Peds final study guide

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A 4-month-old infant comes to the clinic for a well-infant checkup. Immunizations she should receive are DTaP (diphtheria, tetanus, acellular pertussis) and IPV (inactivated poliovirus vaccine). She is recovering from a cold but is otherwise healthy and afebrile. Her older sister has cancer and is receiving chemotherapy. Nursing considerations should include which? DTaP and IPV can be safely given. DTaP and IPV are contraindicated because she has a cold. IPV is contraindicated because her sister is immunocompromised. DTaP and IPV are contraindicated because her sister is immunocompromised.

ANS: A

A 4-month-old with significant head lag meets the criteria for floppy infant syndrome. A diagnosis of progressive infantile spinal muscular atrophy (Werdnig-Hoffmann disease) is made. What should be included in the nursing care for this child? Infant stimulation program Stretching exercises to decrease contractures Limited physical contact to minimize seizures Encouraging parents to have additional children

ANS: A

A 6-year-old boy is hospitalized for intravenous antibiotic therapy. He eats very little on his regular diet trays. He tells the nurse that all he wants to eat is pizza, tacos, and ice cream. What nursing action is the most appropriate? Request these favorite foods for him. Identify healthier food choices that he likes. Explain that he needs fruits and vegetables. Reward him with ice cream at the end of every meal that he eats.

ANS: A

A burn patient is experiencing anxiety over dressing changes. Which prescription should the nurse expect to be ordered to control anxiety? Lorazepam (Ativan) Oxycodone (OxyContin) Fentanyl (Sublimaze) Morphine Sulfate (Morphine)

ANS: A

A child has been diagnosed with a Wilms tumor. What should preoperative nursing care include? Careful bathing and handling Monitoring of behavioral status Maintenance of strict isolation Administration of packed red blood cells

ANS: A

A child is admitted with a suspected diagnosis of Munchausen syndrome by proxy (MSBP). What is an important consideration in the care of this child? Monitoring the parents whenever they are with the child Reassuring the parents that the cause of the disorder will be found Teaching the parents how to obtain necessary specimens Supporting the parents as they cope with diagnosis of a chronic illness

ANS: A

A child with growth hormone (GH) deficiency is receiving GH therapy. When is the best time for the GH to be administered? At bedtime After meals Before meals After arising in morning

ANS: A

A parent of a hospitalized child on chemotherapy asks the nurse if a sibling of the hospitalized child should receive the varicella vaccination. The nurse should give which response? The sibling can get a varicella vaccination. The sibling should not get a varicella vaccination. The sibling should wait until the child is finished with chemotherapy. The sibling should get varicella-zoster immune globulin if exposed to chickenpox.

ANS: A

A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he "heard a pop," that the pain is "pretty bad," and that the ankle feels "as if it is coming apart." Based on this description, the nurse suspects what injury? Sprain Fracture Dislocation Stress fracture

ANS: A

A student athlete was injured during a basketball game. The nurse observes significant swelling. The player states he thought he heard a pop, that the pain is pretty bad, and that the ankle feels as if it is coming apart. Based on this description, the nurse suspects what injury? Sprain Fracture Dislocation Stress fracture

ANS: A

A young child with leukemia has anorexia and severe stomatitis. What approach should the nurse suggest that the parents try? Relax any eating pressures. Firmly insist that the child eat normally. Serve foods that are either hot or cold. Provide only liquids because chewing is painful.

ANS: A

According to Erikson, the psychosocial task of adolescence is developing what? a. Identity b. Intimacy c. Initiative d. Independence

ANS: A

According to Piaget, magical thinking is the belief of which? Thoughts are all powerful. God is an imaginary friend. Events have cause and effect. If the skin is broken, the insides will come out.

ANS: A

After surgery yesterday for gastroesophageal reflux, the nurse finds that the infant has somehow removed the nasogastric (NG) tube. What nursing action is most appropriate to perform at this time? a. Notify the practitioner. b. Insert the NG tube so feedings can be given. c. Replace the NG tube to maintain gastric decompression. d. Leave the NG tube out because it has probably been in long enough.

ANS: A

An 18-month-old child is seen in the clinic with otitis media (OM). Oral amoxicillin is prescribed. What instructions should be given to the parent? Administer all of the prescribed medication. Continue medication until all symptoms subside. Immediately stop giving medication if hearing loss develops. Stop giving medication and come to the clinic if fever is still present in 24 hours.

ANS: A

An 8-year-old girl is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. What intervention will help her most in her adjustment to the hospital? Explain hospital schedules to her, such as mealtimes. Use terms such as "honey" and "dear" to show a caring attitude. Explain when parents can visit and why siblings cannot come to see her. Orient her parents, because she is too young, to her room and hospital facility.

ANS: A

An adolescent whose leg was crushed when she fell off a horse is admitted to the emergency department. She has completed the tetanus immunization series, receiving the last tetanus toxoid booster 8 years ago. What care is necessary for therapeutic management of this adolescent to prevent tetanus? Tetanus toxoid booster is needed because of the type of injury. Human tetanus immunoglobulin is indicated for immediate prophylaxis. Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed. No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years.

ANS: A

An important distinction in understanding substance abuse is that drug misuse, abuse, and addiction are considered what? Voluntary behaviors based on psychosocial needs. Problems that occur in conjunction with addiction. Involuntary physiologic responses to the pharmacologic characteristics of drugs. Legal use of substances for purposes other than medicinal.

ANS: A

An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infant's nutritional needs, the nurse states that: many children will grow out of the allergy. all dairy products must be eliminated from the child's diet. it is important to have the entire family follow the special diet. antihistamines can be used, so the child can have milk products.

ANS: A

An infant has been diagnosed with an allergy to milk. In teaching the parent how to meet the infants nutritional needs, the nurse states that Most children will grow out of the allergy. All dairy products must be eliminated from the childs diet. It is important to have the entire family follow the special diet. Antihistamines can be used so the child can have milk products.

ANS: A

An infant, age 5 months, is brought to the clinic by his parents for a well-baby checkup. What is the best advice that the nurse should include at this time about injury prevention? a. "Keep buttons, beads, and other small objects out of his reach." "Do not permit him to chew paint from window ledges because he might absorb too much lead." "When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall." "Lock the crib sides securely because he may stand and lean against them and fall out of bed."

ANS: A

An infants parents ask the nurse about preventing otitis media (OM). What information should be provided? Avoid tobacco smoke. Use nasal decongestants. Avoid children with OM. Bottle- or breastfeed in a supine position.

ANS: A

An injury to which part of the brain will cause a coma? a. Brainstem Cerebrum Cerebellum Occipital lobe

ANS: A

Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age-group? "No hurt." "Red pain." "Zero hurt." "Least pain."

ANS: A

Heart failure (HF) is a problem after the child has had a congenital heart defect repaired. The nurse knows a sign of HF is what? Wheezing Increased blood pressure Increased urine output Decreased heart rate

ANS: A

In teaching parents how to minimize or prevent bleeding episodes when the child is myelosuppressed, the nurse includes what information? Meticulous mouth care isiessential to avoid mucositis. Rectal temperatures are necessary to monitor for infection. Intramuscular injections are preferred to intravenous ones. Platelet transfusions are given to maintain a count greater than 50,000/mm3.

ANS: A

Parents tell the nurse that their toddler eats little at mealtime, only sits at the table with the family briefly, and wants snacks "all the time." What should the nurse recommend? Give her nutritious snacks. Offer rewards for eating at mealtimes. Avoid snacks so she is hungry at mealtimes. Explain to her in a firm manner what is expected of her.

ANS: A

Parents tell the nurse that their toddler eats little at mealtime, only sits at the table with the family briefly, and wants snacks all the time. What should the nurse recommend? Give her nutritious snacks. Offer rewards for eating at mealtimes. Avoid snacks so she is hungry at mealtimes. Explain to her in a firm manner what is expected of her.

ANS: A

The inheritance of which is X-linked recessive? Hemophilia A Marfan syndrome Neurofibromatosis Fragile X syndrome

ANS: A

The mother of a 7-month-old infant newly diagnosed with cystic fibrosis is rooming in with her infant. She is breastfeeding and provides all the care except for the medication administration. What should the nurse include in the plan of care? Ensuring that the mother has time away from the infant Making sure the mother is providing all of the infant's care Determining whether other family members can provide the necessary care so the mother can rest Contacting the social worker because of the mother's interference with the nursing care

ANS: A

The nurse is aware that which age group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking? Preschool Young school age Middle school age Adolescent

ANS: A

The nurse is aware that which age-group is at risk for childhood injury because of the cognitive characteristic of magical and egocentric thinking? Preschool Young school age Middle school age Adolescent

ANS: A

The nurse is caring for a 10-year-old child who has an acute head injury, has a pediatric Glasgow Coma Scale score of 9, and iis unconscious. What intervention should the nurse include in the child's care plan? a. Elevate the head of the bed 15 to 30 degrees with the head maintained in midline. b. Maintain an active, stimulating environment.c. Perform chest percussion and suctioning every 1 to 2 hr.d. Perform active range of motion and nontherapeutic touch every 8 hr.

ANS: A

The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first? Administer naloxone (Narcan). Discontinue the IV infusion. Discontinue morphine until the child is fully awake. Stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply.

ANS: A

The nurse is caring for a child receiving a continuous intravenous (IV) low-dose infusion of morphine for severe postoperative pain. The nurse observes a slower respiratory rate, and the child cannot be aroused. The most appropriate management of this child is for the nurse to do which first? Discontinue infusion and administer naloxone (Narcan). Direct the charge nurse to call a Code Blue. Discontinue morphine until the child is fully awake. Document clinical findings.

ANS: A

The nurse is caring for a neonate born with a myelomeningocele. Surgery to repair the defect is scheduled the next day. What is the most appropriate way to position and feed this neonate? Prone with the head turned to the side On the side Supine in an infant carrier Supine, with defect supported with rolled blankets

ANS: A

The nurse is planning care for a 3-year-old boy who has Down syndrome and is on continuous oxygen. He recently began walking around furniture. He is spoon fed by his parents and eats some finger foods. What goal is the most appropriate to promote normal development? Encourage mobility. Encourage assistance in self-care. Promote oral-motor development. Provide opportunities for socialization.

ANS: A

The nurse is planning care for a school-age child with bacterial meningitis. What intervention should be included? Keep environmental stimuli to a minimum. Have the child move her head from side to side at least every 2 hr. Avoid giving pain medications that could dull sensorium. Measure head circumference to assess developing complications.

ANS: A

The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching? Childhood obesity is the most common nutritional problem among children. Immunization rates are the same among children of different races and ethnicity. Dental caries is not a problem commonly seen in children since the introduction of fluorinated water. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.

ANS: A

The nurse is talking to a group of parents of school-age children at an after-school program about childhood health problems. Which statement should the nurse include in the teaching? Childhood obesity is the most common nutritional problem among children. Immunization rates are the same among children of different races and ethnicity. Dental caries is not a problem commonly seen in children since the introduction of fluoridated water. Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents.

ANS: A

The nurse is teaching parents of a preschool child strategies to implement when the child delays going to bed. What strategy should the nurse recommend? Use consistent bedtime rituals. Give in to attention-seeking behavior. Take the child into the parent's bed for an hour. d. Allow the child to stay up past the decided bedtime.

ANS: A

The nurse is teaching parents of a preschool child strategies to implement when the child delays going to bed. What strategy should the nurse recommend? Use consistent bedtime rituals. Give in to attention-seeking behavior. Take the child into the parents bed for an hour. Allow the child to stay up past the decided bedtime.

ANS: A

The nurse is teaching the family of an infant with cerebral palsy how to administer a diazepam (Valium) pill by gastrostomy tube. What should the nurse include in the teaching session? The pill should be crushed and mixed with a small amount of water. The pill should be crushed and mixed with the infant's formula. After administering the medication, flush the tube with air. Before administering the medication, check the placement of the tube.

ANS: A

The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. The nurse's response should be based on remembering what? This is acceptable to encourage head control and turning over. This is acceptable to encourage fine motor development. This is unacceptable because of the risk of sudden infant death syndrome (SIDS). This is unacceptable because it does not encourage achievement of developmental milestones.

ANS: A

The parents of a newborn ask the nurse what caused the baby's facial nerve paralysis. The nurse's response is based on remembering that this is caused by what? Birth injury Genetic defect Spinal cord injury Inborn error of metabolism

ANS: A

The parents of a newborn ask the nurse what caused the babys facial nerve paralysis. The nurses response is based on remembering that this is caused by what? Birth injury Genetic defect Spinal cord injury Inborn error of metabolism

ANS: A

What cardiovascular defect results in obstruction to blood flow? Aortic stenosis Tricuspid atresia Atrial septal defect Transposition of the great arteries

ANS: A

What describes nonpharmacologic techniques for pain management? They may reduce pain perception. They usually take too long to implement. They make pharmacologic strategies unnecessary. They trick children into believing they do not have pain.

ANS: A

What does impetigo ordinarily results in? No scarring Pigmented spots Atrophic white scars Slightly depressed scars

ANS: A

What explanation provides the rationale for why iron-deficiency anemia is common during infancy? Cow's milk is a poor source of iron. Iron cannot be stored during fetal development. Fetal iron stores are depleted by 1 month of age. Dietary iron cannot be started until 12 months of age.

ANS: A

What explanation provides the rationale for why iron-deficiency anemia is common during infancy? Cows milk is a poor source of iron. Iron cannot be stored during fetal development. Fetal iron stores are depleted by 1 month of age. Dietary iron cannot be started until 12 months of age.

ANS: A

What intervention is contraindicated in a suspected case of appendicitis? Enemas Palpating the abdomen Administration of antibiotics Administration of antipyretics for fever

ANS: A

What is an important nursing intervention for a full-term infant receiving phototherapy? Observing for signs of dehydration Using sunscreen to protect the infant's skin Keeping the infant diapered to collect frequent stools Informing the mother why breastfeeding must be discontinued

ANS: A

What is an important nursing intervention for a full-term infant receiving phototherapy? Observing for signs of dehydration Using sunscreen to protect the infants skin Keeping the infant diapered to collect frequent stools Informing the mother why breastfeeding must be discontinued

ANS: A

What is descriptive of the nutritional requirements of preschool children? The quality of the food consumed is more important than the quantity. The average daily intake of preschoolers should be about 3000 calories. Nutritional requirements for preschoolers are very different from requirements for toddlers. Requirements for calories per unit of body weight increase slightly during the preschool period.

ANS: A

What is important to incorporate in the plan of care for a child who is experiencing a seizure? a. Describe and record the seizure activity observed. b. Suction the child during a seizure to prevent aspiration. c. Place a tongue blade between the teeth if they become clenched. d. Restrain the child when seizures occur to prevent bodily harm.

ANS: A

What pain medication is contraindicated in children with sickle cell disease (SCD)? Meperidine (Demerol) Hydrocodone (Vicodin) Morphine sulfate Ketorolac (Toradol)

ANS: A

What statement best describes Hirschsprung disease? The colon has an aganglionic segment. It results in frequent evacuation of solids, liquid, and gas. The neonate passes excessive amounts of meconium. It results in excessive peristaltic movements within the gastrointestinal tract.

ANS: A

What statement is correct about young children who report sexual abuse? They may exhibit various behavioral manifestations. In more than half the cases, the child has fabricated the story. Their stories should not be believed unless other evidence is apparent. They should be able to retell the story the same way to another person.

ANS: A

What statement is correct about young children who report sexual abuse? a. They may exhibit various behavioral manifestations. b. In more than half the cases, the child has fabricated the story. c. Their stories should not be believed unless other evidence is apparent. d. They should be able to retell the story the same way to another person.

ANS: A

What tests aid in the diagnosis of cystic fibrosis (CF)? Sweat test, stool for fat, chest radiography Sweat test, bronchoscopy, duodenal fluid analysis Sweat test, stool for trypsin, biopsy of intestinal mucosa Stool for fat, gastric contents for hydrochloride, radiography

ANS: A

What urine test result is considered abnormal? pH 4.0 WBC 1 or 2 cells/mL Protein level absent Specific gravity 1.020

ANS: A

Which is a complication that can occur after abdominal surgery if pain is not managed? Atelectasis Hypoglycemia Decrease in heart rate Increase in cardiac output

ANS: A

Which statement is true concerning the nutritional needs of preterm infants? The secretion of lactase is low. Carbohydrates and fats are better tolerated than protein. The demand for nutrients is less than in full-term infants. Breast milk lacks the proper concentration of nutrients.

ANS: A

The nurse is preparing to admit a 2-year-old child with spina bifida occulta. What clinical manifestations of spina bifida occulta should the nurse expect to observe? (Select all that apply.) Dark tufts of hair Skin depression or dimple Port-wine angiomatous nevi Soft, subcutaneous lipomas Bladder and sphincter paralysis

ANS: A, B, C, D

The nurse is preparing to admit a 7-year-old child with ataxic cerebral palsy. What clinical manifestations of ataxic cerebral palsy should the nurse expect to observe? (Select all that apply.) Wide-based gait Rapid, repetitive movements performed poorly Slow, twisting movements of the trunk or extremities Hypertonicity with poor control of posture, balance, and coordinated motion Disintegration of movements of the upper extremities when the child reaches for objects

ANS: A, B, E

In what condition should the nurse be alert for altered fluid requirements in children? (Select all that apply.) Oliguric renal failure Increased intracranial pressure Mechanical ventilation Compensated hypotension Tetralogy of Fallot Type 1 diabetes mellitus

ANS: A,B,C

The nurse is conducting a teaching session for parents on nutrition. Which characteristics of families should the nurse consider that can cause families to struggle in providing adequate nutrition? (Select all that apply.) Homelessness Lower income Migrant status Working parents Single parent status

ANS: A,B,C

The nurse is preparing to admit a 10-year-old child with appendicitis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) Fever Vomiting Tachycardia Flushed face Hyperactive bowel sounds

ANS: A,B,C

The nurse is teaching parents about the effects of media on childhood obesity. The nurse realizes the parents understand the teaching if they make which statements? (Select all that apply.) "Advertising of unhealthy food can increase snacking." "Increased screen time may be related to unhealthy sleep." "There is a link between the amount of screen time and obesity." "Increased screen time can lead to better knowledge of nutrition." "Physical activity increases when children increase the amount of screen time."

ANS: A,B,C

Which describe the feelings and behaviors of adolescents related to divorce? (Select all that apply.) a. Disturbed concept of sexuality May withdraw from family and friends Worry about themselves, parents, or siblings Expression of anger, sadness, shame, or embarrassment Engage in fantasy to seek understanding of the divorce

ANS: A,B,C,D

The nurse is administering a unit of blood to a child. What are signs and symptoms of a transfusion reaction? (Select all that apply.) Chills Shaking Flank pain Hypothermia Sudden severe headache

ANS: A,B,C,E

The nurse is preparing to admit a 6-month-old infant with increased intracranial pressure (ICP). What clinical manifestations should the nurse expect to observe in this infant? (Select all that apply.) High-pitched cry Poor feeding Setting-sun sign Sunken fontanel Distended scalp veins Decreased head circumference

ANS: A,B,C,E

The nurse is preparing to admit a neonate with bacterial meningitis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) a. Jaundice b. Cyanosis c. Poor tone Nuchal rigidity Poor sucking ability

ANS: A,B,C,E

The nurse is preparing to admit an adolescent with bacterial meningitis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) Fever Chills Headache Poor tone Drowsiness

ANS: A,B,C,E

What interventions should the nurse implement to prevent a pressure ulcer in a critically ill child? (Select all that apply.) Nutrition consults Using skin moisturizers Turning the child every 2 hr Using plastic disposable underpads Using draw sheets to minimize shear

ANS: A,B,C,E

he major initial goal in managing atopic dermatitis would include: (Select all that apply.) skin hydration. relieve pruritus. reduce inflammation. antibiotic therapy. prevent secondary infection.

ANS: A,B,C,E

The clinic nurse completed a teaching session with a 12 year old who is in the eighty-fifth percentile on weight. Which of the following indicate an understanding of the teaching points regarding the risk of obesity? (Select all that apply.) "I should focus on eating foods that are good for me." "I should have at least 60 minutes of physical activity every day." "I will lift weights with my older brother every day to increase my muscle mass." "I will work on changing my habit of watching television and eating sugary snacks."

ANS: A,B,D

The clinic nurse is administering influenza vaccinations. Which children should not receive the live attenuated influenza vaccine (LAIV)? (Select all that apply.) A child with asthma A child with diabetes A child with hemophilia A A child with cancer receiving chemotherapy A child with gastroesophageal reflux disease

ANS: A,B,D

The nurse is caring for a child with secondary hypertension. What renal disorders are associated with secondary hypertension? (Select all that apply.) a. Renal tumor b. Hydronephrosis c. Vesicoureteral reflux d. Glomerulonephritis e. Urinary tract infection

ANS: A,B,D

What are characteristics of middle adolescence (15 to 17 years) with regard to relationships with peers? (Select all that apply.) Behavioral standards set by peer group Acceptance of peers extremely important Seeks peer affiliations to counter instability Exploration of ability to attract opposite sex Peer group recedes in importance in favor of individual friendship

ANS: A,B,D

Additional biobehavioral interventions may be helpful in reducing pain. Which of the following may be considered? (Select all that apply.) Transcutaneous nerve stimulation Distraction Steroidal treatment Percutaneous nerve ablation e. Cognitive-behavioral therapy

ANS: A,B,E

The nurse is caring for a child with a urinary tract infection who is on intravenous gentamicin (Garamycin). What interventions should the nurse plan for this child with regard to this medication? (Select all that apply.) Encourage fluids. Monitor urinary output. Monitor sodium serum levels. Monitor potassium serum levels. Monitor serum peak and trough levels.

ANS: A,B,E

The nurse is caring for a child with a urinary tract infection who is on trimethoprim- sulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child? (Select all that apply.) Rash Urticaria Pneumonitis Renal toxicity Photosensitivity

ANS: A,B,E

The nurse is providing anticipatory guidance to parents of a 4-month-old infant on preventing an aspiration injury. What should the nurse include in the teaching? (Select all that apply.) Keep baby powder out of reach. Inspect toys for removable parts. Allow the infant to take a bottle to bed. Teething biscuits can be used for teething discomfort. The infant should not be fed hard candy, nuts, or foods with pits.

ANS: A,B,E

What are symptoms of abusive head trauma (AHT) in the more severe form that may be present? (Select all that apply.) Seizures Posturing Tachypnea Tachycardia Altered level of consciousness

ANS: A,B,E

What preventive measures should the nurse teach parents of toddlers to prevent early childhood caries? (Select all that apply.) Avoid using a bottle as a pacifier. Eliminate bedtime bottles completely. Place juice in a bottle for the child to drink. Wean from the bottle by 18 months of age. Avoid coating pacifiers in a sweet substance.

ANS: A,B,E

The nurse is teaching parents of a child with gastroesophageal reflux (GER) disease foods that can exacerbate acid reflux. What foods should be included in the teaching session? (Select all that apply.) Citrus Bananas Spicy foods Peppermint Whole wheat bread

ANS: A,C,D

The nurse is preparing to admit a 6-month-old child with gastroesophageal reflux disease. What clinical manifestations should the nurse expect to observe? (Select all that apply.) Spitting up Bilious vomiting c. Failure to thrive Excessive crying Respiratory problems

ANS: A,C,D,E

The nurse is providing anticipatory guidance to parents of an 8-month-old infant on preventing a drowning injury. Which should the nurse include in the teaching? (Select all that apply.) Fence swimming pools. Keep bathroom doors open. Eliminate unnecessary pools of water. Keep one hand on the child while in the tub. Supervise the child when near any source of water.

ANS: A,C,D,E

The nurse is providing anticipatory guidance to the parents of a 1-month-old infant on preventing a suffocation injury. Which should the nurse include in the teaching? (Select all that apply.) Do not place pillows in the infant's crib. Crib slats should be 4 inches or less apart. Keep all plastic bags stored out of the infant's reach. Plastic over the mattress is acceptable if it is covered with a sheet. A pacifier should not be tied on a string around the infant's neck.

ANS: A,C,E

The nurse is teaching parents of preschool-aged children strategies to prevent sexual abuse. What should the nurse include in the teaching session? (Select all that apply.) Back up a child's right to say no. Don't take what your child says too seriously. Carefully observe how others act toward the child Don't be too detailed about examples of sexual assault. Remind children that even "nice" people sometimes do mean things.

ANS: A,C,E

The nurse is preparing a community outreach program for adolescents about the characteristic differences between type 1 and type 2 diabetes mellitus (DM). What concepts should the nurse include? (Select all that apply.) Type 1 DM has an abrupt onset. Type 1 DM is often controlled with oral glucose agents. Type 1 DM occurs primarily in whites. Type 2 DM always requires insulin therapy. Type 2 DM frequently has a familial history. Type 2 DM occurs in people who are overweight.

ANS: A,C,E,F

The nurse is caring for a neonate with an intraventricular hemorrhage. What interventions should the nurse avoid to prevent any increase in intracranial pressure? (Select all that apply.) Keeping the head of the bed flat Keeping the environment quiet Handling the neonate minimally Suctioning the endotracheal tube frequently Maintaining the neonate's head in a midline position

ANS: A,D

The nurse is caring for a 14-year-old child with systemic lupus erythematous (SLE). What clinical manifestations should the nurse expect to observe? (Select all that apply.) Arthralgia Weight gain Polycythemia Abdominal pain Glomerulonephritis

ANS: A,D,E

The nurse is caring for a child with increased intracranial pressure (ICP). What interventions should the nurse plan for this child? (Select all that apply.) Avoid jarring the bed. Keep the room brightly lit. Keep the bed in a flat position. Administer prescribed stool softeners. Administer a prescribed antiemetic for nausea.

ANS: A,D,E

The nurse is preparing to admit a 2-month-old child with hypertrophic pyloric stenosis. What clinical manifestations should the nurse expect to observe? (Select all that apply.) Weight loss Bilious vomiting Abdominal pain Projectile vomiting The infant is hungry after vomiting

ANS: A,D,E

The nurse is teaching an adolescent girl strategies to relieve dysmenorrhea. What should the nurse include in the teaching session? (Select all that apply.) Effleurage Diet high in fat Limiting exercise Use of a heating pad Massaging the lower back

ANS: A,D,E

The nurse is caring for a 12-year-old child who is on fall precautions secondary to seizures. What interventions should be included in the child's care plan? (Select all that apply.) Place a call light and desired items within reach. Keep the bed in the highest position with the two side rails up. Turn off the lights and television at night. Keep personal belongings and clutter contained in one area of the floor. Have the child wear an appropriate-size gown and nonskid footwear.

ANS: A,E

2-year-old child starts to have a tonic-clonic seizure. The child's jaws are clamped. What is the most important nursing action at this time? a. Place a padded tongue blade between the child's jaws. b. Stay with the child and observe his respiratory status. c. Prepare the suction equipment. d. Restrain the child

ANS: B

A 13-year-old child with cystic fibrosis (CF) is a frequent patient on the pediatric unit. This admission, she is sleeping during the daytime and unable to sleep at night. What should be a beneficial strategy for this child? Administer prescribed sedative at night to aid in sleep. Negotiate a daily schedule that incorporates hospital routine, therapy, and free time. Have the practitioner speak with the child about the need for rest when receiving st the preschool years. therapy for CF.d. Arrange a consult with the social worker to determine whether issues at home are interfering with her care.

ANS: B

A 15-year-old girl tells the school nurse that she has not started to menstruate yet. Onset of secondary sexual characteristics was about 2 1/2 years ago. The nurse should take which action? a. Explain that this is not unusual.b. Refer the adolescent for an evaluation.c. Make an assumption that the adolescent is pregnant.d. Suggest that the adolescent stop exercising until menarche occurs.

ANS: B

A 2-year-old child is receiving digoxin (Lanoxin). The nurse should notify the practitioner and withhold the medication if the apical pulse is less than which rate? a. 60 beats/min 90 beats/min 100 beats/min 120 beats/min

ANS: B

A 3-year-old child with Hirschsprung disease is hospitalized for surgery. A temporary colostomy will be necessary. How should the nurse prepare this child? a. It is unnecessary because of childs age. b. It is essential because it will be an adjustment. c. Preparation is not needed because the colostomy is temporary. d. Preparation is important because the child needs to deal with negative body image.

ANS: B

A 5-year-old child will be starting kindergarten next month. She has cerebral palsy, and it has been determined that she needs to be in a special education classroom. Her parents are tearful when telling the nurse about this and state that they did not realize her disability was so severe. What is the best interpretation of this situation? This is a sign the parents are in denial. This is a normal anticipated time of parental stress. The parents need to learn more about cerebral palsy. The parents expectations are too high.

ANS: B

A 6-month-old infant with Hirschsprung disease is scheduled for a temporary colostomy. What should postoperative teaching to the parents include? Dilating the stoma Assessing bowel function Limitation of physical activities Measures to prevent prolapse of the rectum

ANS: B

A bone marrow aspiration and biopsy are needed on a school-age child. The most appropriate action to provide analgesia during the procedure is which? Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure. Use a combination of fentanyl and midazolam for conscious sedation. Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure. Apply a transdermal fentanyl (Duragesic) patch immediately before the procedure.

ANS: B

A cancer patient is experiencing neuropathic cancer pain. Which prescription should the nurse expect to be ordered? Lorazepam (Ativan) Gabapentin (Neurontin) Hydromorphone (Dilaudid) Morphine sulfate (MS Contin)

ANS: B

A cardiac defect that allows blood to shunt from the (high pressure) left side of the heart to the (lower pressure) right side can result in which condition? Cyanosis Heart failure Decreased pulmonary blood flow Bounding pulses in upper extremities

ANS: B

A child has been admitted to the hospital with a blood lead level of 72 mcg/dL. What treatment should the nurse anticipate? Referral to social services Initiation of chelation therapy Follow-up testing within 1 month Aggressive environmental intervention

ANS: B

A child is admitted with acute glomerulonephritis. What should the nurse expect the urinalysis during this acute phase to show? Bacteriuria and hematuria Hematuria and proteinuria Bacteriuria and increased specific gravity Proteinuria and decreased specific gravity

ANS: B

A child who has cystic fibrosis is admitted to the pediatric unit with methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse recognizes that in addition to a private room, the child is placed on what precautions? Droplet Contact Airborne Standard

ANS: B

A child with a hip spica cast is being prepared for discharge. Recognizing that caring for a child at home is complex, the nurse should include what instructions for the parents discharge teaching? Turn every 8 hours. Specially designed car restraints are necessary. Diapers should be avoided to reduce soiling of the cast. Use an abduction bar between the legs to aid in turning.

ANS: B

A child with cystic fibrosis (CF) receives aerosolized bronchodilator medication. When should this medication be administered? After chest physiotherapy (CPT) Before chest physiotherapy (CPT) After receiving 100% oxygen d. Before receiving 100% oxygen

ANS: B

A child with heart failure is on Lanoxin (digoxin). The laboratory value a nurse must closely monitor is which? a. Serum sodium b. Serum potassium c. Serum glucose d. Serum chloride

ANS: B

A child with sickle cell anemia (SCA) develops severe chest and back pain, fever, a cough, and dyspnea. What should be the first action by the nurse? Administer 100% oxygen to relieve hypoxia. Notify the practitioner because chest syndrome is suspected. Infuse intravenous antibiotics as soon as cultures are obtained. Give ordered pain medication to relieve symptoms of pain episode.

ANS: B

A child, age 10 years, has a neuroblastoma and is in the hospital for additional chemotherapy treatments. What laboratory values are most likely this child's? White blood cell count, 17,000/mm3; hemoglobin, 15 g/dL White blood cell count, 3,000/mm3; hemoglobin, 11.5 g/dL Platelets, 450,000/mm3; hemoglobin, 12 g/dL White blood cell count, 10,000/mm3; platelets, 175,000/mm3

ANS: B

A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child? Bottle or tube feed him a specialized formula until he gains sufficient weight. Stabilize his jaw with caregiver's hand (either from a front or side position) to facilitate swallowing. Place him in a well-supported, semi-reclining position. Place him in a sitting position with his neck hyperextended to make use of gravity flow.

ANS: B

A child, age 3 years, has cerebral palsy (CP) and is hospitalized for orthopedic surgery. His mother says he has difficulty swallowing and cannot hold a utensil to feed himself. He is slightly underweight for his height. What is the most appropriate nursing action related to feeding this child? Bottle or tube feed him a specialized formula until he gains sufficient weight. Stabilize his jaw with caregivers hand (either from a front or side position) to facilitate swallowing. Place him in a well-supported, semireclining position. Place him in a sitting position with his neck hyperextended to make use of gravity flow.

ANS: B

A goal for children with spina bifida is to reduce the chance of allergy development. What is a priority nursing intervention? Recommend allergy testing. Provide a latex-free environment. Use only powder-free latex gloves. Limit use of latex products as much as possible.

ANS: B

A hospitalized school-age child with phenylketonuria (PKU) is choosing foods from the hospital's menu. Which food choice should the nurse discourage the child from choosing? a. Banana Milkshake Fruit juice Corn on the cob

ANS: B

A nurse must do a venipuncture on a 6-year-old child. What consideration is important in providing atraumatic care? Use an 18-gauge needle if possible. Show the child the equipment to be used before the procedure. If not successful after four attempts, have another nurse try. Restrain the child completely.

ANS: B

A woman, age 43 years, is 6 weeks pregnant. It is important that she be informed of which? The need for a therapeutic abortion Increased risk for Down syndrome Increased risk for Turner syndrome The need for an immediate amniocentesis

ANS: B

An infant has tetralogy of Fallot. In reviewing the record, what laboratory result should the nurse expect to be documented? Leukopenia Polycythemia Anemia Increased platelet level

ANS: B

An infant who has chronic diaper dermatitis is being evaluated in the clinic. The parent states she is keeping the infant dry, using a nonsoap cleaner and alcohol-free wipes. She says the stools are somewhat loose. The physician wants to evaluate for a possible infection seen in 90% of chronic diaper dermatitis by what micro-organism? Helicobacter pylori Candida albicans Streptococcus thermophilus Trichophyton rubrum

ANS: B

An infant with respiratory syncytial virus (RSV) is being admitted to the hospital. The nurse should stress the importance of: enteric precautions hygiene/cough etiquette the use of a respirator bloodborne disease precautions

ANS: B

An infant with short bowel syndrome is receiving total parenteral nutrition (TPN). The practitioner has added continuous enteral feedings through a gastrostomy tube. The nurse recognizes this as important for which reason? Wean the infant from TPN the next day. Stimulate adaptation of the small intestine. Give additional nutrients that cannot be included in the TPN. Provide parents with hope that the child is close to discharge.

ANS: B

Care for the child with acute idiopathic thrombocytopenic purpura (ITP) includes which therapeutic intervention? a. Splenectomy Intravenous administration of anti-D antibody Use of nonsteroidal anti-inflammatory drugs (NSAIDs) Helping child participate in sports

ANS: B

Congenital adrenal hyperplasia (CAH) is suspected in a newborn because of ambiguous genitalia. The parents are appropriately upset and concerned about their childs gender. In teaching the parents about CAH, what should the nurse explain? Reconstructive surgery as a female is preferred. Sexual assignment should wait until genetic sex is determined. Prenatal masculinization will strongly influence the childs development. The child should be raised as a boy because of the presence of a penis and scrotum.

ANS: B

Gingivitis is a common problem in children with cerebral palsy (CP). What preventive measure should be included in the plan of care? High-carbohydrate diet Meticulous dental hygiene Minimum use of fluoride Avoidance of medications that contribute to gingivitis

ANS: B

Glucocorticoids, mineralocorticoids, and sex steroids are secreted by which gland? Thyroid gland Adrenal cortex Anterior pituitary Parathyroid glands

ANS: B

In anticipation of the admission of a child with hereditary spherocytosis (HS) who is experiencing an aplastic crisis, what action should the nurse plan? Secure an isolation room. Prepare for a transfusion of packed red blood cells. Anticipate preoperative preparation for a splenectomy. Gather equipment and medication for treatment of shock.

ANS: B

Nutritional management of the child with Crohn disease includes a diet that has which component? High fiber Increased protein c. Reduced calories d. Herbal supplements

ANS: B

Parents are switching their toddler, who has met the weight requirement, from a rear-facing car seat to a forward-facing seat. The nurse should recommend the parents place the seat where in the car? In the front passenger seat In the middle of the rear seat In the rear seat behind the driver In the rear seat behind the passenger

ANS: B

Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. What is the most appropriate recommendation for the nurse to make? Punish the children so this behavior stops. Neither condone nor condemn the curiosity. Get counseling for this unusual and dangerous behavior. Allow the children unrestricted permission to satisfy this curiosity.

ANS: B

Pertussis vaccination should begin at which age? Birth 2 months 6 months 12 months

ANS: B

Rh hemolytic disease is suspected in a mother's second baby, a son. Which factor is important in understanding how this could develop? The first child was a girl. The first child was Rh positive. Both parents have type O blood. She was not immunized against hemolysis.

ANS: B

The clinic nurse completed a teaching session with a 16-year-old patient who is being treated for acne vulgaris. Which statement indicates understanding of the teaching points? "I will clean my face twice daily with a facial scrub pad." "I will use a gentle cleanser once or twice daily." "I will squeeze the whitehead to keep the pores open." "I will use the most expensive cleanser on the market to make sure I am getting the best product available."

ANS: B

The development of sexual orientation during adolescence is what? Inflexible A developmental process Differs for boys and girls Proceeds in a defined sequence

ANS: B

The middle school nurse is speaking to parents about prevention of injuries as a goal of the physical education program. How should the goal be achieved? Use of protective equipment at the familys discretion Education of adults to recognize signs that indicate a risk for injury Sports medicine program to help student athletes work through overuse injuries Arrangements for multiple sports to use same athletic fields to accommodate more children

ANS: B

The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which? Take vital signs every hour. Place the infant in the prone position to minimize tension on the sac. Watch for signs that might indicate developing hydrocephalus. Apply a heat lamp to facilitate drying and toughening of the sac.

ANS: B

The nurse is assessing a neonate who was born 1 hour ago to healthy white parents in their early forties. Which finding should be most suggestive of Down syndrome? Hypertonia Low-set ears Micrognathia Long, thin fingers and toes

ANS: B

The nurse is assessing a neonate who was born 1 hr ago to healthy parents in their early forties. Which finding should be most suggestive of Down syndrome? Hypertonia Low-set ears Micrognathia Long, thin fingers and toes

ANS: B

The nurse is caring for a 1-month-old infant with respiratory syncytial virus (RSV) who is receiving 23% oxygen via a plastic hood. The child's SaO2 saturation is 88%, respiratory rate is 45 breaths/min, and pulse is 140 beats/min. Based on these assessments, what action should the nurse take? Withhold feedings. Notify the health care provider. Put the infant in an infant seat. Keep the infant in the plastic hood.

ANS: B

The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, "My child has a low platelet icount, and we are being discharged this afternoon. What do I need to do at home?" What statement is most appropriate for the nurse to make? a. "You should give your child aspirin instead of acetaminophen for fever or pain." b. "Your child should avoid contact sports or activities that could cause bleeding." c. "You should feed your child a bland, soft, moist diet for the next week."d. "Your child should avoid large groups of people for the next week."

ANS: B

The nurse is caring for a child receiving chemotherapy for leukemia. The child's granulocyte count is 600/mm3 and platelet count is 45,000/mm3. What oral care should the nurse recommend for this child? Rinsing mouth with water Daily toothbrushing and flossing Lemon glycerin swabs for cleansing Wiping teeth with moistened gauze or Toothettes

ANS: B

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the potential risk of a cerebrovascular accident (stroke). What strategy is an important objective to decrease this risk? Minimize seizures. Prevent dehydration. Promote cardiac output. Reduce energy expenditure.

ANS: B

The nurse is caring for a child with persistent hypoxia secondary to a cardiac defect. The nurse recognizes the risk of cerebrovascular accidents (strokes) occurring. What strategy is an important objective to decrease this risk? Minimize seizures. Prevent dehydration. Promote cardiac output. Reduce energy expenditure.

ANS: B

The nurse is collecting a 24-hr urine sample on a child with suspected diagnosis of neuroblastoma. What finding in the urine is expected with neuroblastomas? Ketones Catecholamines Red blood cells Excessive white blood cells

ANS: B

The nurse is discussing the management of atopic dermatitis (eczema) with a parent. What should be included? Dress infant warmly to prevent chilling. Keep the infant's fingernails and toenails cut short and clean. Give bubble baths instead of washing lesions with soap. Launder clothes in mild detergent; use fabric softener in the rinse.

ANS: B

The nurse is making a home visit 48 hours after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit? Give contraceptive information. Provide information on the grief process. Reassure parents that SIDS is not likely to occur again. Thoroughly investigate the home situation to verify SIDS as the cause of death.

ANS: B

The nurse is making a home visit 48 hr after the death of an infant from sudden infant death syndrome (SIDS). What intervention is an appropriate objective for this visit? Give contraceptive information. Provide information on the grief process. Reassure parents that SIDS is not likely to occur again. Thoroughly investigate the home situation to verify SIDS as the cause of death.

ANS: B

The nurse is notified that a 9-year-old boy with nephrotic syndrome is being admitted. Only semiprivate rooms are available. What roommate should be best to select? A 10-year-old girl with pneumonia An 8-year-old boy with a fractured femur A 10-year-old boy with a ruptured appendix A 9-year-old girl with congenital heart disease

ANS: B

The nurse is preparing a staff education in-service session for a group of new graduate nurses who will be working in a long-term care facility for children; many of the children have cerebral palsy (CP). What statement should the nurse include in the training? Children with dyskinetic CP have a wide-based gait and repetitive movements. Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus. Children with hemiplegia CP have mouth muscles and one lower limb affected. Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria.

ANS: B

The nurse is preparing to give digoxin (Lanoxin) to a 9-month-old infant. The nurse checks the dose and draws up 4 mL of the drug. The most appropriate nursing action is which? Mix the dose with juice to disguise its taste. Do not give the dose; suspect a dosage error. Check the heart rate; administer digoxin if the rate is greater than 100 beats/min. Check the heart rate; administer digoxin if the rate is greater than 80 beats/min.

ANS: B

The nurse is providing support to a family that is experiencing anticipatory grief related to their child's imminent death. What statement by the nurse is therapeutic? "Your other children need you to be strong." "You have been through a very tough time." "His suffering is over; you should be happy." "God never gives us more than we can handle."

ANS: B

The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active? Ask her, Are you sexually active? Ask her, Are you having sex with anyone? Ask her, Are you having sex with a boyfriend? Ask both the girl and her parent if she is sexually active.

ANS: B

The nurse is teaching a class on obesity prevention to parents in the community. What is a contributing factor to childhood obesity? Birth weight Parental overweight Age at the onset of puberty Asian ethnic background

ANS: B

The nurse is teaching the parents of a child with recurrent headaches methods to modify behavior patterns that increase the risk of headache. Which statement by the parents indicates understanding the teaching? a. We will allow the child to miss school if a headache occurs. b. We will respond matter-of-factly to requests for special attention. c. We will be sure to give much attention to our child when a headache occurs. d. We will be sure our child doesnt have to perform at a band concert if a headache occurs.

ANS: B

The nurse notes that a child has lost 3.6 kg (8 lb) after 4 days of hospitalization for acute glomerulonephritis. What is the most likely cause of this weight loss? Poor appetite Reduction of edema Restriction to bed rest Increased potassium intake

ANS: B

The nurse should suspect a child has cerebral palsy (CP) if the parent says what? "My 6-month-old baby is rolling from back to prone now." "My 4-month-old doesn't lift his head when on his tummy." "My 8-month-old can sit without support." "My 10-month-old is not walking."

ANS: B

The nurse should suspect a child has cerebral palsy (CP) if the parent says what? a. My 6-month-old baby is rolling from back to prone now. My 4-month-old doesnt lift his head when on his tummy. My 8-month-old can sit without support. My 10-month-old is not walking.

ANS: B

The parent of an 8.2-kg (18-pounds) 9-month-old infant is borrowing a federally approved car seat from the clinic. The nurse should explain that the safest way to put in the car seat is what? Front facing in back seat Rear facing in back seat Front facing in front seat with air bag on passenger side Rear facing in front seat if an air bag is on the passenger side

ANS: B

The parents of a child with spastic cerebral palsy (CP) state that their child seems to have significant pain. In addition to systemic pharmacologic management, the nurse includes which teaching? a. Patterning b. Positions to reduce spasticity c. Stretching exercises after meals d. Topical analgesics for muscle spasms

ANS: B

The parents of a preterm infant in a neonatal intensive care unit are concerned about their infant experiencing pain from so many procedures. The nurse's response should be based on which characteristic about preterm infants' pain? They may react to painful stimuli but are unable to remember the pain experience. They may perceive and react to pain in much the same manner as children and adults. They do not have the cortical and subcortical centers that are needed for pain perception. They lack neurochemical systems associated with pain transmission and modulation.

ANS: B

The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury? Female, multiple siblings, stable home life Male, high activity level, stressful home life Male, even tempered, history of previous injuries Female, reacts negatively to new situations, no serious previous injuries

ANS: B

The school nurse is assessing children for risk factors related to childhood injuries. Which child has the most risk factors related to childhood injury? a. Female, multiple siblings, stable home life b. Male, high activity level, stressful home life c. Male, even tempered, history of previous injuries d. Female, reacts negatively to new situations, no serious previous injuries

ANS: B

What clinical manifestation is a common sign of digoxin toxicity? Seizures Vomiting Bradypnea Tachycardia

ANS: B

What condition occurs when the normal adult hemoglobin is partly or completely replaced by abnormal hemoglobin? a. Aplastic anemia b. Sickle cell anemia c. Thalassemia major d. Iron deficiency anemia

ANS: B

What do nursing responsibilities regarding weight gain for an adolescent with anorexia nervosa include? Administer tube feedings until target weight is achieved. Restore body weight to within 2 pounds of the adolescent's ideal weight. Encourage continuation of strenuous exercise as long as adolescent is not losing weight. Facilitate as rapid a weight gain as possible with a high-calorie diet.

ANS: B

What is a priority intervention for an infant with a temporary colostomy for Hirschsprung disease? Teaching how to irrigate the colostomy Protecting the skin around the colostomy Discussing the implications of a colostomy during puberty d. Using simple, straightforward language to prepare the child

ANS: B

What is a significant secondary prevention nursing activity for lead poisoning? Chelation therapy Screening children for blood lead levels Removing lead-based paint from older homes Questioning parents about ethnic remedies containing lead

ANS: B

What is an important consideration when using the FACES pain rating scale with children? Children color the face with the color they choose to best describe their pain. The scale can be used with most children as young as 3 years. The scale is not appropriate for use with adolescents. The FACES scale is useful in pain assessment but is not as accurate as physiologic responses.

ANS: B

What is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)? Discourage the parents from making a last visit with the infant. Make a follow-up home visit to the parents as soon as possible after the childs death. Explain how SIDS could have been predicted and prevented. Interview the parents in depth concerning the circumstances surrounding the childs death.

ANS: B

What is an important responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)? Discourage the parents from making a last visit with the infant. Follow-up home visit to the parents as soon as possible after the child's death. Explain how SIDS could have been predicted and prevented. Interview the parents in depth concerning the circumstances surrounding the child's death.

ANS: B

What is the most common skin problem in the adolescent population? Seborrheic dermatitis Acne vulgaris Atopic dermatitis Scabies

ANS: B

What is the nursing action related to the applying of biologic or synthetic skin coverings for a child with partial-thickness burns of both legs? Splint the legs to prevent movement. Observe wounds for signs of infection. Monitor closely for manifestations of shock. Examine dressings for indications of bleeding.

ANS: B

What measure of fluid balance status is most useful in a child with acute glomerulonephritis? Proteinuria Daily weight Specific gravity Intake and output

ANS: B

What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis? Infarction of renal vessels Immune complex formation and glomerular deposition Bacterial endotoxin deposition on and destruction of glomeruli Embolization of glomeruli by bacteria and fibrin from endocardial vegetation

ANS: B

What statement best identifies the cause of heart failure (HF)? Disease related to cardiac defects Consequence of an underlying cardiac defect Inherited disorder associated with a variety of defects Result of diminished workload imposed on an abnormal myocardium

ANS: B

What type of cerebral palsy (CP) is the most common type? Ataxic Spastic Dyskinetic Mixed type

ANS: B

When teaching injury prevention during the school-age years, what should the nurse include? a. Teach children about the need to fear strangers. Teach basic rules of water safety. Avoid letting children cook in microwave ovens. Caution children against engaging in competitive sports.

ANS: B

Which drug is usually the best choice for patient-controlled analgesia (PCA) for a child in the immediate postoperative period? Codeine sulfate (Codeine) Morphine (Roxanol) Methadone (Dolophine) Meperidine (Demerol)

ANS: B

Which is the most consistent and commonly used data for assessment of pain in infants? Self-report Behavioral Physiologic Parental report

ANS: B

The nurse is preparing to admit a 5-year-old with spina bifida cystica that was below the second lumbar vertebra. What clinical manifestations of spina bifida cystica below the second lumbar vertebra should the nurse expect to observe? (Select all that apply.) No motor impairment Lack of bowel control Soft, subcutaneous lipomas Flaccid, partial paralysis of lower extremities Overflow incontinence with constant dribbling of urine

ANS: B, D, E

What nursing interventions should the nurse plan for a hospitalized toddler to minimize fear of bodily injury? (Select all that apply.) Perform procedures slowly. Maintain parent-child contact. Use progressively smaller dressings on surgical incisions. Tell the child bleeding will stop after the needle is removed. Remove a dressing as quickly as possible from surgical incisions.

ANS: B,C

The nurse is admitting a 9-year-old child with hemolytic uremic syndrome. What clinical manifestations should the nurse expect to observe? (Select all that apply.) Hematuria Anorexia Hypertension Purpura Proteinuria Periorbital edema

ANS: B,C,D

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as nutrition, diet, and lifestyle or behavioral health changes? (Select all that apply.) Reflexology Macrobiotics Megavitamins Health risk reduction Chiropractic medicine

ANS: B,C,D

What clinical manifestations should be observed in a 2-year-old child with hypotonic dehydration? (Select all that apply.) Thick, doughy feel to the skin Slightly moist mucous membranes Absent tears Very rapid pulse Hyperirritability

ANS: B,C,D

The clinic nurse is assessing a child with a heavy ascariasis lumbricoides (common roundworm) infection. Which assessment findings should the nurse expect? (Select all that apply.) Anemia Anorexia Irritability Intestinal colic Enlarged abdomen

ANS: B,C,D,E

The nurse is caring for a 14-year-old child with juvenile idiopathic arthritis (JIA). What clinical manifestations should the nurse expect to observe? (Select all that apply.) Erythema over joints Soft tissue contractures Swelling in multiple joints Morning stiffness of the joints Loss of motion in the affected joints

ANS: B,C,D,E

A 12-month-old infant has been diagnosed with failure to thrive (FTT). Which assessment findings does the nurse expect to be documented with this infant? (Select all that apply.) Fear of strangers Minimal smiling Avoidance of eye contact Meeting developmental milestones Wide-eyed gaze and continual scan of the environment

ANS: B,C,E

The clinic nurse is evaluating causes for iron deficiency due to impaired iron absorption. What should the nurse recognize as causes for iron deficiency due to impaired iron absorption? (Select all that apply.) Gastric acidity Chronic diarrhea Lactose intolerance Absence of phosphates Inflammatory bowel disease

ANS: B,C,E

The nurse is caring for a child with hypercalcemia. The nurse evaluates the child for which signs and symptoms of hypercalcemia? (Select all that apply.) Tetany Anorexia Constipation Laryngospasm Muscle hypotonicity

ANS: B,C,E

The school nurse is explaining to older school children that obesity increases the risk for which disorders? (Select all that apply.) Asthma Hypertension Dyslipidemia Irritable bowel disease Altered glucose metabolism

ANS: B,C,E

What risk factors can cause a sensorineural hearing impairment in an infant? (Select all that apply.) Cat scratch disease Bacterial meningitis Childhood case of measles Childhood case of chicken pox Administration of aminoglycosides for more than 5 days

ANS: B,C,E

What are characteristics of diabetic ketoacidosis? (Select all that apply.) a. Pallor b. Acidosis c. Bradypnea Dehydration Electrolyte imbalance

ANS: B,D,E

What identified characteristics occur more frequently in parents who abuse their children? (Select all that apply.) Older parents Socially isolated Middle-class parents History of substance abuse Few supportive relationships

ANS: B,D,E

10. A child has been seizure free for 2 years. A father asks the nurse how much longer the child will need to take the antiseizure medications. How should the nurse respond? a. Medications can be discontinued at this time.b. The child will need to t:ake the drugs for 5 years after the last seizure.c. A step-wise approach will be used to reduce the dosage gradually.d. Seizure disorders are a lifelong problem. Medications cannot be discontinued.

ANS: C

11. The nurse is teaching the parents of a 3-year-old child who has been diagnosed with tonic- clonic seizures. What statement by the parent should indicate a correct understanding of the teaching? "I should attempt to restrain my child during a seizure." "My child will need to avoid contact sports until adulthood." "I should place a pillow under my child's head during a seizure." "My child will need to be taken to the emergency department (ED) after each seizure."

ANS: C

A 14-year-old adolescent is hospitalized with cystic fibrosis. What nursing note entry represents best documentation of his breakfast meal? Tolerated breakfast well Finished all of breakfast ordered One pancake, eggs, and 240 ml OJ No documentation is needed for this age child.

ANS: C

A 14-year-old adolescent is hospitalized with cystic fibrosis. What nursing note entry represents best documentation of his breakfast meal? a. Tolerated breakfast well.b. Finished all of breakfast ordered.c. One pancake, eggs, and 240 mL OJ.d. No documentation is needed for this age child.

ANS: C

A 14-year-old boy is of normal weight, and his parents are concerned about bilateral breast enlargement. The nurse's discussion of this should be based on what? The presence of too much body fat Symptom that a hormonal imbalance is present Most likely part of normal pubertal development Indication that he is developing precocious puberty

ANS: C

A 14-year-old girl is in the intensive care unit after a spinal cord injury 2 days ago. What nursing intervention is a priority for this child? Minimizing environmental stimuli Administering immunoglobulin Monitoring and maintaining systemic blood pressure Discussing long-term care issues with the family

ANS: C

A 14-year-old is admitted to the emergency department with a fracture of the right humerus epiphyseal plate through the joint surface. What information does the nurse know regarding this type of fracture? It will create difficulty because the child is left handed.It will heal slowly because this is the weakest part of the bone.This type of fracture requires different management to prevent bone growth complications. This type of fracture necessitates complete immobilization of the shoulder for 4 to 6 weeks.

ANS: C

A 17-month-old child should be expected to be in which stage, according to Piaget? a. Preoperations Concrete operations Tertiary circular reactions Secondary circular reactions

ANS: C

A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that "he's like a rag doll. He doesn't cuddle up to me like my other babies did." What is the nurse's best interpretation of this lack of clinging or molding? Sign of detachment and rejection Indicative of maternal deprivation A physical characteristic of Down syndrome Suggestive of autism associated with Down syndrome

ANS: C

A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that hes like a rag doll. He doesnt cuddle up to me like my other babies did. What is the nurses best interpretation of this lack of clinging or molding? Sign of detachment and rejection Indicative of maternal deprivation A physical characteristic of Down syndrome Suggestive of autism associated with Down syndrome

ANS: C

A 2-year-old child is being admitted to the hospital for possible bacterial meningitis. When preparing for a lumbar puncture, what should the nurse do? Set up a tray with equipment the same size as for adults. Apply EMLA to the puncture site 15 minutes before the procedure. Prepare the child for conscious sedation being used for the procedure. Reassure the parents that the test is simple, painless, and risk free.

ANS: C

A 3-day-old infant presents with abdominal distention, is vomiting, and has not passed any meconium stools. What disease should the nurse suspect? Pyloric stenosis Intussusception Hirschsprung disease Celiac disease

ANS: C

A 6 year old is being discharged home, which is 90 miles from the hospital, after an outpatient hernia repair. In addition to explicit discharge instructions, what should the nurse provide? An ambulance for transport home Verbal information about follow-up care Prescribed pain medication before discharge Driving instructions for a route with less traffic

ANS: C

A 6-year-old child has patient-controlled analgesia (PCA) for pain management after orthopedic surgery. The parents are worried that their child will be in pain. What should your explanation to the parents include? The child will continue to sleep and be pain free. Parents cannot administer additional medication with the button. The pump can deliver baseline and bolus dosages. There is a high risk of overdose, so monitoring is done every 15 minutes.

ANS: C

A 7-year-old is identified as being at risk for skin breakdown. What intervention should the nursing care plan include? Massaging reddened bony prominences Teaching the parents to turn the child every 4 hours Ensuring that nutritional intake meets requirements Minimizing use of extra linens, which can irritate the childs skin

ANS: C

A child has a nasogastric (NG) tube after surgery for Hirschsprung disease. What is the purpose of the NG tube? Prevent spread of infection. Monitor electrolyte balance. Prevent abdominal distention. Maintain accurate record of output.

ANS: C

A child is in the intensive care unit after a motor vehicle collision. The child has numerous fractures and is in pain that is rated 9 or 10 on a 10-point scale. In planning care, the nurse recognizes that the indicated action is which? Give only an opioid analgesic at this time. Increase dosage of analgesic until the child is adequately sedated. Plan a preventive schedule of pain medication around the clock. Give the child a clock and explain when she or he can have pain medications.

ANS: C

A child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal anti-inflammatory drug (NSAID). What nursing consideration should be included? Monitor heart rate. Administer NSAIDs between meals. Check for abdominal pain and bloody stools. Expect inflammation to be gone in 3 or 4 days.

ANS: C

A child with severe anemia requires a unit of red blood cells (RBCs). The nurse explains to the child that the transfusion is necessary for which reason? Allow her parents to come visit her. Fight the infection that she now has. Increase her energy so she will not be so tired. Help her body stop bleeding by forming a clot (scab).

ANS: C

A feeding technique the nurse can teach to parents of a child with cerebral palsy to improve use of the lips and the tongue to facilitate speech is which? Feeding pureed foods Placing food on the tongue Placing food at the side of the tongue Placing food directly into the mouth with a spoon

ANS: C

A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition? School phobia Glomerulonephritis Urinary tract infection (UTI) Attention deficit hyperactivity disorder (ADHD)

ANS: C

A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition? a. School phobia b. Glomerulonephritis c. Urinary tract infection (UTI) d. Attention deficit hyperactivity disorder (ADHD)

ANS: C

A hospitalized child with minimal change nephrotic syndrome is receiving high doses of prednisone. What nursing goal is appropriate for this child? Stimulate appetite. Detect evidence of edema. Minimize risk of infection. Promote adherence to the antibiotic regimen.

ANS: C

A new parent asks the nurse, How can diaper rash be prevented? What should the nurse recommend? Wash the infant with soap before applying a thin layer of oil. Clean the infant with soap and water every time diaper is changed. Wipe stool from the skin using water and a mild cleanser. When changing the diaper, wipe the buttocks with oil and powder the creases.

ANS: C

A newborn assessment shows a separated sagittal suture, oblique palpebral fissures, a depressed nasal bridge, a protruding tongue, and transverse palmar creases. These findings are most suggestive of which condition? Microcephaly Cerebral palsy Down syndrome Fragile X syndrome

ANS: C

A parent of an infant with gastroesophageal reflux asks how to decrease the number and total volume of emesis. What recommendation should the nurse include in teaching this parent? a. Surgical therapy is indicated. b. Place in prone position for sleep after feeding. c. Thicken feedings and enlarge the nipple hole. d. Reduce the frequency of feeding by encouraging larger volumes of formula.

ANS: C

A school-age child is diagnosed with a life-threatening illness. The parents want to protect their child from knowing the seriousness of the illness. The nurse should provide which explanation? This attitude is helpful to give parents time to cope. This will help the child cope effectively by denial. Terminally ill children know when they are seriously ill. Terminally ill children usually choose not to discuss the seriousness of their illness.

ANS: C

A school-age child with acute diarrhea and mild dehydration is being given oral rehydration solutions (ORS). The child's mother calls the clinic nurse because he is also occasionally vomiting. The nurse should recommend which intervention? Bring the child to the hospital for intravenous fluids. Alternate giving ORS and carbonated drinks. Continue to give ORS frequently in small amounts. Keep child NPO (nothing by mouth) for 8 hr and resume ORS if vomiting has subsided.

ANS: C

A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition? Allergies Acute pharyngitis Foreign body in the nose Acute nasopharyngitis

ANS: C

A toddler has a unilateral foul-smelling nasal discharge and frequent sneezing. The nurse should suspect what condition? a. Allergies b. Acute pharyngitis c. Foreign body in the nose d. Acute nasopharyngitis

ANS: C

According to Piaget, a 6-month-old infant should be in which developmental stage? a. Use of reflexes b. Primary circular reactions c. Secondary circular reactions d. Coordination of secondary schemata

ANS: C

After a tonic-clonic seizure, what symptoms should the nurse expect the child to experience? Diarrhea and abdominal discomfort Irritability and hunger Lethargy and confusion Nervousness and excitability

ANS: C

After the acute stage and during the healing process, what is the primary complication from burn injury? a. Shock Asphyxia Infection Renal shutdown

ANS: C

An adolescent has just been brought to the emergency department with a spinal cord injury and paralysis from a diving accident. The parents keep asking the nurse, "How bad is it?" The nurse's response should be based on which knowledge? Families adjust better to life-threatening injuries when information is given over time. Immediate loss of function is indicative of the long-term consequences of the injury. Extent and severity of damage cannot be determined for several weeks or even months. Numerous diagnostic tests will be done immediately to determine extent and severity of damage. i n c h ild re n o n yo no honey

ANS: C

An adolescent has just been brought to the emergency department with a spinal cord injury and paralysis from a diving accident. The parents keep asking the nurse, How bad is it? The nurses response should be based on which knowledge? Families adjust better to life-threatening injuries when information is given over time. Immediate loss of function is indicative of the long-term consequences of the injury.Extent and severity of damage cannot be determined for several weeks or even months. Numerous diagnostic tests will be done immediately to determine extent and severity of damage.

ANS: C

An adolescent with a spinal cord injury is admitted to a rehabilitation center. Her parents describe her as being angry, hostile, and uncooperative. The nurse should recognize that this is suggestive of which psychosocial state? a. Normal phase of adolescent developmentb. Severe depression that will require long-term counselingc. Normal response to her situation that can be redirected in a healthy way d. Denial response to her situation that makes rehabilitative efforts more difficult

ANS: C

An infant is brought to the emergency department with the following clinical manifestations: poor skin turgor, weight loss, lethargy, tachycardia, and tachypnea. This is suggestive of which situation? Water excess Sodium excess Water depletion Potassium excess

ANS: C

An infant with bronchiolitis is hospitalized. The causative organism is respiratory syncytial virus (RSV). The nurse knows that a child infected with this virus requires what type of isolation? Reverse isolation Airborne isolation Contact Precautions Standard Precautions

ANS: C

Chronic otitis media with effusion (OME) differs from acute otitis media (AOM) because it is usually characterized by which signs or symptoms? Severe pain in the ear Anorexia and vomiting A feeling of fullness in the ear Fever as high as 40 C (104 F)

ANS: C

Decreasing the demands on the heart is a priority in care for the infant with heart failure (HF). In evaluating the infants status, which finding is indicative of achieving this goal? Irritability when awake Capillary refill of more than 5 seconds Appropriate weight gain for age Positioned in high Fowler position to maintain oxygen saturation at 90%

ANS: C

Descriptions of young people with anorexia nervosa (AN) often include which criteria? Impulsive Extroverted Perfectionist Low achieving

ANS: C

Descriptions of young people with anorexia nervosa (AN) often include which criteria? a. Impulsive b. Extroverted c. Obsessive-compulsive d. Low achieving

ANS: C

Early diagnosis of congenital hypothyroidism (CH) and phenylketonuria (PKU) is essential to prevent which? Obesity Diabetes Cognitive impairment Respiratory distress

ANS: C

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vasoocclusion and hypoxiaischemia cycle. What information should the nurse share with parents in a teaching plan? Encourage drinking. Keep accurate records of output. Check for moist mucous membranes. Monitor the concentration of the childs urine.

ANS: C

In providing nourishment for a child with cystic fibrosis (CF), what factors should the nurse keep in mind? Fats and proteins must be greatly curtailed. Most fruits and vegetables are not well tolerated. Diet should be high in calories, proteins, and unrestricted fats. Diet should be low fat but high in calories and proteins.

ANS: C

Parents tell the nurse they do not want to let their school-age child know his illness is terminal. What response should the nurse make to the parents? a. "Have you discussed this with your health care provider?"b. "I would do the same thing in your position; it is better the child doesn't know." c. "I understand you want to protect your child, but often children realize the seriousness of their illness."d. "I praise you for that decision; it can be so difficult to be truthful about the seriousness of your son's illness."

ANS: C

Peripheral precocious puberty (PPP) differs from central precocious puberty (CPP) in which manner? PPP results from a central nervous system (CNS) insult. PPP occurs more frequently in girls. PPP may be viewed as a variation in sexual development. PPP results from hormonal stimulation of the hypothalamic gonadotropin-releasing hormone (Gn-RH).

ANS: C

Spastic cerebral palsy (CP) is characterized by which clinical manifestations? Athetosis, dystonic movements Tremors, lack of active movement Hypertonicity; poor control of posture, balance, and coordinated motion Wide-based gait; poor performance of rapid, repetitive movements

ANS: C

The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration? a. Decreased blood viscosity b. Deficiency in coagulation c. Increased red blood cell (RBC) destruction d. Greater affinity for oxygen

ANS: C

The clinical manifestations of sickle cell anemia (SCA) are primarily the result of which physiologic alteration? Decreased blood viscosity Deficiency in coagulation Increased red blood cell (RBC) destruction Greater affinity for oxygen

ANS: C

The middle school nurse is planning a behavior modification program for overweight children. What is the most important goal for participants of the program? Learn how to cook low-fat meals. Improve relationships with peers. Identify and eliminate inappropriate eating habits. Achieve normal weight during the program.

ANS: C

The mother of a child with cognitive impairment calls the nurse because her son has been gagging and drooling all morning. The nurse suspects foreign body ingestion. What physiologic occurrence is most likely responsible for the presenting signs? Gastrointestinal perforation may have occurred. The object may have been aspirated. The object may be lodged in the esophagus. The object may be embedded in stomach wall.

ANS: C

The nurse has determined that an adolescents body mass index (BMI) is in the 90th percentile. What information should the nurse convey to the adolescent? a. The adolescent is overweight. b. The adolescent has maintained weight within the normal range. c. The adolescent is at risk for becoming overweight. d. Nutritional supplementation should occur at least three times per week

ANS: C

The nurse is caring for a 4-year-old child with cerebral palsy (CP). The child, developmentally, is at an infant stage. Appropriate developmental stimulation for this child should be what? Playing pat-a-cake with the child None so the child does not become overstimulated Putting a colorful mobile with music on the bed Giving the child a coloring book and crayons

ANS: C

The nurse is caring for a child admitted with acute abdominal pain and possible appendicitis. What intervention is appropriate to relieve the abdominal discomfort during the evaluation? Place in the Trendelenburg position. Apply moist heat to the abdomen. Allow the child to assume a position of comfort. Administer a saline enema to cleanse the bowel.

ANS: C

The nurse is discussing sexuality with the parents of an adolescent girl who has a moderate cognitive impairment. What factor should the nurse consider when dealing with this issue? Sterilization is recommended for any adolescent with cognitive impairment. Sexual drive and interest are very limited in individuals with cognitive impairment. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.

ANS: C

The nurse is examining an infant, age 10 months, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions. What is the most likely cause? Impetigo Urine and feces Candida albicans infection Infrequent diapering

ANS: C

The nurse is explaining to an adolescent the rationale for administering a Tdap (tetanus, diphtheria, acellular pertussis) vaccine 3 years after the last Td (tetanus) booster. What should the nurse tell the adolescent? "It is time for a booster vaccine." "It is past the time for a booster vaccine." "This vaccine will provide pertussis immunity." "This vaccine will be the last booster you will need."

ANS: C

The nurse is explaining to an adolescent the rationale for administering a Tdap (tetanus, diphtheria, acellular pertussis) vaccine 3 years after the last Td (tetanus) booster. What should the nurse tell the adolescent? It is time for a booster vaccine. It is past the time for a booster vaccine. This vaccine will provide pertussis immunity. This vaccine will be the last booster you will need.

ANS: C

The nurse is facilitating a conference between the teachers and parents of a 7-year-old child newly diagnosed with attention deficit hyperactivity disorder (ADHD). What does the nurse stress? Academic subjects should be taught in the afternoon. Low-interest activities in the classroom should be minimized. Visual references should accompany verbal instruction. The child's environment should be visually stimulating.

ANS: C

The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care? Limit explanation of procedures because the child is preschool aged. Ask that all family members leave the room when performing procedures. Allow the child to choose the type of juice to drink with the administration of oral medications. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective.

ANS: C

The nurse is planning care for a hospitalized preschool-aged child. Which should the nurse plan to ensure atraumatic care? Limit explanation of procedures because the child is preschool aged. Ask that all family members leave the room when performing procedures.Allow the child to choose the type of juice to drink with the administration of oral medications. Explain that EMLA cream cannot be used for the morning lab draw because there is not time for it to be effective.

ANS: C

The nurse is planning to administer a nonopioid for pain relief to a child. Which timing should the nurse plan, so the nonopioid takes effect? 15 minutes until maximum effect 30 minutes until maximum effect 1 hr until maximum effect 1 1/2 hr until maximum effect

ANS: C

The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night. What intervention should the nurse suggest in helping the parent to cope with this sleep disturbance? Establish a consistent punishment if the child does not go to bed when told. Allow the child to fall asleep in a different room and then gently move the child to his or her bed.c. Establish limited rituals that signal readiness for bedtime. d. Allow the child to watch television until almost asleep.

ANS: C

The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night. What intervention should the nurse suggest in helping the parent to cope with this sleep disturbance? Establish a consistent punishment if the child does not go to bed when told. Allow the child to fall asleep in a different room and then gently move the child to his or her bed. Establish limited rituals that signal readiness for bedtime. Allow the child to watch television until almost asleep.

ANS: C

The nurse is teaching a child experiencing severe edema associated with minimal change nephrotic syndrome about his diet. The nurse should discuss what dietary need? Consuming a regular diet Increasing protein Restricting fluids Decreasing calories

ANS: C

The nurse is teaching a class on nutrition to a group of parents of 10- and 11-year-old children. What statement by one of the parents indicates a correct understanding of the teaching? "My child does not need to eat a variety of foods, just his favorite food groups." "My child can add salt and sugar to foods to make them taste better." "I will serve foods that are low in saturated fat and cholesterol." "I will continue to serve red meat three times per week for extra iron."

ANS: C

The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause? Poor hygiene Constipation Urinary stasis Congenital anomalies

ANS: C

The nurse is teaching a client to prevent future urinary tract infections (UTIs). What factor is most important to emphasize as the potential cause? a. Poor hygiene b. Constipation c. Urinary stasis d. Congenital anomalies

ANS: C

The nurse is teaching feeding strategies to a parent of a 12-month-old infant with Down syndrome. What statement made by the parent indicates a need for further teaching? "If the food is thrust out, I will retry it." "I will use a small, long, straight-handled spoon." "I will place the food on the top of the tongue." "I know the tongue thrust doesn't indicate a refusal of the food."

ANS: C

The nurse is teaching the family of a child, age 8 years, with moderate hemophilia about home care. What should the nurse tell the family to do to minimize joint injury? Administer nonsteroidal anti-inflammatory drugs (NSAIDs). Administer DDAVP (synthetic vasopressin). Provide intravenous (IV) infusion of factor VIII concentrates. Encourage elevation and application of ice to the involved joint.

ANS: C

The nurse understands that which occurring soon after birth can indicate cystic fibrosis? Murmur Hypoglycemia Meconium ileus Muscle weakness

ANS: C

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurse's reply? The antibiotic therapy contributes to labile blood pressure values. Hypotension leading to sudden shock can develop at any time. Acute hypertension is a concern that requires monitoring. Blood pressure fluctuations indicate that the condition has become chronic.

ANS: C

The parent of a child hospitalized with acute glomerulonephritis asks the nurse why blood pressure readings are being taken so often. What knowledge should influence the nurses reply? The antibiotic therapy contributes to labile blood pressure values. Hypotension leading to sudden shock can develop at any time. Acute hypertension is a concern that requires monitoring. Blood pressure fluctuations indicate that the condition has become chronic.

ANS: C

The parents of 9-year-old twin children tell the nurse, They have filled up their bedroom with collections of rocks, shells, stamps, and bird nests. The nurse should recognize that this is which? Indicative of giftedness Indicative of typical twin behavior Characteristic of cognitive development at this age Characteristic of psychosocial development at this age

ANS: C

The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA? SCA is not inherited. All siblings will have SCA. Each sibling has a 25% chance of having SCA. There is a 50% chance of siblings having SCA.

ANS: C

The parents of a child with sickle cell anemia (SCA) are concerned about subsequent children having the disease. What statement most accurately reflects inheritance of SCA? a. SCA is not inherited. B. All siblings will have SCA c. Each sibling has a 25% chance of having SCA. d. There is a 50% chance of siblings having SCA

ANS: C

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurse's response should be based on which knowledge? Affected children have some degree of cognitive impairment. Around 20% of affected children have normal intelligence. About 30% to 50% of affected children have significant cognitive impairments. Cognitive impairment is expected if motor and sensory deficits are severe.

ANS: C

The parents of an infant with cerebral palsy (CP) ask the nurse if their child will have cognitive impairment. The nurses response should be based on which knowledge? Affected children have some degree of cognitive impairment. Around 20% of affected children have normal intelligence. About 45% of affected children have normal intelligence. Cognitive impairment is expected if motor and sensory deficits are severe.

ANS: C

The practitioner has ordered a liquid oral antibiotic for a toddler with otitis media. The prescription reads 1 1/2 tsp four times per day. What should the nurse consider in teaching the mother how to give the medicine? A measuring spoon should be used, and the medication must be given every 6 hr. The mother is not able to handle this regimen. Long-acting intramuscular antibiotics should be administered. A hollow-handled medication spoon is advisable, and the medication should be equally spaced while the child is awake. A household teaspoon should be used and the medicine given when the child wakes up, around lunch time, at dinner time, and before bed.

ANS: C

The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize? Questions need to be discouraged in this setting. Most children in the fifth grade are too young for sex education. Sexuality is presented as a normal part of growth and development. Correct terminology should be reserved for children who are older.

ANS: C

The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize? Questions need to be discouraged in this setting. Most children in the fifth grade are too young for sex education. c. Sexuality is presented as a normal part of growth and development. d. Correct terminology should be reserved for children who are older.

ANS: C

Urinary tract anomalies are frequently associated with what irregularities in fetal development? Myelomeningocele Cardiovascular anomalies Malformed or low-set ears Defects in lower extremities

ANS: C

What behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)? Eats in secrecy. Uses food as a coping mechanism. Has a marked preoccupation with food. Lacks awareness of how eating affects weight loss.

ANS: C

What child has a cyanotic congenital heart defect? a. An infant with patent ductus arteriosus A 1-year-old infant with atrial septal defect A 2-month-old infant with tetralogy of Fallot A 6-month-old infant with repaired ventricular septal defect

ANS: C

What condition is the most common cause of acute renal failure in children? Pyelonephritis Tubular destruction Severe dehydration Upper tract obstruction

ANS: C

What explains physiologically the edema formation that occurs with burns? Vasoconstriction Reduced capillary permeability Increased capillary permeability Diminished hydrostatic pressure within capillaries

ANS: C

What factor predisposes an infant to fluid imbalances? Decreased surface area Lower metabolic rate Immature kidney functioning Decreased daily exchange of extracellular fluid

ANS: C

What finding is a c"linical manifestation of increased intracranial pressure (ICP) in children? a. Low-pitched cry b. Sunken fontanel c. Diplopia, blurred vision d. Increased blood pressure

ANS: C

What information should the nurse include when teaching the mother of a 9-month-old infant about administering liquid iron preparations? Give with meals. Stop immediately if nausea and vomiting occur. Adequate dosage will turn the stools a tarry green color. Allow preparation to mix with saliva and bathe the teeth before swallowing.

ANS: C

What intervention is most appropriate for fostering the development of a school-age child with disabilities associated with cerebral palsy? Provide sensory experiences. Help develop abstract thinking. Encourage socialization with peers. Give choices to allow for feeling of control.

ANS: C

What is a priority of care for an infant with an intraventricular hemorrhage? Avoid use of analgesia. Keep the infant's head to the right side. Minimize interventions that cause crying. Encourage the staff and parents to hold the infant.

ANS: C

What is a significant common side effect that occurs with opioid administration? Euphoria Diuresis Constipation Allergic reactions

ANS: C

What is an important consideration for the school nurse planning a class on injury prevention for adolescents? Adolescents generally are not risk takers. Adolescents can anticipate the long-term consequences of serious injuries. Adolescents need to discharge energy, often at the expense of logical thinking. During adolescence, participation in sports should be limited to prevent permanent injuries.

ANS: C

What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning? a. Maintain bed rest. Maintain isolation precautions. Keep an accurate record of intake and output. Institute measures to prevent skeletal fracture. the

ANS: C

What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning?a. Maintain bed rest. Maintain isolation precautions. Keep an accurate record of intake and output. Institute measures to prevent skeletal fracture.

ANS: C

What is an important nursing consideration when a child is hospitalized for chelation therapy to treat lead poisoning? Maintain bed rest. Maintain isolation precautions. Keep an accurate record of intake and output. Institute measures to prevent skeletal fracture.

ANS: C

What is most descriptive of atopic dermatitis (AD) (eczema) in an infant? Easily cured Worse in humid climates Associated with cow's milk allergy Related to upper respiratory tract infections

ANS: C

What is most descriptive of atopic dermatitis (AD) (eczema) in an infant? Easily cured Worse in humid climates Associated with hereditary allergies Related to upper respiratory tract infections

ANS: C

What is the primary objective of care for the child with minimal change nephrotic syndrome (MCNS)? Reduce blood pressure. Lower serum protein levels. Minimize excretion of urinary protein. Increase the ability of tissue to retain fluid.

ANS: C

What is the recommended first line treatment for attention deficit hyperactivity disorder (ADHD)? a. Medication regimen b. Family counseling c. Behavioral therapy d. Psychotherapy

ANS: C

What medication used to treat heart failure (HF) is a diuretic? Captopril (Capten) Digoxin (Lanoxin) Hydrochlorothiazide (Diuril) Carvedilol (Coreg)

ANS: C

What signals the resolution of the Oedipus or Electra complex? Learns sex differences. Learns sexually appropriate behavior. Identifies with the same-sex parent. Has guilt over feelings toward the father or mother.

ANS: C

What statement best describes Duchenne (pseudohypertrophic) muscular dystrophy (DMD)? It has an autosomal dominant inheritance pattern. Onset occurs in later childhood and adolescence. It is characterized by presence of Gower sign, a waddling gait, and lordosis. Disease stabilizes during adolescence, allowing for life expectancy to approximately age 40 years.

ANS: C

What statement is most accurate in describing tetanus? Inflammatory disease that causes extreme, localized muscle spasm. Disease affecting the salivary gland with resultant stiffness of the jaw. Acute infectious disease caused by an exotoxin produced by an anaerobic spore-forming, gram- positive bacillus. Acute infection that causes meningeal inflammation resulting in symptoms of generalized muscle spasm.

ANS: C

When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation? Anorexia Bradycardia Sudden relief from pain Decreased abdominal distention

ANS: C

When caring for a neonate in a radiant warmer, what should the nurse be alert to? Exposure to prolonged cold stress. Need for Plexiglas shields to protect the infant. Transepidermal water loss leading to dehydration. Increased risk of infection from the open environment.

ANS: C

When doing a nutritional assessment on a Hispanic family, the nurse learns that their diet consists mainly of vegetables, legumes, and starches. The nurse should recognize that this diet is which? Lacking in protein Indicating they live in poverty Providing sufficient amino acids d. Needing enrichment with meat and milk

ANS: C

Which is true regarding an infant's kidney function? Conservation of fluid and electrolytes occurs. Urine has color and odor similar to the urine of adults. A functional deficiency in the ability to concentrate urine. Normally, urination does not occur until 24 hr after delivery.

ANS: C

Which is true regarding an infants kidney function? Conservation of fluid and electrolytes occurs. Urine has color and odor similar to the urine of adults. The ability to concentrate urine is less than that of adults. Normally, urination does not occur until 24 hours after delivery.

ANS: C

With the National Center for Health Statistics criteria, which body mass index (BMI)-for-age percentiles should indicate the patient is at risk for being overweight? 10th percentile 75th percentile 85th percentile 95th percentile

ANS: C

With the National Center for Health Statistics criteria, which body mass index (BMI)for-age percentiles should indicate the patient is at risk for being overweight? 10th percentile 75th percentile 85th percentile d. 95th percentile

ANS: C

hat behavior is the nurse most likely to assess in an adolescent with anorexia nervosa (AN)? Eats in secrecy Uses food as a coping mechanism Has a marked preoccupation with food Lacks awareness of how eating affects weight loss

ANS: C

he nurse understands that which occurring soon after birth can indicate cystic fibrosis? Murmur Hypoglycemia Meconium ileus Muscle weakness

ANS: C

What are characteristics of late adolescence (1820 years) with regard to sexuality? (Select all that apply.) Exploration of self-appeal Limited dating, usually group Intimacy involves commitment Growing capacity for mutuality and reciprocity May publicly identify as gay, lesbian, or bisexual

ANS: C, D, E

The nurse is preparing to admit a 7-year-old child with focal seizures without impaired awareness, (formerly complex partial seizures). What clinical features of complex partial seizures should the nurse recognize? (Select all that apply.) They last less than 10 seconds. There is usually no aura. Mental disorientation is common. There is frequently a postictal state. There is usually an impaired consciousness.

ANS: C,D,E

What are characteristics of late adolescence (18 to 20 years) with regard to sexuality? (Select all that apply.) Exploration of "self-appeal" Limited dating, usually group Intimacy involves commitment Growing capacity for mutuality and reciprocity May publicly identify as gay, lesbian, or bisexual

ANS: C,D,E

What are risk factors for sudden infant death syndrome? (Select all that apply.) Postterm Female gender Low Apgar scores Recent viral illness Native American infants

ANS: C,D,E

Which are components of the FLACC scale? (Select all that apply.) Color Capillary refill time Leg position Facial expression Activity

ANS: C,D,E

A 12-year-old child is injured in a bicycle accident. When considering the possibility of renal trauma, the nurse should consider what factor? Flank pain rarely occurs in children with renal injuries. Few nonpenetrating injuries cause renal trauma in children. Kidneys are immobile, well protected, and rarely injured in children. The amount of hematuria is not a reliable indicator of the seriousness of renal injury.

ANS: D

A 6-month-old infant presents to the clinic with failure to thrive, a history of frequent respiratory infections, and increasing exhaustion during feedings. On physical examination, a systolic murmur is detected, no central cyanosis, and chest radiography reveals cardiomegaly. An echocardiogram is idone that shows left-to-right shunting. This assessment data is characteristic of what? a. Tetralogy of Fallot b. Coarctation c. Pulmonary stenosis d. Ventricular septal defect

ANS: D

A child eats some sugar cubes after experiencing symptoms of hypoglycemia. This rapid- releasing sugar should be followed by which dietary intervention? Sports drink and fruit Glucose tabs and protein Glass of water and crackers Milk and peanut butter on bread

ANS: D

A child is admitted for minimal change nephrotic syndrome (MCNS). The nurse recognizes that the childs prognosis is related to what factor? Admission blood pressure Creatinine clearance Amount of protein in urine Response to steroid therapy

ANS: D

A child is admitted with extensive burns. The nurse notes burns on the child's lips and singed nasal hairs. The nurse should suspect what condition in the child? A chemical burn A hot-water scald An electrical burn An inhalation injury

ANS: D

A child with pyloric stenosis is having excessive vomiting. The nurse should assess for what potential complication? Hyperkalemia Hyperchloremia Metabolic acidosis Metabolic alkalosis

ANS: D

A mother tells the nurse that she does not want her infant immunized because of the discomfort associated with injections. What should the nurse explain? This cannot be prevented. Infants do not feel pain as adults do. This is not a good reason for refusing immunizations. A topical anesthetic can be applied before injections are given.

ANS: D

A preterm infant has just been admitted to the neonatal intensive care unit and will undergo numerous painful procedures. The infant's parents ask the nurse about pain in the neonate and further asked about anesthesia for these procedures. What should the nurse's explanation be? Nerve pathways of neonates are not sufficiently myelinated to transmit painful stimuli. The risks accompanying anesthesia and analgesia are too great to justify any possible benefit of pain relief. Neonates do not possess sufficiently integrated cortical function to interpret or recall pain experiences. Pain pathways and neurochemical systems associated with pain transmission are intact and functional in neonates and should be considered when giving care.

ANS: D

A quantitative sweat chloride test has been done on an 8-month-old child. What value should be indicative of cystic fibrosis (CF)? Less than 18 mEq/L 18 to 40 mEq/L 40 to 60 mEq/L Greater than 60 mEq/L

ANS: D

A woman who is 6 weeks pregnant tells the nurse that she is worried that, even though she is taking folic acid supplements, the baby might have spina bifida because of a family history. The nurse's response should be based on what? Prenatal detection is not possible yet. There is no genetic basis for the defect. Chromosome studies done on amniotic fluid can diagnose the defect prenatally. Open neural tube defects (NTDs) result in elevated concentrations of alpha-fetoprotein in amniotic fluid.

ANS: D

According to Piaget, adolescents tend to be in what stage of cognitive development? Concrete operations Conventional thought Postconventional thought Formal operational thought

ANS: D

Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is the best explanation for this? They tend to be immature. They do not need to use reasoned decision making. They lack cognitive skills to use reasoned decision making. They are dealing with various stressors.

ANS: D

An 8-year-old girl is receiving a blood transfusion when the nurse notes that she has developed precordial pain, dyspnea, distended neck veins, slight cyanosis, and a dry cough. These manifestations are most suggestive of what complication? a. Air embolism b. Allergic reaction c. Hemolytic reaction d. Circulatory overload

ANS: D

An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurse's response should be based on which knowledge? Most activities such as Girl Scouts cannot be adapted for children with CP. After-school activities usually result in extreme fatigue for children with CP. Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP. Recreational activities often provide children with CP with opportunities for socialization and recreation.

ANS: D

An 8-year-old girl with moderate cerebral palsy (CP) recently began joining a regular classroom for part of the day. Her mother asks the school nurse about joining the after-school Girl Scout troop. The nurses response should be based on which knowledge? a. Most activities such as Girl Scouts cannot be adapted for children with CP. After-school activities usually result in extreme fatigue for children with CP. Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP . Recreational activities often provide children with CP with opportunities for socialization and recreation.

ANS: D

An adolescent girl asks the school nurse for advice because she has dysmenorrhea. She says that a friend recommended she try an over-the-counter nonsteroidal anti-inflammatory drug (NSAID). The nurse's response should be based on what? Hormone therapy is necessary for the treatment of dysmenorrhea. Acetaminophen is the drug of choice for the treatment of dysmenorrhea. Over-the-counter NSAIDs are rarely strong enough to provide adequate pain relief. NSAIDs are effective because they inhibit prostaglandins, leading to reduction in uterine activity.

ANS: D

An adolescent girl calls the nurse at the clinic because she had unprotected sex the night before and does not want to be pregnant. What should the nurse explain? It is too late to prevent an unwanted pregnancy. An abortion may be the best option if she is pregnant. The risk of pregnancy is minimal, so no action is necessary. Postcoital contraception is available to prevent implantation and therefore pregnancy.

ANS: D

At a seminar for parents with preschool-age children, the nurse has discussed anticipatory tasks during the preschool years. Which statement by a parent should indicate a correct understanding of the teaching? "I should be worried if my 4-year-old child has an increase in sexual curiosity because this is a sign of sexual abuse." "I should expect my 5-year-old to change from a tranquil child to an aggressive child when school starts." "I should be concerned if my 4-year-old child starts telling exaggerated stories and has an imaginary playmate, since these could be signs of stress." "I should expect my 3-year-old child to have a more stable appetite and an increase in food selections."

ANS: D

At a seminar for parents with preschool-age children, the nurse has discussed anticipatory tasks during the preschool years. Which statement by a parent should indicate a correct understanding of the teaching? I should be worried if my 4-year-old child has an increase in sexual curiosity because this is a sign of sexual abuse. I should expect my 5-year-old to change from a tranquil child to an aggressive child when school starts. I should be concerned if my 4-year-old child starts telling exaggerated stories and has an imaginary playmate, since these could be signs of stress. I should expect my 3-year-old child to have a more stable appetite and an increase in food selections.

ANS: D

During the preschool period, the emphasis of injury prevention should be placed on what? Limitation of physical activities Punishment for unsafe behaviors Constant vigilance and protection Teaching about safety and potential hazards

ANS: D

During the preschool period, the emphasis of injury prevention should be placed on what? a. Limitation of physical activities b. Punishment for unsafe behaviors c. Constant vigilance and protection d. Teaching about safety and potential hazards

ANS: D

How might the quality of life for a terminally ill child and his family be enhanced by nurses? Tell the family what is best. Leave the family alone to deal with their tragedy. Remain objective and uninvolved with family grieving. Advocate for and implement pain and symptom relief measures.

ANS: D

Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should be included in the child's care? Delay feeding solid foods until the tongue thrust has stopped. Modify the diet as necessary to minimize the diarrhea that often occurs. Provide calories appropriate to the child's mental age. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.

ANS: D

Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should be included in the childs care? Delay feeding solid foods until the tongue thrust has stopped. Modify the diet as necessary to minimize the diarrhea that often occurs. Provide calories appropriate to the childs mental age. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.

ANS: D

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39 C (102.2 F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication? Decongestants to ease stuffy nose Antihistamines to help the child sleep Aspirin for pain and fever management Benzocaine ear drops for topical pain relief

ANS: D

Parents bring their 15-month-old infant to the emergency department at 3:00 AM because the toddler has a temperature of 39° C (102.2° F), is crying inconsolably, and is tugging at the ears. A diagnosis of otitis media (OM) is made. In addition to antibiotic therapy, the nurse practitioner should instruct the parents to use what medication? Decongestants to ease stuffy nose Antihistamines to help the child sleep Aspirin for pain and fever management Benzocaine ear drops for topical pain relief

ANS: D

Parents of a child with hemophilia A ask the nurse, "What is the deficiency with this disorder?" Which correct response should the nurse make? "Hemophilia A has a deficiency in red blood cells." "Hemophilia A has a deficiency in platelets." "Hemophilia A has a deficiency in factor IX." "Hemophilia A has a deficiency in factor VIII."

ANS: D

Parents of an infant born at 36 weeks of gestation ask the nurse, "Will our infant need a car seat trial before being discharged?" What is the nurse's best response? "Yes, to see if the car seat is the appropriate size." "Yes, to determine if blanket rolls will be needed." "No, your infant was old enough at birth to not need a trial." "Yes, to monitor for possible apnea and bradycardia while in the seat."

ANS: D

Secondary prevention for cognitive impairment includes what activity? a. Genetic counseling b. Avoidance of prenatal rubella infection c. Preschool education and counseling services d. Newborn screening for treatable inborn errors of metabolism

ANS: D

The mother of a 1-month-old infant tells the nurse she worries that her baby will get meningitis like the childs younger brother had when he was an infant. The nurse should base a response on which information? Meningitis rarely occurs during infancy. Often a genetic predisposition to meningitis is found. Vaccination to prevent all types of meningitis is now available. Vaccinations to prevent pneumococcal and Haemophilus influenzae type B meningitis are available.

ANS: D

The nurse is administering an oral antihistamine at bedtime to a child with atopic dermatitis (eczema). Which antihistamine should the nurse expect to be prescribed at bedtime? Cetirizine (Zyrtec) Loratadine (Claritin) Fexofenadine (Allegra) Diphenhydramine (Benadryl)

ANS: D

The nurse is administering the first hepatitis A vaccine to an 18-month-old child. When should the child return to the clinic for the second dose of hepatitis A vaccination? After 2 months After 3 months After 4 months After 6 months

ANS: D

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition? Posturing Vital signs Focal neurologic signs Level of consciousness

ANS: D

The nurse is assessing a child who was just admitted to the hospital for observation after a head injury. What clinical manifestation is the most essential part of the nursing assessment to detect early signs of a worsening condition? a. Posturing Vital signs Focal neurologic signs Level of consciousness

ANS: D

The nurse is assisting the family of a child with a history of encopresis. What should be included in the nurse's discussion with the family? Instruct the parents to sit the child on the toilet at twice-daily routine intervals. Instruct the parents that the child will probably need to have daily enemas. Suggest the use of stimulant cathartics weekly. Reassure the family that most problems are resolved successfully, with some relapses during periods of stress.

ANS: D

The nurse is caring for a newborn with Erb palsy. The nurse understands that which reflex is absent with this condition? Root reflex Suck reflex Grasp reflex Moro reflex

ANS: D

The nurse is discussing long-term care with the parents of a child who has a ventriculoperitoneal shunt. What issues should be addressed? Most childhood activities must be restricted. Cognitive impairment is to be expected with hydrocephalus. Wearing head protection is essential until the child reaches adulthood. Shunt malfunction or infection requires immediate treatment.

ANS: D

The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in their particular diet? Fat Protein Vitamins C and A Iron and calcium

ANS: D

The nurse is helping parents achieve a more nutritionally adequate vegetarian diet for their children. Which is most likely lacking in this diet? Fat Protein Vitamins C and A Iron and calcium

ANS: D

The nurse is interviewing the parents of a 4-month-old boy brought to the hospital emergency department. The infant is dead, and no attempt at resuscitation is made. The parents state that the baby was found in his crib with a blanket over his head, lying face down in bloody fluid from his nose and mouth. The nurse might initially suspect his death was caused by what? Suffocation Child abuse Infantile apnea Sudden infant death syndrome (SIDS)

ANS: D

The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? Less expensive than oral medications Produces a first-pass effect through the liver Does not need to be administered frequently Provides most rapid onset of effect, usually in about 5 minutes

ANS: D

The nurse is planning pain control for a child. Which is the advantage of administering pain medication by the intravenous (IV) bolus route? Less expensive than oral medications. Produces a first-pass effect through the liver. Does not need to be administered frequently. Provides most rapid onset of effect, usually in about 5 minutes.

ANS: D

The nurse is preparing a community outreach program about the prevention of iron-deficiency anemia in infants. What statement should the nurse include in the program? a. Whole milk can be introduced into the infant's diet in small amounts at 6 months. b. Iron supplements cannot be given until the infant is older than 1 year of age. c. Iron-fortified cereal should be introduced to the infant at 2 months of age. d. Breast milk or iron-fortified formula should be used for the first 12 months.

ANS: D

The nurse is preparing a pamphlet for parents of adolescents about guidance during the adolescent years. What suggestion should the nurse include in the pamphlet? Provide criticism when mistakes are made or when views are different. Use comparisons with older siblings or extended family to promote good outcomes. Begin to disengage from school functions to allow the adolescent to gain independence. Provide clear, reasonable limits and define consequences when rules are broken.

ANS: D

The nurse is preparing a pamphlet for parents of adolescents about guidance during the adolescent years. What suggestion should the nurse include in the pamphlet? a. Provide criticism when mistakes are made or when views are different. b. Use comparisons with older siblings or extended family to promote good outcomes. c. Begin to disengage from school functions to allow the adolescent to gain independence. d. Provide clear, reasonable limits and define consequences when rules are broken.

ANS: D

The nurse is preparing to administer a unit of packed red blood cells to a hospitalized child. What is an appropriate action that applies to administering blood? a. Take the vital signs every 15 minutes while blood is infusing. Use blood within 1 hr of its arrival from the blood bank. Administer the blood with 5% glucose in a piggyback setup. Administer the first 50 ml of blood slowly and stay with the child.

ANS: D

The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching? "With minimal sedation, the patient's respiratory efforts are affected, and cognitive function is not impaired." "With general anesthesia, the patient's airway cannot be maintained, but cardiovascular function is maintained." "During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation." "During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation."

ANS: D

The nurse is teaching a staff development program about levels of sedation in the pediatric population. Which statement by one of the participants should indicate a correct understanding of the teaching? With minimal sedation, the patients respiratory efforts are affected, and cognitive function is not impaired. With general anesthesia, the patients airway cannot be maintained, but cardiovascular function is maintained. During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation. During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation.

ANS: D

The nurse should instruct parents to administer a daily proton pump inhibitor to their child with gastroesophageal reflux at which time? a. Bedtime With a meal Midmorning 30 minutes before breakfast

ANS: D

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurse's response should be based on which knowledge? It is a safe, frequently used drug. Parents lack the expertise necessary to administer digoxin. It is difficult to either overmedicate or undermedicate with digoxin. Parents need to learn specific, important guidelines for administration of digoxin.

ANS: D

The parents of a young child with heart failure (HF) tell the nurse that they are nervous about giving digoxin. The nurses response should be based on which knowledge? It is a safe, frequently used drug. Parents lack the expertise necessary to administer digoxin. It is difficult to either overmedicate or undermedicate with digoxin. Parents need to learn specific, important guidelines for administration of digoxin.

ANS: D

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes what intervention? Place a cool compress on eye during transport to the emergency department. Irrigate the eye copiously with a sterile saline solution. Remove the object with a lightly moistened gauze pad. Apply a Fox shield to the affected eye and any type of patch to the other eye.

ANS: D

The school nurse is teaching a class on injury prevention. What should be included when discussing firearms? a. Adolescents are too young to use guns properly for hunting. Gun carrying among adolescents is on the rise, primarily among inner-city youth. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns. Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm.

ANS: D

The school nurse is teaching a class on injury prevention. What should be included when discussing firearms? a. Adolescents are too young to use guns properly for hunting.b. Gun carrying among adolescents is on the rise, primarily among inner-city youth.c. Nonpowder guns (air rifles, BB guns) are a relatively safe alternative to powder guns. Adolescence is the peak age for being a victim or offender in the case of injury involving a d. firearm.

ANS: D

What clinical manifestation occurs with hypoglycemia? Lethargy Confusion Nausea and vomiting Weakness and dizziness

ANS: D

What clinical manifestation should be the most suggestive of acute appendicitis? a. Rebound tenderness b. Bright red or dark red rectal bleeding c. Abdominal pain that is relieved by eating d. Colicky, cramping, abdominal pain around the umbilicus

ANS: D

What is a characteristic of most neonatal seizures? Clonic Generalized Well organized Subtle and barely discernible

ANS: D

What is a major goal of therapy for children with cerebral palsy (CP)? Cure the underlying defect causing the disorder. Reverse the degenerative processes that have occurred. Prevent the spread to individuals in close contact with the child. Recognize the disorder early and promote optimum development.

ANS: D

What is an important consideration in the diagnosis of attention deficit hyperactivity disorder (ADHD)? Learning disabilities are apparent at an early age. The child will always be distracted by external stimuli. Parental observations of the child's behavior are most relevant. It must be determined whether the child's behavior is age appropriate or problematic.

ANS: D

What is probably the most important criterion on which to base the decision to report suspected child abuse? Inappropriate response of child Inappropriate parental concern for the degree of injury Absence of parents for questioning about child's injuries Incompatibility between the history and injury observed

ANS: D

What is probably the most important criterion on which to base the decision to report suspected child abuse? Inappropriate response of child Inappropriate parental concern for the degree of injury Absence of parents for questioning about childs injuries Incompatibility between the history and injury observed

ANS: D

What is the most common cause of cerebral palsy (CP)? Central nervous system (CNS) diseases Birth asphyxia Cerebral trauma Neonatal encephalopathy

ANS: D

What is the most common type of burn in the toddler age-group? Electric burn from electrical outlets Flame burn from playing with matches Hot object burns from cigarettes or irons Scald burn from high-temperature tap water

ANS: D

What laboratory finding, in conjunction with the presenting symptoms, indicates minimal change nephrotic syndrome? Low specific gravity Decreased hemoglobin Normal platelet count Reduced serum albumin

ANS: D

What nutritional component should be altered in the infant with heart failure (HF)? Decrease in fats Increase in fluids Decrease in protein Increase in calories

ANS: D

What recommendation should the nurse make to prevent urinary tract infections (UTIs) in 7- year-old child weighing 25 kg? Ensure clear liquid intake of 2000 mL/day. Ensure clear liquid intake of 2400 mL/day. Ensure clear liquid intake of 1200 mL/day. Ensure clear liquid intake of 1600 mL/day.

ANS: D

What recommendation should the nurse make to prevent urinary tract infections (UTIs) in young girls? Avoid public toilet facilities. Limit long baths as much as possible. Cleanse the perineum with water after voiding. Ensure clear liquid intake of 2 L/day.

ANS: D

What should the nurse suggest to parents of preschoolers about sensitive questions regarding sex? Distract your child from the topic. Offer complete and information. Dismiss the topic until the child is older. Find out what your child knows or thinks.

ANS: D

What statement best describes iron deficiency anemia in infants? It is caused by depression of the hematopoietic system. Diagnosis is easily made because of the infants emaciated appearance. It results from a decreased intake of milk and the premature addition of solid foods. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.

ANS: D

What statement best describes iron-deficiency anemia in infants? It is caused by depression of the hematopoietic system. Diagnosis is easily made because of the infant's emaciated appearance. It results from a decreased intake of milk and the preterm addition of solid foods. Clinical manifestations are related to a reduction in the amount of oxygen available to tissues.

ANS: D

What therapeutic intervention is most appropriate for a child with b-thalassemia major? Oxygen therapy Supplemental iron Adequate hydration Frequent blood transfusions

ANS: D

When caring for the child with Kawasaki disease, what should the nurse know to provide safe and effective care? a. Aspirin is contraindicated. b. The principal area of involvement is the joints c. The child's fever is usually responsive to antibiotics within 48 hr. d. Therapeutic management includes administration of gamma globulin and salicylates.

ANS: D

When only one child is abused in a family, the abuse is usually a result of what? The child is the firstborn. The child is the same gender as the abusing parent. The parent abuses the child to avoid showing favoritism. The parent is unable to deal with the childs behavioral style.

ANS: D

Which nonpharmacologic intervention appears to be effective in decreasing needlestick pain? Tactile stimulation Commercial warm packs Doing procedure during infant sleep Oral sucrose or breastfeeding

ANS: D

What dietary instructions should the nurse give to parents of a child in the oliguria phase of acute glomerulonephritis with edema and hypertension? (Select all that apply.) High-fat Low-protein Encouragement of fluids Moderate sodium restriction Limit foods high in potassium

ANS: D,E

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