likely to see in the infant as a result of hypoglycemia? a. Forceful, low-pitched cry b. Tachypnea c. Jitteriness, tremors, twitching d. Vomiting, refusal to eat

A

What is the most appropriate therapeutic management for rehydration of Jenny, age 8 months, who has been diagnosed with acute diarrhea and has evidence of mild dehydration? a. Beginning oral rehydration therapy of 50 ml/kg b. Restarting lactose-free formula c. Encouraging oral intake of clear fluids, such as fruit juices and gelatin d. Feeding the BRAT diet, which consists of bananas, rice, apples, and toast or tea

A

When a child dies suddenly, which of the following interventions would be least beneficial? a. Avoid having the family view the body of a disfigured child. b. Inform the family of what to expect when they see the disfigured body of their child. c. Offer the parents the opportunity to see the child's body. d. Arrange to have a health care worker with bereavement training meet with the family.

A

When a child has a febrile seizure, it is important for the parents to know that children with febrile seizures: a. usually do not develop epilepsy. b. often develop epilepsy. c. often develop neurologic damage. d. usually need tepid sponge baths to control fever.

A

When administering medications to a child through a gastric tube, the nurse should: a. use oily medications to ease passage through the tube. b. mix the medication with the enteral formula. c. use a syringe with the plunger in place to administer the drug. d. flush the tube well between each medication administration.

A

When assessing 4-year-old Gail's chest, the nurse should expect: a. movement of the chest wall to be symmetric bilaterally and coordinated with breathing. b. respiratory movements to be chiefly thoracic. c. anteroposterior diameter to be equal to the transverse diameter. d. marked retraction of the muscles between the ribs on respiratory movement.

A

When assisting parents in supporting their dying child, the nurse should stress the importance of honesty; if parents are honest and openly discuss their fears, the child is more likely to: a. discuss his or her fears. b. ask fewer distressing questions. c. lose his or her sense of hope. d. do all of the above.

A

When bathing an uncircumcised boy over the age of 3 years, the nurse should: a. gently remind the child to clean his genital area. b. not retract the foreskin. c. gently retract the foreskin. d. avoid cleansing between the skinfolds of the genital area.

A

When helping parents select activities for the convalescing hospitalized child, the nurse should recommend: a. simpler activities than would normally be chosen. b. new toys and games to help distract the child. c. challenging new games to keep the child engaged. d. games that can be played with adults.

A

When initiating a treatment plan for an obese child, the nurse should do which of the following? a. Defer treatment until the family is ready to begin. b. Proceed with the plan regardless of the family's readiness if the child is ready. c. Understand that the child cannot take personal responsibility for dietary habits and physical activity. d. Understand that children who are forced by their parents to seek help can easily become motivated.

A

When listening over the aortic area of the heart, the nurse should place the stethoscope where? a. Second right intercostal space, close to sternum b. Second left intercostal space, close to sternum c. Fifth left intercostal space, close to sternum d. Fifth right intercostal space, left midclavicular line

A

When parents are divorced, who is eligible to consent to medical treatment of the child? a. Usually, the custodial parent consents. b. Only the noncustodial parent may consent. c. Both parents must consent. d. The child is the responsible party.

A

When the parent of a child who is dying tells the nurse the child is in pain, even when the child is on regularly scheduled pain medications, the nurse should: a. institute breakthrough pain control measures. b. continue to administer pain medications on a regular preventive schedule. c. educate parents that pain is a physical process. d. educate parents that the child is probably in less pain than the parents think.

A

Which child is most at risk for minimal-change nephrotic syndrome? a. A 4-year-old recovering from viral upper respiratory tract infection b. A 7-year-old after a group A β -hemolytic streptococcus throat infection c. A 6-year-old with acquired immunodeficiency syndrome (AIDS) d. A 2-year-old who recently received several bee stings

A

Which finding should the nurse expect when assessing physical growth in the school-age child? a. Weight increase of 2 to 3 kg per year b. Height increase of 3 cm per year c. Little change in refined coordination d. Decrease in body fat and muscle tissue

A

Which of the following actions taken by the nurse is least likely to prevent recurrence of poisonings? a. In the emergency department, begin a discussion of ways to injury-proof the home. b. Do a home visit to assess safety before the child is discharged. c. Administer questionnaire for poison prevention to the parents when the child is discharged. d. Advise parents to kneel down to the child's level when determining what products need to be placed out of reach.

A

Which of the following adolescents does the nurse recognize as least likely to begin smoking? a. Johnny, age 16 years, whose father quit smoking 2 years ago b. Karen, age 15 years, whose older sister smokes c. Ted, age 17 years, who smoked a cigarette at home in front of his parents d. Lilly, age 12, who feels uncomfortable with her early-maturing body

A

Which of the following assessment findings of the head and neck does not require a referral? a. Head lag at 4 months of age b. Hyperextension of the head with pain on flexion c. Palpable, enlarged thyroid gland d. Closure of the anterior fontanel at the age of 9 months

A

Which of the following behavioral pain measures includes five categories of behavior and uses a scoring system to quantify pain behaviors, with 0 being no pain behaviors and 10 being the most possible pain behaviors? a. FLACC Pain Assessment Tool (Facial expression, Leg movement, Activity, Cry, and Consolability) b. Pediatric Pain Questionnaire c. COMFORT Scale d. All of the above

A

Which of the following cardiac wave patterns is indicative of hypokalemia? a. Widening of the Q-T interval with a flattened T wave b. Shortening of the Q-T interval with an elevated T wave c. Shortening of the Q-T interval with a flattened T wave d. Widening of the Q-T interval with an elevated T wave

A

Which of the following characteristics most likely predisposes toddlers to frequent infections? a. Short straight internal ear canal and enlarged lymph tissue b. Slower pulse and respiratory rate and higher blood pressure c. Abdominal respirations d. Less efficient defense mechanisms

A

Which of the following describes the most common initial signs of anaphylaxis? a. Cutaneous signs of flushing and urticaria and complaint of feeling warm b. Bronchiolar constriction with wheezing c. Vasodilation and hypotension d. Laryngeal edema and stridor

A

Which of the following does the nurse include in the educational plan when instructing parents about the use of topical corticosteroids? a. Do not use this cream on a fungal infection. b. Apply a thick layer of the cream and rub into the skin well. c. Do not use for longer than 3 days in chronic conditions. d. All of the above should be included.

A

Which of the following drugs used to improve cardiac function in the pediatric patient with shock also improves renal function? a. Dopamine b. Lasix c. Vasopressin d. Epinephrine

A

Which of the following goals of therapy is most appropriate for the child with juvenile idiopathic arthritis? a. Child will exhibit signs of reduced joint inflammation and adequate joint function. b. Child will exhibit no signs of impaired skin integrity due to rash. c. Child will exhibit normal weight and nutritional status. d. Child will exhibit no alteration in respiratory patterns or respiratory tract infection.

A

Which of the following influenza vaccines were discontinued due to concerns about its effectiveness? a. Live attenuated influenza vaccine b. Inactivated influenza vaccine c. Intradermal influenza vaccine

A

Which of the following is a characteristic of the somatic swallow reflex? a. The mandible does not thrust forward. b. The tongue remains in front of the central incisors. c. The tongue is concave and inclined against the palate. d. It is efficient for fluids but not for solids.

A

Which of the following is a complication of immobility that is easily prevented with appropriate nursing intervention? a. Disuse atrophy b. Diarrhea c. Hypocalcemia d. Pain

A

Which of the following is a fungal infection that lives on the skin? a. Tinea corporis b. Herpes simplex type 1 c. Scabies d. Warts

A

Which of the following is a temporary graft obtained from human cadavers and used in burn treatment? a. Allograft b. Xenograft c. Autograft d. Isograft

A

Which of the following is least appropriate when developing an outpatient contract between the patient with an eating disorder and the therapist? a. Begin the psychotherapy immediately before the contract is developed and before weight gain. b. Develop the contract so that the patient's feeling of control and responsibility toward recovery is established. c. Specify in the contract the weight at which tube feedings will be implemented. d. Specify in the contract when rewards for achievement will be implemented.

A

Which of the following is most likely to develop acute diarrhea? a. The 2-month-old infant who attends daycare each day b. The 18-month-old infant who stays at home each day with his mother c. The 6-year-old child who attends public school d. The 24-month-old infant with two older brothers, ages 5 years and 8 years

A

Which of the following is not considered a complementary and alternative medicine therapy? a. Multivitamin b. St. John's wort (herb) c. Massage therapy d. Probiotic

A

Which of the following is not recommended in the treatment of scabies? a. Treat only household members who are symptomatic. b. The drug of choice in children and infants over 2 months is permethrin 5% cream. c. All persons in close contact with affected child should be treated. d. Ivermectin is indicated for those who do not respond to scabicide.

A

Which of the following is the most common symptom of atopic dermatitis (eczema)? a. Pruritis b. Lichenified plaques c. Hyperpigmentation d. Vesicular lesions

A

Which of the following is the most important nursing intervention to prevent urinary tract infections in pediatric patients? a. Teach parents of pediatric patients ways to practice good perineal hygiene b. Teach parents of pediatric patients the importance of administering prescribed medications for infection including dosage and scheduling c. Teach parents of pediatric patients the signs and symptoms of urinary tract infections d. Teach parents the proper collection techniques for urine samples

A

Which of the following laboratory values, often found in acute diarrhea with dehydration, will return to normal after hydration of the patient? a. Elevated hemoglobin, hematocrit, blood urea nitrogen (BUN), and creatinine b. Decreased hemoglobin, hematocrit, BUN, and creatinine c. Red blood cells in stool d. Decreased white blood cell count, decreased hemoglobin, elevated BUN, and creatinine

A

Which of the following patterns is indicative of infection in the postoperative period following cardiac surgery? a. Temperature of 38.6° C (101.5° F) 72 hours after surgery b. Temperature of 37.7° C (100° F) 36 hours after surgery c. Hypothermia in the early postoperative period

A

Which of the following social factors contributes to increased morbidity in children? a. Poverty b. Geographic region c. Birth order d. Paternal age

A

Which of the following statements about Haemophilus influenzae type b (Hib) vaccine is true? a. The vaccine protects against a number of infections including bacterial meningitis, epiglottitis, bacterial pneumonia, septic arthritis, and sepsis. b. The vaccine protects against the virus that produces influenza. c. Only two doses of Hib vaccine should be given to children 15 months of age or older who have not been previously vaccinated. d. Hiberix is a conjugate vaccine licensed for use in infants over the age of 2 months.

A

Which of the following statements about hypoglycemia in the newborn is true? a. Hypoglycemia is present when the newborn's blood glucose is lower than the baby's requirement for cellular energy and metabolism. b. In the healthy term infant who is born without complications, blood glucose is routinely monitored within 24 hours of birth to detect hypoglycemia. c. A plasma glucose level less than 60 mg/dl requires intervention in the term newborn. d. Pregnancy-induced hypertension and terbutaline administration have not been found to alter infant metabolism or increase the hypoglycemia risk in the newborn.

A

Which of the following statements about phototherapy is false? a. For phototherapy to be effective, the infant's skin must be fully exposed to an adequate amount of light or irradiance. b. The initiation of phototherapy should always be based on clinical judgment rather than serum bilirubin levels alone. c. For best results, the goal of phototherapy is to increase irradiance to the 460- to 490-nm band. d. The color of the infant's skin influences the efficacy of phototherapy, with darker-skinned infants needing double or intensive therapy.

A

Which of the following statements about rotavirus disease or immunization against rotavirus is correct? a. Rotavirus is one of the leading causes of diarrhea in infants and young children. b. Rotavirus is one of the leading causes of otitis media in young children. c. One vaccine for rotavirus is RotaTeq, which is approved for children 32 weeks of age or older. d. Rotavirus vaccine usually causes only mild reaction, redness, and soreness at the site of injection.

A

Which of the following statements is false in regard to toilet training? a. Bowel training is usually accomplished after bladder training. b. Nighttime bladder training is usually accomplished after bowel training. c. The toddler who is impatient with soiled diapers is demonstrating readiness for toilet training. d. Fewer wet diapers signal that the toddler is physically ready for toilet training.

A

Which of the following statements related to bullying is correct? a. Bullying usually occurs in school hallways and playgrounds where supervision is minimal but peers are present to witness the attack. b. Bullying or cyberbullying affects 50% of elementary school students either as the bully or the victim. c. The victim of bullying is usually male, depressed, has poor academic performance, and poor relationships and communication with parents. d. Victims of bullying are at higher risk for development of future problems of school dropout, unemployment, and participation in criminal behavior.

A

Which of the following strategies are effective in helping an infant sleep well at night? i. Place infant to sleep in his or her own bed. ii. Give the infant a bottle if it awakes during the night. iii. Establish and enforce a bedtime routine. iv. Allow the infant to watch a movie before bedtime. v. Allow the crying infant to sleep with parents or sibling. vi. Avoid picking up and rocking the infant who awakens during the night. a. i, iii, and vi b. ii, iii, and v c. ii, iii, and vi d. i, ii, and vi

A

Which of the following strategies would be best for the nurse to use to support the family's spiritual needs when their child's death is imminent and a clergy member is unavailable? a. Pray appropriately with the family. b. Implement relaxation techniques. c. Make an appointment for the family to speak with an expert. d. Review the physical signs of death with the family.

A

Which of the following techniques is recommended to assist in weaning an infant? a. Gradually replace one bottle-feeding or breastfeeding at a time b. Always wean to a bottle first c. Always wean directly to a cup d. Eliminate the nighttime feeding first

A

A 9-year-old with leukemia presents with a fever for 2 days; lab shows an absolute neutrophil count (ANC) of 190/mm3. Nursing care for this child should include: a. placing the child in isolation to prevent contaminating other patients. b. practicing meticulous hand washing. c. avoiding needlesticks and skin punctures such as IM injections. d. immediately placing the child on 100% oxygen by face mask.

B

A cerebral dysfunction gait that is described as narrow-based gait with a tendency to walk on toes, along with flexion at knees and hips and shuffling, is: a. ataxia. b. spastic paraplegic gait. c. extrapyramidal gait. d. spastic hemiplegic gait.

B

A child who develops a sudden, rapid onset of fever and a purpuric or petechial rash may possibly have developed: a. aseptic meningitis. b. Waterhouse-Friderichsen syndrome. c. Citrobacter diversus meningitis. d. herpes simplex encephalitis.

B

A child who unintentionally contributes to an abusive situation most likely: a. fits into the "easy-child pattern." b. has demands, both physical and emotional, that contribute to caregiver fatigue. c. has low self-esteem. d. comes from a low socioeconomic background.

B

A child with Hodgkin disease who has lesions in both the left and right supraclavicular area, the mediastinum, and the lungs would be classified as: a. stage I. b. stage II. c. stage III. d. stage IV.

B

A common cause of secondary hyperparathyroidism is: a. maternal hyperparathyroidism. b. chronic renal disease. c. maternal diabetes mellitus. d. adenoma of the parathyroid gland.

B

A disorder associated with a defect in the ability to concentrate urine in which the distal tubules and collecting ducts are insensitive to the action of antidiuretic hormone or its exogenous counterpart, vasopressin, is termed: a. renal tubular acidosis. b. nephrogenic diabetes insipidus. c. hemolytic uremic syndrome. d. unexplained proteinuria.

B

A gram-negative organism that is commonly found on the burn wound surface on the third day after burn and is responsible for wound sepsis is: a. C. difficile. b. Pseudomonas aeruginosa. c. group B streptococci. d. Haemophilus influenzae.

B

A major benefit of using umbilical cord blood for stem cell transplantation is: a. stem cells are found in low frequency in newborns. b. umbilical cord blood is relatively immunodeficient. c. there is a lower risk for acute tumor lysis syndrome. d. umbilical cord blood has a greater number of neutrophils.

B

A nurse discovers 5-year-old Jimmy, a neighbor, lying in the street next to his bicycle. The nurse sends another witness to activate the emergency medical services (EMS) while the nurse begins a primary assessment of Jimmy. Which of the following best describes the primary assessment and its correct sequence? a. Body inspection, level of consciousness, head-to-toe survey, and airway patency b. Level of consciousness, airway patency, respiratory effectiveness, circulatory status c. Open airway, head-to-toe assessment for injuries, and chest compressions d. Weight estimation, symptom analysis, blood pressure measurement

B

According to Freud, middle childhood is described as which of the following periods? a. Anal b. Latency c. Oral d. Oedipal

B

According to Healthy People 2020, strategies that address leading health indicators for the nation would include all of the following areas except: a. decreasing tobacco use. b. increasing innovative treatments for cancer. c. decreasing substance abuse. d. increasing immunization rates.

B

According to Piaget's theory of cognitive development, the three crucial events of the sensorimotor phase are: a. trust, readjustment, and the regulation of frustration. b. separation, object permanence, and mental representation. c. imitation, personality development, and temperament. d. ordering, comfort, and satisfaction with his or her body.

B

According to the American Academy of Pediatrics, a throat culture for streptococcus is recommended in: a. all children with classic signs of strep throat. b. a child with classic signs of strep throat and rapid antigen testing was negative. c. a child with classic signs of strep throat and rapid antigen testing was positive. d. none of the above, as throat culture for streptococcus is not recommended in children.

B

Acute poststreptococcal glomerulonephritis (APSGN): i. is the less common of the noninfectious renal diseases in children. ii. can occur at any age but primarily affects school-age children, the peak age of onset being 3 to 12 years. iii. is an immune complex disease related to a reaction that occurs as a by-product from certain strains of group A β-hemolytic streptococcus. iv. follows a latent period of 1 to 2 weeks between the infection of the throat or 3 to 6 weeks between skin infection and the onset of symptoms for APSGN. v. most commonly occurs in fall and spring. a. i, ii, iii, iv, and v b. ii, iii, and iv c. i, iii, and iv d. ii, iii, and v

B

Adolescents develop the social cognition change of mutual role-taking. Which of the following is the best description of this ability? a. Heightened sense of self-consciousness b. Understanding the perspectives of others and that actions can influence others c. Beliefs that are more abstract and rooted in ideologic principles d. Realization that others have thoughts and feelings

B

After fecal impaction is removed, maintenance therapy for constipation may include laxative use. Why is polyethylene glycol considered safe to use for pediatric patients? a. Decreases fluid in the colon b. Increases fluid in the colon c. Increases peristaltic stimulation d. Increases osmotic pressure and acidification of the colon contents

B

An 18-month-old child hospitalized with RSV is in a crib with side rails up, but he is very mobile and the mother says he has climbed out of his crib at home. The best way to provide a safe environment for this toddler is to: a. place him in a Posey vest. b. use a papoose board to keep him from climbing out of the bed. c. place a crib top on the crib. d. use bilateral elbow restraints.

B

Assessment of family interactions and roles, decision making and problem solving, communication, and expression of feelings and individuality is known as assessment of: a. family structure. b. family function. c. family composition. d. home and community environment.

B

Because of the preschooler's egocentric thought, the best approach for effective communication is through: a. speech. b. play. c. drawing. d. actions.

B

Bedbugs, although once considered to be practically nonexistent, have remerged within the past decade as troublesome. Which of the following does the nurse recognize as incorrect information about bedbugs? a. They tend to inhabit warm, dark areas such as furniture and emerge at night to feed. b. They act as vectors for disease transmission. c. The treatment of bedbugs should focus on proper identification, treatment of symptoms, and eradication. d. Their bites are often misdiagnosed as scabies, spider bites, or mosquito bites.

B

Brock, 12 years old, has burns involving the epidermis and part of the dermis. Blister and edema formation are present, and the burns are extremely sensitive to temperature changes, exposure to air, and light touch. Brock has: a. superficial first-degree burns. b. partial-thickness second-degree burns. c. full-thickness third-degree burns. d. full-thickness fourth-degree burns.

B

Mrs. Green has brought her daughter Karen to the clinic where you work as a nurse. Karen, age 12 years, is a new patient and needs a physical examination so that she can play volleyball. Which of the following techniques would not be helpful to establish effective communication during the interview process? a. You introduce yourself and ask the name of all family members present. b. After the introduction, you are careful to direct questions about Karen to Mrs. Green, since she is the best source of information. c. After the introduction and explanation of your role, you begin the interview by saying to Karen, "Tell me about your volleyball team." d. You choose to conduct the interview in a quiet area with few distractions.

B

Mumps immunization: a. is recommended for children ages 4 years of age or older. b. is typically given in combination with measles and rubella. c. can be administered to infants as young as 6 months of age. d. is correct for all of the above.

B

Neurofibromatosis: i. is an autosomal dominant genetic disorder. ii. is suspected café-au-lait spots. iii. is suspected when the infant develops axillary or inguinal freckling. iv. is associated with learning disabilities. v. has the risk of being transmitted to 100% of the offspring. vi. therapy is limited to excision of tumors that produce pain or impair function and symptomatic management of symptoms. a. i, ii, iii, iv, and v b. i, ii, iii, iv, and vi c. i, iii, v, and vi d. ii, iii, iv, v, and vi

B

Nora has been brought to the emergency department by her father after having been bitten by the family dog. Examination reveals three puncture wounds of the hand. Expected therapeutic management for these wounds includes: a. suturing the wounds. b. administering prophylactic antibiotics. c. irrigating with hydrogen peroxide. d. administering a tetanus toxoid booster, since Nora's last booster was given 13 months ago.

B

Nursing considerations for the patient diagnosed with osteogenesis imperfecta include: a. preventing fractures by holding on to the child's ankles when changing diapers. b. providing nonjudgmental support while parents may be dealing with accusations of child abuse. c. advising parents to limit touching or handling the child in order to prevent fractures. d. educating parents that the use of braces and splints can increase the rate of fracture.

B

Nursing interventions in caring for the child with acute glomerulonephritis include: a. enforced bed rest. b. daily weights. c. keeping the child NPO. d. a high-sodium diet.

B

Of the following antibiotics, the one that would most likely be prescribed for uncomplicated otitis media would be: a. tetracycline. b. amoxicillin. c. gentamicin. d. methicillin.

B

Of the following assessment findings, the one that would most likely be seen in a child with leukemia is: a. weakness of the eye muscle. b. bruising, pallor, and fatigue. c. wheezing and shortness of breath. d. abdominal swelling.

B

Of the following descriptions, the heart sound that would be considered normal in a young child is: a. splitting of S1. b. splitting of S2. c. splitting of S3. d. splitting of S4.

B

On auscultation of 8-year-old Tammie's lung fields, the nurse hears inspiratory sounds that are louder, longer, and higher pitched than on expiration. These sounds are heard over the chest, except over the scapula and sternum. These sounds are: a. bronchovesicular breath sounds. b. vesicular breath sounds. c. bronchial breath sounds. d. adventitious breath sounds.

B

One behavior associated with hearing impairment in the infant is: a. a monotone voice. b. consistent lack of the startle reflex to sound. c. a louder than usual cry. d. inability to form the word "da-da" by 6 months.

B

One of the best ways to prevent drowning in the toddler group is for parents to: a. learn cardiopulmonary resuscitation (CPR). b. supervise children within arm's reach whenever they are near any source of water. c. enroll the toddler in a swimming program. d. not allow the child to swim.

B

One of the most important digestive system changes completed during the toddler period is: a. increased acidity of the gastric contents. b. voluntary control of the sphincters. c. the protective function of the gastric contents. d. increased capacity of the stomach.

B

One strategy for parents of infants with lactase deficiency would be to: a. substitute human milk for cow's milk. b. substitute a low-lactose or lactose-free formula for human milk. c. drink milk alone without other food or drink. d. substitute frozen yogurt for fresh yogurt.

B

One strategy that may provide a clue to the origin of a seizure is: a. to attempt to place an airway in the mouth. b. to gently open the eyes to observe their movement. c. to provide a clear description of events before the seizure. d. to provide a clear description of events after the seizure.

B

Problems with the child adjusting to the self-management of type 1 diabetes are most likely to occur when the condition is diagnosed in: a. infancy. b. adolescence. c. the toddler years. d. the school-age years.

B

Prostaglandin is administered to the newborn with a congenital heart defect to: a. close the ductus arteriosus. b. keep the ductus arteriosus open. c. keep the foramen ovale open. d. close the foramen ovale.

B

Routine nutrition screening for all adolescents should include: a. a complete laboratory evaluation. b. questions about meal patterns and consumption of foods. c. a complete physical examination. d. a complete family history.

B

Separation anxiety would be most expected in the hospitalized child at which age-group? a. Infant b. Toddler c. Preschool d. School-age

B

Since the advent of immunization for H. influenza type B, there has been a decrease in the incidence of: a. laryngotracheobronchitis. b. acute epiglottitis. c. bacterial tracheitis. d. bronchiolitis.

B

Sixteen-year-old Ben has been brought to the school nurse's office for heatstroke. He has a temperature of 40° C (104° F) and is awake but disoriented. Which of the following is contraindicated? a. Immediate removal of clothing and application of cool water to the skin b. Administration of antipyretics c. Use of fans directed at Ben d. Activation of EMS for transport to hospital

B

Skin in the infant and small child, as compared with skin in older children and adults: a. is tightly bound to the dermis. b. is more likely to have blister formation from an inflammatory process. c. is more likely to react to a sensitizing allergen than to a primary irritant. d. is less susceptible to superficial bacterial infection.

B

Stevens-Johnson syndrome a. is rare and occurs most often in females. b. is a hypersensitivity reaction to certain drugs. c. begins with generalized rash over the entire body except for palms, soles, and extensor surfaces. d. is caused by a bite from a flea.

B

Strategies to minimize the effects of separation in school-age children and adolescents include: i. allowing visits from peers ii. allowing children to wear their own clothes iii. bringing favorite items from home, such as a laptop or stuffed animal iv. enforcing strict rules and routines regarding diagnostic procedures v. asking the family to leave the room when the physician enters a. i, ii, and iv b. i, ii, and iii c. iv and v

B

Strategies used to minimize the hospitalized child's feelings of loss of control include attempts to: a. alter the child's schedule to match the hospital schedule. b. establish a daily schedule for the hospitalized child. c. eliminate rituals that have been used at home. d. perform all of the above.

B

Studies indicate that toddlers up to 24 months of age are safest when they are: a. placed in a car restraint seat in the front seat of the car. b. placed in a car restraint seat facing the rear in the back seat. c. placed in a front passenger seat with a deactivated airbag. d. allowed to stand in the back seat holding on to a shoulder belt.

B

Systemic response to thermal injury would include: a. hypoglycemia. b. increased capillary permeability. c. myoglobinuria. d. decreased metabolic rate.

B

Systemic responses to severe burns may include: i. blood flow decreases to the gastrointestinal system by one-third even though cardiac output is maintained by resuscitation fluids. ii. adrenal activity decreases. iii. hematocrit decreases. iv. loss of circulating red blood cells. v. metabolic acidosis. a. ii, iii, and iv b. i, iv, and v c. i, iii, and v d. ii and iv

B

Terry, age 11 years, comes to the urgent care clinic with a major laceration sustained while working on a cattle fence. The laceration requires extensive cleaning and suturing. Terry last received a tetanus booster on entry to school at age 7 years and is considered underimmunized. Ideally, Terry should receive which of the following for protection against tetanus? a. Tetanus antitoxin and tetanus toxoid b. Tetanus immunoglobulin (TIG) and tetanus toxoid c. Tetanus immunoglobulin (TIG) and tetanus antitoxin

B

Testing of the parents is necessary to identify the carrier and offer genetic counseling when Down syndrome is caused by: a. mosaicism. b. translocation. c. maternal age over 40. d. paternal age over 40.

B

Tetralogy of Fallot consists of these defects: i. VSD ii. ASD iii. Right ventricular hypertrophy iv. Pulmonic stenosis v. Overriding aorta vi. Patent ductus arteriosus a. ii, iii, iv, and vi b. i, iii, iv, and v c. ii, iv, v, and vi

B

The Adolescent Pediatric Pain Tool (APPT): a. is used in children over 6 years of age. b. is grouped by sensory, affective, and evaluative qualities. c. uses a straight line. d. uses the scale of 0 to 10 to rate the degree of pain.

B

The Numeric Rating Scale: a. consists of six culturally specific photographs of faces. b. is appropriate for most children 8 years and older. c. uses descriptive words. d. is harder to use but more reliable than other methods.

B

The Pediatric Pain Questionnaire: a. is useful in infants. b. is used to assess patient, provider, and parental pain perceptions. c. consists of a series of four questions related to pain assessment. d. is completed jointly by the physician, child, and family.

B

The best definition of biliary atresia is: a. jaundice persisting beyond 2 weeks of age with elevated direct bilirubin levels. b. progressive inflammatory process causing intrahepatic and extrahepatic bile duct fibrosis. c. absence of bile pigment. d. hepatomegaly and palpable liver.

B

The best technique to use to prevent spread of nasopharyngitis is: a. antibiotic administration. b. to avoid contact with infected persons. c. mist vaporization. d. to ensure adequate fluid intake.

B

The care plan for the child during the acute phase of osteomyelitis always includes: a. performing wound irrigations. b. ensuring administration of antibiotics. c. isolating the child. d. incorporating passive range-of-motion exercises for the affected area.

B

The characteristic of the respiratory system that predisposes the infant to middle ear infection is the: a. short, angled eustachian tube. b. short, straight eustachian tube. c. close proximity of the trachea to the bronchi. d. size of the lumen of the eustachian tube.

B

The child with type 1 diabetes mellitus needs to test his or her urine: a. for ketones every day. b. for ketones at times of illness. c. for glucose every day. d. for glucose at times of illness.

B

The development of a personal value system or value autonomy during adolescence usually occurs by what age? a. 14 to 16 years b. 18 to 20 years c. 13 to 14 years d. 16 to 18 years

B

The drug that reduces the chance that the human immunodeficiency virus (HIV)-infected pregnant mother will infect her infant is called: a. valproate. b. zidovudine. c. nitrazepam. d. felbamate.

B

The first goal in nursing care of the pregnant teenager is: a. to arrange for the pregnant teen to register for food supplement programs to ensure proper nutrition. b. to assist the pregnant teen in obtaining health care. c. to involve the boyfriend and parents in the pregnancy so that the pregnant teen will have support during her pregnancy. d. to educate the pregnant teen regarding child care.

B

The first pubescent change in boys is: a. appearance of pubic hair. b. testicular enlargement with thinning, reddening, and increased looseness of the scrotum. c. penile enlargement. d. temporary breast enlargement and tenderness.

B

The first-line pharmacologic agent of choice for supraventricular tachycardia in a child is: a. digoxin. b. adenosine. c. amiodarone. d. lidocaine.

B

The following statements are about hepatitis A illness or vaccination. Which one is correct? a. The illness has a gradual onset, with often dark urine and jaundice being the only symptoms. b. The vaccine is recommended for all children at age 1 year. c. The vaccine consists of a series of three injections timed 2 months apart. d. The illness is spread by all body secretions.

B

The incidence of accidental drowning is highest in both boys and girls in what age-group? a. Less than 1 year b. 1 to 4 years c. 5 to 14 years d. 15 to 24 years

B

The largest percentage of respiratory tract infections in children is caused by: a. pneumococci. b. viruses. c. streptococci. d. Haemophilus influenzae.

B

The main focus of nursing care management for the patient with encephalitis is: a. isolation. b. control of rising ICP. c. support for the parents. d. control of nutritional deficiencies.

B

The major anomaly most frequently associated with myelomeningocele is: a. Chiari malformation. b. hydrocephalus. c. clubfoot. d. developmental dysplasia of the hips.

B

The major goal in treatment of contact dermatitis is: a. reverse the associated immunologic changes. b. prevent further exposure to offending substance. c. educate on management of symptoms. d. prevent transmission.

B

The method of fracture reduction is not determined by: a. the child's age. b. the manner in which the fracture occurred. c. the degree of displacement. d. the amount of edema.

B

The most accurate method for determining the safe dosage of a chemotherapy medication for a child is to use: a. the body surface area formula. b. Clark rule. c. Wright rule. d. milligrams per kilogram.

B

The most appropriate way to prevent firearm injury among adolescents is: a. teaching the adolescent proper use of firearms. b. counseling the adolescent on nonviolent ways to resolve conflict. c. passing laws to prevent parents from having guns. d. telling parents to keep guns and ammunition in separate locations within the house.

B

The most common clinical manifestation of Wilms tumor is: a. painless, firm abdominal mass that does not cross the midline. b. painful abdominal mass that crosses the midline. c. nausea and vomiting. d. anorexia.

B

The most common early manifestation of cystic fibrosis is: a. meconium aspiration. b. meconium ileus. c. growth failure. d. chronic cough.

B

The most effective method of preoperative preparation for a child is: a. consistent supportive care. b. systematic preparation at specific stress points. c. offering parents the option of attending the induction of anesthesia. d. a single session of preparation.

B

The most reliable way to detect peptic ulcer disease in children is: a. fiberoptic endoscopy. b. an upper GI series. c. C urea breath test. d. complete blood count with differential, erythrocyte sedimentation rate, and stool analysis.

B

The mutual participation model of care for the child who is cognitively impaired and needs hospitalization would include: a. isolating the child from others to avoid conflicts. b. allowing parents to room in and participate in the care. c. having the parents perform all activities of daily living. d. having the nurse perform all activities of daily living.

B

The nurse can expect an infant whose birth weight was 7 lb to weigh __________ lb by 12 months of age. a. 14 b. 21 c. 28 d. 32

B

The nurse expects to assist with administration of a specific antidote for poisoning in which one of the following pediatric patients? a. The 8-month-old child admitted to the emergency department after eating 8 or 10 holly berries b. The 13-year-old girl who ingested an overdose of diazepam (Valium) c. The 8-year-old child who ingested three of his mother's birth control pills d. The 6-year-old child who ingested an overdose of an unidentified corrosive substance

B

The nurse instructs the parents of a 4-month-old with GER to include which of the following in the infant's care? a. Stop breastfeeding, since breast milk is too thin and easily leads to reflux. b. Reschedule the family's routine to accommodate more frequent feeding times. c. Increase the infant's intake of fruit and citrus juices. d. Try to increase feeding volume right before bedtime, because this is the time when the stomach is more able to retain foods.

B

The nurse is administering a dose of intravenous cisplatin when the child suddenly starts complaining of difficulty breathing and is markedly flushed. The nurse's highest priority is to: a. administer an oral antihistamine. b. stop the infusion immediately. c. slow down the infusion rate. d. call the practitioner.

B

The nurse is assessing Carol, age 8 years, for complications related to her recent fracture and the application of a fiberglass cast to her forearm and elbow. Carol is crying with pain, the nurse is unable to locate pulses in the affected extremity, and there is lack of sensitivity to the area as well as some edema. Which of the following would the nurse suspect as most likely to be occurring? a. Normal occurrence for the first few hours after application of traction b. Volkmann contracture c. Nerve compression syndrome d. Epiphyseal damage

B

Bryan, age 6 months, is starting daycare as his mother is returning to work. Bryan has had no immunizations. Which of the following statements provided by the nurse to the mother is the most appropriate at this time? a. "Since Bryan has not started his immunizations for streptococcal pneumococci yet, it is best to wait until after he gets established at daycare before beginning his injections." b. "Streptococcal pneumococci are responsible for a number of bacterial infections that are especially problematic for children under 2 years of age who attend daycare. Bryan should start his series of pneumococcal vaccine right away." c. "Why has Bryan not received any immunizations? He is past due. Don't you care about his health?" d. "Pneumococcal vaccine (PCV13) is the only vaccine recommended for Bryan at this time."

B

Burkitt lymphoma is a type of: a. Hodgkin disease. b. non-Hodgkin lymphoma. c. acute myelocytic leukemia. d. neuroblastoma.

B

Burn injuries in the toddler age-group are most often the result of: a. flame burns from playing with matches. b. scald burn from hot liquids. c. hot object burns from cigarettes or irons. d. electric burns from electrical outlets.

B

By the age of 2 years, most toddlers demonstrate increased gross motor skills by: a. jumping using both feet. b. walking up and down stairs. c. running and skipping on alternate feet. d. jumping from a height of 3 feet without falling.

B

Childhood depression: a. is easily detected because children tend to act out their problems and feelings. b. has characteristics that are determined by parallel developments in symbolism, language, and cognitive development. c. does not interrupt normal growth and development. d. treatment consists of antidepressants that must be at a therapeutic level for at least 6 to 8 weeks to achieve beneficial effect.

B

Children on strict vegetarian and macrobiotic diets should be evaluated for: a. constipation and heart disease. b. rickets and iron-deficiency anemia. c. scurvy. d. severe acute malnutrition.

B

Children who receive induction therapy for acute lymphocytic leukemia are likely to: a. receive cyclophosphamide, cytarabine, and mercaptopurine. b. receive vincristine, prednisone, and L-asparaginase. c. receive a bone marrow transplant. d. relapse 5 years after a complete remission.

B

Full-term infants at risk for hypoglycemia shortly after birth include which of the following? i. Those born to diabetic mothers ii. Those who are small for gestational age iii. Those with perinatal hypoxia a. i, ii, and iii b. i and ii c. ii and iii d. i and iii

B

General guidelines for care of a child's skin include: a. covering the fingers of the extremity used for an intravenous line. b. lifting the child under the arms to transfer the child from the bed to a stretcher. c. placing a pectin-based skin barrier directly over excoriated skin. d. keeping the skin moist at all times.

B

Head circumference is: a. measured in all children up to the age of 24 months. b. equal to chest circumferences at about 1 to 2 years of age. c. about 8 to 9 cm smaller than chest circumference during childhood. d. measured slightly below the eyebrows and pinna of the ears.

B

Healthy ways of serving food to toddlers include: a. establishing a pattern of sitting at a table for meals. b. permitting nutritious snacks in lieu of meals. c. discouraging between-meal snacking. d. allowing the toddler to choose preferred foods at every meal.

B

Human papillomavirus (HPV): a. has 10 serotypes associated with causing genital warts. b. has lesions that typically resolve on their own without treatment. c. has lesions that decrease in size or disappear during pregnancy. d. has lesions always visible to the naked eye on the cervix.

B

IBD can be treated with immunomodulators such as 6-mercaptopurine and azathioprine. When the patient is receiving these drugs, the nurse knows that which of the following adverse effects can occur? a. Anemia b. Malignancy c. Peripheral neuropathy d. Decreased serum calcium levels, leading to osteoporosis

B

Identify which of the following statements describing fears in the school-age child is true. a. School-age children are increasingly fearful of body safety. b. Most of the new fears that trouble school-age children are related to school and family. c. School-age children should be encouraged to hide their fears to prevent ridicule by their peers. d. School-age children with numerous fears need continuous protective behavior by parents to eliminate these fears.

B

In caring for the child with frostbite, the nurse remembers that: a. slow thawing is associated with less tissue necrosis. b. the frostbitten part appears white or blanched, feels solid, and is without sensation. c. rewarming produces a small return of sensation with a small amount of pain. d. rewarming is accomplished by rubbing the injured tissue.

B

In caring for the donor site following split-thickness skin graft, the nurse expects: a. the dressing to be changed daily. b. the dressing to separate at 10 to 14 days. c. the area to be washed daily with soap and water. d. the application of an antibiotic ointment daily.

B

In children, the most common method of cardiac catheterization is through the: a. left side of the heart. b. right side of the heart.

B

In comparison to toddlers, preschoolers eat: a. slightly less. b. slightly more. c. remain the same.

B

In conducting the physical examination of a pediatric burn patient, how would the nurse best assess to see whether circulation to the area is intact? a. Touch the area to see if pain is felt b. Test injured surfaces for blanching and capillary refill c. Inspect the burns for eschar formation d. Watch for edema of the affected part

B

In discussing sexuality with the teenager who has a spinal injury, the nurse correctly includes which of the following in the discussion? a. Development of secondary sexual characteristics will be delayed. b. Well-motivated young people can look forward to successful participation in marital and family activities. c. If injury occurs before onset of menstruation, ovulation and conception are not possible. d. Females can easily experience vaginal or clitoral orgasms.

B

In eliciting the chief complaint, the nurse identifies which of the following techniques as not appropriate? a. Limiting the chief complaint to a brief statement restricted to one or two symptoms b. Using labeling-type questions such as "How are you sick?" to facilitate information exchange c. Recording the chief complaint in the child's or parent's own words d. Using open-ended neutral questions to elicit information

B

In infants and young children, the most accurate means of describing dehydration or fluid loss is: a. as a percentage. b. by milliliters per kilogram of body weight. c. by the amount of edema present or absent. d. by the degree of skin elasticity.

B

In major burn injuries of children weighing less than 30 kg (66 lb), adequate fluid replacement during the emergent phase is best assessed by which of the following? a. Urinary output of 30 ml/hr b. Urinary output of 0.5 to 1 ml/kg/hr c. Increasing hematocrit d. Normal blood pressure

B

In pediatric examinations, the normal sequence of head-to-toe direction is often altered to accommodate the patient's developmental needs. The nurse identifies which of the following goals as least likely to guide the examination process? a. Minimizing the stress and anxiety associated with the assessment of body parts b. Recording the findings according to the normal sequence c. Fostering a trusting nurse-child relationship d. Preserving the essential security of the parent-child relationship

B

In preschool children, GER may manifest with: a. symptoms of heartburn and reswallowing. b. intermittent vomiting. c. respiratory conditions such as bronchospasm and pneumonia. d. failure to thrive, bleeding, and dysphagia.

B

In regard to behavioral and physiologic responses to pain, children: a. remain consistent from age to age. b. vary widely in their responses. c. exhibit typical behaviors at each development stage. d. are unaffected by temperament.

B

In regard to fragile X syndrome, the fragile site is caused by: a. 5 to 40 repeats of nucleotide base pairs. b. gene mutation. c. infection. d. advanced maternal age.

B

In regard to the development of temperament in the preschool years, which of the following statements is true? a. Temperamental characteristics change considerably during the preschool years. b. The effect of temperament on adjustment in a group becomes important during the preschool years. c. Children need to be treated the same regardless of differences in temperament. d. There really is no tool that will adequately identify temperamental characteristics during the preschool years.

B

In the United States, severe acute malnutrition (SAM) may occur where: a. the food supply is inadequate. b. the food supply may be adequate. c. the adults eat first, leaving insufficient food for children. d. the diet consists mainly of starch grains.

B

In working with children, nurses include family members in the care plan. Which of the following statements does the nurse recognize as false when planning nursing interventions for the family? a. A complete family assessment is needed to discover family dynamics, family strengths, and family weaknesses. b. There is no expectation for parents to participate in their child's care when using the systems theory. c. The intervention used with families depends on the nurse's view of the theoretic model of the family. d. The level of assistance a family needs depends on the type of crisis, factors affecting family adjustment, and the family's level of functioning.

B

Infants and children experience a substantial amount of pain due to routine immunization. Based on current research, which of the following statements is false? a. The child should be positioned upright, either sitting or being held by the caregiver during the immunizations. b. The caregiver and the nurse should use verbal reassurance, empathy, and apology during the immunizations. c. The nurse should administer the least painful vaccine first when administering multiple vaccines. d. The nurse should administer the vaccines rapidly and without aspiration.

B

Infectious mononucleosis is usually a: a. disease complicated by pneumonitis and anemia. b. self-limiting disease. c. disabling disease. d. difficult and prolonged disease.

B

Ingestion of injurious agents by children: a. occurs most frequently at grandparents' or a friend's home. b. occurs because infants and toddlers explore their environment through oral experimentation. c. has increased despite the use of child-resistant containers. d. can be avoided by teaching preschoolers which substances are dangerous.

B

Intervening therapeutically with terminally ill children and their families requires: a. only self-awareness. b. nursing practice that is based on a theoretic formulations and empiric observations. c. years of experience. d. personal experience with death.

B

Intimate relationships are not necessarily characterized by: a. concern for each other's well-being. b. sharing of sexual intimacy. c. a willingness to disclose private, sensitive topics. d. sharing of common interests and activities.

B

Intracranial pressure monitoring has been found to be useful in pediatric critical care to: a. provide quick and effective relief of increased pressure. b. evaluate children with Glasgow Coma Scale scores less than 8. c. maintain PaCO2 at 25 to 30 mm Hg. d. prevent herniation.

B

Intravenous immunoglobulin (IVIG) is effective in reducing bilirubin levels in infants: a. with Rh isoimmunization and ABO incompatibility. b. with breastfeeding jaundice. c. who are late-term and term infants. d. when administered to the mother immediately before delivery.

B

Jenny, an 8-year-old, has been brought to the clinic with continuing pain in the epigastric region of the abdomen. The medical provider has ordered Helicobacter pylori testing. Which of the following tests does the nurse recognize as being the most accurate method to determine active infection? a. Serology test b. C urea breath test c. Esophagus manometry d. Occult blood guaiac test

B

Jimmy, age 9 years, has fallen and scraped his knee at school. He is brought to the school nurse for treatment. Which of the following does the nurse recognize as being least likely to promote healing? a. Changing the dressing when it becomes loose or soiled. b. Washing the injury with hydrogen peroxide and applying a dry gauze dressing. c. Applying an occlusive dressing. d. Washing the area with mild soap and water and applying a topical antibiotic with a nonadherent dressing.

B

Johnny spills his milk on the living room rug. His mother smacks him on the bottom and says, "You are a messy, bad boy, Johnny." Which of the following discipline strategies are used? i. Consequence ii. Corporal punishment iii. Scolding iv. Behavior modification v. Ignoring a. i, ii, and iii b. ii and iii c. iii and v d. ii, iii, and iv

B

Johnny's mother is calling the clinic because Johnny has developed a rash over his entire body. Two days ago he was prescribed amoxicillin for an ear infection, and now his mother tells the nurse she thinks Johnny may have gotten a small rash with this medication when he took it before. Which of the following would be the best intervention by the nurse at this time? a. Question the mother about other symptoms that Johnny may have developed. b. Continue the medication and have Johnny come in tomorrow to see the practitioner. c. Stop the medication and inform the practitioner. d. Tell the mother to give only half the prescribed dose of the medication until Johnny can return to the clinic to see the practitioner.

B

Johnny, age 2 years, is diagnosed with uncomplicated diarrhea with no signs of dehydration. Diagnostic evaluation should include which of the following? a. Cultures of the stool b. Presence of associated symptoms c. Complete blood count d. Urine specific gravity

B

Justin, age 1 month, is brought to the clinic by his mother. The nurse suspects pyloric stenosis. Which of the following symptoms would support this theory? a. Diarrhea b. Projectile vomiting c. Fever and dehydration d. Abdominal distention

B

Limit setting and discipline are positive, necessary components of childrearing. Which one of the following best describes how these functions help children? a. Reduce the need for children to have limits set b. Support children's ability to test their limits of control c. Allow unrestricted freedom to ensure children's growth potential d. Reassure children that they are able to protect themselves from harm

B

The nurse is assessing Sarah, a neonate born at home, and observes slight blood oozing from the umbilicus. What is the most likely cause of Sarah's hemorrhagic disease? a. The neonate was born with an anatomically immature liver. b. Coagulation factors (II, VII, IX, X) are deactivated in the neonate. c. Vitamin K was administered to the neonate shortly after birth. d. The newborn was born with a sterile intestine and was unable to synthesize vitamin K until feedings began.

B

Marilyn, age 12 years, has been diagnosed with scoliosis and placed in a thoracolumbosacral orthotic (TLSO) brace. Which of the following information provided by the nurse to Marilyn is correct? a. "The brace will cure your curvature." b. "The brace is an underarm brace made of plastic that will be molded and shaped to your body to prevent worsening of the curvature." c. "The brace includes a neck ring to extend the neck." d. "The brace will only be worn in bed, since it prevents walking because of the severity of the trunk bend."

B

Most cases of severe hypertension in children are a result of: a. systemic hypertension. b. secondary hypertension. c. primary hypertension. d. congenital heart defects.

B

The nurse is assisting Billy, aged 10 years, in applying an all-purpose insect repellent that contains the active ingredient DEET. Which of the following should be included in the nurse's discussion with Billy? a. DEET is effective against most insects and arachnids, but not ticks. b. After returning indoors, treated skin needs to be washed off with soap and water before he goes to bed tonight. c. DEET should be applied to the whole body including the face and hands for better protection. d. DEET should be heavily applied and frequent reapplication is necessary.

B

The nurse is caring for 7-year-old Charles after application of skeletal traction. Which of the following is contraindicated? a. Clean pin sites per hospital policy. b. Release the traction when repositioning Charles in bed. c. Inspect pin sites for bleeding or infection. d. Assess for alterations in neurovascular status.

B

The nurse is developing a preventive teaching plan for Tracy, a sexually active 16-year-old who has been diagnosed with a urinary tract infection. Which of the following should be included in the plan? a. Promote perineal hygiene by wiping back to front b. Urinate as soon as possible after intercourse c. Douche as soon as possible after intercourse to flush out bacteria d. Eliminate all carbonated and caffeinated beverages because they irritate the bladder

B

The nurse is preparing the long-term care plan for a child with CP. Which of the following is included in the plan? a. No delay in gross motor development is expected. b. The illness is not progressively degenerative. c. There will be no persistence of primitive infantile reflexes. d. All children will need genetic counseling as they get older before planning for a family.

B

The nurse is suspicious of child abuse (nonaccidental injury) when: i. there is a delay in seeking medical assistance for the injury. ii. the parent's history of the injury is not congruent with the actual injury. iii. x-ray studies demonstrate previous fractures in different stages of healing. iv. the child is crying and fearful of separation from the parent. a. i, ii, iii, and iv b. i, ii, and iii c. ii and iii d. ii, iii, and iv

B

The nurse is to give an injection of the chelation drug calcium disodium edentate. Which of the following does the nurse recognize as most appropriate? a. Keeping the child NPO for 24 hours after administration of the drug b. Mixing the drug with procaine to lessen the pain associated with the injection c. Maintaining seizure precautions at the bedside d. Making certain the patient has no peanut allergy before injection

B

The nurse knows, regarding pertussis, that: a. the incidence has decreased in infants younger than 6 months of age. b. a booster vaccine (Tdap) is now recommended for all children 11 to 12 years of age. c. treatment should begin as soon as exposure is confirmed and includes the antibiotic amoxicillin. d. the disease is not contagious, so close household members do not need treatment.

B

The nurse says to 15-year-old Monique, "Tell me about your cough." This is an example of which type of communication technique? a. Direct b. Open-ended c. Reflective d. Closed

B

As the movement for providing care based on evidence continues, nurses will be using methods to evaluate research such as: a. Agency for Health Care Policy and Research (AHCPR) guidelines in place of guidelines developed locally. b. guidelines that are based on traditional practice. c. the GRADE criteria. d. guidelines that reflect current research but decrease job satisfaction.

C

Ben, a 15-year-old high school student, is at a track event. He has been running multiple events. He was feeling unwell before the event and had been vomiting. Now he is complaining of thirst, headache, fatigue, dizziness, and nausea. He seems to be somewhat disoriented and is sweating. Ben's temperature is normal. Which of the following is the most likely to describe Ben's condition? a. Heat cramps b. Dehydration c. Heat exhaustion d. Heatstroke

C

Billy, age 14, has an ulcer with an acute onset involving the mucosa of the stomach that has resulted from prolonged use of nonsteroidal antiinflammatory agents. The best term to describe the ulcer Billy has is: a. secondary duodenal ulcer. b. primary duodenal ulcer. c. secondary gastric ulcer. d. primary gastric ulcer.

C

Birth injuries may occur during the delivery of the infant. Birth injuries are not usually the result of: a. forceful extraction. b. dystocia. c. excess amniotic fluid. d. breech presentations.

C

The nurse, in working with special groups of adolescents, recognizes which of the following statements is true? a. Effective health promotion programs for minority adolescents must contain culturally competent information and must be provided by health care professionals with the same cultural background as the adolescent. b. Gay and lesbian adolescents are at much greater risk for suicidal behaviors. c. Nurses should encourage all gay and lesbian adolescents to disclose their sexual orientation to their families immediately to help eliminate the stress of keeping "the secret." d. Rural adolescents' access to health care is the same as for urban areas because of the advantages of Medicaid and incentives offered to physicians to work in these areas.

B

The peak age for the incidence of Kawasaki disease is in the: a. infant age-group. b. toddler age-group. c. school-age group. d. adolescent age-group.

B

The pediatric nurse knows that the child diagnosed with IBD needs nutritional support that includes: a. avoiding all foods high in fat. b. supplementation with multivitamins, iron, and folic acid. c. meal planning for three large meals daily. d. using bran as a source for high fiber.

B

The presence of poor ventricular function and atrial arrhythmias increases the risk for: a. infection. b. CVA. c. fever. d. air embolism.

B

The prevention of influenza in children 6 months to 18 years of age is primarily based on: a. administration of antiviral medications. b. yearly immunization with influenza vaccine. c. strict avoidance of infected persons. d. yearly administration of Haemophilus influenzae type B vaccine.

B

The primary manifestation of acute kidney injury is: a. edema. b. oliguria. c. metabolic acidosis. d. weight gain and proteinuria.

B

The principal characteristics of Piaget's preoperational phase are: i. dependence on perception in problem solving. ii. egocentric use of language. iii. the ability to manipulate objects in relation to one another in a logical manner. iv. the ability to problem solve based on what is recalled about objects and events. a. i, ii, and iii b. i and ii c. ii and iii d. ii, iii, and iv

B

The priority nursing goal in the immediate care of a postoperative infant after repair of a cleft lip is to: a. keep the infant well hydrated. b. prevent vomiting. c. prevent trauma to operative site. d. administer medications to prevent drooling.

B

The process of the formation of the heart's atrial septum results in a temporary flap called the: a. truncus arteriosus. b. foramen ovale. c. sinus venosus. d. ductus venosus.

B

The recommended postexposure treatment for rabies includes: a. mass immunization using human rabies immune globulin. b. administration of rabies immunoglobulin and rabies vaccine according to schedule. c. mass immunization using rabies vaccine. d. administration of rabies immunoglobulin 90 days after the exposure.

B

The rectal route of medication administration is used in children when the child: a. is unable to take oral medications. b. needs a reliable route of administration. c. is constipated. d. has all of the above.

B

The standard effective treatment for GABHS is: a. intravenous antibiotic administration. b. oral or intramuscular antibiotic administration. c. nebulized racemic epinephrine. d. warm saline gargles.

B

Therapeutic management that provides the most favorable morbidity and mortality outcomes for the child born with myelomeningocele is: a. early physical therapy. b. surgical closure of the defect within the first 24 to 72 hours. c. vigorous antibiotic therapy. d. splint application to lower extremities.

B

Three-year-old Ivy is brought to the clinic because of a suspected urinary tract infection. Which of the following is the correct method for collecting the urine specimen? a. Encourage large amounts of water because Ivy is unable to void at this time b. Set Ivy on the toilet facing the tank to decrease likelihood of contamination c. Wait until the first-morning voided specimen can be collected d. Bag Ivy with the bag covering the entire perineal area

B

To assist school-age children in coping with stress in their lives, the nurse should: i. be able to recognize signs that indicate the child is undergoing stress. ii. teach the child how to recognize signs of stress in oneself. iii. help the child plan a means for dealing with any stress through problem solving. iv. reassure the child that the stress is only temporary. a. ii, iii, and iv b. i, ii, and iii c. ii and iv d. i and iii

B

To prevent fluorosis, parents of toddlers should use all of the following strategies except: a. supervise the use of toothpaste. b. use fluoride mouthrinses. c. store fluoride products out of reach. d. administer fluoride supplements on an empty stomach.

B

To prevent spread of illnesses from one patient to another after procedures, the most important strategy the nurse can use is to: a. follow disease-specific infection control guidelines. b. wear vinyl gloves. c. avoid wearing nail polish. d. wash the hands routinely after each patient contact.

B

To prevent submersion injuries in children with epilepsy, the child should be instructed to: a. never go swimming. b. take showers. c. wear a bicycle helmet. d. do all of the above.

B

Upon the delivery of an infant with myelomeningocele, which of the following nursing actions is contraindicated? a. Examination of the membranous cyst for intactness b. Diapering the infant c. Keeping moist, sterile normal saline dressings on the defect d. Keeping the infant in the prone position

B

Water intoxication can occur in children from: i. excessive intake of electrolyte-free formula. ii. administration of inappropriate hypotonic solutions. iii. dilution of formula with water. iv. isotonic dehydration. v. vigorous hydration with water following a febrile illness. vi. fluid shifts from intracellular to extracellular spaces. a. i, ii, iii, and iv b. i, ii, iii, and v c. ii, iii, and iv d. ii, iii, v, and vi

B

What antiviral agent is used to treat varicella infections in children at increased risk for complications associated with varicella? a. Varicella-zoster immune globulin b. Acyclovir c. Salicylates d. Steroids

B

When administering the pertussis vaccine, the nurse recognizes which of the following as incorrect? a. Can be given any time during pregnancy b. Cannot be given to the postpartum mother who is breastfeeding c. The acellular pertussis vaccine, from the same manufacturer, is recommended for the first three immunizations and is given along with diphtheria and tetanus at 2, 4, and 6 months of age. d. Is recommended for health care workers having close contact with infants under the age of 12 months

B

When caring for the child diagnosed with functional abdominal pain (FAP), the nurse recognizes which of the following as correct? a. Children with FAP have imagined pain usually located in the periumbilical and/or epigastric region of the abdomen. b. Children at high risk for FAP are those with high expectations and extensive personal goals or whose parents have unusually high expectations for them. c. Diagnosis is based on physical, laboratory, and radiographic findings. d. Initial efforts for therapeutic management include dietary modifications and cognitive-behavioral therapy and biofeedback.

B

When choosing the opioid doses for infants less than 6 months of age: a. use the weight and height to determine exact dosing. b. use one-fourth to one-third the recommended starting dose of opioids for older children. c. use smaller doses because tolerance develops slowly. d. increase the dose for moderate pain by 75% if pain relief is inadequate.

B

When considering the impact of culture on the pediatric patient, the nurse recognizes that culture: a. is synonymous with race. b. affects the development of health beliefs. c. refers to a group of people with similar physical characteristics. d. refers to the universal manner and sequence of growth and development.

B

When educating the public about diphtheria vaccine, the nurse recognizes which of the following as correct? i. Diphtheria vaccine is commonly administered in combination with tetanus and pertussis vaccines (DTaP) or DTaP and Hib vaccines for children under 7 years of age. ii. Diphtheria vaccine is administered with tetanus and acellular pertussin (Tdap) for children 11 years and older. iii. Diphtheria vaccine produces absolute immunity after three doses. iv. Several vaccines contain diphtheria toxoid (Hib, meningococcal, pneumococcal), which confers immunity to the disease. a. i, ii, iii, and iv b. i and ii c. i, ii, and iii d. iii and iv

B

When introducing new food, the parents should not: a. decrease the quantity of the infant's milk. b. mix food with formula to feed through a nipple. c. introduce new foods in small amounts. d. offer the new food by itself at first.

B

When necessary, suprapubic aspiration may be used: a. to access the bladder through the urethra. b. to obtain a sterile urine specimen from an infant. c. even though it may increase the risk for contamination. d. to prevent complications associated with urinary catheterization.

B

When obtaining a history from the parents of an infant suspected of having altered cardiac function, the nurse would expect: a. specific concerns related to palpitations the infant is having. b. feeding difficulty, sweating with activity, and poor weight gain. c. specific concerns about the infant's shortness of breath. d. concerns related to the infant's lack of crying.

B

When preparing a child for a procedure, the nurse should: a. use abstract terms. b. teach based on the child's developmental level. c. use phrases with dual meanings. d. introduce anxiety-laden information first.

B

Which of the following accurately describes the expected cognitive development during the concrete-operational period of middle childhood? a. Children are able to follow directions but unable to verbalize the actions involved in the process. b. Children are able to use their thought processes to experience events and actions and make judgments based on what they reason. c. Children are able to see things from an egocentric outlook that is rigidly developed around the action to be completed. d. Children progress from conceptual thinking to perceptual thinking when making judgments.

B

Which of the following best identifies the spiritual development of school-age children? a. They have little fear of "going to hell" for misbehavior. b. They begin to learn the difference between the natural and the supernatural. c. They petition to God for less tangible rewards. d. They view God as a deity with few human traits.

B

Which of the following clinical manifestations are associated with acute glomerulonephritis? a. Normal blood pressure, generalized edema, oliguria b. Periorbital edema, hypertension, dark-colored urine c. Fatigue, elevated serum lipid levels, elevated serum protein levels d. Temperature elevation, circulatory congestion, normal BUN and creatinine serum levels

B

Which of the following describes moderate sedation? a. Patient is not easily aroused and does not respond to verbal commands. b. Patient responds normally to verbal commands but may not respond to light tactile stimulation. c. Patient's cognitive function may be impaired. d. Patient is not able to maintain a patent airway independently.

B

Which of the following describes the onset of secondary enuresis? a. Occurs following established stool continence b. Occurs after a period of established urinary continence c. Occurs following a gastrointestinal illness d. Occurs as a result of behavioral acting out

B

Which of the following diagnostic findings would suggest decreased renal function? a. Decreased creatinine and elevated BUN b. Elevated BUN, creatinine, and uric acid levels c. Elevated potassium, phosphorus, and calcium d. Proteinuria and decreased creatinine and BUN

B

Which of the following diagnostic tests is particularly useful in diagnosing congenital adrenal hyperplasia? a. Chromosomal typing b. Pelvic ultrasound c. Pelvic x-ray d. Testosterone levels

B

Which of the following discharge instructions should not be included for the child who is post hypospadias repair and still has a catheter or stent? a. Position the urine bag below the bladder. b. The child is allowed to take a tub bath daily. c. Preventative bladder spasm medication is important. d. Continue pain medication to control discomfort.

B

Which of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschooler? a. Lisp b. Stuttering c. Nystagmus d. Echolalia

B

Which of the following examples would be most indicative of a communication impairment? a. A 9-month-old who has not started babbling or gesturing b. An 18-month-old who has not uttered his first word c. A 22-month-old who hasn't uttered a two-word phrase d. A 4-year-old who stutters

B

Which of the following factors, according to Craft's 1993 framework, would be considered most likely to negatively influence the reactions of siblings to the hospitalized child? a. The sibling is an adolescent. b. Care providers are not relatives. c. The sibling has received information about the ill child. d. The ill child is cared for in the home.

B

Which of the following indicators is best to use to determine the depth of the comatose state? a. Motor activity b. Level of consciousness c. Reflexes d. Vital signs

B

Which of the following infant traits is most likely to contribute to shaken baby syndrome (traumatic brain injury)? a. laughing aloud b. crying c. soiling the diaper d. pulling up to furniture

B

Which of the following information given to the parents about administration of a proton pump inhibitor for the treatment of GER is correct? a. The medication is administered on a full stomach. b. The medication is administered 30 minutes before breakfast. c. The medication will be immediately effective in suppressing acid formation. d. Side effects of the drug include increased fatigue, dry mouth, and bloating.

B

Which of the following is administered prophylactically to infants at high risk for complications from RSV? a. Ribavirin b. Palivizumab c. Pneumococcal vaccine d. Penicillin G

B

Which of the following is an acute manifestation of pain in the neonate? a. Increased transcutaneous oxygen saturation b. Prolonged hyperglycemia c. Decreased muscle tone and increased vagal nerve tone d. Increased skin dryness, decreased blood pressure, hyperglycemia

B

Which of the following is associated with 75% of all penile neoplasias? a. Human papillomavirus (HPV) types 6 and 11 b. HPV type 16 c. Uncircumcised males d. Paraphimosis

B

Which of the following is not a function of the gastrointestinal (GI) system? a. Process and absorb nutrients necessary to support growth and development b. Maintain thermoregulatory functions c. Perform excretory functions d. Maintain fluid and electrolyte balance

B

Which of the following is not a potential consequence of mass media? a. Body dissatisfaction b. Visual impairment c. Violence desensitization d. Sedentary lifestyle

B

Which of the following is the best method to establish an adequate airway for a burned pediatric patient exhibiting changes in sensorium, air hunger, nasal flaring, and grunting? a. 100% oxygen administration b. Intubation c. Administration of bronchodilators d. Suctioning to remove secretions

B

Which of the following is the most common method of successful suicide among adolescents? a. Overdose of drugs b. Firearms c. Self-inflicted lacerations d. Hanging

B

Which of the following is true about topical therapy for acute treatment of dermatologic problems? a. Application of heat to the area will relieve itching. b. Apply the topical application in a systematic manner following the contour of the body surface. c. Chemicals that are nonirritating to intact skin will be nonirritating to inflamed skin. d. Emollient action of soaks, baths, or lotions increases skin irritation.

B

Which of the following is true regarding diagnostic evaluations for bilirubin? a. Newborn levels of unconjugated bilirubin must exceed 5 mg/dl before jaundice is observable. b. Hyperbilirubinemia is defined as a serum bilirubin value above 8 mg/dl in full-term infants. c. When jaundice occurs before 24 hours of age, bilirubin level assessment is unnecessary. d. Transcutaneous bilirubinometry is an effective cutaneous measurement of bilirubin in full-term infants being treated with phototherapy.

B

Which of the following manifestations of chronic kidney disease can have the most social consequences for the developing child? a. Anemia b. Growth delay c. Bone demineralization d. Septicemia

B

Which of the following statements about adolescents and school is true? a. Transition from elementary school to middle school has no negative effects on adolescents. b. Teenagers whose grades fall below average spend more time in perceived negative environments and feel alienated from school. c. Students who repeat one or more grades are more likely to bring weapons to school. d. Students with above-average grades have been identified as more likely to engage in suicide attempts.

B

Which of the following statements about ipecac use for poisonous substance ingestion is true? a. Ipecac helps absorb the toxin. b. Ipecac is no longer recommended for routine home treatment of poisoning. c. Ipecac is useful when a corrosive substance has been ingested. d. Ipecac is useful when an overdose of a calcium channel blocker has been ingested.

B

Which of the following statements about pattern of growth during adolescence is true? a. Knowing the correct sequence of the growth pattern is useful only when assessing abnormal growth patterns versus normal growth patterns. b. Girls usually begin puberty and reach maturity about 2 years earlier than boys do. c. Girls and boys experience an increase of muscle mass that begins during early puberty and lasts throughout adolescence. d. Girls and boys experience an increase in linear growth that begins for both during midpuberty.

B

Which of the following statements about the ketogenic diet is true? a. It is a high-carbohydrate, high-fat diet with adequate protein. b. It has shown effectiveness for treatment of epilepsy. c. Consumption of the diet forces the body to shift from using fat as the primary source to using glucose, thus developing a state of ketosis. d. Vitamin supplements are rarely necessary with the diet.

B

Which of the following statements about the preschooler's physical proportions is true? a. Preschoolers have a squat and potbellied frame. b. Preschoolers have a slender but sturdy frame. c. The muscle and bones of the preschooler have matured. d. Sexual characteristics can be differentiated in the preschooler.

B

Which of the following statements about undescended testes is false? a. In the case of retractile testes, the parents may report intermittently observing the testes in the scrotum, interspersed with periods when they cannot be palpated or observed. b. Retractile testes and true undescended testes both will need surgical correction. c. Surgical repair of undescended testes is done to prevent damage to the undescended testicle, decrease incidence of malignancy, avoid trauma and torsion, and close the processus vaginalis. d. Surgical correction is likely needed if testes do not descend spontaneously by age 6 months.

B

Which of the following terms describes a physiologic state in which abrupt cessation of an opioid results in a withdrawal syndrome? a. Tolerance b. Physical dependence c. Addiction d. Pseudoaddiction

B

Which of the following vitamins when taken in excess would be most likely to cause problems for the infant or child? a. Folate b. Vitamin A c. Biotin d. Vitamin C

B

Which of the following will 50% of infants who are sensitive to cow's milk protein also demonstrate a sensitivity to? a. Yogurt b. Soy formula c. Amino acid formula d. Goat's milk

B

Which of the following would the nurse not expect to observe as characteristic of peer group relationships of 8-year-old Mark? a. Mark demonstrates loyalty to the group by adhering to the secret code rules. b. Mark demonstrates a greater individual egocentric outlook when compared with other peer group members. c. Mark is willing to conform to the group's rule of "not talking to girls." d. Mark has a best friend within the peer group with whom he shares his secrets.

B

Which one of the following findings for growth is cause for potential concern and should be followed closely? a. Height and weight fall above the 5th percentile on the growth chart. b. Height and weight fall below the 5th percentile on the growth chart. c. Height and weight fall below the 95th percentile on the growth chart. d. Height and weight fall within the 50th percentile on the growth chart.

B

Which one of the following statements about injuries in childhood is false? a. Developmental stage partially determines the prevalence of injuries at a given age. b. Most fatal injuries occur in children under the age of 9 years. c. Developmental stage helps direct preventive measures. d. Children ages 5 to 9 years are at greatest risk for bicycle fatalities.

B

Which symptoms would the nurse expect in a child with hypocalcemia? a. Abdominal cramps, oliguria b. Tingling of nose, ears, fingertips, and toes; neuromuscular irritability; tetany c. Thirst, low urine specific gravity d. Flushed, mottled extremities and weight gain

B

_________________ is the capacity to understand what another person is feeling by experiencing the situation from that person's frame of reference. a. Sympathy b. Empathy c. Reassurance d. Encouragement

B

Bobby, age 12 years, has been diagnosed with chronic kidney disease since the age of 6 years. He has reached end-stage renal disease and will need to begin dialysis. Which of the following nursing care management interventions should not be included in Bobby's care plan? a. Assist Bobby in adjusting to the fact that he will always be different from his peers. He will be shorter, more tired at times, and unable to participate in all activities b. Anticipate possible disharmony and denial from Bobby and his family c. Explain to Bobby that he will no longer be able to go to school d. Assist the parents in exploring the financial drain the disease will have on the family resources and provide information on assistance that is available

C

Bobby, age 2 years, has suffered a minor burn injury. Expected management would include: a. redressing the wound with a gauze dressing every 3 days. b. soaking stuck dressings in hydrogen peroxide before removal. c. watching wound margins for redness, edema, or purulent drainage. d. administering narcotics for pain.

C

Brian, 16 years old, has been diagnosed with cirrhosis. The health care practitioner has ordered daily administration of lactulose. What is the rationale for the use of this drug? a. Decreases ascites b. Decreases bleeding from the esophageal varices c. Decreases the formation of ammonia d. Improves absorption of fat-soluble vitamins

C

By the age of 2, the toddler generally: a. has clear body boundaries. b. participates willingly in most procedures. c. has a sense of maleness or femaleness. d. is unable to learn correct terms for body parts.

C

Care of bacterial skin infections in children may include all of the following except: a. good hand washing. b. changing clothes daily and washing in hot water. c. puncturing the surface of the pustule. d. applying topical antibiotics.

C

Childhood nutritional marasmus usually results in populations where: a. the caloric intake is inadequate. b. the food supply is adequate for protein. c. the adults eat first, leaving insufficient food for children. d. the diet consists mainly of starch grains.

C

Children who are identified as having a difficult or easily distracted temperament: a. rarely pose a problem. b. usually exhibit discomfort when introduced to new situations. c. benefit from practice sessions before an event. d. should not be told when to stop activities, since this can trigger a reaction event.

C

Children who have profound anemia during induction therapy should: a. strictly limit their activities. b. regulate their own activity with adult supervision. c. receive blood transfusions until the hemoglobin level approaches 10 g/dl. d. receive chemotherapy until the hemoglobin level reaches 10 g/dl.

C

Children with DKA require fluid volume replacement with what type of IV fluid initially? a. Dextrose 5% in water (D5W) b. Dextrose 5% in 0.9% normal saline with 20 mEq/KCl per liter c. 0.9% normal saline d. 10% dextrose with 10 mEq sodium bicarbonate per liter

C

Children with spina bifida who are confined to a wheelchair are at increased risk for: a. tethered cord syndrome. b. Chiari malformation. c. skin breakdown. d. orthopedic deformities.

C

Cindy has been diagnosed with anorexia nervosa. Her therapeutic management plan includes dietary interventions combined with family psychotherapy. Which of the following would the nurse recognize as appropriate? a. Weight gain is a sign that the patient is not relapsing from the plan. b. The patient is only allowed to participate in setting up a food plan as a reward for weight gain. c. The plan needs to be firm but flexible. d. A reasonable goal for weight gain is about 4 lb/week.

C

Complicated grief reactions: a. usually take about a year. b. are accompanied by support of the family at the funeral. c. may extend over years. d. can be eliminated if the family is well prepared.

C

Debbie is 2 years old and lives with her brother Mark, her sister Mary, and her mother. Her father and mother recently divorced, and now her father lives 1 hour away. Debbie sees her father once a month for a day's visit. Her mother retains custody of Debbie. Debbie's grandparents live in a different state, but she visits them each year. Debbie's family represents which one of the following? a. Binuclear family b. Extended family c. Single-parent family d. Blended family

C

Detecting communication disorders during early childhood: a. adversely affects the child's social relationships. b. increases the child's difficulty with academic skills. c. increases the child's ability to achieve full potential d. adversely affects the child's emotional interactions.

C

Developmentally by 12 months of age most children: a. use a spoon adeptly. b. relinquish the bottle voluntarily. c. eat the same food as the rest of the family. d. reject all solid food in preference for the bottle.

C

Diabetic ketoacidosis in children with type 1 diabetes mellitus: a. is the most common chronic complication. b. is a result of too much insulin. c. is a life-threatening complication. d. rarely requires hospitalization.

C

Diagnosis of infectious mononucleosis is established when the: a. red blood cell count is depressed. b. leukocyte count is depressed. c. heterophil agglutination test is positive. d. heterophil agglutination test is negative.

C

Diagnostic evaluation of dehydration to initiate a therapeutic plan includes: i. serum electrolytes. ii. acid-base imbalance determination. iii. physical assessment to determine degree of dehydration. iv. type of dehydration based on pathophysiology. a. i and ii b. i, ii, and iii c. i, ii, iii, and iv d. iii and iv

C

Dillon is a 6-year-old starting in a new neighborhood school. On the first day of school, he complains of a headache and tearfully tells his mother he does not want to go to school. Dillon's mother takes him to school, and the nurse is consulted. The nurse recognizes that Dillon is slow to warm up to others and suggests which of the following? a. Put Dillon in the classroom with the other children and leave him alone. b. Insist that Dillon join and lead the class song. c. Include Dillon in activities without assigning him tasks until he willingly participates in activities. d. Send Dillon home with his mom because he has a headache.

C

During continuous enteral feedings, the nurse should: a. use the same pole as used for the intravenous line. b. use a burette to calibrate the feeding times. c. give the infant a pacifier for sucking. d. do all of the above.

C

During the adolescent health screening interview, the nurse focuses on which of the following to best address injury prevention? a. Drownings b. Burns c. Motor vehicle crashes d. Drug use

C

Early appearance of secondary sex characteristics of girls during preadolescence may be associated with which of the following feelings? a. Satisfaction with physical appearance and higher self-esteem b. Increase in self-confidence and a more outgoing personality c. Dissatisfaction with physical appearance and lower self-esteem d. Increased substance use and reckless vehicle use

C

Early symptoms of malignant hyperthermia include: a. anemia. b. enlarged lymph nodes. c. tachycardia. d. hypertension.

C

Elements of principled moral reasoning emerge during adolescence. Which of the following is the best description of this moral development? a. Moral guidelines are seen to emanate from authority figures. b. Moral standards are seen as objective and not to be questioned. c. Absolutes and rules are questioned and subject to disagreement. d. A personal value system is developed.

C

Elevated cholesterol in childhood: a. can predict the long-term risk for heart disease for the individual. b. can predict the risk for hypertension in adulthood. c. is a major predictor of the adult cholesterol level. d. is associated with presymptomatic atherosclerosis.

C

Evaluation of the infant for edema is different from that of the older child in that: a. weight is not reliable as an early sign. b. pedal edema is most pronounced in the newborn. c. edema is usually generalized and difficult to detect. d. distended neck veins are the most reliable sign.

C

Fear of the unknown is one of the greatest threats to seriously ill children of which age-group? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

C

Following assessment and identification of a language problem, the nurse should advise the family to: a. wait and see what happens. b. wait because the child will grow out of it. c. obtain a specialized evaluation. d. repeat words so that the child will learn more language.

C

For parents using the Internet to obtain information about their child's cardiac diagnosis, it is important for the nurse to remind them that: a. information is difficult to access. b. most information found will not be helpful. c. not all websites offer accurate information. d. information on the Internet is usually reliable.

C

Functional abdominal pain in children: a. typically lasts for 2 weeks or less. b. does not interfere with the child's normal activities. c. has no identifiable pathologic cause. d. requires the nurse to understand that because there is no organic cause for the pain, the reported pain is not a true pain.

C

Group A β-hemolytic streptococci infection is usually a: a. serious infection of the upper airway. b. common cause of pharyngitis in children over the age of 15 years. c. brief illness that leaves the child at risk for serious sequelae. d. disease of the heart, lungs, joints, and central nervous system.

C

How does the nurse assess for pitting edema? a. Measure abdominal girth b. Observe for fluid retention in the lower extremities c. Press fingertip against bony prominence for 5 seconds d. Observe for loss of normal skin creases

C

Human papillomavirus (HPV) vaccine is recommended for all of the following populations except: a. female adolescents to prevent HPV-related cervical cancer. b. boys and men (9 to 26 years) to reduce the likelihood of genital warts. c. female preadolescents ages 6 to 8 years. d. female adolescents who are not sexually active.

C

If a child needs support during an invasive procedure, the nurse should: a. insist that the parents participate in distraction techniques. b. instruct parents to stand quietly in the back of the room and maintain eye contact with the child. c. respect parents' wishes and coach the parents about techniques and support during the procedure. d. instruct parents to stay close by to console the child immediately after the procedure.

C

If the infant weighs 8 kg at age 5 months, about how many kilograms was his or her probable birth weight? a. 7 kg b. 6 kg c. 4 kg d. 15 kg

C

In about half of all cases of infectious mononucleosis, there will be: a. skin rash. b. otitis media. c. splenomegaly. d. failure to thrive.

C

In an 8-month-old infant admitted with pertussis, the nurse should assess the: a. living conditions of the infant. b. labor and delivery history of the mother. c. immunization status of the infant. d. alcohol and drug intake of the mother.

C

In an attempt to prevent central nervous system invasion of malignant cells, children with leukemia usually receive prophylactic: a. cranial-spinal irradiation. b. intravenous steroid therapy. c. intrathecal chemotherapy. d. intravenous methotrexate and cytarabine.

C

In caring for the infant with exstrophy, which of the following is incorrect? a. Staged repair is started during the neonatal period, preferably within the first 1 to 2 days of life. b. Until closure is performed, the bladder is covered with clear plastic wrap or a thin film dressing. c. Petroleum jelly is used to keep the area moist and prevent breakdown. d. After closure, the infant is monitored for urinary output and signs of urinary tract infection.

C

In fetal circulation, the umbilical vein divides and sends blood directly to the inferior vena cava by way of the ductus venosus. This division occurs at the: a. heart. b. lungs. c. liver. d. placenta.

C

In performing an examination for scoliosis, the nurse understands that which of the following is an incorrect method? a. The child should be examined only in his or her underpants (and a bra if an older girl). b. The child should stand erect, with the nurse observing from behind. c. The child should squat down with hands extended forward so the nurse can observe for asymmetry of the shoulder blades. d. The child should bend forward with the back parallel to the floor so that the nurse can observe from the side.

C

In planning strategies to improve the child's compliance with the prescribed treatment, the nurse knows that: a. an every-8-hour schedule should be implemented. b. an every-6-hour schedule should be implemented. c. the child may not be able to swallow pills. d. the family usually does not remember or understand the instructions given.

C

In relation to body image, school-age children: a. are not aware of physical disabilities in others. b. pay little attention to their own body capabilities. c. seldom express concerns about their bodies to their families. d. do not model themselves after their parents or compare themselves with images observed in the media.

C

Infant mortality decreased significantly in the 1990s for which of the following? a. Low birth weight b. Congenital heart defects c. Human immunodeficiency virus (HIV) infection d. Sudden infant death syndrome (SIDS)

C

Infants at risk for early-onset hypocalcemia include: a. postterm infants. b. infants who develop jaundice. c. infants born to hypertensive mothers. d. small-for-gestational-age infants who experience perinatal asphyxia.

C

Infants of adolescents are at risk because: a. teenage mothers often neglect their infants, leaving them for long periods with grandparents. b. teenage mothers supply excessive amounts of cognitive stimulation to their infants. c. adolescents often lack knowledge about normal infant growth and development. d. adolescents are less likely to treat their infant as love objects or playthings.

C

Jim, a 7-year old boy, has just been diagnosed with childhood obesity. Which of the following does the nurse recognize as being most likely to contribute to Jim's obesity? a. Caloric needs are diminished in relation to body size during middle childhood. b. When Jim entered school, he developed an eating style that was increasingly independent from parental influence. c. The availability of inexpensive high-caloric foods and the tendency toward sedentary activities has led to Jim being overweight. d. Jim is a latchkey child and makes his own breakfast and lunch.

C

Johnny, age 13 months, is being admitted for parenteral fluid therapy because of excessive vomiting. The nurse would recognize which of the following as most essential in implementing care for Johnny? a. Give Johnny oral fluids until the parenteral fluid therapy can be established. b. Question the provider's order for parenteral fluid therapy of 0.9% sodium chloride. c. Withhold the ordered potassium additive until Johnny's renal function has been verified. d. Replace half of Johnny's estimated fluid deficit over the first 24 hours of parenteral fluid therapy.

C

Jordan, age 12 years, has suffered severe burns, and now his chest appears constricted. The nurse should prepare for: a. intubation. b. chest tube insertion. c. escharotomy. d. hydrotherapy.

C

On routine physical examination, 2-year-old Zach is found to have an elevated blood lead level. The most likely cause for this finding is: a. Zach is allowed to play in the local sandbox at the park. b. Zach lives in a house built after 1980. c. Zach is fed from pottery that the family makes themselves. e. Zach's father is an artist and works at home.

C

One difference between toddlers and older school-age children in their reactions to hospitalization is that most older school-age children: a. experience more separation anxiety. b. show less fright or overt resistance to pain. c. may react more to separation from friends. d. may throw temper tantrums.

C

One important strategy for feeding a child with failure to thrive would be to: a. avoid having the same nurse feed the child. b. distract the child during meals with television and toys. c. structure the feeding environment and schedule. d. vary the feeding routines to make the feeding time more interesting.

C

One of the strategies the nurse can use to progressively increase a child's activity in the postoperative period after cardiac surgery is to: a. ambulate on the first day. b. keep the child on strict bedrest. c. ambulate after analgesic medication.

C

One role of the nurse in the parent-professional partnership is to: a. decide what is most important for the family. b. decide what is most important for the child. c. strengthen the family's ability to make informed choices. d. manipulate the available resources.

C

One strategy to provide atraumatic care for pediatric patients undergoing surgery is to: a. restrict fluids in infants for at least 10 hours. b. always use a face mask during induction. c. allow the child to wear underpants or pajama bottoms into surgery. d. remove parents from the child's sight.

C

One way to decrease total fat intake in the preschooler is to: a. drink less milk. b. eat fewer quantities of dairy products. c. substitute for low-fat food sources. d. consume more fruit juice.

C

Pain medication for the child in the postoperative period following a tonsillectomy should be administered: a. rectally at regular intervals. b. orally only as requested. c. orally or intravenously at regular intervals. d. rectally or intravenously as needed.

C

Parents of the child with precocious puberty need to know that: a. dress and activities should be aligned with the child's sexual development. b. heterosexual interest will usually be advanced. c. the child's mental age is congruent with the chronologic age. d. overt manifestations of affection represent sexual advances.

C

Pediatric nurses report that a common obstacle to the provision of good palliative care is: a. parents who do not understand the concept of palliative care. b. communication with practitioners is inadequate. c. uncertainty about the goals of care. d. the cost of providing palliative care is excessive.

C

Physical assessment for child sexual abuse: a. includes documentation of only abnormal genital findings. b. includes collecting forensic evidence obtained directly from a prepubertal victim's body within 3 days of the incident. c. includes examination of the anal area. d. includes documentation of the size of the hymenal opening, since it is predictive of sexual abuse.

C

Preoperative care of the neonate with esophageal atresia and tracheoesophageal fistula includes all of the following except: a. keep NPO. b. accumulated secretions are suctioned frequently from the mouth and pharynx. c. feed through the gastrostomy tube. d. position neonate in the supine position with the head elevated on an inclined plane of 30 degrees.

C

Read the following entry from a pediatric health history: "Nausea and vomiting for 3 days. Started with abdominal cramping after eating hamburger at home. No pain or cramping at present. Unable to keep any food down but able to drink clear liquids without vomiting. No temperature elevation, no diarrhea." This entry represents which component of the health history? a. Chief complaint b. Past history c. Present illness d. Review of systems

C

Research has shown that when two languages are presented to children simultaneously in early childhood, bilingual children are most likely to experience: a. adverse effects in their receptive language development. b. adverse effects in performance in the majority language. c. language milestones at similar stages to monolinguals. d. adverse effects to areas in addition to language.

C

Sandy's testing reflects that she has not had hepatitis A. Because her exposure to hepatitis A occurred within the past 2 weeks, the nurse would expect the provider to order which of the following for prophylactic administration? a. Hepatitis B immune globulin (HBIG) b. HBV vaccine c. Standard immune globulin (IG) d. HAV vaccine

C

School-linked clinics: a. are located on school property and serve adolescent populations from that campus. b. do not require parental consent before service can be provided to the adolescent. c. provide greater access to adolescents for preventive and primary care services. d. have not been widely accepted by the adolescents, since they are not receptive to services offered.

C

Sex typing involves the process by which the preschooler develops: a. a strong attachment to the same-sex parent. b. an identification with the opposite-sex parent. c. behavior and beliefs for his or her culture and sex. d. all of the above.

C

Sexual abusers: i. can be anyone but most often a male who is known by the victim. ii. can hold full-time jobs and are active in community affairs. iii. are most often not family members. iv. often spend time with the victims to gain their trust before initiating any sexual contact. v. rarely abuse the younger child if the older child is not present. a. ii, iii, iv, and v b. i, iii, and iv c. i, ii, and iv d. iii, iv, and v

C

Skin disorder assessment includes the objective data collected by inspection and palpation. Which of the following is not an example of objective data? a. The lesion has an increased erythematous margin edge. b. The rash appears as macules and papules. c. The lesion is painful and itches. d. The lesion is moist.

C

Sleep patterns among adolescents: a. show that teens should get at least 10 hours of sleep nightly. b. show that one in eight teens is regularly sleep deprived. c. show that sleep deprivation contributes to school problems. d. show that one in four teens reports use of the Internet as the major reason for lack of sufficient sleep.

C

Spinal cord injuries are classified as either complete or incomplete. In a complete spinal cord injury: a. there is loss of sensation, pain, and proprioception with normal cord function, including motor function. b. there is transient loss of neural function below the level of the acute spinal cord lesion, resulting in flaccid paralysis and loss of tendon autonomic and cutaneous reflex activity. c. there is no motor or sensory function more than three segments below the neurologic level of the injury. d. there is tetraplegia, commonly with sacral sparing, with patients gaining some motor recovery.

C

Spiritual development during adolescent years can best be described by which of the following? a. Places less emphasis on what a person believes b. Places more emphasis on whether a person attends religious services c. Becomes more focused on spiritual and ideologic matters and less on observing religious customs d. Becomes more focused on observing religious customs and less on ideologic matters

C

Steve, age 8, has been diagnosed with tinea capitis. Which of the following does the nurse include in the teaching plan for Steve and his parents? a. No animal-to-person transmission is associated with this infection. b. Steve can continue to share hair-grooming articles with his younger brother. c. Griseofulvin should be administered with high-fat foods. d. Treatment may be discontinued once symptoms subside.

C

Strategies to use when caring for the hospitalized child with autism include: a. maintaining direct eye contact when explaining procedures. b. using holding and touch to comfort the child. c. decreasing stimulation. d. all of the above.

C

The American Academy of Pediatrics recommends treating cow's milk allergy in infants by changing the formula to: a. soy formula. b. goat's milk. c. hydrolyzed formula. d. milk pretreated with microbial-derived lactase.

C

The Functional Disability Inventory (FDI): a. is used to evaluate depression in children with chronic pain. b. is used to evaluate the influence of acute pain on physical functioning. c. is used to assess the child's ability to perform everyday physical activities. d. has both child and parent versions.

C

The advantages of a hospital unit specifically for adolescents include: a. exclusive group membership. b. fewer preparation requirements. c. increased socialization with peers. d. all of the above.

C

The best positioning technique for a lumbar puncture in a neonate is a: a. side-lying position with neck flexion. b. sitting position. c. side-lying position with modified neck extension. d. side-lying position with knees to chest.

C

The cancer that occurs with the most frequency in children is: a. lymphoma. b. neuroblastoma. c. leukemia. d. melanoma.

C

The child with long-standing hypoparathyroidism will usually exhibit: a. short, stubby fingers. b. dimpling of the skin over the knuckles. c. dry, scaly skin and poor growth. d. a short, thick neck.

C

The child with obstruction of the renal pelvis or ureter is most likely to present with which of the following clinical manifestations? a. Poor force of urinary stream or intermittency of voided stream b. Nocturia, urgency to urinate, and pain in the lower abdomen c. Pain in the flank and lower back or abdomen that is not relieved by changes in position d. Fever, chills, vomiting, and proteinuria

C

The child with type 1 diabetes mellitus is taught to weigh and measure food to: a. receive the nutrients prescribed. b. prevent hypoglycemia. c. learn to estimate food portions. d. prevent hyperglycemia.

C

The clinical manifestations expected with Meckel diverticulum include which of the following? a. Fever, vomiting, and constipation b. Weight loss, hypotension, and obstruction c. Painless rectal bleeding, abdominal pain, or intestinal obstruction d. Abdominal pain, bloody diarrhea, and foul-smelling stool

C

The correct term to use for a person whose hearing disability precludes successful processing of linguistic information through audition without the use of a hearing aid is: a. deaf-mute. b. slight to moderate hearing loss. c. severe to profound hearing loss. d. deaf and dumb.

C

The development of gender identity is reported to begin: a. after the first year. b. during the phallic stage. c. in utero. d. at puberty.

C

The diagnostic procedure that is usually noninvasive and permits visualization of the neurologic structures using radiofrequency emissions from elements is called: a. DSA. b. PET. c. MRI. d. CT.

C

The diagnostic test that has been used increasingly in recent years to confirm the diagnosis of a congenital heart defect without a cardiac catheterization is the: a. ECG. b. echocardiography. c. Holter monitor. d. cardiac magnetic resonance imaging.

C

The diet requirement for minimal-change nephrotic syndrome includes: a. water restriction. b. low-protein diet in both acute and remission stages. c. salt restriction during periods of edema and while on corticosteroid therapy. d. high-protein diet during both acute and remission stages.

C

The dietary history of a pediatric patient includes: a. a 12-hour dietary intake recall. b. a more specific, detailed history for the older child. c. financial and cultural factors that influence food selection. d. criticism of parents' allowance of nonessential foods.

C

The disease inherited only as an autosomal recessive trait and characterized by progressive weakness and wasting of skeletal muscles caused by degeneration of anterior horn cells is: a. cerebral palsy. b. Kugelberg-Welander disease. c. infantile SMA type 1 (Werdnig-Hoffmann disease). e. Guillain-Barré syndrome (GBS).

C

The electrolyte that is usually depleted with most diuretic therapy and is most likely to cause dysrhythmias is: a. sodium. b. chloride. c. potassium. d. magnesium.

C

The etiology of bacterial meningitis has changed in recent years because of the: a. increased surveillance of tuberculosis. b. increased awareness of rubella and polio vaccines. c. routine use of H. influenzae type B and Streptococcus pneumoniae vaccines. d. routine use of hepatitis B and hepatitis A vaccines.

C

The expected immaturity of the infant's functioning endocrine system will be demonstrated in the infant's: a. growth patterns. b. thyroid levels. c. homeostatic control. d. immunoglobulin levels.

C

The first action parents should be taught to initiate in a poisoning is to: a. induce vomiting. b. take the child to the family physician's office or emergency center. c. call the poison control center. d. follow the instructions on the label of the product.

C

The immediate management of syndrome of inappropriate antidiuretic hormone (SIADH) consists of: a. increasing fluids. b. administering antibiotics. c. restricting fluids. d. administering vasopressin.

C

The infant with hydrocephalus has which of the following clinical manifestations? a. Upward eye slanting b. Strabismus c. Setting-sun sign d. Decreased head circumference

C

The leading cause of death in the first 3 years after heart transplantation (the greatest risk in the first 6 months) in children is: a. heart failure. b. infection. c. rejection. d. renal dysfunction.

C

The most common cause of malocclusion is: a. thumb sucking. b. tongue thrusting. c. hereditary factors. d. abnormal growth patterns.

C

The most common organic cause of pituitary under secretion is: a. tumor in the adrenocortical region. b. autoimmune hypophysitis. c. tumor in the pituitary or hypothalamic region. d. perinatal trauma.

C

The most common side effect of opioid therapy is: a. respiratory depression. b. pruritus. c. nausea. d. agitation.

C

The most important therapeutic management for the child with celiac disease is: a. eliminating corn, rice, and millet from the diet. b. adding iron, folic acid, and fat-soluble vitamins to the diet. c. eliminating wheat, rye, barley, and oats from the diet. d. educating the child's parents about the short-term effects of the disease and the necessity of reading all food labels for content until the disease is in remission.

C

The nurse is conducting an educational session for the parents of a child diagnosed with varicella. Which one of the following is not an appropriate comfort measure to include in this session? a. Promote skin care including daily bathing and changing clothes. b. Use Caladryl lotion on rash to decrease itching. c. Use hot bath water to promote skin rash healing. d. Keep nails short and smooth to decrease chances of infection from scratching.

C

The nurse is discussing PID with a group of sexually active adolescent females. Which of the following is correct information? i. C. trachomatis is a common cause. ii. Using IUDs for birth control with more than one sexual partner increases the risk of developing PID. iii. Pain is not always found in patients presenting with PID. iv. After a single episode of PID, infertility occurs because of tubal scarring. v. After a single episode of PID, the risk for ectopic pregnancy increases. vi. All pregnant women with PID should be hospitalized and treated with parenteral antibiotics. a. i, ii, iii, and vi b. ii, v, and vi c. i, ii, v, and vi d. ii, iv, v, and vi

C

The nurse is planning to advise a school-age child's parents about appropriate physical activity for their child. Which fact does the nurse include? a. School-age children have the same stamina and control as 15-year-old teens. b. School-age children are prepared for participation in strenuous competitive athletics. c. Activities that promote coordination in the school-age child include running and skipping rope. d. Most children need continued encouragement to engage in physical activity.

C

The nurse recognizes that which one of the following should be included in the postoperative care of a patient with a shunt? a. Positioning the patient in a head-up position b. Continuous pumping of the shunt to assess function c. Monitoring for abdominal or peritoneal distention d. Positioning the child on the side of the operative site to facilitate drainage

C

The nurse should obtain the vital signs of an infant in what order? a. Measure temperature, then count the pulse, and then count respirations. b. Count the pulse, then count respirations, and then measure the temperature. c. Count respirations, then count the pulse, and then measure the temperature. d. Measure the temperature, then count respirations, and then count the pulse.

C

The nurse should suspect epiglottitis if the child has: a. cough, sore throat, and agitation. b. cough, drooling, and retractions. c. drooling, agitation, and absence of cough. d. hoarseness, retractions, and absence of cough.

C

The nurse, while conducting a home visit, finds that the mother of 4-year-old Nathan is using a mercury thermometer to take his axillary temperature. Which of the following is the best intervention for the nurse at this time? a. Tell the mother to stop using mercury thermometers because if the mercury is ingested, it can cause mercury toxicity. b. Explain to the mother that mercury poisoning can cause acrodynia. c. Explain to the mother that mercury thermometers are no longer recommended and that if broken, the inhaled vapors can cause toxicity. d. Reassure the mother that as long as the mercury thermometer is not broken, it is okay to continue to use it.

C

The position of choice for the child in shock is: a. Trendelenburg. b. head-down with feet straight. c. flat with the legs elevated. d. semi-Fowler.

C

The preschooler's body image has developed to include: a. a well-defined body boundary. b. knowledge about his or her internal anatomy. c. fear of intrusive experiences. d. anxiety and fear of separation.

C

The question "How does your child usually handle problems or disappointments?" would be asked on admission to assess the child's: a. role-relationship pattern. b. sexuality-reproductive pattern. c. coping-stress tolerance pattern. d. value-belief pattern.

C

The recommended treatment for DDH in an infant 2 months old is: a. surgical fixation. b. hip spica cast. c. Pavlik harness. d. hip abduction orthosis.

C

The school nurse is planning an educational program centered on smoking prevention for high school adolescents. Which of the following methods does the nurse recognize as the most effective way to present this program? a. Focus on the negative, long-term effects of smoking on health b. Teach methods of resistance to peer pressure c. Use peer-led programs that emphasize social consequences d. Use media, videotapes, and films on smoking prevention

C

The severe cellular damage that is caused by chemotherapy drugs infiltrating into surrounding tissue occurs when the chemotherapeutic agent is a(n): a. hormone. b. steroid. c. vesiccant. d. antimetabolite.

C

The treatment for the pediatric patient with anemia related to chronic renal failure includes all of the following except: a. ferrous sulfate supplements. b. ascorbic acid supplements. c. vitamin B12 supplements. d. administration of erythropoietin.

C

The two-step approach for pain management: a. is used with children older than 3 years of age. b. always starts with administration of a nonopioid. c. consists of a choice of category of analgesic medications according to the level of pain. d. always starts with the administration of morphine as the drug of choice.

C

The typical number of words acquired by the age of 2 years is: a. 50. b. 100. c. 300. d. 500.

C

Therapeutic management for a child with a tic disorder primarily consists of: a. behavioral modification to teach the child to suppress the tic disorder. b. administration of haloperidol to suppress the tic disorder. c. education and support for the child and family with reassurance about the prognosis. d. genetic counseling for the parents.

C

Therapeutic management in nephrotic syndrome includes the administration of prednisone. The nurse teaches which of the following as correct administration guidelines? a. Corticosteroid therapy is begun after BUN and serum creatinine elevation. b. Prednisone is administered orally once daily for 3 weeks. c. The drug is given daily for 4 to 6 weeks, then decreased in dosage and given on alternate days for 2 to 5 months with taper. d. The drug is discontinued as soon as the urine is free from protein.

C

Therapy for epilepsy should begin with: a. short-term drug therapy. b. combination drug therapy. c. only one drug. d. drugs that correct the brain wave pattern.

C

There is evidence that ___________ is associated with rare but life-threatening adverse events or death in some children after tonsillectomy or adenoidectomy. a. acetaminophen b. morphine c. codeine d. oxycodone

C

To collect a blood culture specimen from a central venous line or peripheral lock, research suggests that the nurse: a. must use the first sample of blood. b. may not need to discard the first sample of blood. c. irrigate the device with D5W first. d. use a heparinized collection tube.

C

To confirm the diagnosis of Hirschsprung disease, the nurse prepares the child for which of the following tests? a. Barium enema b. Upper GI series c. Rectal biopsy d. Esophagoscopy

C

To help the parents deal with issues related to separation while their child is hospitalized, the nurse should not suggest: a. using associations to help the child understand time frames. b. ways to explain departure and return. c. quietly leaving while the child is distracted or asleep. d. short, frequent visits over an extended stay if rooming in is impossible.

C

To increase the caloric intake of an infant with failure to thrive, the nurse might recommend: a. using developmental stimulation by a specialist during feedings. b. avoiding solids until after the bottle is well accepted. c. restricting juice intake. d. varying the schedule for routine activities on a daily basis.

C

Treatment for migraine headaches in adolescents over 12 years of age may include: a. ergots. b. opioids. c. almotriptan. d. all of the above.

C

Vesicoureteral reflux (VUR) is closely associated with which of the following? a. Acute glomerulonephritis b. Nephrotic syndrome c. Renal scarring and kidney damage d. High alkaline content in the urine

C

Vitamin A deficiency has been reported with increased morbidity and mortality in children: a. with sickle cell disease. b. exposed to environmental tobacco smoke. c. with measles. d. who are breastfed.

C

What is the chief solute in extracellular fluid (ECF) and the primary determinant of ECF? a. Potassium b. Calcium c. Sodium d. Water

C

What should be included in the plan for emergency care of the burned child? a. Apply large amounts of cold water over denuded areas b. Apply ointments to the burned area c. Remove jewelry and metal d. Apply neutralizing agents to the skin of chemical burn areas

C

When a thyroidectomy is planned, the nurse should explain to the child that: a. iodine preparations will be mixed with flavored foods and then eaten. b. he or she will need to hyperextend the neck postoperatively. c. the skin, not the throat, will be cut. d. laryngospasm can be a life-threatening complication.

C

When caring for the child in isolation, the nurse should: a. spend as little time as possible in the room. b. teach the parents to care for the child to decrease the risk for spreading infection. c. let the child see the nurse's face before donning the mask. d. perform all of the above.

C

When children develop heart failure from a congenital heart defect, the failure is usually: a. right-sided only. b. left-sided only. c. both right- and left-sided.

C

When performing a painful procedure on a child, to minimize fear of bodily injury, the nurse should attempt to: a. perform the procedure in the playroom. b. standardize techniques from one age-group to the next. c. perform the procedure quickly with the parent present. d. have the parents leave during the procedure.

C

When teaching a child with a cognitive impairment, the nurse's best strategy to present cues in an exaggerated, concrete form is: a. singing. b. memorizing. c. demonstration. d. ignoring the child.

C

When using epidural analgesia to manage pain, the nurse knows that: a. analgesia results from the drug's effect on the brain. b. respiratory depression is fast to develop, usually 1 to 2 hours after administration. c. the epidural spaces at the lumbar or caudal level are used most often. d. securing the catheter with an occlusive dressing does little to prevent infection.

C

Which drug therapy is used in the removal of potassium from the body? a. Mannitol b. Sodium bicarbonate c. Kayexalate d. Calcium gluconate

C

Which feeding practices should be used for the infant with a cleft lip or palate? a. Use a large, hard nipple with a large hole b. Use a normal nipple and position it sideways in the mouth c. Use a special nipple, positioned so it is compressed by the infant's tongue and existing palate d. Withhold breastfeeding until after surgical correction of the defect

C

Which of the following best describes the formal operational thinking that occurs between the ages of 11 and 14 years? a. Thought process includes thinking in concrete terms. b. Thought process includes information obtained from the environment and peers. c. Thought process includes thinking in abstract terms, possibilities, and hypotheses. d. Thought process is limited to what is observed.

C

Which of the following birth injuries is most likely to need further evaluation? a. Subcutaneous fat necrosis b. Ecchymoses c. Petechiae d. Scleral hemorrhage

C

Which of the following current beliefs about acne formation is true? a. Cosmetics containing lanolin and lauryl alcohol are not known to contribute to acne formation. b. There is scientific research to support the theory that stress will cause an acne outbreak. c. Exposure to oils in cooking grease can be a precursor to acne in adolescents working over fast-food restaurant oils. d. Acne usually worsens with dietary intake of chocolates and other foods high in sugars.

C

Which of the following defects has the best prognosis? a. Tetralogy of Fallot b. Ventricular septal defect c. Atrial septal defect d. Hypoplastic left heart syndrome

C

Which of the following dietary instructions given by the nurse to the parents of a pediatric patient with acute diarrhea without dehydration is correct? a. Follow the BRAT diet for the first 24 hours b. Give clear fluid diet for the first 24 hours c. Give fluids and a normal diet during diarrhea illness d. Keep the patient NPO (nothing by mouth) until stool output slows

C

Which of the following differences is seen when infant death rates are categorized according to race? a. Disparities among races have continued to increase dramatically in the United States. b. Infant mortality for Hispanic infants is much higher than for any other group. c. Infant mortality for African Americans is twice the rate of whites. d. Infant mortality for white infants is the same as for other races.

C

Which of the following does the nurse recognize as contraindicated in providing comfort measures to children with communicable diseases? a. Use of acetaminophen or ibuprofen for control of elevated temperature in children with varicella b. Use of diphenhydramine (Benadryl) or hydroxyzine (Atarax) for itching c. Use of aspirin to control elevated temperature and/or symptoms with varicella d. Use of lozenges and saline rinses in an 8-year-old child with sore throat

C

Which of the following guidelines, if provided to the adolescent about tanning, is correct? a. If using self-tanning cream, no further sun protection is required. b. Sunscreens should include a sun protective factor (SPF) higher than 15 and an alcohol base with lanolin. c. Long-term effects can include premature aging of the skin; increased risk for skin cancer; and, in some adolescents, phototoxic reactions. d. Dermatologists recommend tanning machines if used no more often than two times monthly.

C

Which of the following has been shown to have calming and pain-relieving effects when used with invasive procedures in neonates? a. Allowing parent to hold neonate during procedure b. Allowing neonate quiet time in the bassinet before the procedure c. Administering concentrated sucrose with or without nonnutritive sucking before procedure d. Using relaxation techniques during the procedure

C

Which of the following heart rates would be considered tachycardia in an infant? a. A resting heart rate of 120 beats/min b. A crying heart rate of 200 beats/min c. A sleeping heart rate of 170 beats/min d. A crying heart rate of 180 beats/min

C

Which of the following helping statements would be least therapeutic for the nurse to use with the bereaved family? a. "You can stay with him and hold him if you wish." b. "It must be painful for you to return to the doctor's office without her." c. "Fortunately, his suffering is over now." d. "You have been through a very difficult time."

C

Which of the following is a true statement about Guillain-Barré syndrome (GBS)? a. GBS is an autosomal recessive inherited disease. b. GBS is more likely to affect children than adults, with children under the age of 4 years having the higher susceptibility. c. GBS is an acute demyelinating polyneuropathy with a progressive, usually ascending, flaccid paralysis. d. GBS is an autoimmune disorder associated with the attack of circulating antibodies on the acetylcholine receptors.

C

Which of the following is acceptable in providing postoperative care for the infant with a cleft lip or palate? a. Use of tongue depressor in the mouth to assess surgical site b. Continuous elbow restraints to prevent injury c. Placement of infant in the prone position after cleft lip repair d. Positioning infant to prevent airway obstruction

C

Which of the following is most likely to cause acute diarrhea? a. Food allergy b. Malabsorption syndromes c. Parasitic infections d. Immunodeficiency

C

Which of the following is not a major manifestation of rheumatic fever? a. Carditis b. Chorea c. Uveitis d. Polyarthritis

C

Which of the following is not included in the teaching plan of a child with a brace or prosthesis? a. Frequent assessment of all areas in contact with the brace for signs of skin irritation b. Assessment of the stump area before application of the prosthesis c. Removal of the prosthesis limited to bedtime unless skin breakage occurs d. Use of protective clothing under the brace

C

Which of the following is not one of the principles of managing diabetes during illness? a. Blood glucose should be monitored every 3 hours. b. Insulin dosage requirements may increase, decrease, or remain the same. c. Insulin should always be omitted when excessive vomiting occurs. d. Oral fluids should be encouraged to avoid dehydration.

C

Which of the following is not thought to contribute to peptic ulcer disease? a. H. pylori b. Alcohol and smoking c. Caffeine-containing beverages and spicy foods d. Psychologic factors such as stressful life events

C

Which of the following is true about acute subdural hematoma in infants and children? a. Arterial hemorrhage is usually present. b. Skull fracture is almost always present. c. It is more common than epidural hematoma. d. It occurs in patients older than 2 years.

C

Which of the following is used to visualize the surface of the GI tract to diagnose the extent of inflammation and narrowing in IBD? a. Upper GI series b. Magnetic resonance imaging c. Endoscopy d. Ultrasound

C

Which of the following may be used to prevent positional plagiocephaly in the first few months of life? a. Serial casting b. Molded helmet c. Alternating head position when sleeping d. Ventricular shunting

C

Which of the following nursing interventions are recognized as appropriate for the infant with hypoglycemia? i. Institute early bottle-feeding or breastfeeding. ii. Increase environmental stimulants. iii. Protect from cold stress and respiratory difficulty that predispose the infant to decreased blood glucose levels. iv. Force early oral glucose feedings, avoiding formula and breast milk until the newborn is stable. a. i, ii, iii, and iv b. i and iii c. iii and iv d. i, ii, and iii

C

Which of the following nursing interventions is not appropriate for 6-month-old Terry, admitted to the pediatric unit with acute diarrhea and vomiting? a. Ongoing assessment of Terry's intake and output and physical appearance b. Education of the parents about administering oral rehydration solution c. Rectal temperatures at least every 4 hours to monitor fever elevations d. Gentle cleansing of perianal areas and application of protective topical ointments

C

Which of the following pediatric patients is at higher risk for complications from burn injury? a. The 12-month-old infant who pulled a pan of hot water over on his chest b. The 12-month-old infant who is burned on his chest by gasoline c. The 9-month-old infant who is burned on the hands and feet with scalding water d. The 12-year-old child who is burned on one side of the face as a result of playing with cigarettes

C

Which of the following sources of stress is typical of a 3-year-old? a. Insecurity b. Masturbation c. Jealousy d. Sexuality

C

Which of the following statements about adoption is true? a. Adoptive children from racial backgrounds different from that of the family should be treated no differently from biologic children. b. The task of telling children that they are adopted should follow clear-cut timing guidelines. c. The sooner infants enter their adoptive home, the better the chances of parent-infant attachment. d. Older children display fewer behavioral changes after adoption disclosure than do younger children.

C

Which of the following statements about polio vaccine and immunization is not correct? a. Inactivated poliovirus vaccine (IPV) is now recommended for routine childhood vaccination in the United States. b. Oral polio vaccine (OPV) has been associated with vaccine-associated polio paralysis. c. KINRIX contains DTaP, hepatitis B, and IPV and may be used only in children aged 4 years or older as the fourth dose. d. The combination vaccine PEDIARIX (containing DTaP, hepatitis B, and IPV) may be used as the primary immunization beginning at 2 months of age.

C

Which of the following statements as it relates to use of tobacco, alcohol, and cannabis among adolescents is true? a. Substance abuse decreases with age, and adolescents between 14 and 15 years of age have the highest use pattern. b. The prevalence of binge drinking and tobacco use among high school students is increasing. c. Adolescents may use tobacco, alcohol, and marijuana because these substances provide an opportunity to challenge authority, demonstrate autonomy, gain entry into a peer group, or simply relieve the stress of growing up. d. Adolescents who begin smoking at a later age are at greater risk for becoming a life-long smoker.

C

Which of the following statements is most characteristic of a 24-month-old child in regard to motor development? a. Motor skills are fully developed but occur in isolation from the environment. b. The toddler walks alone but falls easily. c. The toddler's activities begin to produce purposeful results. d. The toddler is able to grasp small objects but cannot release them at will.

C

Which of the following statements regarding herpes simplex virus (HSV) is correct? a. Lesions take several weeks to ulcerate and crust over. b. The mother always has a history of symptoms of infection at the time of vaginal transmission. c. Approximately 86% to 90% of transmission occurs during delivery. d. It always manifests with some type of rash.

C

Which of the following strategies would best help the intellectually disabled child acquire social skills? a. Use discipline and negative reinforcement. b. Provide information about the importance of socialization skills. c. Use active rehearsal with role-playing and practice sessions. d. Use all of the above.

C

Which of the following techniques would be considered an example of the most therapeutic communication to use with the bereaved family? a. Cheerfulness b. Interpretation c. Validation of loss d. Reassurance

C

Which of the following would be expected in the infant with hypotonia? a. When held in horizontal suspension, the infant responds by slightly raising the head. b. When pulled to a sitting position, the infant demonstrates head lag that is quickly corrected to a normal position. c. When placed in horizontal suspension position, the infant's head droops over the examiner's supporting hand and the infant's extremities hang loosely. d. The infant has a slower weight gain but a good sucking reflex.

C

Which of the following would negatively affect the communication process between the nurse and the patient? a. The nurse allows the child to express his or her concerns and fears. b. The nurse includes the child, as well as the parents, in the communication process. c. The nurse uses verbal and nonverbal communication to reflect approval of the patient's statement. d. The nurse uses a slow, even, steady voice to convey instruction.

C

Which of the following would not be expected in the child diagnosed with cirrhosis? a. Hepatosplenomegaly b. Jaundice c. Decreased ammonia levels d. Ascites

C

Which one of the following can the nurse expect to be included in the care plan for controlling acute pain in sickle cell crisis? a. Administration of long-term oxygen b. Application of cold compresses c. IV opioid administration d. Relieving the pain completely as the goal of treatment of the acute episode

C

Which one of the following diagnostic strategies is the most definitive for identifying a milk allergy? a. Stool analysis for blood b. Serum IgE levels c. Challenge testing with milk d. Skin testing

C

Which one of the following findings should the nurse recognize as normal when measuring the vital signs of a 5-year-old child? a. Femoral pulses graded at + 1 b. Oral temperature of 100.9°F c. Blood pressure < 90th percentile d. Absent femoral pulses

C

Which one of the following is not considered important by parents when telling their children about the decision to divorce? a. Initial disclosure should include both parents and siblings. b. Time should be allowed for discussion with each child individually. c. The initial disclosure should be kept simple, and reasons for divorce should not be included. d. Parents should physically hold or touch their child to provide feelings of warmth and reassurance.

C

Which one of the following methods of analgesic drug administration is a liquid gel that provides anesthesia to nonintact skin in about 15 minutes? a. Midazolam b. EMLA (eutectic mixture of local anesthetics) c. LAT (lidocaine-adrenaline-tetracaine) d. Numby Stuff

C

Which one of the following statements about bilirubin encephalopathy is true? a. Development may be enhanced by metabolic acidosis, lowered albumin levels, intracranial infections, and increases in the metabolic demands for oxygen or glucose. b. It produces no permanent neurologic damage. c. Serum bilirubin levels alone can predict the risk for brain injury. d. It produces permanent liver damage by deposits of conjugated bilirubin within the cell.

C

Which one of the following statements is true about infant mortality in the United States? a. There has been a recent dramatic increase in infant mortality in the United States. b. The United States is currently a world leader in reducing infant mortality. c. In the United States, infant mortality for whites is considerably lower than other races. d. The United States has lower infant mortality rates than most other developed countries.

C

You are assessing 7-year-old Mary's lymph nodes. Using the distal portions of your fingers, you press gently but firmly in a circular motion along the occipital and postauricular node areas. You record the findings as "tender, enlarged, warm lymph nodes." Which of the following is true? a. Your findings are within normal limits for Mary's age. b. Your assessment technique was incorrect and should be repeated. c. Your findings suggest infection or inflammation in the scalp area or external ear canal. d. Your recording of the information is complete because it includes temperature and tenderness.

C

When instructing the parents caring for an infant with conjunctivitis, the nurse will include which of the following in the plan? a. Accumulated secretions are removed by wiping from outer canthus inward. b. Hydrogen peroxide placed on cotton swabs is helpful in removing crusts from eyelids. c. Compresses of warm tap water are kept in place on the eye to prevent crusting. d. Washcloth and towel used by the infant are kept separate and not used by others.

D

When suctioning an infant after cardiac surgery, the nurse should: a. oxygenate before suctioning. b. suction for no more than 5 seconds. c. oxygenate after suctioning. d. perform all of the above.

D

Which of the following about herpes simplex virus (HSV) is true? a. It presents with a less severe clinical course in men than women. b. It is treated with acyclovir, famciclovir, and valacyclovir for cure of the disease. c. It is treated with ointments containing cortisone to help reduce inflammation. d. Cesarean birth is recommended for women in labor or ruptured membranes with visible lesions present.

D

Which of the following accounts for the most deaths in infants under 1 year of age? a. Pneumonia and influenza b. Infections specific to the perinatal period c. Accidental injuries d. Congenital anomalies

D

Which of the following assessment findings would be expected in an infant with retinoblastoma? a. Visible red reflex b. Leukocoria c. Nystagmus d. Strabismus

D

Which of the following children meet(s) referral criteria? a. Jason, age 14 years, who identified fewer than four of six correct letters with his right eye and five of six correct with his left eye during visual acuity testing b. Sandra, age 3 years, who demonstrated eye movement with the unilateral cover test c. Tommy, age 4 years, who demonstrated a two-line difference between eyes on his visual acuity testing d. All of the above

D

Which of the following defects has the worst prognosis? a. Tetralogy of Fallot b. Atrial ventricular canal defect c. Transposition of the great vessels d. Hypoplastic left heart syndrome

D

Which of the following descriptions of school-age children is most closely linked to Erikson's theory? a. During this time, children experience relationships with same-sex peers. b. During this time, there is an overlapping of developmental characteristics between childhood and adolescence. c. During this time, temperamental traits from infancy continue to influence behavior. d. During this time, interests expand and children, with a growing sense of independence, engage in tasks that can be carried through to completion.

D

Which of the following diagnostic tests, for the child presenting with head injury, is least helpful in providing a more definitive diagnosis of the type and extent of the trauma? a. CT scan b. MRI c. History and physical d. Skull x-ray

D

Which of the following does not predispose the patient to urinary tract infections? a. The short urethra in the young girl b. Urinary stasis c. Urinary reflux d. Lowering of urine pH

D

Which of the following factors influences aggressive behavior? a. Frustration b. Modeling c. Gender d. All of the above

D

Which of the following foreign bodies is least likely to be successfully removed with tweezers? a. Pieces of glass b. Spines of cactus c. Embedded needle in the foot d. All of the above

D

Which of the following has a teratogenic effect on the fetus? a. Folic acid b. X-rays taken of the pelvis and abdomen 1 week after menstruation c. Amoxicillin d. Valproic acid

D

Which of the following instructions for treating the child with mild dehydration is not correct? a. Administer 2 to 5 ml of oral rehydration solution (ORS) by syringe or small medication cup every 2 to 3 minutes until the child is able to tolerate larger amounts. b. Oral administration of ondansetron (Zofran) to the child with acute gastroenteritis and vomiting may prevent the need for intravenous (IV) therapy. c. ORS management consists of replacement of fluid loss over 4 to 6 hours. d. ORS should not be started until after all vomiting has stopped.

D

Which of the following interventions is most important for the dying child? a. Emotional support b. Preparing parents to deal with fears c. Relief from pain d. Control of pain

D

Which of the following is a congenital anomaly that results in mechanical obstruction from inadequate motility of part of the intestine? a. Intussusception b. Short-bowel syndrome c. Crohn disease d. Hirschsprung disease

D

Which of the following is most characteristic of the relationship between school-age children and their families? a. Children desire to spend equal time with family and peers. b. Children are prepared to reject parental controls. c. The group replaces the family as the primary influence in setting standards of behavior and rules. d. Children need and want restrictions placed on their behavior by the family.

D

Which of the following is not a common reason for chest tube drainage in the child after cardiac surgery? a. Removal of pleural drainage b. Removal of air c. Prevention of pneumothorax d. Removal of an empyema

D

Which of the following is not a serious and immediate physiologic disturbance associated with severe diarrheal disease? a. Dehydration b. Acid-base imbalance c. Circulatory status impairment d. Decreased growth rate

D

Which of the following is not an influenza vaccine recommendation? a. The vaccine is administered in early fall before the flu season begins and is repeated yearly. b. Trivalent inactivated influenza vaccine is approved for vaccine use in children ages 6 months and older. c. Children with severe egg allergy history should not routinely receive the influenza vaccine. d. The live attenuated influenza vaccine (LAIV) form is recommended for children 2 to 4 years of age with a history of wheezing or asthma.

D

Which of the following is not considered a standard treatment for GBS? a. Plasmapheresis b. Corticosteroids c. Administration of IVIG d. Administration of neostigmine

D

Which of the following is not considered to be a major stressor of hospitalization in the young child? a. Separation b. Loss of control c. Bodily injury d. School absence

D

Which of the following is not included in cultural humility? a. Lifelong commitment to self-reflection and critique b. Addressing the power imbalances in the nurse-patient relationship c. Developing mutually beneficial partnerships with the community d. Conforming to cultural norms to provide security and encourage change

D

Which of the following is not usually a cause of ARDS/ALI in children? a. Smoke inhalation b. Submersion injury c. Sepsis d. Gastroesophageal reflux

D

Which of the following opioids is considered the gold standard for severe pain management? a. Hydromorphone b. Fentanyl c. Oxycodone d. Morphine

D

Which of the following parental behavioral responses should alert the nurse to the possibility of maltreatment of the child? a. Parent displays extreme care for the child, not wanting to leave the child's side. b. Parent displays signs of guilt, not being able to eat or sleep. c. Parent displays abnormal interest in the incident, going over each detail repeatedly. d. Parent belittles the child for being injured.

D

Which of the following statements about "nursemaid's elbow" is correct? a. This most common partial dislocation of the radial head of the elbow is usually found in children ages 1 to 4 years. b. This condition is caused by a sudden pull at the wrist while the arm is fully extended and the forearm is pronated. c. The longer the dislocation is present, the longer it takes the child to recover mobility after treatment. d. All of the above statements are correct.

D

Which of the following statements about Integra, an artificial skin used in burn treatment, is correct? a. It is applied only to full-thickness burns. b. The fibrous layer is pulled off after the dermis is formed. c. It replaces the need for additional skin grafting. d. It prepares the burn wound to accept an ultrathin autograft.

D

Which of the following statements about Tourette syndrome (TS) is true? a. Manifestations are stable in intensity and rarely change once developed. b. Children with TS have no associated obsessive-compulsive symptoms. c. Tics lead to physical deterioration and affect life expectancy. d. Behaviors are involuntary.

D

Which of the following statements about children with orthodontic braces is true? a. There is pain when the child has the braces applied or adjusted, which lasts about 30 minutes. b. The bands and brackets offer protection and prevent plaque. c. If an arch wire breaks, cover the broken wire with dental wax and keep the regularly scheduled appointment with the orthodontist. d. Forbidden foods during orthodontic treatment include chewing gum, ice, nuts, uncut apples, corn on the cob, hard candy, hard taco shells, nachos, and popcorn.

D

Which of the following statements about developmental assessment is true? a. Screening procedures are designed to identify normal developmental levels. b. They provide a means of obtaining subjective measurements of present developmental function. c. The Denver II is the most sensitive and specific method for testing age-appropriate development markers. d. The Ages & Stages Questionnaires are age-specific surveys asking parents about developmental skills common in daily life for their children.

D

Which of the following statements about posttraumatic stress disorder (PTSD) is true? a. PTSD is the development of characteristic symptoms after exposure to a traumatic experience or event that is usually not life threatening. b. The second phase of PTSD lasts approximately 4 weeks and is one of coping. c. The third phase of PTSD extends over 6 months and is a period of direct inquiry. The victim wants to know what happened and appears to be getting better when actually getting worse. d. Any child exhibiting a sudden change in behavior needs to be assessed for exposure to a traumatic event.

D

Which of the following statements about septic arthritis is true? a. The most common causative agent in children under 2 years of age is Haemophilus influenzae. b. Knees, hips, ankles, hands, and feet are the joints most commonly affected. c. Early radiographic findings show soft tissue swelling and erosions of the bone. d. IV antibiotic use is based on Gram stain and clinical presentation.

D

Which of the following statements about social development of the preschooler is false? a. Imaginary playmates are a normal part of the preschooler's play. b. Preschoolers have overcome much of their anxiety regarding strangers. c. Preschoolers use telegraphic speech between the ages of 3 and 4 years. d. Preschoolers particularly enjoy parallel play.

D

Which of the following statements about stress in toddlers is true? a. Toddlers are rarely exposed to stress or the results of stress. b. Any stress is destructive because toddlers have a limited ability to cope. c. Most children are exposed to a stress-free environment. d. Small amounts of stress help toddlers develop effective coping skills.

D

Which of the following statements about use of topical therapy in the pediatric population is true? a. Use of silver impregnated in dressing as foam decreases the bacterial burden and bioburden of the wound and has little absorption effect in the pediatric population. b. Application of heat provides a soothing effect to reduce inflammatory processes. c. The use of immunomodulators is suggested as first-line treatment in children younger than 2 years of age. d. Topical immunomodulators have been linked to possible skin cancer and lymphoma in children younger than 2 years.

D

Which of the following statements as it relates to adolescent physical fitness is true? a. Female students are more likely to engage in vigorous physical activity. b. High levels of physical activity may increase cardiovascular disease risk factors during adolescence. c. Routine exercise has little positive effect on adolescents' risk for depression and emotional stress. d. Routine screening of all adolescents should include information about frequency, intensity, and type of physical activity.

D

Which of the following statements is true in regard to nonpharmacologic pain management? a. When used properly, nonpharmacologic measures are a good substitute for analgesics. b. Nurses and physicians are generally well educated about nonpharmacologic approaches to pain management. c. Nonpharmacologic approaches to pain management are not effective with children. d. When possible, nonpharmacologic and pharmacologic measures should be combined to manage pain.

D

Which of the following statements related to prognosis of seizures in children is incorrect? a. A history of two unprovoked seizures is sufficient to diagnose epilepsy. b. The etiology and specific epilepsy syndromes are the most important factors affecting prognosis. c. Mortality is often due to coexisting neurologic conditions and poor seizure control. d. Children who have cognitive impairments, as compared to children who have no cognitive impairments, are at no higher risk for developing epilepsy.

D

Which of the following strategies is a powerful coping method that can be used with a small child during painful procedures? a. Ask the child whether he or she wants to take the pain medicine b. Administer medication in the playroom c. Give a comprehensive explanation of what will occur d. Use distraction techniques for a painful procedure

D

Which of the following symptoms would be considered normal grief behavior? a. Depression b. Anger c. Hearing the dead person's voice d. All of the above

D

Which of the following types of meningitis is self-limiting and least serious? a. Meningococcal meningitis b. Tuberculous meningitis c. H. influenzae meningitis d. Nonbacterial (aseptic) meningitis

D

Which of the following would alert the nurse to possible peritonitis from a ruptured appendix in a child suspected of having appendicitis? a. Colicky abdominal pain with guarding of the abdomen b. Periumbilical pain that progresses to the lower right quadrant of the abdomen with an elevated white blood cell count c. Low-grade fever of 38° C (100.6° F) with the child demonstrating difficulty walking and assuming a side-lying position with the knees flexed toward the chest d. Temperature of 38.8° C (102° F), rigid guarding of the abdomen, and sudden relief from abdominal pain

D

Which of the following would be considered the least allergenic? a. Orange juice b. Eggs c. Soy d. Rice

D

Which of the following would the nurse not include while educating the family about managing atopic dermatitis? a. Keep fingernails cut short. b. Long sleeves and long pants are recommended. c. Avoid irritating products. d. Use fabric softeners to decrease fabric irritation.

D

Which one of the following best describes the appropriate use of play as a communication technique with children? a. Small infants have little response to activities that focus on repetitive actions like patting and stroking. b. Few clues about intellectual or social developmental progress are obtained from the observation of children's play behaviors. c. Therapeutic play has little value in reduction of trauma from illness or hospitalization. d. Play sessions serve as assessment tools for determining children's awareness and perception of illness.

D

Which one of the following statements about mass media is true? a. Evidence demonstrates a benefit to selective media usage beginning in infancy. b. Educational television programming teaches the habits of mind to be a good leader. c. Reading ability and intelligence are linked to the numbers and types of comic books read. d. Cognitive and social outcomes in preschool-aged children may benefit from high-quality programming.

D

While Jenny, age 16, is in for her routine checkup, her mother tells the nurse that Jenny wants to get a job at a local fast-food restaurant, where she would work 30 hours a week to earn extra money for clothes. The mother wonders whether this is a good idea. Which of the following is the nurse's best response? a. "Jenny is healthy, and there is no reason she could not take the job." b. "All adolescents are preoccupied with clothes, so let her go ahead." c. "That sounds like a dead-end job. Why would Jenny want to work there?" d. "Working 30 hours a week may take time away from her studies and extracurricular activities and increase fatigue. Looking together at Jenny's future career goals may help identify alternatives."

D

While conducting an assessment of the child, the nurse communicates with the child's family. Which of the following does the nurse recognize as not productive in obtaining information? a. Obtaining verbal and nonverbal input from the child b. Observing the relationship between parents and child c. Using broad, open-ended questions d. Avoiding the use of guiding statements to direct the focus of the interview

D

You are assessing skin turgor in 10-month-old Ryan. You grasp the skin on the abdomen between the thumb and index finger, pull it taut, and quickly release it. The tissue remains suspended, or tented, for a few seconds and then slowly falls back on the abdomen. Which of the following conclusions can you correctly assume? a. The tissue shows normal elasticity. b. The child is properly hydrated. c. The assessment was done incorrectly. d. The child has poor skin turgor.

D

Amanda, age 18, comes to the school nurse's office early in the morning, visibly upset. She tells the nurse that she and her boyfriend were having sexual relations last night and the condom broke. Amanda asks the nurse about a new pill she has read about that will keep her from becoming pregnant. She wants the nurse to give her more information about this pill. Which of the following statements made to Amanda provides the best information about levonorgestrel? a. "It is available without a prescription and must be taken within 24 hours of the unprotected sexual intercourse." b. "It is very effective but has side effects, so you will need to be out of school at least 1 day." c. "It contains estrogen, so you will need to have a pregnancy test before it can be administered." d. "It is available to women age 17 years and older without a prescription. It must be taken within 120 hours of the unprotected sexual intercourse."

D

An appropriate nursing intervention for the care of a child with an extremity in a new cast is to: a. keep the cast covered with a sheet. b. use the fingertips when handling the cast to prevent pressure areas. c. use heated fans or dryers to circulate air and speed the cast-drying process. d. turn the child at least every 2 hours to help dry the cast evenly.

D

An assessment finding that is consistent with the presence of a brain tumor is increased: a. temporal headaches. b. appetite. c. pulse rate. d. blood pressure.

D

An important assessment for the nurse to perform in identifying cleft palate is to: a. assess sucking ability of infant. b. assess color of lips. c. palpate the palate with a gloved finger. d. do all of the above.

D

An infant who weighs 7 kg (15.4 lb) has just returned to the ICU after cardiac surgery. The urinary output has been 20 ml in the past hour. In this situation, what is the first action for the nurse to take? a. Notify the surgeon b. Identify any other signs of hypervolemia c. Suction the patient d. Assess for other signs of renal failure

D

Ana, age 16, has not had a period for the past 3 months, and her pregnancy test is positive. Which of the following is not an appropriate action for the nurse to take at this time? a. Inform Ana privately that her test is positive. b. Review with Ana facts about the pregnancy, including the duration of pregnancy and anticipated due date. c. Understand that Ana's reaction may be one of ambivalence, shock, fear, or apathy. d. Arrange for Ana's parents to be present when Ana is given the news.

D

Areas of concern for parents of adoptive children include: a. the initial attachment process. b. telling the children that they are adopted. c. identity formation of children during adolescence. d. all of the above.

D

Assessment of which of the following is not helpful in identifying potentially communicable diseases? a. Prodromal symptoms b. Immunization history c. Past medical history d. Family history

D

Associated disabilities and problems related to the child with CP include which of the following? a. All children with CP have intelligence testing in the abnormal range. b. A large number of eye cataracts are associated with CP and require surgical correction. c. Seizures are a common occurrence among children with athetosis and diplegia. d. Coughing and choking, especially while eating, predispose children with CP to aspiration.

D

At what decibel level would a hearing loss be considered profound? a. 26 to 55 dB b. 56 to 70 dB c. 71 to 90 dB d. At or over 91 dB

D

Behavior that signals the child's readiness to cooperate during the physical examination does not include: a. talking to the nurse. b. making eye contact with the nurse. c. allowing physical touching. d. sitting on the parent's lap or playing with a doll.

D

Billy has come in contact with poison ivy on a school picnic. The best intervention for the nurse to implement at this time is to: a. wash the area with a strong soap and water solution. b. apply Calamine lotion to the area. c. prevent spread by instructing Billy not to scratch the lesions. d. flush the area immediately with cold water.

D

Bob, age 7 years, is diagnosed with Legg-Calvé-Perthes disease. Which of the following manifestations is not consistent with this diagnosis? a. Intermittent appearance of a limp on the affected side b. Hip soreness, ache, or stiffness that can be constant or intermittent c. Pain and limp most evident on arising and at the end of a long day of activities d. Specific history of injury to the area

D

Bone healing is characteristically more rapid in children than in adults because: a. children have less constant muscle contraction associated with the fracture. b. children's fractures are less severe than adult fractures. c. children have an active growth plate that helps speed repair with less likelihood of deformity. d. children have thickened periosteum and a more generous blood supply.

D

Causes of diaper dermatitis include prolonged contact with: a. urine. b. feces. c. detergents. d. all of the above.

D

Certain groups of children are at risk for serious complications from communicable diseases. These children do not include which of the following groups? a. Children with an immunodeficiency or immunologic disorder b. Children receiving steroid therapy c. Children with leukemia d. Children who have recently undergone a surgical procedure

D

Characteristic features of Duchenne muscular dystrophy include all of the following except: a. waddling gait. b. lordosis. c. calf muscle hypertrophy. d. neurogenic bladder.

D

Children who have been treated for rheumatic fever: a. do not need additional prophylaxis against BE. b. are immune to rheumatic fever for the rest of their lives. c. will have transitory manifestations of chorea for the rest of their lives. d. may need antibiotic therapy for years.

D

Chronic hypoxemia is manifested clinically by which of the following signs? a. Fatigue b. Polycythemia c. Clubbing d. All of the above

D

Cindy, age 16, has been sent to the school nurse because her gym teacher has noticed a marked decrease in Cindy's weight since vacation. Which of the following does the nurse recognize as a common finding in an adolescent girl with anorexia nervosa? a. Wears form-fitting clothes like tank tops and jeans b. Has strong peer relationships with classmates and several best friends c. Has poor schoolwork performance because of little interest in school d. Is present at meals and appears to family and friends to be eating appropriately

D

Cindy, age 8 years, is brought to the clinic with a sore on her arm. She tells the nurse that she scratched it on a piece of metal at the playground about 1 week ago. Which of the following signs would the nurse expect to find if the sore has become infected? a. Itching at the site of the sore b. Rough edges around the sore c. No pain at the site d. Increased erythema, especially around the sore

D

Dental care for a child whose platelet count is 32,000/mm3 and granulocyte count is 450/mm3 should include daily: a. toothbrushing with flossing. b. toothbrushing without flossing. c. flossing without toothbrushing. d. wiping with moistened sponges.

D

Diagnostic criteria for autism spectrum disorders (ASD) include symptoms related to: a. social interactions. b. impairments in communication. c. repetitive behavior patterns. d. all of the above.

D

Discharge instructions from the ambulatory setting should include all of the following except: a. guidelines for when to call. b. dietary restrictions. c. activity restrictions. d. referral to a home health agency.

D

During the chill phase of the febrile state: a. shivering and vasoconstriction generate and conserve heat. b. the temperature stabilizes at a higher range. c. a crisis of the temperature is occurring. d. the temperature is greater than the set point.

D

During the school-age years, children learn valuable lessons from age-mates. How is this accomplished? a. The child learns to appreciate the varied points of view within the peer group. b. The child becomes sensitive to the social norms and pressures of the group. c. The child's interactions among peers lead to the formation of intimate friendships between same-sex peers. d. All of the above are true.

D

Early childhood caries may result from: a. using a pacifier coated with honey. b. feeding the last bottle just before bedtime. c. long, frequent nocturnal breastfeeding. d. all of the above.

D

Early reintroduction of nutrients (normal diet) in the patient with diarrhea: a. is delayed until after the diarrhea has stopped except in the case of breastfed infants. b. has adverse effects and actually prolongs diarrhea. c. should be limited to formula-fed infants being given lactose-free formula. d. has no adverse effects, lessens the severity and duration of the illness, and improves weight gain when compared to gradual reintroduction of foods.

D

Emergency care for tooth avulsion includes: a. replanting the tooth after bleeding has stopped. b. storing the tooth in tap water until it and the child can be transported to the dentist. c. holding the tooth by the root. d. rinsing the dirty tooth gently under running water before replanting.

D

Emergency care of the child during a seizure includes: a. giving ice chips slowly. b. restraining the child. c. putting a tongue blade in the child's mouth. d. loosening restrictive clothing.

D

Exercise for the child with type 1 diabetes mellitus may: a. be restricted to noncontact sports. b. require a decreased intake of food. c. necessitate an increased insulin dose. d. require an increased intake of food.

D

Expected characteristics of emotional autonomy during early adolescence include: a. increased independence from friends. b. increased need for parental approval. c. belief that parents are all-knowing and all-powerful. d. less emotional dependence on parents.

D

Family support for the child who has suffered a head injury includes all of the following except encouraging the parents to: a. hold and cuddle the child. b. bring familiar belongings into the child's room. c. make a tape recording of familiar voices or sounds. d. search for clues that the child is recovering.

D

Fifty percent of all acute conditions of childhood can be accounted for by: a. injuries and accidents. b. bacterial infections. c. parasitic disease. d. respiratory illness.

D

Flossing is necessary: a. to remove plaque from below the gum margin. b. to remove debris from between the teeth. c. to reach areas where brushing is ineffective. d. for all of the above.

D

Fluids are especially important to monitor after cardiac surgery, because during surgery: a. the cardiopulmonary pump uses a large volume of extra fluid. b. the patient's blood is diluted by the use of the pump. c. there is total body edema. d. all of the above may occur.

D

Hodgkin disease increases in incidence in children between the ages of: a. 1 and 5 years. b. 5 and 10 years. c. 11 and 14 years. d. 15 and 19 years.

D

Human bites: a. are treatable at home. b. do not require tetanus immunization. c. should not have ice applied to the area. d. should receive medical attention.

D

Identify which of the following therapies is not usually included in the care of the child or adolescent with cystic fibrosis. a. Administration of pancreatic enzymes b. Airway clearance therapy c. Administration of fat-soluble vitamins d. Administration of water-soluble vitamins

D

If a child has a penetrating injury to the eye, the nurse should: a. apply an eye patch. b. attempt to remove the object. c. irrigate the eye. d. use strict aseptic technique to examine the eye.

D

If a child is permanently unconscious, it would be inappropriate for the nurse to: a. permit the parents to bring a child's favorite toy. b. provide guidance and clarify information that the physician has already given. c. suggest the parents plan for periodic relief from the continual care of their child. d. use reflexive muscle contractions as a sign of hope for recovery.

D

If a child vomits in the postoperative period following surgery for a brain tumor, it may predispose the child to: a. incisional rupture. b. increased intracranial pressure. c. aspiration. d. all of the above.

D

If bleeding occurs at the insertion site after a cardiac catheterization, the nurse should apply: a. warmth to the unaffected extremity. b. pressure 1 inch below the insertion site. c. warmth to the affected extremity. d. pressure 1 inch above the insertion site.

D

Implementation of phototherapy for an infant with jaundice does not include: a. shielding the infant's eyes with an opaque mask. b. recognizing that once phototherapy has been started, visual assessment of jaundice increases in validity; therefore fewer serum bilirubin levels will be necessary. c. monitoring for temperature instability. d. assessing the infant for side effects, including loose, greenish stools; skin rashes; hyperthermia; dehydration; and increased metabolic rates.

D

Important prognostic factors in determining long-term survival for children with acute lymphoblastic leukemia include: a. initial white blood cell count. b. age and gender. c. immunophenotype and cytogenetics. d. all of the above.

D

In addition to the prevention of fractures, the nursing care of a child with osteogenesis imperfecta should include: a. oral and dental care. b. meticulous skin care. c. care related to the effects of drug treatment. d. all of the above.

D

In discussing prevention of STIs, the nurse tells the adolescent that which of the following is most effective? a. Birth control pills b. Natural skin condoms with nonoxynol-9 c. Spermicides d. Latex condoms

D

In identification of the abused child, the nurse knows: a. physical abuse can be readily identified during the physical examination. b. specific behavioral problems will be seen in the abused child. c. maltreated children easily admit to the abuse they received from their parents. d. incompatibility between the history and the injury is probably the most important criterion on which to base the decision to report suspected abuse.

D

In obtaining a history pertaining to an incident of abuse, the nurse should: a. expect the child to betray the parents by admitting to the abuse received. b. expect the child to defend the parents out of a sense of loyalty. c. recognize that the child will have a sense of relief after telling someone about the abuse. d. avoid biasing the child's retelling of the events.

D

In preparing the parents of a child with cleft palate, the nurse educates the parents about which of the following in the long-term problems? a. Explanation that tooth development will be delayed b. Explaining the importance of early intervention for speech development c. Use of decongestants and acetaminophen to care for frequent upper respiratory tract symptoms d. All of the above

D

In regard to meal planning for the child with type 1 diabetes mellitus, parents should be aware that: a. fast foods must be eliminated. b. foods must always be weighed and measured. c. the exchange list is limited to one type of food. d. foods with sorbitol are metabolized into glucose.

D

In regard to whether a child should attend the funeral of a loved one, the nurse should consider: a. the child's age. b. that it will be a frightening experience. c. his or her responsibility to protect the child from distressing events. d. that attending the funeral may be beneficial to the child.

D

In the female adolescent who has reached puberty, the luteinizing hormone initiates which of the following actions? a. Production of estrogen b. Growth of ovarian follicles c. Production of gonadotropin-releasing hormone d. Ovulation

D

In the postoperative period following a tonsillectomy, the child should be: a. placed in Trendelenburg position. b. encouraged to cough and deep breathe. c. suctioned vigorously to clear the airway. d. observed for subtle signs of hemorrhage.

D

In treating eating disorders: a. weight gain is a reliable sign of positive progress. b. when a therapeutic environment is removed, relapses seldom occur. c. antianxiety or antidepressant drug use has not been proven effective. d. psychotherapy is aimed at resolving adolescent identity crises and distorted body image.

D

Infants and young children are at high risk for fluid and electrolyte imbalances. Which of the following factors contributes to this vulnerability? a. Decreased body surface area b. Lower metabolic rate c. Mature kidney function d. Increased extracellular fluid volume

D

Interventions to help the family prepare for the care of a terminally ill child include: a. educating the family about complications of overfeeding or overhydration. b. providing a supply of medications to alleviate discomfort. c. encouraging fun and memorable activities. d. all of the above.

D

Jim, who has no history of previous suicide attempts, is talking with the school nurse about his feelings of despair and hopelessness about the future. He tells the nurse he would be better off dead. The nurse's best response is which of the following? a. Recognize that Jim is going through a common phase of adolescence. b. Recognize that Jim is at low risk for suicide because he has not previously attempted it. c. Explain to Jim that suicide never solved anything and that he will feel better tomorrow. d. Take Jim seriously, allow time for him to verbalize his feelings, and stay with him until referral.

D

Jimmy, a 13-year-old, is sent to the school nurse because he and some of his peers were caught chewing tobacco while playing baseball. The nurse knows that the best way to influence Jimmy's behavior for health promotion would be which of the following? a. Tell Jimmy that he will be suspended from school if he continues to chew the tobacco. b. Show Jimmy pictures of oral cancer from chewing tobacco. c. Tell Jimmy about the dangers of chewing tobacco and stress the fact that girls do not like boys who chew tobacco. d. Arrange for a local baseball hero to talk with Jimmy and his friends, stressing that he does not use chewing tobacco, his friends do not chew tobacco, and chewing tobacco causes ugly teeth.

D

Joan, age 3 years, is admitted for fluid and electrolyte disturbances. The nurse's assessment should include: i. general appearance observation. ii. vital signs. iii. intake and output measurements. iv. daily weights. v. assess capillary filling time. a. i, ii, iii, and iv b. ii, iii, and iv c. iii, iv, and v d. i, ii, iii, iv, and v

D

Joey, a 14-year-old adolescent, has recently relocated from Mexico to the United States. While helping his dad do farm work, Joey suffered a laceration in the horse barn. Review of Joey's immunization record from Mexico shows that Joey has had two previous tetanus and diphtheria vaccine immunization shots, the last one being at the age of 6 years. Which of the following would the nurse in the emergency department expect to give at this time? a. Tdap b. DTaP c. Td booster d. Tetanus immunoglobulin (TIG) human and Tdap

D

Justin, age 8 years, has been diagnosed with pyelonephritis. The nurse would expect medical management to include all of the following except: a. admission to the hospital with intravenous antibiotics administered for the first 48 hours. b. blood and urine cultures obtained on admission. c. urine cultures repeated after therapy. d. administration of nitrofurantoin.

D

Karen is suspected of having bulimia nervosa. The nurse recognizes which of the following as clinically characteristic of this disease? a. Bulimia often begins with decreased dietary intake associated with poor relationships with family members. b. Once started, the bingeing decreases in frequency to only about once per day. c. Insulin production is decreased because of excessive self-induced vomiting. d. Impulse control and satiety regulation are problems in bulimic adolescents.

D

Kwashiorkor occurs in populations where: a. the caloric intake is inadequate. b. the food supply is adequate for protein. c. the adults eat first, leaving insufficient food for children. d. the diet consists mainly of starch grains.

D

Lance, a 2-year-old, has been brought to the clinic because his parents are afraid he swallowed a small disc battery from his father's watch, which he was playing with. The nurse recognizes which of the following as the most appropriate nursing action at this time? a. Reassure the parents that Lance has probably not swallowed the battery because he has no symptoms, he is playing in the examination room, and his lung fields are clear. b. Explain to the parents that Lance will probably be allowed to normally pass the battery through the GI system because Lance has been able to eat and drink normally since the event. c. Start immediate teaching of Lance's parents on how to assess Lance's environment for hazardous objects, and how to assess Lance's toys and other items he might play with for safety. d. Explain the battery will need to be removed immediately to prevent damage.

D

Leukemia is characterized by: a. a high leukocyte count. b. destruction of normal cells by abnormal cells. c. low numbers of blast cells. d. overproduction of blast cells.

D

Measles immunization includes which of the following? a. Given at 12 to 15 months of age with a second dose given at age 4 to 6 years of age and revaccination at 11 to 12 years of age b. Child vaccinated before 12 months of age should receive two additional doses beginning at 12 to 15 months and separated by at least 4 weeks c. Revaccination of all individuals born after 1956 who have not received two doses of measles vaccine after 12 months of age d. All of the above

D

Measures aimed at helping control the calcium/phosphorus imbalance for osteodystrophy in chronic renal failure include all the following except: a. supplemental calcium b. phosphorus-binding agents c. vitamin D d. monitoring serum calcium levels daily.

D

Methods to support grieving families at the time of death and in the grieving period after death include: a. encouraging family members to avoid upsetting each other by keeping their feelings to themselves. b. consoling with phrases such as "I know how you feel." c. emphasizing that the painful grieving usually lasts less than a year. d. allowing the family time to stay with the child after the death.

D

Migraine headaches in children: a. have typical symptoms of abdominal pain and episodic pallor in the older child. b. occur most often in the morning, awakening the child from sleep. c. are more common in boys after the onset of puberty. d. have typical symptoms of nausea, vomiting, and abdominal pain that are relieved by sleep.

D

Most children with diabetes mellitus tend to exhibit characteristics of: a. maturity-onset diabetes of youth. b. gestational-onset diabetes. c. type 2 diabetes. d. type 1 diabetes.

D

Nancy, age 16 years, comes to see the nurse because of acne on her face and shoulders. After talking with Nancy, the nurse makes a nursing diagnosis of knowledge deficit related to proper skin care. Which of the following would the nurse include in the instruction plan for Nancy? a. Wash the areas vigorously with antibacterial soaps. b. Brush the hair down on the forehead to conceal the acne areas. c. Avoid the use of all cosmetics. d. Gently wash the areas with a mild soap once or twice daily.

D

Nonopioids: a. are used for moderate to severe pain. b. have the same effect on pain as morphine. c. have little antipyretic actions. d. are the first step for pain management.

D

Nursing care for soft tissue injury is typically not directed toward: a. assessing the injury. b. preventing breakdown and infection. c. providing explanations and reassurance to the parents. d. explaining the need for careful follow-up of injury after the infant's discharge.

D

Obesity in children and adolescents is defined as: a. BMI ≥90th percentile for age and height. b. BMI ≤90th percentile for age and gender. c. BMI ≥95th percentile for age and height. d. BMI ≥95th percentile for age and gender.

D

Observational pain measures: a. are used most often with school-aged children. b. are less effective and more time consuming when used in conjunction with a subject self-report measure. c. are most reliable when measuring recurrent or chronic pain. d. are most reliable when measuring short, sharp, procedural pain.

D

Of the following croup syndromes, the one that is potentially life threatening is: a. spasmodic croup. b. laryngotracheobronchitis. c. acute spasmodic laryngitis. d. acute epiglottitis.

D

Preoperatively, the nursing plan for suspected pyloric obstruction should include which of the following? i. Observation for dehydration ii. Keeping body temperature below 37.7° C (100° F) iii. Parental support and reassurance iv. Observation for coughing and gagging after feeding v. Observation of quality of stool a. i, ii, iii, iv, and v b. i, iii, and iv c. iii, iv, and v d. i, iii, and v

D

Preprocedural preparation of the child who is scheduled to have a cystourethrography includes: a. keeping the child NPO (nothing by mouth) for 8 hours before the test. b. assessing for an allergy to iodine. c. administering a Fleet enema before the examination. d. preparing the child for catheterization.

D

Prevention measures for diarrhea in children include all of the following except: a. wash hands, utensils, and work area with hot, soapy water after contact with raw meat. b. proper disposal of soiled diapers. c. during travel to areas where water may be contaminated, allow the child to drink only bottled water from the container through a straw supplied from home. d. administration of vaccines and medications to prevent traveler's diarrhea before travel.

D

Primary nursing implementations for the child with tetanus include: i. controlling or eliminating stimulation from sound, light, and touch. ii. placing the child in isolation. iii. arranging for the child not to be left alone, since these children are mentally alert. iv. realizing that vecuronium does not cause total paralysis. v. encouraging high intake of fluid. vi. decreasing the environmental stimuli. a. i, ii, iii, and vi b. ii, iv, and v c. iii, v, and vi d. i, iii, and vi

D

Questions related to activities of daily living at the time of admission are: a. inappropriate and should be saved for later. b. directed toward evaluation of the child's preparation for hospitalization. c. asked directly and in the order provided on the assessment form. d. designed to help the nurse promote a more normal environment for the hospitalized child.

D

Rape victims display a variety of manifestations. Which of the following might the nurse see in 16-year-old Sally as she arrives at the emergency department for treatment after being raped? a. Hysterical crying or giggling b. Calm and controlled behavior c. Anger and rage alternating with helplessness and agitation d. All of the above

D

Readiness for teaching self-care skills should be assessed by determining: a. which skills the child already possesses. b. the child's developmental readiness to learn the task. c. the family's readiness to teach the skill. d. all of the above.

D

Recurrent otitis media with effusion after a total of 3 to 6 months of bilateral effusion with bilateral hearing deficit would most likely be managed therapeutically by: a. tonsillectomy. b. steroids. c. polyvalent pneumococcal polysaccharide vaccine. d. tympanostomy tubes.

D

Reduction of poisonings in children and infants can be accomplished by: a. use of child-resistant containers. b. educating parents and grandparents to place products out of reach of small children. c. educating parents to relocate plants out of reach of infants, toddlers, and small children. d. doing all of the above.

D

Regression in toddlers occurs when there is: a. stress. b. a threat to their autonomy. c. a need to revert to dependency. d. all the above.

D

Reorganization after the death of a child means that the: a. loved one is forgotten. b. pain is gone. c. survivors have "let go." d. survivors have recovered from their loss.

D

School-age children: a. have little interest in complex board, card, or computer games. b. rarely collect items. c. tire of having stories read aloud. d. participate in hero worship.

D

School-based health promotion interventions for adolescents do not include which of the following? a. Classroom health education b. Adopting school-level policies c. Environmental changes at the school d. Mass media production

D

Sensitivity to cow's milk in an infant may be manifested clinically by: a. irritability. b. excessive crying. c. vomiting and diarrhea. d. all of the above.

D

Sensorineural hearing loss occurs as a result of: a. kernicterus. b. use of ototoxic drugs. c. congenital defects of inner ear structures. d. all of the above.

D

Standard Precautions involve the use of barrier protection to prevent contamination from: a. blood. b. body fluids. c. mucous membranes. d. all of the above.

D

Standard precautions involve the use of personal protective equipment such as gloves, gown, and mask to prevent contamination from: a. blood. b. body fluids. c. mucous membranes. d. all of the above.

D

Studies have shown that excessive fruit juice consumption in infants and small children increases the risk for: a. hypervitaminosis. b. fluorosis. c. rickets. d. dental caries.

D

The Reed-Sternberg cell is a significant finding because it: a. is absent in all diseases other than Hodgkin disease. b. is absent in all diseases other than the lymphomas. c. eliminates the need for laparotomy to determine the stage of the disease. d. is absent in all lymphomas other than Hodgkin disease.

D

The age-group with the highest asthma mortality risk includes: a. infants and toddlers. b. preschoolers. c. school-age. d. adolescents.

D

The benefit(s) of the ambulatory/outpatient setting is reduction of: a. stressors. b. infection risk. c. cost. d. all of the above.

D

The best approach to effectively teach a child and his or her family the complex concepts of the home management of type 1 diabetes mellitus is to: a. provide intensive training a day or so after diagnosis. b. provide intensive training the first 3 or 4 days after diagnosis. c. teach nothing until 2 weeks after diagnosis. d. teach essentials at diagnosis, followed by intense information later.

D

The best approach to stop a toddler's attention-seeking behavior of a temper tantrum with head banging is to: a. ignore the behavior. b. provide time-out. c. offer a toy to calm the child. d. protect the child from injury.

D

The best intervention for the treatment of hyperthermia in a 4-year-old child is to administer: a. a tepid sponge bath. b. acetaminophen. c. an alcohol sponge bath. d. aspirin.

D

The blood-brain barrier in a newborn is: a. less permeable than in the adult. b. impermeable to protein. c. impermeable to glucose. d. permeable to large molecules.

D

The formation of sexual identity development during adolescence usually involves which of the following? i. Forming close friendships with same-sex peers during early adolescence ii. Developing intimate relationships with members of the opposite sex during middle adolescence iii. Developing emotional and social identities separate from those of families iv. Incorporating sexuality successfully into intimate relationships a. i, ii, and iii b. ii, iii, and iv c. ii and iii d. i, ii, iii, and iv

D

The general contraindication for all immunizations is: a. minor illness such as common cold. b. breastfeeding. c. pregnancy. d. severe febrile illness.

D

The major emphasis of nursing care for the vomiting infant or child is: a. determining prior treatments used for the vomiting. b. preventing the spread of the infection. c. managing the fever associated with the vomiting. d. observing and reporting vomiting behavior and associated symptoms.

D

The moral development of the preschooler is characterized by: a. concern for why something is wrong. b. actions that are directed toward satisfying the needs of others. c. thoughts of loyalty and gratitude. d. a very concrete sense of justice.

D

The most common bone cancer in children is: a. Ewing sarcoma. b. Osteosarcoma.

D

The most common burn among young children is caused by: a. playing with matches. b. heaters such as kerosene or wood burning. c. careless smoking. d. scald burns, as with hot water or grease.

D

The most common signs and symptoms of brain tumor are: a. weight gain and hemiparesis. b. undetectable while the sutures are open. c. vomiting after feedings and weight loss. d. headache and vomiting not related to feeding.

D

The nurse caring for the child with spinal cord injury and neurogenic bladder knows: a. to keep the patient's urine alkaline. b. that administration of dicyclomine (Bentyl) will relax the bladder musculature but will not promote increased bladder capacity or more adequate emptying. c. that the bladder that empties periodically by reflex action will not need intermittent catheterization. d. that pyelonephritis and renal failure are the most significant causes of death in long-standing paraplegic patients.

D

The nurse caring for the infant who has hypocalcemia and is receiving intravenous calcium gluconate recognizes that which of the following is included in the care plan? a. The scalp veins are the preferred site for intravenous administration of calcium gluconate. b. Signs of acute hypercalcemia include vomiting and bradycardia. c. Rapid infusion administration is best tolerated by the infant. d. Calcium gluconate is compatible with sodium bicarbonate.

D

The nurse has been asked to present an educational program on prevention of adolescent stress and suicide. In planning the program, the nurse should include: a. the importance of being supportive and establishing positive communication patterns between family and teens. b. the precipitating factors for suicide. c. effective coping mechanisms and problem-solving skills. d. all of the above.

D

The nurse has conducted an assessment of the sleep patterns of Janie and found that Janie delays going to bed each night. Which of the following interventions does the nurse recognize as least helpful? a. Consistent bedtime ritual, like reading a book before bedtime b. Not allowing the child to stay up past a reasonable hour c. Keeping a light on in the room d. Taking the child into the parents' bed

D

The nurse is asked to obtain a urine specimen from 5-year-old Anne. Which of the following is the correct procedure? a. Place a urine bag on Anne to collect the next specimen b. Obtain a catheterized specimen c. Encourage Anne to drink large volumes of water in an attempt to obtain a specimen d. Obtain a clean-catch specimen, preferably the first-morning specimen

D

After severe burns, changes in the gastrointestinal system include all the following except: a. ischemia that can produce ulcer formation, enterocolitis, and intestinal perforation. b. disruption of the GI mucosal integrity, which allows sepsis to occur. c. a greatly accelerated metabolic rate. d. blood glucose levels are decreased as a result of insulin resistance.

D

All of the following digestive processes are deficient in an infant until about 3 to 6 months except: a. amylase. b. lipase. c. digestive enzymatic activity. d. trypsin.

D

All of the following strategies will enhance communication with a child who is hearing impaired except: a. touching the child lightly to signal the presence of a speaker. b. speaking at eye level or moving to a 45-degree angle. c. using facial expressions to convey the message better. d. moving and using animated body language to communicate better.

D

All of the following techniques for medication administration in the infant are acceptable except: a. adding the medication to the infant's formula. b. allowing the infant to sit in the parent's lap during administration. c. allowing the infant to suck the medication from a nipple. d. inserting a needleless syringe into the side of the mouth while the infant nurses.

D

Although statutes vary from state to state, mature minors are usually recognized after they: a. are 16 years old. b. become pregnant. c. use drugs or alcohol. d. are legally designated as having the ability to understand informed consent.

D

The receptionist at the clinic where you are employed as a nurse has forwarded a call to you from Mrs. Garcia, mother of 4-year-old Maria. Mrs. Garcia tells you that Maria has had a fever all morning of around 37.8° C (100° F) and that she now has diarrhea and vomiting. Mrs. Garcia reports Maria is alert and still urinating. As you provide triage by phone, which of the following actions is appropriate? a. Reassure Mrs. Garcia that Maria is not very sick and will be fine in a day or two. b. Confer with the practitioner at once. c. Wait to document in Maria's medical record until she comes in for a visit. d. Offer advice for home care and instruct Mrs. Garcia to call or come to the clinic if Maria's symptoms do not improve.

D

The resolution of grief usually: a. occurs in sequential phases. b. is completed in about 2 years. c. is completed in about 3 years. d. is a timeless process that is never completed.

D

The severity of burn injury is determined by which of the following? i. Pain associated with the burn, measured on a scale of 0 to 10 ii. Percentage of body surface area burned iii. Level of consciousness of the victim iv. Depth of the burn v. Vital sign measurements vi. The causative agent a. i, ii, and iv b. i, ii, iii, and v c. iv, v, and vi d. ii, iv, and vi

D

The sudden development of high fever, vomiting and diarrhea, profound hypotension, shock, oliguria, and an erythematous macular rash with subsequent desquamation are clinical signs of: a. anaphylaxis. b. irreversible shock. c. C. difficile infections. d. toxic shock syndrome.

D

The surgical technique that uses computed tomography and magnetic resonance imaging is called: a. sclerotherapy. b. microsurgery. c. laser surgery. d. stereotactic surgery.

D

The term used to describe the yellow staining of the brain cells that can result in bilirubin encephalopathy is: a. jaundice. b. physiologic jaundice. c. kernicterus. e. icterus neonatorum.

D

The test that provides the most reliable evidence of recent streptococcal infection is the: a. throat culture. b. Mantoux test. c. elevation of liver enzymes. d. ASLO titer test.

D

The transdermal patch Duragesic may be used: a. in infants for acute pain management. b. for patients who are opioid tolerant. c. as a safe and effective medication for children of all ages. d. to provide prolonged (72-hour) pain relief.

D

The transfer of gastric contents into the esophagus is termed: a. esophageal atresia. b. Meckel diverticulum. c. gastritis. d. gastroesophageal reflux (GER).

D

Therapeutic interventions for lead poisoning do not include: a. removal of the source of lead. b. improving nutrition. c. using chelation therapy. d. intravenous administration of dimercaprol.

D

To best promote socialization for the child with a hearing aid, teachers should: a. discourage hearing-impaired children from playing together. b. use frequent group projects to promote communication. c. use audiovisual-assisted instruction as much as possible. d. minimize background noise.

D

To effectively provide anticipatory guidance to the family, the nurse should: a. provide information to deal with each problem as it develops. b. provide teaching and interventions based on needs identified by the professional. c. be suspicious of the parent's ability to deal effectively with the child's needs. d. assist the parents in building competence in their parenting abilities.

D

To integrate spiritual care into practice, the nurse should: a. demonstrate respect. b. support visitation of spiritual leaders. c. listen to ensure understanding. d. do all of the above.

D

To manage opioid-induced respiratory depression in patients receiving opioids by continuous infusion, the nurse should: a. increase the infusion by 25%. b. allow the patient long periods of uninterrupted sleep. c. administer naloxone and discontinue the infusion. d. administer naloxone by slow intravenous push every 1 to 2 minutes until the effect is obtained.

D

To prevent rickets, the mother who is exclusively breastfeeding should consider the administration of: a. iron. b. calcium. c. vitamin E. d. vitamin D.

D

To prevent spread of contamination from one patient to another after procedures, the most important strategy the nurse can use is to: a. follow disease-specific infection control guidelines. b. wear vinyl gloves. c. avoid wearing nail polish. d. wash the hands routinely after each patient contact and after removing gloves.

D

Toward the end of middle childhood, the discrepancies in growth and maturation between boys and girls becomes apparent. Which of the following statements is true? a. There is usually a 4-year difference between the onset of pubescence in girls and boys. b. The universal age at which the first physiologic signs appear in girls is 9 years of age. c. The onset of puberty at age 7 years is considered normal. d. The average age of puberty is 12 years in girls and 14 years in boys.

D

Toxic shock syndrome (TSS) is caused by the toxins produced by: a. C. difficile bacteria. b. human papillomavirus. c. Streptococcus bacteria. d. Staphylococcus bacteria.

D

Treatment for port-wine stain includes laser therapy. The teaching plan for treatment expectations includes which of the following? a. The lesion will have a bright pink appearance for 10 days after treatment. b. Expose the infant to sunlight for 15 minutes daily after treatments. c. Administer salicylates before each treatment for pain. d. After treatment, gently wash the area with water and dab it dry.

D

Uninhibited scribbling and drawing can help the child develop: a. symbolic language. b. fine muscle skills. c. eye-hand coordination. d. all of the above.

D

When administering intravenous medication to an infant, the nurse should: a. check site for patency before each dose. b. administer medications along with blood products. c. combine antibiotics to avoid fluid overload. d. use the maximum dilution of the drug permitted by the manufacturer.

D

When assessing the ear of an infant, the nurse should: a. expect cerumen in the external ear canal. b. use the smallest speculum to prevent trauma to the ear. c. pull the pinna up and back to visualize the canal better. d. pull the pinna down and back to visualize the canal better.

D

When children enter school: a. parents no longer exert the major influence on them. b. teachers have the most significant psychologic impact on children's development and socializations within the community. c. the school becomes the center for establishing all rules and regulations. d. the school serves as a major source of socialization for the child.

D

A complete pediatric health history includes 10 expected components. List these components.

Identifying information, chief complaint, present illness, past history, review of systems, family medical history, psychosocial history, sexual history, family history, nutritional assessment

Describe how knowledge of family characteristics that help families function effectively can be utilized by the nurse.

In guiding the nurse throughout the nursing process to help predict ways that families can cope and respond to stressful events, in providing individualized support that builds on family strengths and functioning style, and in assisting family members in obtaining resources

A candidate for stem cell transplantation is the child who: a. is unlikely to be cured by other means. b. has acute leukemia. c. has chronic leukemia. d. has a compatible donor in his or her family.

A

Which one of the following is not part of the past history to be included in a pediatric health history? a. Symptom analysis b. Allergies c. Birth history d. Current medications

A

A febrile seizure is least likely to occur with a: a. fever in a 2-year-old child. b. fever in an 8-year-old child. c. fever in an 18-month-old child with otitis media.

B

After birth, maximum levels of immunoglobulin A, D, and E in humans are: a. reached during infancy. b. attained in early childhood. c. transferred from the mother. d. reached before 9 months of age.

B

Sally, age 5, has been diagnosed with chronic constipation. Management includes: a. decreasing the water and increasing the milk in Sally's diet. b. an organized approach of at least 6 to 12 months of treatment to be effective. c. daily use of rectal stimulation to promote stool passage. d. having Sally sit on the toilet each day until she has a bowel movement.

B

Separation anxiety and stranger fear normally begin to appear by: a. 4 weeks. b. 6 months. c. 8 months. d. 12 months.

B

The best test to screen for tuberculosis in a child is the: a. chest x-ray. b. tuberculin skin test. c. sputum culture. d. multipuncture tests (MPT), such as the tine test.

B

The goal of therapeutic management for the child with CP is: a. assisting with motor control of voluntary muscle. b. promoting an optimal developmental course to enable children to achieve their maximal potential. c. delaying the development of sensory deprivation. d. surgically correcting deformities.

B

Al's intussusception is reduced without surgery. The nurse should expect care for Al after the reduction to include: a. administration of antibiotics. b. enema administration to remove remaining stool. c. observation of stools. d. rectal temperatures every 4 hours.

C

Rhabdomyosarcoma is a: a. malignant bone neoplasm. b. nonmalignant soft tissue tumor. c. nonmalignant solid tumor. d. malignant solid tumor of the soft tissue.

C

Which of the following does not contribute to sleep disturbances during preschool years? a. Evening media use b. Inconsistent bedtime routines c. Growing pains d. Nighttime fears

C

Which of the following play activities would be least appropriate to suggest to parents for their 3-month-old infant? a. Provide bright objects. b. Use rattles. c. Place in an infant walker. d. Place in an infant swing.

C

Which of these is not usually a factor in the development of a pediatric pressure ulcer? a. Shear b. Skin moisturizer c. Moisture d. Chemical factors e. Friction

C

Which of the following is not considered a secondary cause of DI? a. Trauma b. Phenytoin c. Meningitis d. Obesity

D

Wound care instructions to parents should include which of the following? a. Use betadine, alcohol, and hydrogen peroxide to prevent infection. b. Use hydrocolloid dressing that just covers the wound with little overlap. c. Formation of yellow gel with a fruity odor under hydrocolloid dressings is a sign of infection. d. Apply topical antibiotics after washing with mild soap and water.

D

Which of the following patients with infective endocarditis (IE) is at highest risk for death? a. A 15-year-old with IE caused by a bacterium that is susceptible to ampicillin b. A 2-month-old infant with IE caused by a fungus c. A 5-year-old child with IE following a mitral valve replacement d. A 9-year-old with IE and aortic stenosis

B

Which of the following situations would be considered abnormal? a. A neonate who lacks binocularity b. A toddler whose mother says he looks cross-eyed c. A 5-year-old who has hyperopia d. Presence of a red reflex in a 7-year-old

B

Which of the following statements about renal tubal disorders is false? a. Renal tubal disorders can be either congenital or acquired. b. Renal tubal disorders are primarily metabolic disorders. c. Renal tubal disorders present with normal blood urea nitrogen. d. Renal tubal disorders present with normal urinalysis.

B

Which of the following statements about temperature measurement in children is true? a. Rectal site is preferred in children under 1 month of age. b. Tympanic thermometry for children older than 2 years of age and temporal artery thermometry in all age groups are recommended. c. Ear (tympanic) temperature is a precise measurement of core body measurement. d. Oral temperature is a better indicator of rapid changes in core body temperature and accuracy and is the preferred method when the patient is under 5 years of age.

B

Which of the following statements is correct about eye care and sports? a. Glasses may interfere with the child's ability in sports. b. Face mask and helmet should be required gear for softball and baseball. c. Contact lenses provide less visual acuity than glasses for sports. d. It is usually difficult to convince children to wear their glasses to play sports.

B

Which of the following statements is true in regard to nutritional changes from the infant to the toddler years? a. Growth rate increases. b. Caloric requirements decrease. c. Protein requirements are minimal. d. Fluid requirements increase.

B

Which of the following statements made to the athlete by the nurse is correct? a. It is more important to replace sodium and chloride than water. b. Recommended dietary energy intake for adolescents involved in sports is 50% of caloric intake from carbohydrates. c. Iron replacement is necessary only for the female athlete. d. Energy for prolonged exercise is best obtained from high-carbohydrate foods eaten 2 hours before the event.

B

Which of the following types of seizures is most common in children between the ages of 5 and 8 years? a. Salaam seizures b. Absence seizures c. Atonic seizures d. Jackknife seizures

B

A complete remission of leukemia is determined by: i. absence of clinical signs or symptoms. ii. presence of more than 9% blast cells in the bone marrow. iii. WBC count of 10-12/mm3. iv. presence of less than 5% blast cells in the bone marrow. a. i and iii b. i, ii, and iv c. i and iv

C

Because of the medication used for long-term therapy, children with Kawasaki disease are at increased risk for: a. chickenpox. b. influenza. c. Reye syndrome. d. myocardial infarction.

C

Epidermal necrosis and erythema multiforme are associated with which of the following conditions? a. Neurofibromatosis b. Alopecia areata c. Stevens-Johnson syndrome d. Intertrigo

C

Epithelial wound healing: a. begins 72 hours after the wound is incurred. b. occurs by autolysis of epithelial cells from the wound center toward the wound margins. c. occurs more rapidly when the wound is moist and crust-free. d. occurs more rapidly when the skin is allowed to dry and to form an eschar, or scab.

C

Even with optimal glucose control, a child with type 1 diabetes mellitus may frequently suffer the acute complication of: a. retinopathy. b. ketoacidosis. c. hypoglycemia. d. hyperosmolar nonketotic coma.

C

In children 1 to 19 years of age, the most frequent causes of death are: a. accidents/trauma, infectious illness, and suicide. b. injuries/trauma, cancer, and congenital anomalies. c. accidents/trauma, homicide, cancer, and suicide. d. prematurity, congenital birth defects, and infectious illness.

C

In guiding parents who are choosing a daycare center, the nurse should stress that state licensure represents a program that maintains: a. optimal care. b. health features. c. minimum requirements. d. safety features.

C

In most children who have a febrile seizure, the factor that triggers the seizure tends to be: a. rapidity of the temperature elevation. b. duration of the temperature elevation. c. height of the temperature elevation. d. any of the above.

C

In the child with idiopathic hypopituitarism, growth hormone replacement therapy: a. will continue for life. b. will not result in achievement of a normal familial height. c. requires subcutaneous injection. d. requires intramuscular injection.

C

Late-onset lactase deficiency is also known as: a. congenital lactase deficiency. b. secondary lactose deficiency. c. primary lactase deficiency. d. congenital lactose intolerance.

C

Limit-setting and discipline should begin in: a. middle childhood or adolescence. b. toddlerhood, with voice tone and eye contact. c. infancy, with voice tone and eye contact. d. infancy, with time-out in a chair for misbehavior.

C

Middle childhood is also referred to as the middle years, the school years, or the school-age years. What ages does this period represent? a. Ages 5 to 13 years b. Ages 4 to 14 years c. Ages 6 to 12 years d. Ages 6 to 16 years

C

Most children with croup: a. require hospitalization. b. will need to be intubated. c. can be cared for at home. d. are over 6 years old.

C

Of the following characteristics of vision, the one that is developed at the earliest age is: a. binocularity. b. stereopsis. c. corneal reflex. d. convergence.

C

Parenting practices differ in small and large families. Which one of the following characteristics is not found in small families? a. Emphasis is placed on the individual development of the child, with constant pressure to measure up to family expectations. b. Adolescents identify more strongly with their parents and rely more on their parents for advice. c. Emphasis is placed more on the group and less on the individual. d. Children's development and achievement are measured against those of children in the same neighborhood and social class.

C

Surgical intervention is usually necessary in the first few months of life when an infant is born with: a. atrial septal defect. b. ventricular septal defect. c. transposition of the great vessels. d. patent ductus arteriosus.

C

The most likely reason that the respiratory tract infection rate increases drastically in the age range from 3 to 6 months is that the: a. infant's exposure to pathogens is greatly increased during this time. b. viral agents that are mild in older children are severe in infants. c. maternal antibodies have disappeared, and the infant's own antibody production is immature. d. diameter of the airways is smaller in the infant than in the older child.

C

The nurse counsels the family of a 4-year-old child that in the period immediately following remission he must: a. consume a large amount of food items containing potassium to maintain adequate potassium levels. b. consume a large amount of foods containing iron to replenish deleted iron stores. c. practice meticulous hand washing and monitor for signs of hemorrhage. d. do all of the above, as they are important in this time period.

C

The nurse is planning an educational session for a group of 9-year-olds and their parents aimed at decreasing injuries and accidents among this group. The nurse would best accomplish this goal by reviewing: a. safety rules to prevent burns when dealing with fire. b. safety rules to prevent poisonings when dealing with toxic substances. c. pedestrian safety rules and skills training programs to prevent motor vehicle accidents. d. safety rules for the use of all-terrain vehicles, encouraging their use only with supervision.

C

The proper use of isotretinoin 12-cis-retinoic acid (Accutane) for adolescents includes: i. reserving its use for severe, cystic acne that has not responded to other treatments. ii. limiting treatment to 20 weeks. iii. watching for side effects, including mood changes, depression, and suicidal ideation. iv. watching for detrimental effects on bone mineralization. v. recognizing that it is contraindicated in pregnancy and in sexually active females not using an effective contraceptive method. vi. monitoring for elevated cholesterol and triglyceride levels before and during treatment. a. i, ii, iv, and v b. i, iii, and v c. i, ii, iii, v, and vi d. i, ii, iii, iv, v, and vi

C

The standard pediatric ECG has: a. 6 leads. b. 12 leads. c. 15 leads. d. 18 leads.

C

Therapeutic management for craniosynostosis is:a. placement of ventriculoperitoneal shunt.b. removal of neoplasm.c. release of fused sutures.d. supportive assistance for parents.

C

To prevent skin injuries from shear, the nurse should: a. use sheepskin over the elbows. b. pull the patient up in bed without a lift sheet. c. pull the patient up in bed with a lift sheet. d. use Montgomery straps.

C

To reduce anxiety in the child undergoing cast removal, which of the following nursing interventions would the nurse expect to be least effective? a. Demonstrate how the cast saw works before beginning the procedure. b. Describe cast saw as feeling "tickly" and warm. c. Explain that it will take only a few minutes. d. Continue to reassure that all is going well and that the child's behavior is accepted during the removal process.

C

Treatment of tolerance to opioid therapy includes: a. discontinuing the drug. b. decreasing the dose. c. increasing the dose. d. increasing the duration between doses.

C

Using Erikson's theory as a foundation, the primary developmental task of the toddler period is to: a. satisfy the need for basic trust. b. achieve a sense of accomplishment. c. learn to give up dependence for independence. d. acquire language or mental symbolism.

C

What is the most frequent cause of prerenal failure in infants and children? a. Nephrotoxic agents b. Obstructive uropathy c. Dehydration related to diarrhea and vomiting d. Burn shock

C

What is the primary goal in treating any pediatric patient with allergies? a. Have Benadryl available for use immediately for any contact b. Obtaining a thorough and complete health history c. Prevention of a reaction d. Prevention of anaphylaxis

C

When is a screening hemoglobin or hematocrit recommended for adolescents? a. At the first health provider encounter with an adolescent b. At the end of pubertal development c. At both of the above visits d. At neither of the above visits

C

Which nutritional requirement may be difficult to meet in the toddler years? a. Calories b. Proteins c. Minerals d. Fluids

C

Which of the following characteristics is not typically seen in a gifted or talented child? a. Asynchrony across developmental domains b. Insatiable curiosity c. Less need for attention than other children d. Intensity of feelings and emotions

C

Which of the following children with acute lymphoid leukemia has the best prognosis? a. An 11-year-old girl with a leukocyte count of 30,000/mm3 b. A 6-year-old boy with a leukocyte count of 120,000/mm3 c. A 6-year-old boy with a leukocyte count of 30,000/mm3 d. A 1-year-old girl with a leukocyte count of 120,000/mm3

C

Which of the following describes joint legal custody? a. Each parent is awarded custody of one or more of the children. b. The parents alternate the physical care and control of the children on an agreed-on basis while maintaining shared parenting responsibilities legally. c. The children reside with one parent but both parents are the legal guardians and both participate in childrearing. d. The children reside with the grandparents while both parents assume legal guardianship.

C

Which of the following diagnostic adjuncts is often used to diagnose acute epiglottitis? a. A two-view chest radiograph (anterior and lateral views) b. Throat inspection with tongue blade c. A lateral neck soft tissue radiograph d. Laryngoscopy with mild sedation

C

Which of the following is not correct in describing erythema toxicum neonatorum? a. It is a benign, self-limiting rash that appears within the first 2 days of life. b. The rash is most obvious during crying episodes. c. The rash may be located on all areas of the body, including the soles of the feet and the palms of the hands. d. Lesions appear as 1- to 3-mm, white or pale yellow pustules with an erythematous base. Smears of the pustules show increased numbers of eosinophils and lowered numbers of neutrophils.

C

Which of the following statements about school phobia is correct? a. School phobia is most common in boys over the age of 12. b. School phobia produces symptoms in children that are unrelieved when the student stays home from school. c. Students with school phobia that have separation anxiety are not typically afraid to go to school, but rather are afraid to leave home. d. School phobia fear is helped by a close intense relationship between the child and mother.

C

Which of the following statements about varicella vaccine is correct? a. Varicella vaccine is recommended for all children regardless of past disease history. b. A single dose of 0.5 ml of varicella vaccine should be given by deep intramuscular injection. c. The first dose of varicella vaccine is recommended for children ages 12 to 15 months, and to ensure adequate protection, a second varicella vaccination is recommended for children at 4 to 6 years of age. d. Varicella vaccine should not be administered simultaneously with MMR.

C

Which of the following statements concerning impetigo is not correct and should be omitted by the nurse from the teaching plan? a. Impetigo is treated with oral antibiotics and topical application of mupirocin (Bactroban). b. Impetigo is an eruption of vesicular lesions that occurs on skin that has not been traumatized. c. Distribution of impetigo lesions usually occurs on the perineum, trunk, face, and buttocks. d. The infected child or infant must be isolated from others until all lesions have healed.

C

Which of the following techniques would be contraindicated for the nurse to recommend to parents to prevent recurrent otitis externa? a. Place a combination of vinegar and alcohol in each ear after swimming b. Limit swimming to less than one hour c. Dry the ear canal after swimming with a cotton swab d. Use a hair dryer on low heat at 18 to 24 inches for 30 seconds several times a day

C

Which of the following therapies should the nurse expect to implement for jaundice associated with breastfeeding? a. Increased frequency of breastfeedings b. Permanent discontinuation of breastfeedings c. Discontinuation of breastfeedings for 24 hours with the use of home phototherapy d. Vitamin D supplementation and addition of caloric supplements

C

Which of the following urine tests is conducted daily while the child is receiving medicine for nephrotic syndrome? a. Glucose b. Specific gravity c. Albumin d. pH

C

Which of the following vitamin supplements is recommended for all women of childbearing age to prevent neural tube defects? a. Vitamin D b. Vitamin B12 c. Folic acid d. Vitamin K

C

Which one of the following is not a correct definition of the term family as it is viewed today? a. The family is what the patient considers it to be. b. The family may be related or unrelated. c. The family is always related by legal ties or genetic relationships, and members live in the same household. d. The family members share a sense of belonging to their own family.

C

Compared with adults who have suffered craniocerebral trauma, children usually have a: a. lower incidence of cognitive dysfunction. b. higher mortality rate. c. less favorable prognosis. d. higher incidence of cognitive dysfunction.

D

Complete maturity of the kidneys occurs: a. at birth. b. by 6 months. c. by 1 year. d. by 24 months.

D

Conductive hearing loss in children is most often a result of: a. the use of tobramycin and gentamicin. b. the high noise levels from ventilators. c. congenital defects. d. recurrent serous otitis media.

D

Decrease in cardiac output in the postburn period is caused by which of the following? a. Circulating myocardial depressant factor b. Fluid losses through denuded skin c. Vasodilation and increased capillary permeability d. All of the above

D

In scheduling immunizations, the nurse knows which of the following is correct? a. The beginning primary immunization for infants begins at 2 months of age. b. Children who are born preterm receive only half the normal dose of each vaccine followed by the second half of the vaccine 2 weeks later. c. Children who begin primary immunization at the recommended age but fail to receive all the doses by the suggested age need to begin the series again. d. When there is doubt that the child will return for follow-up immunizations according to the optimum schedule, HBV vaccine (HepB), DTaP, IPV (poliovirus vaccine), MMR, varicella, and Hib vaccines can be administered simultaneously at separate injection sites.

D

Of the following assessment findings in the postoperative care of a child who had surgery to remove a brain tumor, the one with the most serious implications is: a. a comatose child. b. serosanguineous drainage on the dressing. c. colorless drainage on the dressing. d. decreased muscle strength.

D

Of the following factors, the best predictor of outcome in submersion injury victims is: a. respiratory rate. b. degree of acidosis on admission. c. level of consciousness. d. length of time the child was submerged.

D

Of the following heelstick techniques, the one that would be most important to use to avoid the complication of necrotizing osteochondritis would be to: a. warm the site. b. cleanse the site with alcohol. c. puncture no deeper than 2 mm. d. use the inner aspect of the heel.

D

Parents of a child who has Addison disease should be instructed to: a. use extra hydrocortisone only when signs of crisis are present. b. discontinue the child's cortisone if side effects develop. c. decrease the cortisone dose during times of stress. d. administer hydrocortisone consistently.

D

Parents of the child with a congenital heart defect should know the signs of heart failure, which include: a. poor feeding. b. easily fatigued. c. dyspnea. d. all of the above.

D

Parents sometimes view the child's moon face from steroids as an appearance of: a. an anorexic, undernourished child. b. a malnourished child with a swollen abdomen. c. an overweight but undernourished child. d. a well-nourished, healthy child.

D

Pediatric nurses must incorporate which of the following into their routine care of managing children's pain? a. Pain prevention b. Pain assessment c. Pain treatment d. All of the above

D

Physical inactivity has been linked with overweight children. Which of the following explain this decrease in childhood activity? i. Decrease in physical activity in secondary and elementary schools ii. Parental obesity and low levels of physical activity at home iii. Increased time spent with television, video games, computers, and the Internet iv. Lack of sidewalks, parks, and bike paths in low-income communities a. i, ii, and iii b. ii and iii c. i and iv d. i, ii, iii, and iv

D

Physiologic anorexia in toddlers is characterized by: a. strong taste preferences. b. extreme changes in appetite from day to day. c. heightened awareness of social aspects of meals. d. all of the above.

D

Preoperative care of the neonate with either gastroschisis or omphalocele includes all of the following except: a. protect the exposed bowel from injury. b. adequate thermoregulation. c. fluid management. d. mechanical ventilation.

D

Preparation for hospitalization reduces stress in which of the following age-groups? a. Adolescence b. Toddlerhood c. Preschool d. All of the above

D

Prevention of burn injury in children includes education of parents and caregivers. Which of the following is not included in the educational program? a. Stressing the importance of adequate supervision and establishment of a safe play area in the home b. Teaching children at an early age how to "stop, drop, and roll" to extinguish a fire c. Placing microwave ovens higher than children's faces d. Setting hot water heater thermostats no higher than 54° C (130° F)

D

Pulmonary congestion in an infant may be identified by: a. inability to feed. b. mild cyanosis. c. costal retractions. d. all of the above.

D

Symptoms of urinary tract infection often observed in children over age 2 years include: i. incontinence in a child previously toilet trained. ii. abdominal pain. iii. strong or foul odor to the urine. iv. frequency of urination. v. diarrhea. a. i, ii, and iii b. iii and iv c. iii, iv, and v d. i, ii, iii, and iv

D

The condition that often occurs when an infant is placed supine which results in an oblique or asymmetric head is: a. microcephaly. b. craniosynostosis. c. hydrocephaly. d. positional plagiocephaly.

D

The current trend toward evidence-based practice involves: a. questioning whether a better approach exists. b. analyzing published clinical research. c. increased emphasis on measurable outcomes. d. a, b, and c are correct.

D

The drug mannitol is often administered to treat ICP resulting from cerebral edema. The nurse knows which of the following statements to be correct? a. Mannitol is always given by slow IV infusion. b. Mannitol is given with adrenocorticosteroids for cerebral edema secondary to head trauma. c. Mannitol is always given by rapid IV infusion. d. An indwelling catheter is inserted to ensure bladder emptying because of the profound diuretic effect of the drug.

D

The nurse is assisting the family of a child with a history of encopresis. Which of the following should be included in the nurse's discussion with this family? a. Instructing the parents to sit the child on the toilet at two daily routine intervals b. Instructing the parents that the child will probably need to have daily enemas for the next year c. Suggesting the use of stimulant cathartics weekly d. Reassuring the family that most problems resolve successfully, with some relapses during periods of stress

D

The nurse is completing a physical examination on 6-month-old Brian. Which of the following would be an abnormal finding suggestive of CP? a. Brian is able to hold on to the nurse's hands while being pulled to a sitting position. b. Brian has no Moro reflex. c. Brian has no tonic neck reflex. d. Brian has an obligatory tonic neck reflex.

D

The nurse is conducting a review of health records for incoming fifth-grade students and discovers that Mary has a history of having had a severe life-threatening systemic response to a Hymenoptera sting. Which of the following is most important for the nurse to do at this time? a. Make sure that Mary has an identification bracelet to alert others of her allergy. b. Contact Mary's parents about which hospital Mary should be taken to if a sting occurs at school. c. Talk to Mary and see if she has had skin testing to confirm her allergy. d. Contact Mary's parents and provider to obtain emergency medication for Mary to use if necessary at school.

D

The nurse should suspect pain in the comatose child if the child exhibits: a. increased flaccidity. b. increased oxygen saturation. c. decreased blood pressure. d. increased agitation.

D

When communicating with dying children, the nurse should remember that: a. older children tend to be concrete thinkers. b. when children can recite facts, they understand the implications of those facts. c. if children's questions direct the conversation, the assessment will be incomplete. d. games, art, and play provide a good means of expression.

D

When educating the preschool child about injury prevention, the parents' emphasis should be on: a. setting a good example. b. helping children establish basic safety habits. c. protection and education for injury prevention. d. doing all of the above.

D

When examining a child's genitalia, the nurse should: a. conduct this examination first so that the child will not be as apprehensive. b. ask the parent to leave the room so that the young child will not be as shy. c. wait until the end of the examination before discussing findings with the parent and child. d. understand that this examination may provoke anxiety in the child.

D

Another name for trisomy 21 is: a. phenylketonuria. b. Turner syndrome. c. Down syndrome. d. galactosemia.

C

Fine motor development is evaluated in the 10-month-old infant by observing the: a. ability to stack blocks. b. pincer grasp. c. righting reflexes. d. tonic neck reflex.

B

For postoperative or cancer pain control, analgesics should be administered: a. whenever needed. b. around the clock. c. before the pain escalates. d. after the pain peaks.

B

After a seizure in a child over 3 years of age, the Babinski reflex often: a. remains positive. b. remains negative. c. fluctuates. d. is unable to be tested correctly.

C

An infant who weighs 7 kg (15.4 lb) has just returned to the ICU after cardiac surgery. The chest tube has drained 40 ml in the past hour. In this situation, what is the first action for the nurse to take? a. Notify the surgeon b. Identify any other signs of hemorrhage c. Suction the patient d. Identify any other signs of renal failure

A

An invagination of one portion of the intestine into another is called: a. intussusception. b. pyloric stenosis. c. tracheoesophageal fistula. d. Hirschsprung disease.

A

An otoscopic examination in a child with OM would reveal: a. bulging tympanic membrane. b. a light reflex. c. orange tympanic membrane. d. mobile tympanic membrane.

A

As the child moves through the toddler period, there is a decrease in the frequency of: a. solitary play. b. imitative play. c. tactile play. d. parallel play.

A

Barbara has been diagnosed with attention deficit/hyperactivity disorder and placed on methylphenidate by her primary care provider. Which of the following statements, made by the nurse to Barbara's parents, is correct? a. "Barbara's appetite may decrease with this drug." b. "Dosage is usually unchanged until adolescence." c. "This medication takes 2 to 3 weeks to achieve an effect." d. "Barbara's appetite will be increased with this drug."

A

Of the following hematopoietic changes that occur in infancy, the one that is considered abnormal in the first 5 months of life is: a. low iron levels. b. physiologic anemia. c. presence of fetal hemoglobin. d. low hemoglobin level.

A

Of the following techniques, which is the best to use when toilet training a toddler? a. Limit sessions to 5 to 8 minutes of practice. b. Remove child from the bathroom to flush the toilet. c. Ensure the toddler's privacy during the sessions. d. Place potty chair near a television to help distract the child during the sessions.

A

A child having a complex partial seizure rather than a simple partial seizure is more likely to exhibit: a. impaired consciousness. b. clonic movements. c. a seizure duration of less than 1 minute. d. all of the above.

A

A common finding on physical examination of the child with acute rheumatic heart disease is: a. a regurgitant murmur. b. a pleural friction rub. c. an ejection click. d. a split S2.

A

A drug approved for medical abortion is mifepristone. Which of the following statements about this drug is true? a. The drug binds progesterone receptors and blocks the action of progesterone. b. The drug acts directly on the cervix to soften and dilate and on the uterine muscle to stimulate contractions. c. The abortion completion rate is 100% in pregnancies if used correctly. d. The drug is administered intramuscularly up to 49 days after the last menstrual period.

A

A major challenge in management of burn pain is: a. changing patterns of pain across time. b. providing analgesia that allows safe sedation during and after procedures. c. adding additional medications that decrease anxiety without adversely affecting respirations. d. using psychologic interventions effectively.

A

A newborn develops hyperbilirubinemia at 48 hours of age. The condition peaks at 96 hours and declines at about age 14 days. The most likely cause of this hyperbilirubinemia is: a. physiologic jaundice. b. pathologic jaundice. c. hemolytic disease of the newborn. d. breast milk jaundice.

A

A simple, effective, and safe treatment for home or prehospital management of status epilepticus is: a. intranasal midazolam. b. intravenous diazepam. c. intravenous lorazepam. d. rectal fosphenytoin.

A

A syndrome of sustained metabolic acidosis in which there is impaired reabsorption of bicarbonate or excretion of net hydrogen ion but in which glomerular function is normal is termed: a. renal tubular acidosis. b. nephrogenic diabetes insipidus. c. hemolytic uremic syndrome. d. unexplained proteinuria.

A

According to Erikson, a key to identity achievement in adolescence is: a. related to the adolescent's interactions with others and serves as a mirror reflecting information back to the adolescent. b. linked to the role the adolescent plays within the family. c. related to the adolescent's acceptance of parental guidelines. d. related to the adolescent's ability to complete his or her plans for future accomplishments.

A

According to Piaget, what is the stage of development for middle childhood? a. Concrete operational b. Preoperational c. Formal operational d. Sensorimotor

A

According to recent research, which of the following intramuscular injection sites is associated with fewer local and systemic reactions? a. Deltoid muscle b. Vastus lateralis c. Dorsogluteal d. Ventrogluteal

A

According to recent studies, the best place for the infant car restraint is in the: a. back seat of the car, facing the rear. b. back seat of the car, facing front. c. front passenger seat of the car with an air bag, facing front. d. front passenger seat of the car without an air bag, facing back.

A

Air embolism may form in the venous system, traveling directly to the brain in the child with: a. a right-to-left shunt. b. a left-to-right shunt. c. dehydration and hypoxemia. d. hypernatremia and hypokalemia.

A

An infant suffers a fracture of the clavicle during birth. Which of the following would the nurse expect to observe on the physical examination of this infant? a. Crepitus felt over the affected area b. Symmetric Moro reflex c. Complete fracture with overriding fragments d. Positive scarf sign

A

Johnny, age 12, had a renal transplant 5 months ago. He now comes to the hospital outpatient clinic with fever, tenderness over the graft area, decreased urinary output, and slightly elevated blood pressure. The nurse's priority at this time is: a. to recognize that Johnny is probably undergoing acute rejection and to notify the physician immediately. b. to recognize that this is an episode of increased inflammation within the donor kidney because Johnny has probably been noncompliant with his immunosuppressant drugs. The nurse should educate Johnny regarding drug compliance and notify Johnny's physician when he makes rounds. c. to obtain a urine specimen for culture and sensitivity and a blood count to quickly identify Johnny's infection before alerting the physician. d. to recognize that Johnny is in chronic rejection and that no present therapy can halt the progressive process.

A

Johnny, age 8 years, suffered partial-thickness second-degree burns of his chest, abdomen, and upper legs while on a recent camping trip. He is scheduled for hydrotherapy each morning for 20 minutes followed by debridement. The best nursing action to assist Johnny at this time is to: a. ensure that pain medication is given before treatment. b. hold Johnny's breakfast until he returns from treatment. c. offer sedation after the procedure to promote rest. d. reassure Johnny that hydrotherapy and debridement are not painful.

A

Kenny, age 5, is brought to the emergency department for severe burns on his anterior trunk and neck. Singed nasal hair and some minor burns are evident on physical examination. What immediate complication should be watched for? a. Inhalation injury b. Facial deformities c. Bacterial pneumonia d. Carbon monoxide inhalation

A

Language during the preschool years: a. includes telegraphic speech. b. is simple and concrete. c. uses phrases, not sentences. d. includes the ability to follow complex commands.

A

Lesley is a sexually active adolescent. She comes to the clinic with abdominal pain and vaginal bleeding. The nurse recognizes that which of the following must be ruled out immediately? a. Ectopic pregnancy b. Ovarian cyst c. STIs d. Endometriosis

A

Major consequences of immobility in the pediatric patient include which of the following? a. Bone demineralization leading to osteoporosis b. Orthostatic hypertension c. Dependent edema in the lower extremities d. Increase in the metabolic rate

A

Management of brown recluse spider bites includes: a. possible skin graft. b. administration of antivenin. c. applying lemon juice mixed with baking soda directly to the bite. d. administering epinephrine and corticosteroids for impending shock.

A

Mark, age 14 years, has been rushed to the emergency department because of illegal drug ingestion at a party. Which of the following are most important for the nurse to collect to assist in the emergency treatment plan? i. The type and amount of drug taken ii. The time the drug was taken and mode of administration iii. Number of times Mark has previously overdosed iv. Why the drug was taken a. i and ii b. i, ii, and iii c. i only d. i, ii, iii, and iv

A

Mary, age 7 years, fell and sustained a laceration to her chin. She was taken to the emergency department, where the laceration was sutured with the edges well approximated. The nurse expects the repair healing to take place by: a. primary intention. b. secondary intention. c. tertiary intention.

A

Meningococcal conjugate vaccines (MCV4) are not recommended for which of the following populations? a. Routinely for children ages 9 months to 10 years b. Children aged 2 years to 18 years who travel to or reside in countries where N. meningitidis is hyperendemic or epidemic c. Children and adolescents 11 to 12 years of age d. College freshmen living in dormitories

A

Middle childhood is the time when children: i. learn the value of doing things with others. ii. learn the benefits derived from division of labor in accomplishing goals. iii. achieve a sense of industry and accomplishment. iv. expand interests and engage in tasks that can be carried to completion. a. i, ii, iii, and iv b. i, iii, and iv c. i and iv d. ii and iii

A

Mike and Beverly Parker are adopting a 3-year-old girl from Russia. They have approached you for preadoptive counseling. What would you include in the counseling? a. Provide information on appropriate referral agencies that can help with the adoptive process and support groups. b. Reassure them that because they are adopting the child at an early age, the child is less likely to remember previous parenting persons. c. Reassure them that because they are adopting, they will have greater sources of support and preparation than biologic parents. d. Instruct them on how to form an early parent-infant attachment that will eliminate difficulties.

A

Mr. Alls brings his 12-month-old son, Keith, in for his regular well-infant examination. The nurse knows that the best approach to the physical examination for this patient will be to: a. have the infant sit in the parent's lap to complete as much of the examination as possible. b. place the infant on the examination table with parent out of view. c. perform examination in head-to-toe direction. d. completely undress Keith and leave him undressed during the examination.

A

Newborns are more prone to produce higher levels of bilirubin because they: i. have higher concentrations of circulating erythrocytes. ii. have red blood cells with a shorter life span. iii. have reduced albumin concentrations. iv. have anatomically underdeveloped livers. a. i, ii, iii, and iv b. i, ii, and iii c. ii, iii, and iv d. iii and iv

A

Nursing care after surgery for the infant with craniosynostosis includes: a. careful monitoring of hematocrit and hemoglobin because of expected large blood loss during surgery. b. applying ice compresses for 5 minutes every hour because eyelids are often swollen shut. c. avoiding sedation and pain medications because neurologic status may be altered. d. avoiding supine positioning.

A

Nursing care directed toward nonsurgical management in a teenager with scoliosis primarily includes: a. promoting self-esteem and positive body image. b. preventing immobility. c. promoting adequate nutrition. d. preventing infection.

A

Nursing interventions aimed at preventing problems associated with immobility include which of the following? a. Encouraging self-care b. Restricting fluids with strict intake and output c. Limiting active range-of-motion exercises to once per day d. Decreasing sensory stimulation to allow adequate rest

A

What are the most important developmental milestones to record when completing the child's health history?

Age of holding up head steadily; age of sitting alone without support; age of walking without assistance; age of saying first words with meaning; present grade in school; scholastic performance; whether the child has a best friend, and interaction with other children, peers, and adults

______________________ ______________________ refers to the best approach to prevention that uses teaching and counseling of parents and others about developmental expectations and that alerts parents to the issues that are most likely to arise at a given age.

Anticipatory Guidance

Describe the concept of atraumatic care and list the three principles that provide a framework for its implementation.

Atraumatic care is the provision of care that minimizes or eliminates psychologic and physical distress experienced by children and their families. The three principles are: (1) prevent or minimize child's separation from family, (2) promote a sense of control in the child and family, and (3) prevent or minimize bodily injury or pain.

Chloe, age 4 weeks, is brought to the clinic by her mother. When asking about Chloe's feeding schedule, the nurse learns that the mother has been adding twice the required amount of dry formula powder to water in Chloe's bottles for the past 2 days. The mother thinks that this will help Chloe gain weight faster. Which of the following does the nurse recognize as true about this practice? a. The infant's kidneys are functionally mature at birth and able to handle this concentration of formula. b. The infant's kidneys are functionally immature at birth, and this concentration of formula can cause Chloe to be dehydrated. c. The infant's kidneys are functionally immature at birth, and this concentration of formula will cause Chloe to become overhydrated. d. The infant's kidneys are functionally mature at birth, but because of her greater body surface area and longer gastrointestinal tract, Chloe would need the formula diluted.

B

Chronic diarrhea: a. can be caused by viral, bacterial, and parasitic pathogens. b. is an increase in stool frequency and increased water content with a duration of more than 14 days. c. is a leading cause of illness in children younger than 5 years of age. d. is often associated with upper respiratory or urinary tract infections.

B

Clinical manifestations of juvenile dermatomyositis include: i. proximal limb and trunk muscle weakness. ii. elevated serum enzymes. iii. decreased ductal muscle strength and reflex response. iv. heliotropic rash of the eyelids. v. Gottron papules on knuckles, knees, and elbows. a. i, ii, iii, and iv b. i, ii, iv, and v c. iii, iv, and v d. ii, iii, and iv

B

Clinical manifestations of lowering blood pressure, pronounced tachycardia, narrowed pulse pressure, poor capillary filling, and increased confusion would suggest which of the following? a. Compensated shock b. Hypotensive (decompensated shock) c. Irreversible shock

B

Clinical manifestations of nephrotic syndrome include: a. weight gain, pallor, edema, and decreased urinary output. b. weight loss, pallor, periorbital edema, flank pain. c. oliguria, decreased urinary output, and weight loss. d. weight gain, generalized edema, increased urinary output, and generalized erythema.

B

Common therapeutic management of peptic ulcer disease includes histamine receptor antagonists. Which of the following medications is an example of this drug class? a. Bismuth subsalicylate b. Famotidine (Pepcid) c. Omeprazole (Prilosec) d. Sulfasalazine

B

Constipation in infancy: a. may be due to normal developmental changes. b. may be related to dietary practices. c. is found more often in breastfed infants. d. may be due to environmental stressors.

B

Continuous pressure on the radial nerve may result in: a. footdrop. b. wristdrop.

B

Desmopressin acetate (DDAVP) may be administered: a. intramuscularly. b. intranasally. c. topically. d. by all of the above routes.

B

Diagnosis of acute adrenocortical insufficiency is based on: a. elevated plasma cortisol levels. b. the clinical presentation. c. depressed plasma cortisol levels. d. depressed aldosterone levels.

B

Diagnostic evaluation for the patient with GBS would include which of the following results? a. Complete blood count elevated b. Cerebrospinal fluid high in protein c. Creatinine phosphokinase elevated d. Sensory nerve conduction time increased

B

Diagnostic evaluation of the child who is seen with a spinal cord injury includes a complete neurologic examination. Motor system evaluation is done by: a. stimulating peripheral receptors by eliciting reflex such as the patellar. b. observing gait if the child is able to walk; noting balance maintenance; and assessing the ability to lift, flex, and extend extremities. c. testing all 12 cranial nerves. d. using the blunt end of a safety pin and the sharp point to test each dermatome.

B

Dietary regulation in the child with chronic renal failure includes: a. increasing dietary phosphorus. b. providing protein of high biologic value in the diet. c. continuous restricting of potassium. d. adding vitamin A, E, and K supplements.

B

Dog bites in children occur most often: a. on the upper extremities in young children. b. from dogs owned by the family or by a neighbor. c. from stray dogs. d. in schoolyards and neighborhood parks.

B

During middle childhood: a. children are less susceptible to development of dental caries. b. plasticized sealant, applied to deep fissures and grooves of healthy teeth, can prevent cavity formation. c. periodontal disease contributes to childhood tooth loss. d. regular administration of fluoride dental varnish is no longer recommended.

B

During the physical exam of 8-year-old Kevin, the nurse sees a rash at the umbilicus and surrounding area. Kevin tells the nurse that the rash "comes and goes" but "does itch." The nurse recognizes the rash as contact dermatitis. Which of the following is the most likely cause of this rash? a. Insect bite b. Nickel used in Kevin's belt c. Laundry detergent used to clean Kevin's clothes d. A food allergy

B

Effective health education and health care for adolescents does not include which of the following? a. Recognizes that adolescents, as they progress through adolescence, can assume additional responsibility for their own health b. Recognizes that the need to maintain privacy and confidentiality decreases as the adolescent ages c. Should meet the physical and emotional needs of the adolescent d. Recognizes that parents need to respect their teenagers' independence and move more toward the role of health consultant

B

Emergency treatment for the child with a fracture includes: a. moving the child to allow removal of clothing from the area of injury. b. immobilization of the limb, usually including joints above and below the injury site. c. pushing the protruding bone under the skin. d. keeping the area of injury in a dependent position.

B

Examination of the abdomen is performed correctly by the nurse in what order? a. Inspection, palpation, and auscultation b. Inspection, auscultation, and palpation c. Palpation, auscultation, and inspection d. Auscultation, inspection, and palpation

B

Fear of punishment is one of the greatest threats to seriously ill children of which age-group? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

B

A clue in the mother's history that is important in the diagnosis of congenital heart disease is: a. rheumatoid arthritis. b. rheumatic fever. c. streptococcal infection. d. rubella.

D

A common risk factor for infant botulism includes: a. contamination of the umbilical stump after birth. b. ingestion of an uncooked meat product. c. ingestion of uncooked and unwashed vegetables. d. ingestion of honey.

D

A congenital diaphragmatic hernia is suspected when the newborn has which of the following? a. Acute respiratory distress b. Scaphoid abdomen c. Signs of shock d. All of the above

D

After bone marrow aspiration is performed on a child, the nurse should: a. apply an adhesive bandage. b. place the child in the Trendelenburg position. c. ask the child to remain in the supine position. d. apply a pressure bandage.

D

After cardiac surgery in a child, the central venous pressure (CVP) line may be used to: a. administer fluids. b. obtain vital information. c. act as a central line outside the ICU. d. do all of the above.

D

After cardiac surgery, fluid intake calculations for a child would include: a. intravenous fluids. b. arterial and CVP line flushes. c. fluid used to dilute medications. d. all of the above.

D

After administering an intramuscular injection, the nurse would best reassure the young child with poorly defined body boundaries by:a. telling the child that the bleeding will stop after the needle is removed.b. using a large bandage to cover the injection site.c. using a small bandage to cover the injection site.d. using a bandage but removing it a few hours after the injection.

C

After mouth or lip surgery, the nurse would choose to restrain the small child using: a. arm and leg restraints. b. elbow restraints. c. a jacket restraint. d. a mummy restraint.

C

An 8-year-old is to receive a chemotherapeutic drug in the outpatient clinic; his mother comments that he is not eating well because he gets so nauseous with the chemo. One way to minimize these effects is to: a. administer an antiemetic when the child complains of nausea. b. avoid foods in the room that make him nauseous. c. administer an antiemetic 30 minutes to an hour before the chemo infusion. d. omit the chemotherapeutic drug from his regimen.

C

An example of an organizational strategy to improve compliance would be for the nurse to: a. incorporate teaching principles that are known to enhance understanding. b. encourage the family to adapt hospital medication schedules to their home routine. c. increase the frequency of health care appointments. d. do all of the above.

C

An infant with moderate dehydration has what clinical signs? a. Mottled skin color, decreased pulse and respirations b. Decreased urinary output, tachycardia, and fever c. Tachycardia, oliguria, capillary filling within 2 to 4 seconds d. Tachycardia, bulging fontanel, decreased blood pressure

C

Anne, an 8-year-old, has been diagnosed with giardiasis. The nurse would expect Anne to have most likely been seen initially with which of the following signs and symptoms? a. Diarrhea with blood in the stools b. Nausea and vomiting with a mild fever c. Abdominal cramps with intermittent loose stools d. Weight loss of 5 lb in the past month

C

A 10-year-old child has received a dose of l-asparaginase to which he had an anaphylactic reaction a month ago. The boy's mother urges him to get his belongings together so they can leave the outpatient area. The nurse, however, insists that he stay for a period to be observed, because he had a previous reaction. The safe minimum time of observation for this child should be:l a. 20 minutes. b. 30 minutes. c. 60 minutes. d. 90 minutes.

C

A 12-month-old infant would be likely to have: a. 2 teeth. b. 4 teeth. c. 6 teeth. d. 12 teeth.

C

A burn pediatric patient is in the rehabilitative phase of care. Which of the following statements about scar tissue during this period is correct? a. Scar tissue that is raised, red, and firm is considered inactive. b. Uniform pressure applied to the scar increases the blood supply and forces the collagen into a more normal alignment. c. Continuous pressure to areas of scarring can be achieved by elastic pressure garments and can help prevent scarring. d. When pressure to the scar is removed, blood supply to the scar slowly increases; therefore elastic pressure garments can be removed frequently without scar formation.

C

A child in a very deep comatose state would exhibit: a. hyperkinetic activity. b. purposeless plucking movements. c. few spontaneous movements. d. combative behavior.

C

A factor that most influences the amount and manner of discipline and limit-setting imposed on school-age children is: a. the parent's age. b. the parent's education. c. the child's response to rewards and punishments. d. the parent's ability to communicate with the school system.

C

A formerly maltreated child who manifests behaviors such as lack of suspicion of strangers and poor impulse control may be suffering from: a. separation anxiety. b. stranger fear. c. disinhibited social engagement disorder. d. spoiled child syndrome.

C

A major difference in moral development between young school-age children and older school-age children is best described by which of the following? a. Younger children believe that standards of behavior come from within themselves. b. Children 6 to 7 years of age know the rules and understand the reasons behind the rules. c. Older school-age children are able to judge an act by the intentions that prompted it and not only by the consequences. d. Rewards and punishments guide older school-age children's behavior.

C

A particular area of concern for the adolescent receiving irradiation is: a. frequent vomiting. b. altered sexual function. c. high risk for sterility. d. precocious puberty.

C

A treatment of choice for adolescents with dysmenorrhea is: a. acetaminophen. b. oral contraceptives. c. nonsteroidal antiinflammatory drugs. d. estrogen-suppression drugs.

C

Activated charcoal: a. is odorless, tasteless, and delivered with fewer complications via gastric lavage. b. stimulates the gastric mucosa. c. is often mixed with cola drinks and served through a straw from an opaque container. d. has a bitter taste.

C

Adequate intakes (AIs), a category of the Dietary Reference Intakes, are based on nutrient intake of: a. preterm breast-fed infants. b. preterm bottle-fed infants. c. full-term breast-fed infants. d. full-term bottle-fed infants.

C

Adolescents with anorexia nervosa are at risk for refeeding syndrome. Which of the following best describes refeeding syndrome? a. It reduces the risk for osteoporosis and returns the menses to normal. b. The risk for heart failure is greatest during the first 2 days of treatment. c. It occurs because of shifts in phosphate from extracellular to intracellular spaces in persons with total body phosphorus depletion. d. It causes mitral valve prolapse and significant electrolyte imbalance.

C

After a child reaches the age of 1 year, the leading cause of death is from: a. human immunodeficiency virus (HIV). b. congenital anomalies. c. unintentional injuries. d. heart disease.

C

Julie, 12 years old, is brought to the primary care providers office by her mother. Julie has started to develop breast tissue and some pubic hair. Both the mother and daughter are concerned because Julie has been having increased vaginal discharge. Julie tells the nurse, "I wash my private area every day, but I still have fluid that comes out." What is the nurse's best response? a. "It sounds like you have an infection. We'll have the provider check you to see what is causing this discharge." b. "Have you been using soap when you wash?" c. "This sounds like a normal discharge that happens to all girls as they start to mature. It is a sign that your body is preparing for your periods to begin." d. "This is probably not related to hygiene. Are you concerned that this discharge might be causing an odor?"

C

Julie, age 10, has just returned from surgery for repair of an open fracture; she has a dressing and elastic bandage wrap on her leg from upper thigh to midcalf. The nurse immediately notifies the physician if assessment findings include which of the following? a. Appearance of blood-stained area the size of a dime on the dressing b. 2+ pedal pulse c. Inability to move the toes d. Report of pain level of 4/10 on Wong-Baker Faces Pain Rating Scale

C

Kwashiorkor, SAM, and marasmus would be least likely to be managed by: a. providing a high-protein, high-carbohydrate diet. b. replacing fluids and electrolytes. c. providing a high-fiber, high-fat diet. d. providing for essential physiologic needs.

C

Magical thinking, according to Piaget, is the belief that: a. events have cause and effect. b. God is an imaginary friend. c. thoughts are all-powerful. d. if the skin is broken, the child's insides will come out.

C

Major goals in the therapeutic management of children with muscular dystrophy include which of the following? a. Promoting strenuous activity and exercise b. Promoting large caloric intake c. Promoting optimum function in all muscles for as long as possible d. Preventing cognitive impairment

C

Mental health problems in children: a. affect 1 in 20 adolescents. b. make the children less likely to drop out of school than those with other disabilities. c. include attention deficit/hyperactivity disorder (ADHD). d. are more common in children living in large urban centers.

C

Ms. Jones is a single mother caring for her 10-year-old son, James. At an office appointment for James, his mother asks the nurse how to prevent her son from becoming involved in gang violence. The best response is which of the following? a. "Try to be more of a pal to James so that he won't seek outside approval." b. "Relax restrictions on James. He needs to increase his independence, and this will show that you trust him." c. "Become aware of any gang-related activities in your community and become acquainted with your son's friends." d. "Don't allow James to join any 'boys only' groups."

C

Multiple cases of hemolytic uremic syndrome caused by enteric infection of the E. coli O157:H7 serotype have been traced to: i. undercooked meat, especially ground beef. ii. unpasteurized apple juice. iii. alfalfa sprouts. iv. public pools. v. unwashed grapes. a. i, iv, and v b. i and ii c. i, ii, iii, and iv d. ii, iii, and v

C

Neonatal myasthenia gravis: a. occurs in approximately 30% to 50% of infants born to mothers with myasthenia gravis. b. produces exaggerated Moro reflex and shrill cry in the infant. c. may require administration of cholinesterase inhibitors to improve feeding ability. d. produces strength changes in the infant even after the maternal acetylcholine receptor antibodies have cleared the infant's system.

C

Neuroblastoma is often classified as a silent tumor because: a. diagnosis is not usually made until after metastasis. b. the primary site is intracranial. c. the primary site is the bone marrow. d. diagnosis is made based on the location of the primary site.

C

Noncompliance is more likely among families that: a. share typical characteristics. b. have less education than compliant families. c. have complex medical regimens. d. have an increased loss of control.

C

Nursing considerations for the infant with SMA type 1 should include which of the following to promote developmental care? a. Feeding by nasogastric tube b. Using an infant walker to develop muscle strength c. Incorporating verbal, tactile, and auditory stimulation d. Encouraging the parents to seek genetic counseling

C

Nursing intervention for a child during a tonic-clonic seizure should include attempts to: a. halt the seizure as soon as it begins. b. restrain the child. c. remain calm and prevent the child from sustaining any harm. d. place an oral airway in the child's mouth.

C

Of the following activities, the one that has been shown to increase intracranial pressure is: a. using earplugs to eliminate noise. b. range-of-motion exercises. c. suctioning. d. osmotherapy.

C

Of the following blood glucose levels, the value that most certainly indicates a diagnosis of type 1 diabetes mellitus is a: a. fasting blood glucose of 120 mg/dl. b. random blood glucose of 160 mg/dl. c. fasting blood glucose of 160 mg/dl. d. glucose tolerance test (oral) value of 160 mg/dl for the 2-hour sample.

C

Of the following foods, the most appropriate to offer first to an alert child in the postoperative period following a tonsillectomy would be: a. ice cream. b. red gelatin. c. flavored ice pops. d. flavored yogurt.

C

Of the following strategies, which is most appropriate for parents to use to prepare a toddler for the birth of a sibling? a. Explain the upcoming birth as early in the pregnancy as possible. b. Move the toddler to his or her own new room. c. Provide a doll for the toddler to imitate parenting. d. Tell the toddler that a new playmate will come home soon.

C

Of the following symptoms, the one that would not be considered a hallmark of concussion in a child is: a. alteration of mental status. b. amnesia. c. loss of consciousness. d. confusion.

C

Of the following techniques, which is the best one to deal with the negativism of the toddler? a. Quietly and calmly ask the child to comply b. Provide few or no choices for the child c. Reduce the number of opportunities for "no" answer d. Remain serious and intent

C

Offensive mouth odor, persistent dry cough, and a voice with a muffled nasal quality are commonly the result of: a. pneumonia. b. otitis externa. c. tonsillitis. d. otitis media.

C

A recent survey of breastfeeding mothers identified causes for the mother to stop breastfeeding before 6 months. Which of the following was not a cause for a mother to stop breastfeeding? a. Concern about infant weight gain b. Difficulties with lactation c. Effort to pump and maintain milk supply d. Infant refusing to nurse

D

According to Erikson, what is the developmental goal of middle childhood? a. Autonomy b. Trust c. Initiative d. Industry

D

According to Kohlberg, the best way to discipline children is to: a. use a punishment and obedience orientation. b. withhold privileges. c. use power to control behavior. d. give explanations and help the child change.

D

Acquiring social skills for the child who is intellectually disabled includes: a. learning acceptable sexual behavior. b. being exposed to strangers. c. learning to greet visitors appropriately. d. all of the above.

D

Adolescents are more likely to participate in health care services when: a. they understand the potentially negative consequences of their health behavior. b. they rank confidential care and respect higher than site cleanliness. c. they view their health problems as not organic in nature. d. they see the health provider as caring and respectful.

D

Adolescents who feel close to their parents show: i. more positive psychosocial development. ii. greater behavioral competence. iii. less susceptibility to negative peer pressure. iv. less tendency to be involved in risk-taking behaviors. a. i, iii, and iv b. i and ii c. iii and iv d. i, ii, iii, and iv

D

A 14-year-old boy is admitted to the ER and placed on a suicide watch, as he told his mother he would kill himself if she went out drinking again. This is his second or third threat in as many weekends, and the ER staff is acquainted with the family situation. The adolescent is placed in a locked room with a nonbreakable glass window in the wood door. A hospital security guard is positioned at the door. The practitioner asks the nurse if he thinks body restraints are necessary to protect the child. The nurse's priority intervention would be to: a. immediately place the boy in a Posey vest. b. assess his mental status with focus on risk for self-harm. c. ask the mother for permission to administer sedation to the adolescent to prevent him from harming himself. d. do none of the above, as they are not appropriate.

D

A change in vital signs of the young child in the postanesthesia recovery room that demands immediate attention is: a. increased temperature. b. tachypnea. c. muscle rigidity. d. all of the above.

D

A child with growth hormone deficiency will exhibit the signs of: a. restricted height and weight. b. abnormal skeletal proportions. c. malnutrition. d. short stature but proportional height and weight.

D

The nurse is conducting an educational session with Cindy and her parents on medications used for acne. Which of the following is correct information? i. Benzoyl peroxide gel has a bleaching effect on bed coverings and towels. ii. Topical clindamycin is applied only to the individual lesions. iii. Oral contraceptive medications contain estrogen, which will increase acne formation and should be avoided. iv. Tretinoin requires that Cindy protect herself from sun exposure. v. Oral antibiotic side effects may include GI upset, photosensitivity, or vaginal candidiasis. vi. Results are better if systemic antibiotics are combined with topical antibiotic creams. vii. Early intervention with topical medications may prevent development of severe acne. a. i, iv, and vi b. i, ii, iii, and iv c. ii, iv, v, vi, and vi d. i, iv, v, and vii

D

The nurse is conducting an interview with 8-year-old Jesus and his mother, Mrs. Lopez. Mrs. Lopez is worried because Jesus has been acting up at home and at school and disrupting everyone. An interpreter has been requested, since the mother speaks little English. When using an interpreter for communication with Mrs. Lopez, the nurse realizes that: a. the interpreter will have little to do because Jesus can interpret for his mother. b. when the interpreter and Mrs. Lopez speak for a long period, it will be necessary to interrupt to refocus the interview. c. the nurse needs to communicate directly with Mrs. Lopez and ignore the interpreter. d. the nurse needs to pose questions to elicit only one answer at a time from Mrs. Lopez.

D

The nurse is counseling the mother of 12-month-old Brian on methods to prevent constipation. Which of the following methods would be contraindicated for Brian? a. Add bran to Brian's cereal. b. Increase Brian's intake of water. c. Add prunes to Brian's diet. d. Add popcorn to Brian's diet.

D

The nurse is instructing parents on the test-tape diagnostic procedure for enterobiasis. Which of the following is included in the explanation? a. Use a flashlight to inspect the anal area while the child sleeps. b. Perform the test 2 days after the child receives the first dose of antiparasitic medication. c. Test all members of the family at the same time using frosted tape. d. Collect the tape in the morning before the child has a bowel movement or bath.

D

The nurse is performing an otoscopic examination on 14-month-old Justin. Which of the following is recognized as an abnormal finding? a. The umbo, tip of the malleus, appears as a round, opaque, concave spot near the center of the drum. b. Light reflex is present. c. Tympanic membrane is translucent, light pearly pink or gray. d. Tympanic membrane is dull, nontransparent.

D

The nurse knows that the sexual history for an adolescent is an opportunity to: a. discuss the patient's plans for future children. b. screen all adolescents for sexually transmitted infections. c. warn of the risk of sexual activity. d. provide anticipatory guidance related to sexual health.

D

The nurse recognizes that which of the following is not indicated for use in promoting wound healing? a. Nutrition with sufficient protein, calories, vitamins C and D, and zinc b. Irrigation of wounds with normal saline c. Application of an occlusive dressing d. Application of povidone-iodine (Betadine) solution

D

The nurse should eliminate which of the following observations when recording the general appearance of the child? a. Impression of child's nutritional status b. Behavior, interactions with parents c. Hygiene, cleanliness d. Vital signs

D

The nurse working with the abused child and family: i. should view the parent and child as victims. ii. should teach the parents through demonstration and example rather than lecture. iii. recognizes that parents need to correct abnormal behavior in the child (e.g., "We told you not to go with strangers"). iv. recognizes that the goal of the nurse-child relationship is to provide a role model for the parents in helping them relate positively to their child. a. i, ii, iii, and iv b. ii, iii, and iv c. i and iii d. ii and iv

D

The nurse would expect to see what clinical manifestations in the child diagnosed with Hirschsprung disease? a. History of bloody diarrhea, fever, and vomiting b. Irritability, severe abdominal cramps, fecal soiling c. Decreased hemoglobin, increased serum lipids, and positive stool for O&P d. History of constipation; abdominal distention; and passage of ribbonlike, foul-smelling stools

D

The nurse's role in relation to hypertension may include: a. routine accurate assessment of blood pressure in infants and children. b. providing information. c. follow-up of the child with hypertension. d. all of the above.

D

The nutritional needs of the infant with heart failure are usually: a. the same as an adult's. b. less than a healthy infant's. c. the same as a healthy infant's. d. greater than a healthy infant's.

D

The pelvic examination in the adolescent: a. should be performed on all females who are sexually active. b. should only be conducted when there is suspicion of a sexually transmitted disease. c. is always conducted with a parent or guardian in the room. d. is only indicated if the adolescent is experiencing genital tract, pelvic, urologic, or rectal problems.

D

The perceived inability to use their parents for emotional support is one of the greatest threats to seriously ill children of which age-group? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

D

The primary diagnostic tool used in developmental dysplasia of the hip (DDH) in a newborn is: a. a radiograph. b. an ultrasound. c. magnetic resonance imaging. d. the Barlow and Ortolani maneuvers.

D

The prognosis for children with short-bowel syndrome has improved as a result of: a. dietary supplement of vitamin B12. b. improvement in surgical procedures to correct the defect. c. improved home care availability. d. total parenteral nutrition and intraluminal nutrition.

D

The question, "How does your child act when annoyed or upset?" would be asked on admission to assess the child's: a. health perception-health management pattern. b. cognitive-perceptual pattern. c. activity-exercise pattern. d. self-perception/self-concept pattern.

D

Which of the following factors is not considered to be a possible etiology for colic? a. Lactase deficiency b. Excessive air swallowing c. Improper feeding technique d. Infant temperament e. Maternal depression

E

Which of the following is not considered a characteristic associated with ALTE? a. Apnea b. Cyanosis c. Coughing d. Hypotonia e. Acrocyanosis

E

____________ ___________ ____________ involves questioning why something is effective and whether a better approach exists. The concept also involves analyzing and translating published clinical research into the everyday practice of nursing.

Evidence-based practice

Describe four principal areas of concern the nurse should focus on when assessing family structure.

Family composition, home and community environment, occupation and education of family members, cultural and religious traditions

Identify one major type of acute condition that children tend to contract in infancy and early childhood.

Respiratory illnesses, infection, parasitic disease, injuries