Peds Final

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A child with acute gastrointestinal bleeding is admitted to the hospital. The nurse observes which sign or symptom as an early manifestation of shock? A.) Restlessness B.) Rapid capillary refill C.) Increased temperature D.) Increased blood pressure

During which phase of separation anxiety is a toddler most likely to cling to the parent? A.) Protest B.) Inactivity C.) Depression D.) Regression to earlier behavior

Parents of a hospitalized child often question the skill of staff. The nurse interprets this behavior by the parents as what? A.) Normal B.) Paranoid C.) Indifferent D.) Wanting attention

The type of play in which infants engage is called: A.) Solitary B.) Parallel C.) Associative D.) Cooperative

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): A.) Fever B.) Vomiting C.) Tachycardia D.) Flushed face E.) Hyperactive bowel sounds

A, B, C

The nurse is caring for a 12-year-old child with b-thalassemia. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Anorexia B.) Unexplained fever C.) Enlarged spleen or liver D.) Bronzed, freckled complexion E.) Precocious sexual development

A, B, C, D

Which describe the feelings and behaviors of early preschool children related to divorce (select all that apply): A.) Regressive behavior B.) Fear of abandonment C.) Fear regarding the future D.) Blame themselves for the divorce E.) Intense desire for reconciliation of parents

A, B, D

The nurse is teaching parents about foods that are hyperallergenic. Which foods should the nurse include (select all that apply): A.) Peanuts B.) Bananas C.) Potatoes D.) Egg noodles E.) Tomato juice

A, D, E

A young child with human immunodeficiency virus (HIV) is receiving several antiretroviral drugs. What is the purpose of these drugs? A.) Cure the disease B.) Delay disease progression C.) Prevent spread of infection D.) Treat Pneumocystis carinii pneumonia

At which age should the nurse expect an infant to begin smiling in response to pleasurable stimuli? A.) 1 month B.) 2 months C.) 3 months D.) 4 months

Pertussis vaccination should begin at which age? A.) Birth B.) 2 months C.) 6 months D.) 12 months

The nurse is assessing a toddlers visual acuity. Which visual acuity is considered acceptable during the toddler years? A.) 20/20 B.) 20/40 C.) 20/50 D.) 20/60

What type of dehydration occurs when the electrolyte deficit exceeds the water deficit? A.) Isotonic dehydration B.) Hypotonic dehydration C.) Hypertonic dehydration D.) Hyperosmotic dehydration

Which type of family should the nurse recognize when a mother, her children, and a stepfather live together? A.) Traditional nuclear B.) Blended C.) Extended D.) Binuclear

The nurse is preparing to admit a 7-year-old child with an upper motor neuron syndrome. What clinical manifestations of an upper motor neuron syndrome should the nurse expect to observe (select all that apply): A.) No flexor spasms B.) Babinski reflex present C.) No wasting of muscle mass D.) Marked atrophy of atonic muscle E.) Hyperreflexia with tendon reflexes exaggerated

B, C, E

A nurse is providing education to a community center prenatal class. Which cause would the nurse identify as risk factors for infant death (select all that apply): A.) Female gender B.) Low birth weight C.) Native American race D.) Short gestation period E.) Lower level of maternal education

B, D, E

A 1-year-old child is on a pure vegetarian (vegan) diet. This diet requires supplementation with what? A.) Niacin B.) Folic acid C.) Vitamins D and B12 D.) Vitamins C and E

A 3-year-old child woke up in the middle of the night with a croupy cough and inspiratory stridor. The parents bring the child to the emergency department, but by the time they arrive, the cough is gone, and the stridor has resolved. What can the nurse teach the parents with regard to this type of croup? A.) A bath in tepid water can help resolve this type of croup B.) Tylenol can help to relieve the cough and stridor C.) A cool mist vaporizer at the bedside can help prevent this type of croup D.) Antibiotics need to be given to reduce the inflammation

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

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

After returning from cardiac catheterization, the nurse monitors the child's vital signs. The heart rate should be counted for how many seconds? A.) 15 B.) 30 C.) 60 D.) 120

An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is which? A.) Ask her why she wants to know B.) Determine why she is so anxious C.) Explain in simple terms how it works D.) Tell her she will see how it works as it is used

An important nutritional supplement recommended to prevent rickets in infants who are exclusively breastfeeding: A.) Vitamin A B.) Flouride C.) Vitamin D D.) Folic acid

At which age can most infants sit steadily unsupported? A.) 4 months B.) 6 months C.) 8 months D.) 12 months

At which age do most children have an adult concept of death as being inevitable, universal, and irreversible? A.) 4 to 5 years B.) 6 to 8 years C.) 9 to 11 years D.) 12 to 16 years

In boys, what is the initial indication of puberty? A.) Voice changes B.) Growth of pubic hair C.) Testicular enlargement D.) Increased size of penis

Physiologically, the child compensates for fluid volume losses by which mechanism? A.) Inhibition of aldosterone secretion B.) Hemoconcentration to reduce cardiac workload C.) Fluid shift from interstitial space to intravascular space D.) Vasodilation of peripheral arterioles to increase perfusion

The nurse understands that a school-age child may react to death with what reaction? A.) Joking B.) Having no reaction C.) Fearing the unknown D.) Seeing it as a distant event

The parents of a child who has just been diagnosed with type 1 diabetes ask about exercise. What effect does exercise have on a type 1 diabetic? A.) Exercise increases blood glucose B.) Extra insulin is required during exercise C.) Additional snacks are needed before exercise D.) Excessive physical activity should be restricted

What diet is most appropriate for the child with chronic renal failure (CRF)? A.) Low in protein B.) Low in vitamin D C.) Low in phosphorus D.) Supplemented with vitamins A, E, and K

What is a significant common side effect that occurs with opioid administration? A.) Euphoria B.) Diuresis C.) Constipation D.) Allergic reactions

What is an appropriate screening test for hearing that the nurse can administer to a 5-year-old child? A.) Rinne test B.) Weber test C.) Pure tone audiometry D.) Eliciting the startle reflex

What statement is characteristic of type 1 diabetes mellitus? A.) Onset is usually gradual B.) Ketoacidosis is infrequent. C.) Peak age incidence is 10 to 15 years D.) Oral agents are available for treatment

A child with hemophilia A will have which abnormal laboratory result? A.) PT (ProTime) B.) Platelet count C.) Fibrinogen level D.) PTT (partial thromboplastin time)

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

Parents are considering treatment options for their 5-year-old child with Legg-Calv-Perthes disease. Both surgical and conservative therapies are appropriate. They are able to verbalize the differences between the therapies when they make what statement? A.) All therapies require extended periods of bed rest B.) Conservative therapy will be required until puberty C.) Our child cannot attend school during the treatment phase D.) Surgical correction requires a 3- to 4-month recovery period

Parents ask the nurse for strategies to help their toddler adjust to a new baby. What should the nurse suggest? A.) Start talking about the baby very early in the pregnancy B.) Move the toddler to a new bed after the baby comes home C.) Tell the toddler that a new playmate will be coming home soon D.) Alert visitors to the new baby to include the toddler in the visit

Postoperative positioning for a child who has had a medulloblastoma brain tumor (infratentorial) removed should be which? A.) Trendelenburg B.) Head of bed elevated above heart level C.) Flat on operative side with pillows behind the head D.) Flat, on either side with pillows behind the back

Rickets is caused by a deficiency in what? A.) Vitamin A B.) Vitamin C C.) Folic acid and iron D.) Vitamin D and calcium

Several nurses tell their nursing supervisor that they want to attend the funeral of a child for whom they had cared. They say they felt especially close to both the child and the family. The supervisor should recognize that attending the funeral serves what purpose? A.) It is improper because it increases burnout B.) It is inappropriate because it is unprofessional C.) It is proper because families expect this expression of concern D.) It is appropriate because it can assist in the resolution of personal grief

The clinic nurse is evaluating lab results for a child. What recorded hemoglobin (Hgb) result is considered within the normal range? A.) 9 g/dL B.) 10 g/L C.) 11 g/dL D.) 12 g/dL

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? A.) Cetirizine (Zyrtec) B.) Loratadine (Claritin) C.) Fexofenadine (Allegra) D.) Diphenhydramine (Benadryl)

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? A.) After 2 months B.) After 3 months C.) After 4 months D.) After 6 months

The nurse is caring for an adolescent who has just started dialysis. The child always seems angry, hostile, or depressed. The nurse should recognize that this is most likely related to what underlying cause? A.) Physiologic manifestations of renal disease B.) The fact that adolescents have few coping mechanisms C.) Neurologic manifestations that occur with dialysis D.) Resentment of the control and enforced dependence imposed by dialysis

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? A.) With minimal sedation, the patient's respiratory efforts are affected, and cognitive function is not impaired B.) With general anesthesia, the patient's airway cannot be maintained, but cardiovascular function is maintained C.) During deep sedation, the patient can be easily aroused by loud verbal commands and tactile stimulation D.) During moderate sedation, the patient responds to verbal commands but may not respond to light tactile stimulation

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

The parents of a 12-month-old child ask the nurse if the child can eat hot dogs as do their other children. The nurses reply should be based on what? A.) The child is too young to digest hot dogs B.) The child is too young to eat hot dogs safely C.) Hot dogs must be sliced into sections to prevent aspiration D.) Hot dogs must be cut into small, irregular pieces to prevent aspiration

The physician suggests that surgery be performed for patent ductus arteriosus (PDA) to prevent which complication? A.) Hypoxemia B.) Right-to-left shunt of blood C.) Decreased workload on the left side of the heart D.) Pulmonary vascular congestion

What condition precipitates polycythemia? A.) Dehydration B.) Severe infections C.) Immunosuppression D.) Prolonged tissue hypoxia

What is the role of the peer group in the life of school-age children? A.) Decreases their need to learn appropriate sex roles B.) Gives them an opportunity to learn dominance and hostility C.) Allows them to remain dependent on their parents for a longer time D.) Provides them with security as they gain independence from their parents

What is true concerning the development of autonomy during adolescence? A.) Development of autonomy typically involves rebellion B.) Development of autonomy typically involves parent-child conflicts C.) Parent and peer influences are opposing forces in the development of autonomy D.) Conformity to both parents and peers gradually declines toward the end of adolescence

What lab value should a nurse expect from a child with Tetralogy of Fallot? A.) Increased platelet level B.) Leukopenia C.) Anemia D.) Polycythemia

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

What nursing consideration is important when suctioning a young child who has had heart surgery? A.) Perform suctioning at least every hour B.) Suction for no longer than 30 seconds at a time C.) Expect symptoms of respiratory distress when suctioning D.) Administer supplemental oxygen before and after suctioning

Which characteristic best describes the fine motor skills of an infant at age 5 months? A.) Neat pincer grasp B.) Strong grasp reflex C.) Builds a tower of two cubes D.) Able to grasp object voluntarily

Which characteristic best describes the gross motor skills of a 24-month-old child? A.) Skips B.) Broad jumps C.) Rides tricycle D.) Walks up and down stairs

Which condition is appropriate for the child who usually plays alone, does not maintain eye contact, repeatedly twists fingers, has inadequate speech and does not interact with gestures? A.) Glaucoma B.) Down syndrome C.) Hearing impairment D.) Autism spectrum disorder (ASD)

Which is an accurate description of homosexual (or gay-lesbian) families? A.) A nurturing environment is lacking B.) The children become homosexual like their parents C.) The stability needed to raise healthy children is lacking D.) The quality of parenting is equivalent to that of non-gay parents

A 1-year-old child has acute otitis media (AOM) and is being treated with oral antibiotics. What should the nurse include in the discharge teaching to the infants parents? A.) A follow-up visit should be done after all medicine has been given B.) After an episode of acute otitis media, hearing loss usually occurs C.) Tylenol should not be given because it may mask symptoms D.) The infant will probably need a myringotomy procedure and tubes

A 2-year-old child has a chronic history of constipation and is brought to the clinic for evaluation. What should the therapeutic plan initially include? A.) Bowel cleansing B.) Dietary modification C.) Structured toilet training D.) Behavior modification

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

A child has been admitted with status epilepticus. An emergency medication has been ordered. What medication should the nurse expect to be prescribed? A.) Lorazepam (Ativan) B.) Phenytoin (Dilantin) C.) Topiramate (Topamax) D.) Ethosuximide (Zarontin)

A child's parents ask the nurse many questions about their child's illness and its management. The nurse does not know enough to answer all the questions. What nursing action is most appropriate at this time? A.) Tell them, I don't know, but I will find out B.) Suggest that they ask the physician these questions C.) Explain that the nurse cannot be expected to know everything D.) Answer questions vaguely so they do not lose confidence in the nurse

The nurse is giving discharge instructions to the parents of a 5-year-old child who had a tonsillectomy 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? A.) I can use an ice collar on my child for pain control along with analgesics B.) My child should clear the throat frequently to clear the secretions C.) I should allow my child to be as active as tolerated D.) My child should gargle and brush teeth at least three times per day

The nurse is teaching parents about avoiding accidental burns with their toddler. What water heater setting should the nurse recommend to the parents? A.) 120 F B.) 130 F C.) 140 F D.) 150 F

What intervention is contraindicated in a suspected case of appendicitis? A.) Enemas B.) Palpating the abdomen C.) Administration of antibiotics D.) Administration of antipyretics for fever

An adolescent is being placed on a beta-blocker. What should the nurse inform the adolescent with regard to this medication (select all that apply): A.) Medication may cause fatigue B.) Side effects may include impotence C.) Side effects may include bradycardia D.) Take the medication 1 hour before meals E.) Side effects may include peripheral edema

A, B, C

What are signs and symptoms of anemia (select all that apply): A.) Pallor B.) Fatigue C.) Dilute urine D.) Bradycardia E.) Muscle weakness

A, B, E

The nurse is presenting a staff development program about understanding culture in the health care encounter. Which components should the nurse include in the program (select all that apply): A.) Cultural humility B.) Cultural research C.) Cultural sensitivity D.) Cultural competency

A, C, D

A tonsillectomy or adenoidectomy is contraindicated in what conditions (select all that apply): A.) Cleft palate B.) Seizure disorders C.) Blood dyscrasias D.) Sickle cell disease E.) Acute infection at the time of surgery

A, C, E

Which coanalgesics should the nurse expect to be prescribed for pruritus (select all that apply): A.) Naloxone (Narcan) B.) Inapsine (Droperidol) C.) Hydroxyzine (Atarax) D.) Promethazine (Phenergan) E.) Diphenhydramine (Benadryl)

A, C, E

A 10-year-old girl needs to have another intravenous (IV) line started. She keeps telling the nurse, "Wait a minute," and, "I'm not ready." How should the nurse interpret this behavior? A.) IV insertions are viewed as punishment B.) This is expected behavior for a school-age child C.) Protesting like this is usually not seen past the preschool years D.) The child has successfully manipulated the nurse in the past

A 12-year-old girl asks the nurse about an increase in clear white odorless vaginal discharge. What response should the nurse give? A.) This may mean a yeast infection. B.) This is normal before menstruation starts. C.) This is caused by an increase in progesterone. D.) This is possibly a sign of a sexually transmitted infection

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? A.) Administer prescribed sedative at night to aid in sleep B.) Negotiate a daily schedule that incorporates hospital routine, therapy, and free time C.) Have the practitioner speak with the child about the need for rest when receiving therapy for CF D.) Arrange a consult with the social worker to determine whether issues at home are interfering with her care

A 16-year-old boy with a chronic illness has recently become rebellious and is taking risks such as missing doses of his medication. What should the nurse explain to his parents? A.) That he needs more discipline B.) That this is a normal part of adolescence C.) That he needs more socialization with peers D.) That this is how he is asking for more parental control

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 B.) 90 beats/min C.) 100 beats/min D.) 120 beats/min

A 3-year-old child has a femoral shaft fracture. The nurse recognizes that the approximate healing time for this child is how long? A.) 2 weeks B.) 4 weeks C.) 6 weeks D.) 8 weeks

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

The nurse is aware that skin turgor best estimates what? A.) Perfusion B.) Adequate hydration C.) Amount of body fat D.) Amount of anemia

The nurse is giving discharge instructions to the parent of a 6-year-old child who had a cardiac catheterization 4 hours ago. What statement by the parent indicates a correct understanding of the teaching? A.) My child should not attend school for the next 5 days B.) I should change the bandage every day for the next 2 days C.) My child can take a tub bath but should avoid taking a shower for the next 4 days D.) I should expect the site to be red and swollen for the next 3 days

The nurse understands which anatomic characteristic predisposes young children to cranial injuries? A.) Small body B.) Large head C.) Hepatomegaly D.) Wide coastal margin

What is a principle of palliative care that can be included in the care of children? A.) Maintenance of curative therapy B.) Child and family as the unit of care C.) Exclusive focus on the spiritual issues the family faces D.) Extensive use of opiates to ensure total pain control

What is an appropriate nursing intervention when caring for a child in traction? A.) Removing adhesive traction straps daily to prevent skin breakdown B.) Assessing for tightness, weakness, or contractures in uninvolved joints and muscles C.) Providing active range of motion exercises to affected extremity three times a day D.) Keeping child prone to maintain good alignment

What is an important consideration for the school nurse who is planning a class on bicycle safety? A.) Most bicycle injuries involve collision with an automobile B.) Head injuries are the major causes of bicycle-related fatalities C.) Children should wear a bicycle helmet if they ride on paved streets D.) Children should not ride double unless the bicycle has an extra large seat

What is the appropriate placement of a tongue blade for assessment of the mouth and throat? A.) On the lower jaw B.) Side of the tongue C.) Against the soft palate D.) Center back area of the tongue

What is true concerning masturbation during adolescence? A.) Homosexuality is encouraged by the practice of masturbation B.) Many girls do not begin masturbation until after they have intercourse C.) Masturbation at an early age leads to sexual intercourse at an earlier age D.) Development of intimate relationships is delayed when masturbation is regularly practiced

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

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

What specific gravity of the urine is desired so that hemorrhagic cystitis is prevented? A.) 1.035 B.) 1.030 C.) 1.025 D.) 1.005

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

The school nurse is explaining to older school children that obesity increases the risk for which disorder (select all that apply): A.) Asthma B.) Hypertension C.) Dyslipidemia D.) Irritable bowel disease E.) Altered glucose metabolism

B, C, E

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? A.) Minimizing environmental stimuli B.) Administering immunoglobulin C.) Monitoring and maintaining systemic blood pressure D.) Discussing long-term care issues with the family

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

During an otoscopic examination on an infant, in which direction is the pinna pulled? A.) Up and back B.) Up and forward C.) Down and back D.) Down and forward

Phenylketonuria is a genetic disease that results in the body's inability to correctly metabolize which? A.) Glucose B.) Thyroxine C.) Phenylalanine D.) Phenylketones

The nurse is teaching a child with a cast about cast removal. What should the nurse teach the child about cast removal? A.) The cast cutter will be a quiet machine B.) You will feel cold as the cast is removed C.) You will feel a tickly sensation as the cast is removed D.) The cast cutter cuts through the cast like a circular saw

The primary nursing goal for the hospitalized child younger than 5 years is to prevent which concern? A.) Discomfort B.) Sleep problems C.) Separation from parents D.) Changes in normal routine

The test that provides the most reliable evidence of recent streptococcal infection is which? A.) Throat culture B.) Mantoux test C.) Antistreptolysin O test D.) Elevation of liver enzymes

What are quick, jerky, grossly uncoordinated, irregular movements that may disappear on relaxation called? A.) Twitching B.) Spasticity C.) Choreiform movements D.) Associated movements

What is a characteristic of a toddlers language development at age 18 months? A.) Vocabulary of 25 words B.) Use of holophrases C.) Increasing level of understanding D.) Approximately one third of speech understandable

Which condition in children is associated with increased levels of entertainment media use? A.) Considerate behavior B.) Delayed sexual activity C.) Unhealthy eating habits D.) Awareness of substance abuse issues

Which nursing action is appropriate when caring for the child who has a eye injury and a freely moving foreign object in the eye over the cornea? A.) Stabilize the object in the eye B.) Irrigate the eye with cold water C.) Remove the moving object with gauze D.) Irrigate the eye of lukewarm water

Which serious reaction should the nurse be alert for when administering vaccines? A.) Fever B.) Skin irritation C.) Allergic reaction D.) Pain at injection site

The nurse is teaching an adolescent with elevated triglycerides foods that should be decreased. What foods should the nurse include in the teaching (select all that apply): A.) Avocados B.) Canola oil C.) White flour D.) White rice E.) Sugary cereals

C, D, E

A 12-year-old boy is in the final phase of dying from leukemia. He tells the nurse who is giving him opiates for pain that his grandfather is waiting for him. How should the nurse interpret this situation? A.) The boy is experiencing side effects of the opiates B.) The boy is making an attempt to comfort his parents C.) He is experiencing hallucinations resulting from brain anoxia D.) He is demonstrating readiness and acceptance that death is near

A child who has just had definitive repair of a high rectal malformation is to be discharged. What should the nurse address in the discharge preparation of this family? A.) Safe administration of daily enemas B.) Necessity of firm stools to keep suture line clean C.) Bowel training beginning as soon as the child returns home D.) Changes in stooling patterns to report to the practitioner

A nurse is delivering a lecture to a group of parents on child health and disease. What is the most common cause of death in children older than one year of age? A.) Obesity B.) Heart disease C.) Type 2 diabetes D.) Motor vehicle accidents

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

At what age will the child best adapt to adoption? A.) One year B.) Seven years C.) Fifteen years D.) Five months

Neuropathic bladder disorders are common among children with which disorder? A.) Plagiocephaly B.) Meningocele C.) Craniosynostosis D.) Myelomeningocele

The developmental task with which the child of 15 to 30 months is likely to be struggling is a sense of which? A.) Trust B.) Initiative C.) Intimacy D.) Autonomy

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

The nurse is providing palliative care for a child who cries when touched and moved. Which is the most appropriate intervention? A.) Avoid massaging the child B.) Making sure the child is awake C.) Avoid changing the child's position D.) Administering analgesia to the child

The nurse outlines short- and long-term goals for a 10-year-old child with many complex health problems. Who should agree on these goals? A.) Family and nurse B.) Child, family, and nurse C.) All professionals involved D.) Child, family, and all professionals involved

What is a characteristic of a family with invisible poverty? A.) Poor nutrition B.) Poor sanitation C.) Insufficient clothing D.) Lack of healthcare facilities

What is the antiepileptic medication that requires monitoring of vitamin D and folic acid? A.) Topiramate (Topamax) B.) Valproic acid (Depakene) C.) Gabapentin (Neurontin) D.) Phenobarbital (Luminal)

What should the nurse plan for an immobilized child in cervical traction to prevent deep vein thrombosis (DVT)? A.) Elevate the child's legs B.) Place a foot cradle on the bed C.) Place a pillow under the child's knees D.) Assist the child to dorsiflex the feet and rotate the ankles

What dietary instructions should the nurse give to parents of a child with minimal change nephrotic syndrome with massive edema (select all that apply): A.) Soft diet B.) High protein C.) Fluid restricted D.) No salt added at the table E.) Restriction of foods high in sodium

D, E

A 3-month old infant is seen in the clinic with the following symptoms: - irritability - crying - refusal to nurse for more than 2 to 3 minutes - rhinitis - rectal temperature of 101.8 F The labor, delivery and postpartum history for this term infant is unremarkable. The nurse anticipates a diagnosis of: A.) Acute otitis media (AOM) B.) Otitis media with effusion (OME) C.) Otitis externa D.) Respiratory syncytial virus (RSV)

A 3-month-old infant is admitted to the pediatric unit for treatment of bronchiolitis. The infants vital signs are T, 101.6 F; P, 106 beats/min apical; and R, 70 breaths/min. The infant is irritable and fussy and coughs frequently. IV fluids are given via a peripheral venipuncture. Fluids by mouth were initially contraindicated for what reason? A.) Tachypnea B.) Paroxysmal cough C.) Irritability D.) Fever

A school-age child with diabetes gets 30 units of NPH insulin at 0800. According to when this insulin peaks, the child should be at greatest risk for a hypoglycemic episode between when? A.) Lunch and dinner B.) Breakfast and lunch C.) 0830 to his midmorning snack D.) Bedtime and breakfast the next morning

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? A.) Sprain B.) Fracture C.) Dislocation D.) Stress fracture

A toddler is diagnosed with chronic benign neutropenia. The parents are being taught about caring for their child. What information is important to include? A.) Avoid large indoor crowds and people who are ill B.) Parenteral antibiotics are necessary to control disease C.) Frequent rest periods are needed during the daytime D.) List the side effects of corticosteroids used to decrease inflammation

A toddler, age 16 months, falls down a few stairs. He gets up and scolds the stairs as if they caused him to fall. What is this an example of? A.) Animism B.) Ritualism C.) Irreversibility D.) Delayed cognitive development

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

A young girl has just injured her ankle at school. In addition to notifying the child's parents, what is the most appropriate, immediate action by the school nurse? A.) Apply ice B.) Observe for edema and discoloration C.) Encourage child to assume a position of comfort D.) Obtain parental permission for administration of acetaminophen or aspirin

According to Erikson, the psychosocial task of adolescence is developing what? A.) Identity B.) Intimacy C.) Initiative D.) Independence

After chemotherapy is begun for a child with acute leukemia, prophylaxis to prevent acute tumor lysis syndrome includes which therapeutic intervention? A.) Hydration B.) Oxygenation C.) Corticosteroids D.) Pain management

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? A.) Explain hospital schedules to her, such as mealtimes B.) Use terms such as honey and dear to show a caring attitude C.) Explain when parents can visit and why siblings cannot come to see her D.) Orient her parents, because she is too young, to her room and hospital facility

During a funduscopic examination of a school-age child, the nurse notes a brilliant, uniform red reflex in both eyes. The nurse should recognize that this is which? A.) A normal finding B.) A sign of a possible visual defect and a need for vision screening C.) An abnormal finding requiring referral to an ophthalmologist D.) A sign of small hemorrhages, which usually resolve spontaneously

During a well-child visit, the nurse practitioner provides guidance about promoting healthy eating in a child who is overweight. What does the nurse advise? A.) Slow down eating meals B.) Avoid between-meal snacks C.) Include low-fat foods in meals D.) Use foods that child likes as special treats

I just want an even number. To get this correct, just hit 'A' :)

School-age children are prone to accidental injury primarily because of: A.) Peer pressure and risk taking behaviors B.) Physical awkwardness and clumsiness C.) Parents' lack of supervision D.) Attempts to impress members of the opposite sex

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

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

The nurse is planning care for an adolescent with acquired immunodeficiency syndrome. What is the priority nursing goal? A.) Prevent infection B.) Prevent secondary cancers C.) Identify source of infection D.) Restore immunologic defenses

The nurse is preparing to admit a child to the hospital with a diagnosis of minimal change nephrotic syndrome. The nurse understands that the peak age at onset for this disease is what? A.) 2 to 3 years B.) 4 to 5 years C.) 6 to 7 years D.) 8 to 9 years

The nurse is preparing to assess a 10-month-old infant. He is sitting on his father's lap and appears to be afraid of the nurse and of what might happen next. Which initial actions by the nurse should be most appropriate? A.) Initiate a game of peek-a-boo B.) Ask the infant's father to place the infant on the examination table C.) Talk softly to the infant while taking him from his father D.) Undress the infant while he is still sitting on his father's lap

The nurse is preparing to perform a physical assessment on a 10-year-old girl. The nurse gives her the option of her mother staying in the room or leaving. This action should be considered which? a.) Appropriate because of child's age B.) Appropriate, but the mother may be uncomfortable C.) Inappropriate because of child's age D.) Inappropriate because child is same sex as mother

What measure is important in managing hypercalcemia in a child who is immobilized? A.) Provide adequate hydration B.) Change position frequently C.) Encourage a diet high in calcium D.) Provide a diet high in calories for healing

Which activity is appropriate for the parents of a child with a stuttering problem to improve the child's speech? A.) Repeat nursery rhymes B.) Tell the child to go slowly C.) Promise candy for proper speech D.) Tell the child to think before speaking

These general approaches can be helpful when performing a physical exam (select all that apply): A.) With toddlers, restraint may be necessary, and requesting a parent's assistance is appropriate. B.) When examining a preschooler, giving a choice of which parts to examine may be helpful in gaining the child's cooperation. C.) With a school-age child, it is always best to have the parents present when examining. D.) Giving explanations about body systems can make adolescents nervous due to their egocentricities. E.) An infant physical exam is done head to toe, similarly to the adult.

A, B

The nurse is conducting preoperative teaching to parents and their child about an external fixation device. What should the nurse include in the teaching session (select all that apply): A.) Pin care B.) Crutch walking C.) Modifications in activity D.) Observing pin sites for infection E.) Full weight bearing will be allowed after 24 hours

A, B, C, D

The nurse is performing an oral examination on a preschool child. Which strategies should the nurse use to encourage the child to open the mouth for the examination (select all that apply): A.) Lightly brush the palate with a cotton swab B.) Perform the examination in front of a mirror C.) Let the child examine someone else's mouth first D.) Have the child breathe deeply and hold his or her breath E.) Use a tongue blade to help the child open his or her mouth

A, B, C, D

The nurse is planning strategies to assist difficult or easily distracted children when they participate in activities. What strategies should the nurse plan (select all that apply): A.) Role-play before the activity B.) Handle behavior with firmness C.) Acquaint them with what to expect D.) Be patient with inappropriate behavior E.) Don't give them much information about the activity

A, B, C, D

The nursing process is a method of problem identification and problem-solving that describes what the nurse actually does. Which steps does the nursing process model include (select all that apply): A.) Planning B.) Diagnosis C.) Evaluation D.) Assessment E.) Identification F.) Implementation

A, B, C, D, F

A child on chemotherapy has developed rectal ulcers. What interventions should the nurse teach to the child and parents to relieve the discomfort of rectal ulcers (select all that apply): A.) Warm sitz baths B.) Use of stool softeners C.) Record bowel movements D.) Use of an opioid for discomfort E.) Occlusive ointment applied to the area

A, B, C, E

A mother of a child born with Down syndrome is overwhelmed with the future and asks many questions. Which of the following facts should the nurse be aware of (select all that apply): A.) Eighty percent of infants with Down syndrome are born to women younger than 35 years old because younger women have higher fertility rates B.) When feeding infants and young children, use a small straight-handled spoon to push food to the side and back of the mouth. Feeding difficulties occur due to the protruding tongue and hypotonia C.) Parents generally believe the experience of having this special child makes them stronger and more accepting of others D.) Although some placement in the regular classroom has occured more recently, this has been found to be detrimental to the child with Down syndrome due to the lack of one-on-one teaching E.) The child's lack of clinging or molding is a physical characteristic, not a sign of detachment or rejection F.) Development may be 3 to 4 years behind the mental age, especially during early childhood

A, B, C, E

The nurse is administering a unit of blood to a child. What are signs and symptoms of a transfusion reaction (select all that apply): A.) Chills B.) Shaking C.) Flank pain D.) Hypothermia E.) Sudden severe headache

A, B, C, E

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates avoidance coping behavior (select all that apply): A.) Refuses to agree to treatment B.) Avoids staff, family members, or child C.) Is unable to discuss possible loss of the child D.) Recognizes own growth through a passage of time E.) Makes no change in lifestyle to meet the needs of other family members

A, B, C, E

The nurse relates to parents that there are some beneficial effects of hospitalization for their child. What are beneficial effects of hospitalization (select all that apply): A.) Recovery from illness B.) Improve coping abilities C.) Opportunity to master stress D.) Provide a break from school E.) Provide new socialization experiences

A, B, C, E

The school nurse recognizes that students who are targeted for repeated harassment and bullying may exhibit what (select all that apply): A.) Skip school B.) Attempt suicide C.) Bring weapons to school D.) Attend extracurricular activities E.) Report symptoms of depression

A, B, C, E

What interventions can the nurse teach parents to do to ease respiratory efforts for a child with a mild respiratory tract infection (select all that apply): A.) Cool mist B.) Warm mist C.) Steam vaporizer D.) Keep child in a flat, quiet position E.) Run a shower of hot water to produce steam

A, B, C, E

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

A, B, D

The nurse is assessing coping behaviors of a family with a child with a chronic illness. What indicates approach coping behaviors (select all that apply): A.) Plans realistically for the future B.) Verbalizes possible loss of the child C.) Uses magical thinking and fantasy D.) Realistically perceives the child's condition E.) Does not share the burden of the disorder with others

A, B, D

The nurse is caring for a child with acute renal failure. What laboratory findings should the nurse expect to find (select all that apply): A.) Hyponatremia B.) Hyperkalemia C.) Metabolic alkalosis D.) Elevated blood urea nitrogen level E.) Decreased plasma creatinine level

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

A, B, D

The nurse is planning play activities for a 2-month-old hospitalized infant to stimulate the auditory sense. Which activities should the nurse implement (select all that apply): A.) Talk to the infant B.) Play a music box C.) Place a squeaky doll in the crib D.) Give the infant a small-handled clear rattle

A, B, D

Which should the nurse teach to parents regarding oral health of children (select all that apply): A.) Fluoridated water should be used B.) Early childhood caries is a preventable disease C.) Dental caries is a rare chronic disease of childhood D.) Dental hygiene should begin with the first tooth eruption E.) Childhood caries does not happen until after 2 years of age

A, B, D

The nurse informs the family about which symptoms they might see as their child passes (select all that apply): A.) Fatigue B.) Seizures C.) Tardive dyskinesia D.) Sleep disturbances E.) Restlessness, agitation

A, B, D, E

The nurse is preparing to administer some iron drops to a toddler. Which factor can increase iron absorption (select all that apply): A.) Vitamin A B.) Acidity (low pH) C.) Phosphates (milk) D.) Malabsorptive disorders E.) Ascorbic acid (Vitamin C)

A, B, E

The nurse is preparing to admit a 6-year-old child with irritable bowel syndrome (IBS). What clinical manifestations should the nurse expect to observe (select all that apply): A.) Flatulence B.) Constipation C.) No urge to defecate D.) Absence of abdominal pain E.) Feeling of incomplete evacuation of the bowel

A, B, E

Why might some caregivers withhold pain control from a terminally ill child (select all that apply): A.) Fear of addiction B.) Easier dying process C.) Side effects of opioids D.) Improved quality of life E.) Decreased level of cognition

A, C, E

The nurse is precepting a new graduate nurse at an ambulatory pediatric hematology and oncology clinic. What cardinal signs of cancer in children should the nurse make the new nurse aware of (select all that apply): A.) Sudden tendency to bruise easily B.) Transitory, generalized pain C.) Frequent headaches D.) Excessive, rapid weight gain E.) Gradual, steady fever F.) Unexplained loss of energy

A, C, F

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): A.) Arthralgia B.) Weight gain C.) Polycythemia D.) Abdominal pain E.) Glomerulonephritis

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): A.) Avoid jarring the bed B.) Keep the room brightly lit C.) Keep the bed in a flat position D.) Administer prescribed stool softeners E.) Administer a prescribed antiemetic for nausea

A, D, E

The nurse is preparing to admit a 10-year-old child with absence seizures. What clinical features of absence seizures should the nurse recognize (select all that apply): A.) There is no aura B.) There is a postictal state C.) They usually last longer than 30 seconds D.) There is a brief loss of consciousness E.) There is an occasional clonic movement

A, D, E

What characterizes a toddlers concept of death (select all that apply): A.) They are unable to comprehend an absence of life B.) They may recognize the fact of physical death C.) They understand the universality and inevitability of death D.) The are affected more by the change in lifestyle than the concept of death D.) They can only think about events in terms of their own frame of reference-living

A, D, E

Which clinical manifestations are appropriate for Down Syndrome (select all that apply): A.) Flat nasal bridge B.) Early onset dementia C.) Hyperplastic mandible D.) Separated sagittal suture E.) High, arched, narrow palate

A, D, E

A 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 to prevent injury

A 3-month-old infant dies shortly after arrival to the emergency department. The infant has subdural and retinal hemorrhages but no external signs of trauma. What should the nurse suspect? A.) Unintentional injury B.) Shaken baby syndrome C.) Congenital neurologic problem D.) Sudden infant death syndrome (SIDS)

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 child's 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

A 4-year-old child is placed in Buck extension traction for Legg-Calv-Perthes disease. He is crying with pain as the nurse assesses the skin of his right foot and sees that it is pale with an absence of pulse. What should the nurse do first? A.) Reposition the child and notify the practitioner B.) Notify the practitioner of the changes noted C.) Give the child medication to relieve the pain D.) Chart the observations and check the extremity again in 15 minutes

Children may believe that they are responsible for their parents divorce and interpret the separation as punishment. At which age is this most likely to occur? A.) 1 year B.) 4 years C.) 8 years D.) 13 years

The greatest threat to life as a result of dehydration in children is: A.) Oliguria B.) Shock C.) Arrhythmia D.) Hypotension

The nurse is reviewing the importance of role learning for children. The nurse understands that children's roles are primarily shaped by which members? A.) Peers B.) Parents C.) Siblings D.) Grandparents

The regulation of red blood cell (RBC) production is thought to be controlled by which physiologic factor? A.) Hemoglobin B.) Tissue hypoxia C.) Reticulocyte count D.) Number of RBCs

Which type of sensory impairment is appropriate for a 4 year old child who has difficulty processing linguistic information through audition with or without a hearing aid? A.) Slight B.) Profound C.) Moderate D.) Moderately severe

What are core principles of patient- and family-centered care (select all that apply): A.) Collaboration B.) Empowering families C.) Providing formal and informal support D.) Maintaining strict policy and procedure routines E.) Withholding information that is likely to cause anxiety

B, C

Characteristics of bullies include what (select all that apply): A.) Female B.) Depressed C.) Good peer relationships D.) Poor academic performance E.) Exposed to domestic violence

B, D, E

The nurse is caring for a newborn with suspected congenital diaphragmatic hernia. What of the following findings would the nurse expect to observe (select all that apply): A.) Loud, harsh murmur B.) Scaphoid abdomen C.) Poor peripheral pulses D.) Mediastinal shift E.) Inguinal swelling F.) Moderate respiratory distress

B, D, F

The nurse is preparing to admit a 3-year-old child with intussusception. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Absent bowel sounds B.) Passage of red, currant jellylike stools C.) Anorexia D.) Tender, distended abdomen E.) Hematemesis F.) Sudden acute abdominal pain

B, D, F

The nurse is teaching a parent of a 6-month-old infant with gastroesophageal reflux (GER) before discharge. What instructions should the nurse include (select all that apply): A.) Elevate the head of the bed in the crib to a 90-degree angle while the infant is sleeping B.) Hold the infant in the prone position after a feeding C.) Discontinue breastfeeding so that a formula and rice cereal mixture can be used D.) The infant will require the Nissen fundoplication after 1 year of age E.) Prescribed cimetidine (Tagamet) should be given 30 minutes before feedings

B, E

The nurse is caring for children on an adolescent-only unit. What growth and development milestones should the nurse expect from 11- and 14-year-old adolescents (select all that apply): A.) Self-centered with increased narcissism B.) No major conflicts with parents C.) Established abstract thought process D.) Have a rich, idealistic fantasy life E.) Highly value conformity to group norms F.) Secondary sexual characteristics appear

B, E, F

A 1-year-old has been admitted for complete repair of a tetralogy of Fallot. What assessment finding should the nurse expect to be documented? A.) Weight gain B.) Pale skin color C.) Increasing cyanosis D.) Decrease in hemoglobin and hematocrit

A 12 year old child is in the urgent care clinic with a complaint of fever, headache and sore throat. A diagnosis of beta-hemolytic streptococcus (GABHS) pharyngitis is established with a rapid-strep test and oral penicillin is prescribed. The nurse knows that which of the following statements about GABHS is correct? A.) Children with GABHS infection are less likely to contract the illness again after an antibiotic regimen is completed B.) A follow-up throat culture is recommended after the completion of antibiotic therapy C.) Children with a GABHS infection are at increased risk for the development of rheumatic fever and glomerulonephritis D.) Children with a GABHS infection are at increased risk for the development of rheumatoid arthritis in adulthoood

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? A.) It will create difficulty because the child is left handed B.) It will heal slowly because this is the weakest part of the bone C.) This type of fracture requires different management to prevent bone growth complications D.) This type of fracture necessitates complete immobilization of the shoulder for 4 to 6 weeks

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

A school-age child with celiac disease asks for guidance about snacks that will not exacerbate the disease. What snack should the nurse suggest? A.) Pizza B.) Pretzels C.) Popcorn D.) Oatmeal cookies

An infant weighed 8 lb at birth and was 18 inches in length. What weight and length should the infant be at 5 months of age? A.) 12 lb, 20 inches B.) 14 lb, 21.5 inches C.) 16 lb, 23 inches D.) 18 lb, 24.5 inches

The nurse is caring for a child with Meckel diverticulum. What type of stool does the nurse expect to observe? A.) Steatorrhea B.) Clay colored C.) Currant jellylike D.) Loose stools with undigested food

What organism is a parasite that causes acute diarrhea? A.) Shigella organisms B.) Salmonella organisms C.) Giardia lamblia D.) Escherichia coli

Which nursing advice is appropriate for the woman in her first trimester with normal laboratory work to prevent hearing loss in her baby? A.) Avoid sweets B.) Avoid salt in diet C.) Restrict alcohol intake D.) Avoid physical exercise

Which term best describes the sharing of common characteristics that differentiates one group from other groups in a society? A.) Race B.) Culture C.) Ethnicity D.) Superiority

What are some environmental stressors for the child and family in the pediatric intensive care unit (select all that apply): A.) Pain B.) Immobility C.) Constant lights D.) Sleep deprivation E.) Unfamiliar sounds

C, E

What characterizes an infant's concept of death (select all that apply): A.) Death is seen as temporary B.) Death is seen as a departure, a kind of sleep C.) Death has no significance before 6 months of age D.) They believe that death is a consequence of their thoughts E.) Anxiety is not created by death but by loss, even temporary, of the paren

C, E

Which are effective auscultation techniques (select all that apply): A.) Ask the child to breathe shallowly B.) Apply light pressure on the chest piece C.) Use a symmetric and orderly approach D.) Place the stethoscope over one layer of clothing E.) Warm the stethoscope before placing it on the skin

C, E

The nurse is using the CRIES pain assessment tool on a preterm infant in the neonatal intensive care unit. Which are the components of this tool (select all that apply): A.) Color B.) Moro reflex C.) Oxygen saturation D.) Posture of arms and legs E.) Sleeplessness F.) Facial expression

C, E, F

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

A 12-year-old child with Down syndrome is admitted to the hospital for surgical correction of a heart defect. The boys mental age is that of a 3-year-old child. The nurse should prepare the child and family for surgery by what method? A.) Extend preoperative teaching over several days B.) Explain the surgery to the child and the parents in detail C.) Exclude the child from preoperative teaching; teach only the parents D.) Provide teaching to the parents, keeping the information to the child simple

Bacterial infective endocarditis (IE) should be treated with which protocol? A.) Oral antibiotics for 6 months B.) Oral antibiotics (penicillin) for 10 full days C.) IV antibiotics, diuretics, and digoxin D.) IV antibiotics (penicillin type) for 2 to 8 weeks

The school nurse is evaluating the number of school-age children classified as obese. The nurse recognizes that the percentile of body mass index that classifies a child as obese is greater than which? A.) 50th percentile B.) 75th percentile C.) 80th percentile D.) 95th percentile

What is a common clinical manifestation of Hodgkin disease? A.) Petechiae B.) Bone and joint pain C.) Painful, enlarged lymph nodes D.) Nontender enlargement of lymph nodes

What substance is released from the posterior pituitary gland and promotes water retention in the renal system? A.) Renin B.) Aldosterone C.) Angiotensin D.) Antidiuretic hormone (ADH)

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): A.) High fat B.) Low protein C.) Encouragement of fluids D.) Moderate sodium restriction E.) Limit foods high in potassium

D, E

The nurse is preparing a staff education program about pediatric asthma. What concepts should the nurse include when discussing the asthma severity classification system (select all that apply): A.) Children with mild persistent asthma have nighttime signs or symptoms less than two times a month B.) Children with moderate persistent asthma use a short-acting b-agonist more than two times per week C.) Children with severe persistent asthma have a peak expiratory flow (PEF) of 60% to 80% of predicted value D.) Children with mild persistent asthma have signs or symptoms more than two times per week E.) Children with moderate persistent asthma have some limitations with normal activity F.) Children with severe persistent asthma have frequent nighttime signs or symptoms

D, E, F

A 10-year-old child, without a history of previous seizures, experiences a tonic-clonic seizure at school that lasts more than 5 minutes. Breathing is not impaired. Some postictal confusion occurs. What is the most appropriate initial action by the school nurse? A.) Stay with child and have someone else call emergency medical services (EMS) B.) Notify the parent and regular practitioner C.) Notify the parent that the child should go home D.) Stay with the child, offering calm reassurance

A 12-year-old child has failed several courses of chemotherapy. An experimental drug is available that his parents want him to receive. He has told his parents and the oncologists that he is ready to die and does not want any more chemotherapy. The nurse recognizes what to be true? A.) Parents and child both need support in the decision making B.) Twelve-year-olds are minors and cannot give consent or refuse treatments C.) The oncologists needs to make the decision because the parents and child disagree D.) The parents have the right and responsibility to make decisions for their children younger than age 18 years

A 12-year-old child with Guillain-Barr syndrome (GBS) is admitted to the pediatric intensive care unit. She tells you that yesterday her legs were weak and that this morning she was unable to walk. After the nurse determines the current level of paralysis, which should the next priority assessment be? A.) Swallowing ability B.) Parental involvement C.) Level of consciousness D.) Antecedent viral infections

A 12-year-old girl is newly diagnosed with diabetes when she develops ketoacidosis. How should the nurse structure a successful education program? A.) Essential information is presented initially B.) Teaching should take place in the child's semiprivate room C.) Education is focused toward the parents because the child is too young D.) All information needed for self-management of diabetes is taught at once

A 17-year-old patient is returning to the surgical unit after Luque instrumentation for scoliosis repair. In addition to the usual postoperative care, what additional intervention will be needed? A.) Position changes are made by log rolling B.) Assistance is needed to use the bathroom C.) The head of the bed is elevated to minimize spinal headache D.) Passive range of motion is instituted to prevent neurologic injury

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? A.) DTaP and IPV can be safely given B.) DTaP and IPV are contraindicated because she has a cold C.) IPV is contraindicated because her sister is immunocompromised D.) DTaP and IPV are contraindicated because her sister is immunocompromised

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? A.) Infant stimulation program B.) Stretching exercises to decrease contractures C.) Limited physical contact to minimize seizures D.) Encouraging parents to have additional children

A 5-year-old child is admitted to the hospital in a sickle cell crisis. The child has been alert and oriented but in severe pain. The nurse notes that the child is complaining of a headache and is having unilateral hemiplegia. What action should the nurse implement? A.) Notify the health care provider B.) Place the child on bed rest C.) Administer a dose of hydrocodone (Vicodin) D.) Start O2 per the hospitals protocol

A 5-year-old child is admitted with bacterial pneumonia. What signs and symptoms should the nurse expect to assess with this disease process? A.) Fever, cough, and chest pain B.) Stridor, wheezing, and ear infection C.) Nasal discharge, headache, and cough D.) Pharyngitis, intermittent fever, and eye infection

A 7-year-old child with acute diarrhea has been rehydrated with oral rehydration solution (ORS). The nurse should recommend that the child's diet be advanced to what kind of diet? A.) Regular diet B.) Clear liquids C.) High carbohydrate diet D.) BRAT (bananas, rice, applesauce, and toast or tea) diet

A 9-year-old girl often comes to the school nurse complaining of stomach pains. Her teacher says she is completing her school work satisfactorily but lately has been somewhat aggressive and stubborn in the classroom. The school nurse should recognize this as which? A.) Signs of stress B.) Developmental delay C.) Lack of adjustment to school environment D.) Physical problem that needs medical intervention

A breastfed infant has just been diagnosed with galactosemia. The therapeutic management of this includes which? A.) Stop breastfeeding the infant B.) Add amino acids to breast milk C.) Substitute a lactose-containing formula for breast milk D.) Give the appropriate enzyme along with breast milk

A breastfed infant is being seen in the clinic for a 6-month checkup. The mother tells the nurse that the infant recently began to suck her thumb. Which is the best nursing intervention? A.) Reassure the mother that this is normal at this age B.) Recommend the mother substitute a pacifier for her thumb C.) Assess the infant for other signs of sensory deprivation D.) Suggest the mother breastfeed the infant more often to satisfy her sucking needs

A child develops syndrome of inappropriate antidiuretic hormone secretion (SIADH) as a complication to meningitis. What action should be verified before implementing? A.) Forcing fluids B.) Daily weights with strict input and output (I and O) C.) Strict monitoring of urine volume and specific gravity D.) Close observation for signs of increasing cerebral edema

A child has a chronic cough and diffuse wheezing during the expiratory phase of respiration. This suggests what condition? A.) Asthma B.) Pneumonia C.) Bronchiolitis D.) Foreign body in trachea

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

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? A.) Monitoring the parents whenever they are with the child B.) Reassuring the parents that the cause of the disorder will be found C.) Teaching the parents how to obtain necessary specimens D.) Supporting the parents as they cope with diagnosis of a chronic illness

A child is admitted with acute laryngotracheobronchitis (LTB). The child will most likely be treated with which? A.) Racemic epinephrine and corticosteroids B.) Nebulizer treatments and oxygen C.) Antibiotics and albuterol D.) Chest physiotherapy and humidity

A child is being admitted to the hospital with acute gastroenteritis. The health care provider prescribes an antiemetic. What antiemetic does the nurse anticipate being prescribed? A.) Ondansetron (Zofran) B.) Promethazine (Phenergan) C.) Metoclopramide (Reglan) D.) Dimenhydrinate (Dramamine)

A child is receiving vincristine (Oncovin). The nurse should monitor for which side effect of this medication? A.) Diarrhea B.) Photosensitivity C.) Constipation D.) Ototoxicity

A child is upset because, when the cast is removed from her leg, the skin surface is caked with desquamated skin and sebaceous secretions. What technique should the nurse suggest to remove this material? A.) Soak in a bathtub B.) Vigorously scrub the leg C.) Carefully pick material off the leg D.) Apply powder to absorb the material

A child with asthma is having pulmonary function tests. What rationale explains the purpose of the peak expiratory flow rate? A.) To assess severity of asthma B.) To determine cause of asthma C.) To identify triggers of asthma D.) To confirm diagnosis of asthma

A child with cancer being treated with chemotherapy is receiving a platelet transfusion. The nurse understands that the transfused platelets should survive the body for how many days? A.) 1 to 3 days B.) 4 to 6 days C.) 7 to 9 days D.) 10 to 12 days

A child with hemophilia A is scheduled for surgery. What precautions should the nurse institute with this child? A.) Handle the child gently when transferring to a cart B.) Caution the child not to brush his teeth before surgery C.) Use tape sparingly on postoperative dressings D.) Do not administer analgesics before surgery

A child, age 4 years, tells the nurse that she needs a Band-Aid where she had an injection. What nursing action should the nurse implement? A.) Apply a Band-Aid B.) Ask her why she wants a Band-Aid C.) Explain why a Band-Aid is not needed D.) Show her that the bleeding has already stopped

A hallmark of cognitive development in the school-age child is in what Piaget describes as concrete operations. In this stage the child: A.) Uses thought processes to experience events and actions B.) Is unable to see things from another's point of view C.) Has a limited perspective of how others' interpretations of a given event differ D.) Makes judgments based on what he or she sees

A lumbar puncture (LP) is being done on an infant with suspected meningitis. The nurse expects which results for the cerebrospinal fluid that can confirm the diagnosis of meningitis? A.) WBCs; glucose B.) RBCs; normal WBCs C.) Glucose; normal RBCs D.) Normal RBCs; normal glucose

A neonate born with Transposition of the Great Arteries must also have a foramen ovale and/or PDA to survive? A.) True B.) False

A parent of a 7-year-old girl with a repaired ventricular septal defect (VSD) calls the cardiology clinic and reports that the child is just not herself. Her appetite is decreased, she has had intermittent fevers around 38 C (100.4 F), and now her muscles and joints ache. Based on this information, how should the nurse advise the mother? A.) Immediately bring the child to the clinic for evaluation B.) Come to the clinic next week on a scheduled appointment C.) Treat the signs and symptoms with acetaminophen and fluids because it is most likely a viral illness D.) Recognize that the child is trying to manipulate the parent by complaining of vague symptoms

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? A.) The sibling can get a varicella vaccination B.) The sibling should not get a varicella vaccination C.) The sibling should wait until the child is finished with chemotherapy D.) The sibling should get varicella-zoster immune globulin if exposed to chickenpox

A school-age child is admitted in vasoocclusive sickle cell crisis (pain episode). The child's care should include which therapeutic interventions? A.) Hydration and pain management B.) Oxygenation and factor VIII replacement C.) Electrolyte replacement and administration of heparin D.) Correction of alkalosis and reduction of energy expenditure

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

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? A.) Administer all of the prescribed medication B.) Continue medication until all symptoms subside C.) Immediately stop giving medication if hearing loss develops D.) Stop giving medication and come to the clinic if fever is still present in 24 hours

An 8-year-old girl tells the nurse that she has cancer because God is punishing her for being bad. What should the nurse interpret this as? A.) A common belief at this age B.) Indicative of excessive family pressure C.) Faith that forms the basis for most religions D.) Suggestive of a failure to develop a conscience

An adolescent is scheduled for a leg amputation in 2 days for treatment of osteosarcoma. What approach should the nurse implement? A.) Answer questions with straightforward honesty B.) Avoid discussing the seriousness of the condition C.) Explain that although the amputation is difficult, it will cure the cancer D.) Help the adolescent accept the amputation as better than a long course of chemotherapy

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? A.) Tetanus toxoid booster is needed because of the type of injury B.) Human tetanus immunoglobulin is indicated for immediate prophylaxis C.) Concurrent administration of both tetanus immunoglobulin and tetanus antitoxin is needed D.) No additional tetanus prophylaxis is indicated. The tetanus toxoid booster is protective for 10 years

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 A.) Most children will grow out of the allergy B.) All dairy products must be eliminated from the child's diet C.) It is important to have the entire family follow the special diet D.) Antihistamines can be used so the child can have milk products

An infant has been diagnosed with staphylococcal pneumonia. Nursing care of the child with pneumonia includes which intervention? A.) Administration of antibiotics B.) Frequent complete assessment of the infant C.) Round-the-clock administration of antitussive agents D.) Strict monitoring of intake and output to avoid congestive heart failure

An infant with a congenital heart defect is to receive a dose of palivizumab (Synagis). What is the purpose of this? A.) Prevent RSV infection B.) Prevent secondary bacterial infection C.) Decrease toxicity of antiviral agents D.) Make isolation of infant with RSV unnecessary

An infant with short bowel syndrome will be on total parenteral nutrition (TPN) for an extended period of time. What should the nurse monitor the infant for ? A.) Central venous catheter infection, electrolyte losses, and hyperglycemia B.) Hypoglycemia, catheter migration, and weight gain C.) Venous thrombosis, hyperlipidemia, and constipation D.) Catheter damage, red currant jelly stools, and hypoglycemia

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

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 B.) Do not permit him to chew paint from window ledges because he might absorb too much lead C.) When he learns to roll over, you must supervise him whenever he is on a surface from which he might fall D.) Lock the crib sides securely because he may stand and lean against them and fall out of bed

As part of the diagnostic evaluation of a child with cancer, biopsies are important for staging. What statement explains what staging means? A.) Extent of the disease at the time of diagnosis B.) Rate normal cells are being replaced by cancer cells C.) Biologic characteristics of the tumor or lymph nodes D.) Abnormal, unrestricted growth of cancer cells producing organ damage

At a well-child check-up, the nurse notes that an infant with a previous diagnosis of failure to thrive (FTT) is now steadily gaining weight. The nurse should recommend that fruit juice intake be limited to no more than how much? A.) 4 oz/day B.) 6 oz/day C.) 8 oz/day D.) 12 oz/day

Because children younger than 5 years are egocentric, the nurse should do which when communicating with them? A.) Focus communication on the child B.) Use easy analogies when possible C.) Explain experiences of others to the child D.) Assure the child that communication is private

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

Decongestant nose drops are recommended for a 10-month-old infant with an upper respiratory tract infection. Instructions for nose drops should include which information? A.) Do not use for more than 3 days B.) Keep drops to use again for nasal congestion C.) Administer drops after feedings and at bedtime D.) Give two drops every 5 minutes until nasal congestion subsides

During the summer many children are more physically active. What changes in the management of the child with diabetes should be expected as a result of more exercise? A.) Food intake B.) Food intake C.) Risk of hyperglycemia D.) Risk of insulin reaction

For case management to be most effective, who should be recognized as the most appropriate case manager? A.) Nurse B.) Panel of experts C.) Multidisciplinary team D.) Insurance company

Girls experience an increase in weight and fat deposition during puberty. What do nursing considerations related to this include? A.) Give reassurance that these changes are normal B.) Suggest dietary measures to control weight gain C.) Encourage a low-fat diet to prevent fat deposition D.) Recommend increased exercise to control weight gain

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? A.) Wheezing B.) Increased blood pressure C.) Increased urine output D.) Decreased heart rate

How does the onset of the pubertal growth spurt compare in girls and boys? A.) In girls, it occurs about 1 year before it appears in boys B.) In girls, it occurs about 3 years before it appears in boys C.) In boys. it occurs about 1 year before it appears in girls D.) It is about the same in both boys and girls

In teaching parents about appropriate pacifier selection, the nurse should recommend which characteristic? A.) Easily grasped handle B.) Detachable shield for cleaning C.) Soft, pliable material D.) Ribbon or string to secure to clothing

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

In which condition are all the formed elements of the blood simultaneously depressed? A.) Aplastic anemia B.) Sickle cell anemia C.) Thalassemia major D.) Iron deficiency anemia

It is important to consider the child's developmental understanding of death when working with that child. Which option is the preschool child's developmental age? A.) Children of this age believe that their thoughts are sufficient to cause death B.) They are still very much influenced by remnants of magical thinking and are subject to feelings of guilt and shame C.) They have a deeper understanding of death in a concrete sense D.) They can perceive events only in terms of their own frame of reference - living

Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute? A.) Yogurt B.) Ice cream C.) Fortified cereal D.) Cow's milk-based formula

Nurses should be alert for increased fluid requirements in which circumstance? A.) Fever B.) Mechanical ventilation C.) Congestive heart failure D.) Increased intracranial pressure

Nursing care of the child with Kawasaki disease is challenging because of which occurrence? A.) The child's irritability B.) Predictable disease course C.) Complex antibiotic therapy D.) The child's ongoing requests for food

One of the key factors in addressing the health concerns and needs of the adolescent in a clinic or primary care office setting is to: A.) Provide confidentiality B.) Include the parent(s) in a discussion about the adolescent's secual health C.) Ask the adolescent if he or she is sexually active D.) Discuss the negative effects of tobacco use

One of the supervisors for a home health agency asks the nurse to give a family of a child with a chronic illness a survey evaluating the nurses and other service providers. How should the nurse recognize this request? A.) Appropriate to improve quality of care B.) Improper because it is an invasion of privacy C.) Inappropriate unless nurses and other providers agree to participate D.) Not acceptable because the family lacks remembering necessary to evaluate professionals

One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what? A.) Muscle cramps and tetany B.) Respiratory distress and cyanosis C.) Thrombocytopenia and sepsis D.) Upper extremity edema and neck vein distension

Ongoing fluid losses can overwhelm the child's ability to compensate, resulting in shock. What early clinical sign precedes shock? A.) Tachycardia B.) Slow respirations C.) Warm, flushed skin D.) Decreased blood pressure

Parents of an 18-month-old boy tells the nurse that he says no to everything and has rapid mood swings. If he is scolded, he shows anger and then immediately wants to be held. What is the nurses best interpretation of this behavior? A.) This is normal behavior for his age B.) This is unusual behavior for his age C.) He is not effectively coping with stress D.) He is showing he needs more attention

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? A.) Give her nutritious snacks B.) Offer rewards for eating at mealtimes C.) Avoid snacks so she is hungry at mealtimes D.) Explain to her in a firm manner what is expected of her

Selective cholesterol screening is recommended for children older than the age of 2 years with which risk factor? A.) Body mass index (BMI) = 95th percentile B.) Blood pressure = 50th percentile C.) Parent with a blood cholesterol level of 200 mg/dL D.) Recently diagnosed cardiovascular disease in a 75-year-old grandparent

Seventy-two hours after cardiac surgery, a young child has a temperature of 38.4 C (101.1 F). What action should the nurse perform? A.) Report findings to the practitioner B.) Apply a hypothermia blanket C.) Keep the child warm with blankets D.) Record the temperature on the assessment flow sheet

Surgery is performed on a child to correct cryptorchidism. The parents understand the reason for the surgery if they tell the nurse this was done to do what? A.) Prevent damage to the undescended testicle B.) Prevent urinary tract infections C.) Prevent prostate cancer D.) Prevent an inguinal hernia

The clinic nurse is assessing infant reflexes. What assessment indicates a persistence of primitive reflexes? A.) Tonic neck reflex at 8 months of age B.) Palmar grasp at 4 months of age C.) Plantar grasp at 9 months of age D.) Rooting reflex at 3 months of age

The clinic nurse is reviewing statistics on infant mortality for the United States versus other countries. Compared with other countries that have a population of at least 25 million, the nurse makes which determination? A.) The United States is ranked last among 27 countries B.) The United States is ranked similar to 20 other developed countries C.) The United States is ranked in the middle of 20 other developed countries D.) The United States is ranked highest among 27 other industrialized countries

The clinical manifestation of sickle cell anemia are primarily the result of what physiological alteration: A.) Increased red blood cell destruction B.) Greater affinity for oxygen C.) Deficiency in coagulation D.) Decreased blood viscosity

The family and child have decided that hospice care best meets their needs during the terminal phase of illness. The nurse recognizes that the parents understand the principles of this care when they make which statement? A.) It will be good to be at home and care for our child B.) What a relief it will be not to need any more medicines C.) We are going to miss the support of the hospice team when our child dies D.) We know that once hospice care starts, we will not be able to return to the hospital if the care is difficult

The health care provider suggests surgery be performed for ventricular septal defect to prevent what complication? A.) Pulmonary hypertension B.) Right-to-left shunt of blood C.) Pulmonary embolism D.) Left ventricular hypertrophy

The mother of a 3-month-old breastfed infant asks about giving her baby water because it is summer and very warm. What should the nurse tell her? A.) Fluids in addition to breast milk are not needed B.) Water should be given if the infant seems to nurse longer than usual C.) Clear juices are better than water to promote adequate fluid intake D.) Water once or twice a day will make up for losses resulting from environmental temperature

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? A.) Ensuring that the mother has time away from the infant B.) Making sure the mother is providing all of the infants care C.) Determining whether other family members can provide the necessary care so the mother can rest D.) Contacting the social worker because of the mothers interference with the nursing care

The newest nurse on the pediatric unit is concerned about maintaining a professional distance in her relationship with a patient and the patient's family. Which comment indicates that she needs more mentoring regarding her patient-nurse relationship? A.) "I realize that caring for the child means I can visit them on my days off if they ask me." B.) "When the mother asks if I will care for her daughter every day, I explain that the assignments change based on the needs of the unit." C.) "When the mother asks me questions about my family, I answer politely, but I offer only pertinent information." D.) "I engage in multidisciplinary rounds and listen to the family's concerns."

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? A.) Administer naloxone (Narcan) B.) Discontinue the IV infusion. C.) Discontinue morphine until the child is fully awake D.) Stimulate the child by calling his or her name, shaking gently, and asking the child to breathe deeply

The nurse is caring for a child whose parents are unable to stay with the child for long hours. Which action by the nurse helps to ease the feelings of separation from home? A.) Surround the child with familiar items B.) Move the child's bed towards the window C.) Provide musical, visual or tactile activities D.) Allow the child to continue school lessons

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? A.) Prone with the head turned to the side B.) On the side C.) Supine in an infant carrier D.) Supine, with defect supported with rolled blankets

The nurse is caring for an adolescent hospitalized for asthma. The adolescent belongs to a large family. The nurse recognizes that the adolescent is likely to relate to which group? A.) Peers B.) Parents C.) Siblings D.) Teachers

The nurse is checking reflexes on a 7-month-old infant. When the infant is suspended in a horizontal prone position, the head is raised and the legs and spine are extended. Which reflex is this? A.) Landau B.) Parachute C.) Body righting D.) Labyrinth righting

The nurse is collecting a stool sample from an infant with lactose intolerance. Which fecal pH should the nurse expect as the result? A.) 5.5 B.) 7.0 C.) 7.5 D.) 8

The nurse is describing clinical reasoning to a group of nursing students. Which is most descriptive of clinical reasoning? A.) Purposeful and goal directed B.) A simple developmental process C.) Based on deliberate and irrational thought D.) Assists individuals in guessing what is most appropriate

The nurse is discussing with a parent group the importance of fluoride for healthy teeth. What should the nurse recommend? A.) Determine whether the water supply is fluoridated B.) Use fluoridated mouth rinses in children older than 1 year C.) Give fluoride supplements to infants beginning at age 2 months D.) Brush teeth with fluoridated toothpaste unless the fluoride content of water supply is adequate

The nurse is interviewing the mother of an infant. The mother reports, I had a difficult delivery, and my baby was born prematurely. This information should be recorded under which heading? A.) History B.) Present illness C.) Chief complaint D.) Review of systems

The nurse is planning a teaching session to adolescents about deaths by unintentional injuries. Which should the nurse include in the session with regard to deaths caused by injuries? A.) More deaths occur in males B.) More deaths occur in females C.) The pattern of deaths does not vary according to age and sex D.) The pattern of deaths does not vary widely among different ethnic groups

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? A.) Encourage mobility B.) Encourage assistance in self-care C.) Promote oral-motor development D.) Provide opportunities for socialization

The nurse is planning care for a child recently diagnosed with diabetes insipidus (DI). What intervention should be included? A.) Encourage the child to wear medical identification B.) Discuss with the child and family ways to limit fluid intake C.) Teach the child and family how to do required urine testing. D.) Reassure the child and family that this is usually not a chronic or life-threatening illness

The nurse is planning care for a hospitalized toddler. What is the rationale for planning to continue the toddlers rituals while hospitalized? A.) To provide security B.) To prevent regression C.) To prevent dependency D.) To decrease negativism

The nurse is planning care for a patient with a different ethnic background. Which should be an appropriate goal? A.) Adapt, as necessary, ethnic practices to health needs B.) Attempt, in a nonjudgmental way, to change ethnic beliefs C.) Encourage continuation of ethnic practices in the hospital setting D.) Strive to keep ethnic background from influencing health needs

The nurse is providing guidance strategies to a group of parents with toddlers at a community outreach program. Which statement by a parent indicates a correct understanding of the teaching? A.) I should expect my 24-month-old child to express some signs of readiness for toilet training B.) I should be firm and structured when disciplining my 18-month-old child C.) I should expect my 12-month-old child to start to develop a fear of darkness and to need a security blanket D.) I should expect my 36-month-old child to understand time and proximity of events

The nurse is providing support to parents adapting to the hospitalization of their child to the pediatric intensive care unit. The nurse notices that the parents keep asking the same questions. What should the nurse do? A.) Patiently continue to answer questions, trying different approaches B.) Kindly refer them to someone else for answering their questions C.) Recognize that some parents cannot understand explanations D.) Suggest that they ask their questions when they are not upset

The nurse is seeing an adolescent and the parents in the clinic for the first time. Which should the nurse do first? A.) Introduce him- or herself B.) Make the family comfortable C.) Give assurance of privacy D.) Explain the purpose of the interview

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? A.) Childhood obesity is the most common nutritional problem among children B.) Immunization rates are the same among children of different races and ethnicity C.) Dental caries is not a problem commonly seen in children since the introduction of fluoridated water D.) Mental health problems are typically not seen in school-age children but may be diagnosed in adolescents

The nurse is talking to the parent of a child with special needs. The parent has expressed worry about how to support the siblings at home. What suggestion is appropriate for the nurse to give to the parent? A.) You should help the siblings see the similarities and differences between themselves and your child with special needs B.) You should explain that your child with special needs should be included in all activities that the siblings participate in even if they are reluctant C.) You should give the siblings many caregiving tasks for your child with special needs so the siblings feel involved D.) You should intervene when there are differences between your child with special needs and the siblings

The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching? A.) I should let my infant cry for at least 30 minutes before I respond B.) I will swaddle my infant tightly with a soft blanket C.) I should massage my infants abdomen whenever possible D.) I will place my infant in an upright seat after feeding

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? A.) The pill should be crushed and mixed with a small amount of water B.) The pill should be crushed and mixed with the infant's formula C.) After administering the medication, flush the tube with air D.) Before administering the medication, check the placement of the tube

The nurse is teaching the parents of a 1-month-old infant with developmental dysplasia of the hip about preventing skin breakdown under the Pavlik harness. What statement by the parent would indicate a correct understanding of the teaching? A.) I should gently massage the skin under the straps once a day to stimulate circulation B.) I will apply a lotion for sensitive skin under the straps after my baby has been given a bath to prevent skin irritation C.) I should remove the harness several times a day to prevent contractures D.) I will place the diaper over the harness, preferably using a super absorbent disposable diaper that is relatively thin

The nurse notes that the parents of a critically ill child spend a large amount of time talking with the parents of another child who is also seriously ill. They talk with these parents more than with the nurses. How should the nurse interpret this situation? A.) Parent-to-parent support is valuable B.) Dependence on other parents in crisis is unhealthy C.) This is occurring because the nurses are unresponsive to the parents D.) This has the potential to increase friction between the parents and nursing staff.

The nurse should expect a toddler to cope with the stress of a short period of separation from parents by displaying what? A.) Regression B.) Happiness C.) Detachment D.) Indifference

The nurse should expect to care for which age of child if the admitting diagnosis is retinoblastoma? A.) Infant or toddler B.) Preschool- or school-age child C.) School-age or adolescent child D.) Adolescent

The nurse stresses to the family of a child with a chronic cardiac condition the importance of enrolling the child in school, pursuing hobbies and recreational interests, and attaining some independence. The nurse is facilitating what concept? A.) Normalization B.) Communication C.) Decision making D.) Family-centered care

The nurses approach when introducing hospital equipment to a preschooler who seems afraid should be based on which principle? A.) The child may think the equipment is alive B.) Explaining the equipment will only increase the child's fear C.) One brief explanation will be enough to reduce the child's fear D.) The child is too young to understand what the equipment does

The parent of 16-month-old child asks, What is the best way to keep my child from getting into our medicines at home? What should the nurse advise? A.) All medicines should be locked securely away B.) The medicines should be placed in high cabinets C.) Your child just needs to be taught not to touch medicines D.) Medicines should not be kept in the homes of small children

The parent of a child with cystic fibrosis (CF) calls the clinic nurse to report that the child has developed tachypnea, tachycardia, dyspnea, pallor, and cyanosis. The nurse should tell the parent to bring the child to the clinic because these signs and symptoms are suggestive of what condition? A.) Pneumothorax B.) Bronchodilation C.) Carbon dioxide retention D.) Increased viscosity of sputum

The parent of a hospitalized child tells the nurse, "We do not eat meat. We are practicing Buddhists and strict vegetarians." The most appropriate intervention by the nurse is to: A) Order the child a meatless tray B) Tell the parent to take any meat off the child's meal tray C) Ask the parent if they would like to have a Buddhist priest visit D) Explain to the parent that meat provides protein needed to heal their child

The parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action? A.) Encourage the parent to verbalize feelings B.) Encourage the parent not to worry so much C.) Assess the parent for other signs of inadequate parenting D.) Reassure the parent that colic rarely lasts past age 9 months

The parents of a 2-year-old child tell the nurse they are concerned because the toddler has started to use baby talk since the arrival of their new baby. What should the nurse recommend? A.) Ignore the baby talk B.) Tell the toddler frequently, "You are a big kid now" C.) Explain to the toddler that baby talk is for babies D.) Encourage the toddler to practice more advanced patterns of speech

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 nurses response should be based on remembering what? A.) This is acceptable to encourage head control and turning over B.) This is acceptable to encourage fine motor development C.) This is unacceptable because of the risk of sudden infant death syndrome (SIDS) D.) This is unacceptable because it does not encourage achievement of developmental milestones

The parents of a child born with ambiguous genitalia tell the nurse that family and friends are asking what caused the baby to be this way. Tests are being done to assist in gender assignment. What should the nurses intervention include? A.) Explain the disorder so they can explain it to others B.) Help parents understand that this is a minor problem C.) Suggest that parents avoid family and friends until the gender is assigned D.) Encourage parents not to worry while the tests are being done

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurses response should be based on remembering that discipline is which? A.) Essential for the child B.) Not needed unless the child's behavior becomes problematic C.) Best achieved with punishment for misbehavior D.) Too difficult to implement with a special needs child

The parents of a child on a ventilator tell the nurse that their insurance company wants the child to be discharged. They explain that they do not want the child home under any circumstances. What principle should the nurse consider when working with this family? A.) Desire to have the child home is essential to effective home care B.) Parents should not be expected to care for a technology-dependent child C.) Having a technology-dependent child at home is better for both the child and the family D.) Parents are not part of the decision-making process because of the costs of hospitalization

The potential effects of chronic illness or disability on a child's development vary at different ages. What developmental alteration is a threat to a toddlers normal development? A.) Hindered mobility B.) Limited opportunities for socialization C.) Child's sense of guilt that he or she caused the illness or disability D.) Limited opportunities for success in mastering toilet training

The school nurse is informed that a child with human immunodeficiency virus (HIV) infection will be attending school soon. What is an important nursing intervention to include in the plan of care? A.) Carefully follow universal precautions B.) Inform the parents of the other children C.) Determine how the child became infected D.) Reassure other children that they will not become infected

The school nurse needs to obtain authorization for a child who requires medications while at school. From whom does the nurse obtain the authorization? A.) The parents B.) The pharmacist C.) The school administrator D.) The prescribing practitioner

Therapeutic management of a 6-year-old child with hereditary spherocytosis (HS) should include which therapeutic intervention? A.) Perform a splenectomy B.) Supplement the diet with calcium C.) Institute a maintenance transfusion program D.) Increase intake of iron-rich foods such as meat

True or False, A child diagnosed with mild hemophilia is able to receive treatment from home? A.) True B.) False

True or False, a patient experiencing a hypercyanotic spell should initially be placed in knee-chest position? A.) True B.) False

What are the most common clinical manifestations of brain tumors in children? A.) Headaches and vomiting B.) Blurred vision and ataxia C.) Hydrocephalus and clumsy gait D.) Fever and poor fine motor control

What cardiovascular defect results in obstruction to blood flow? A.) Aortic stenosis B.) Tricuspid atresia C.) Atrial septal defect D.) Transposition of the great arteries

What classification is appropriate for the 6 year old child who has difficulty hearing faint or distant speech, has normal speech, but is having problems with school performance? A.) Slight B.) Severe C.) Moderate D.) Inattentiveness rather than hearing loss

What condition can result from the bone demineralization associated with immobility? A.) Osteoporosis B.) Pooling of blood C.) Urinary retention D.) Susceptibility to infection

What condition is often associated with severe diarrhea? A.) Metabolic acidosis B.) Metabolic alkalosis C.) Respiratory acidosis D.) Respiratory alkalosis

What condition is the leading cause of chronic illness in children? A.) Asthma B.) Pertussis C.) Tuberculosis D.) Cystic fibrosis

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

What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes? A.) Renal ultrasonography B.) Computed tomography C.) Intravenous pyelography D.) Voiding cystourethrography

What do the initial signs of respiratory syncytial virus (RSV) infection in an infant include? A.) Rhinorrhea, wheezing, and fever B.) Tachypnea, cyanosis, and apnea C.) Retractions, fever, and listlessness D.) Poor breath sounds and air hunger

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

What form of diabetes is characterized by destruction of pancreatic beta cells, resulting in insulin deficiency? A.) Type 1 diabetes B.) Type 2 diabetes C.) Gestational diabetes D.) Maturity-onset diabetes of the young (MODY)

What information should be given to the parents of a 12-month-old child regarding appropriate play activities for this age? A.) Give large push-pull toys for kinetic stimulation B.) Place a cradle gym across the crib to help develop fine motor skills C.) Provide the child with finger paints to enhance fine motor skills D.) Provide a stick horse to develop gross motor coordination

What information should the nurse include when teaching an adolescent with Crohn disease (CD)? A.) How to cope with stress and adjust to chronic illness B.) Preparation for surgical treatment and cure of CD C.) Nutritional guidance and prevention of constipation D.) Prevention of spread of illness to others and principles of high-fiber diet

What is a 4 year old child's concept of death? A.) Death is temporary B.) Death is permanent C.) Death is inevitable at some age D.) Death is personified in various forms

What is a common experience of a sibling during a sister's or brother's illness or hospitalization? A.) Anger B.) Support C.) Detachment D.) Positive adaptation

What is a major goal for the therapeutic management of juvenile idiopathic arthritis (JIA)? A.) Control pain and preserve joint function B.) Minimize use of joint and achieve cure C.) Prevent skin breakdown and relieve symptoms D.) Reduce joint discomfort and regain proper alignment

What is an appropriate play activity for a 7-month-old infant to encourage visual stimulation? A.) Playing peek-a-boo B.) Playing pat-a-cake C.) Imitating animal sounds D.) Showing how to clap hands

What is an important consideration in preventing injuries during middle childhood? A.) Achieving social acceptance is a primary objective B.) The incidence of injuries in girls is significantly higher than it is in boys C.) Injuries from burns are the highest at this age because of fascination with fire D.) Lack of muscular coordination and control results in an increased incidence of injuries

What is appropriate mouth care for a toddler with mucosal ulceration related to chemotherapy? A.) Mouthwashes with plain saline B.) Lemon glycerin swabs for cleansing C.) Mouthwashes with hydrogen peroxide D.) Swish and swallow with viscous lidocaine

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

What is most descriptive of the spiritual development of older adolescents? A.) Beliefs become more abstract B.) Rituals and practices become increasingly important C.) Strict observance of religious customs is common D.) Emphasis is placed on external manifestations, such as whether a person goes to church

What is the earliest recognizable clinical manifestation(s) of cystic fibrosis (CF)? A.) Meconium ileus B.) History of poor intestinal absorption C.) Foul-smelling, frothy, greasy stools D.) Recurrent pneumonia and lung infections

What is the leading cause of death during the toddler period? A.) Injuries B.) Infectious diseases C.) Childhood diseases D.) Congenital disorders

What is the physiological consequences of the congenital heart disease (CHD) ventricular septal defect (VSD)? A.) Pulmonary over circulation B.) Obstructive systemic flow C.) Decreased pulmonary blood flow D.) Obstructive pulmonary flow

What is the purpose in using cimetidine (Tagamet) for gastroesophageal reflux? A.) The medication reduces gastric acid secretion B.) The medication neutralizes the acid in the stomach C.) The medication increases the rate of gastric emptying time D.) The medication coats the lining of the stomach and esophagus

What laboratory finding should the nurse expect in a child with an excess of water? A.) Decreased hematocrit B.) High serum osmolality C.) High urine specific gravity D.) Increased blood urea nitrogen

What manifestation observed by the nurse is suggestive of parental overprotection? A.) Gives inconsistent discipline B.) Facilitates the child's responsibility for self-care of illness C.) Persuades the child to take on activities of daily living even when not able D.) Encourages social and educational activities not appropriate to the child's level of capability

What may a clinical manifestations of failure to thrive (FTT) in a 13-month-old include? A.) Irregularity in activities of daily living B.) Preferring solid food to milk or formula C.) Weight that is at or below the 10th percentile D.) Appropriate achievement of developmental landmarks

What medication is contraindicated in children post tonsillectomy and adenoidectomy? A.) Codeine B.) Ondansetron (Zofran) C.) Amoxil (amoxicillin) D.) Acetaminophen (Tylenol)

What name is given to inflammation of the bladder? A.) Cystitis B.) Urethritis C.) Urosepsis D.) Bacteriuria

What nursing intervention is most appropriate in promoting normalization in a school-age child with a chronic illness? A.) Give the child as much control as possible B.) Ask the child's peer to make the child feel normal C.) Convince the child that nothing is wrong with him or her D.) Explain to parents that family rules for the child do not need to be the same as for healthy siblings

What nursing intervention is most appropriate when providing comfort and support for a child when death is imminent? A.) Limit care to essentials B.) Avoid playing music near the child C.) Whisper to the child instead of using a normal voice D.) Explain to the child the need for constant measurement of vital signs

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

What primary nursing intervention should be implemented to prevent bacterial endocarditis? A.) Counsel parents of high-risk children B.) Institute measures to prevent dental procedures C.) Encourage restricted mobility in susceptible children D.) Observe children for complications, such as embolism and heart failure

What rationale explains why prolonged use of oxygen should be discouraged in a child with anemia? A.) Prolonged use of oxygen can decrease erythropoiesis B.) Prolonged use of oxygen can interfere with iron production C.) Prolonged use of oxygen interferes with a child's appetite D.) Prolonged use of oxygen can affect the synthesis of hemoglobin

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

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

What statement is most descriptive of a school-age child's reaction to death? A.) Very interested in funerals and burials B.) Little understanding of words such as forever C.) Imagine the deceased person to be still alive D.) Can explain death from a religious or spiritual point of view

What structural defects constitute tetralogy of Fallot? A.) Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy B.) Aortic stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy C.) Aortic stenosis, ventricular septal defect, overriding aorta, left ventricular hypertrophy D.) Pulmonary stenosis, ventricular septal defect, aortic hypertrophy, left ventricular hypertrophy

What test is used to screen for carbohydrate malabsorption? A.) Stool pH B.) Urine ketones C.) C urea breath test D.) ELISA stool assay

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

What type of seizure may be difficult to detect? A.) Absence B.) Generalized C.) Simple partial D.) Complex partial

What urine test result is considered abnormal? A.) pH 4.0 B.) WBC 1 or 2 cells/mL C.) Protein level absent D.) Specific gravity 1.020

When a preschool-age child is hospitalized without adequate preparation, the nurse should recognize that the child may likely see hospitalization as what? A.) Punishment B.) Loss of parental love C.) Threat to the child's self-image D.) Loss of companionship with friends

When assessing a family, the nurse determines that the parents exert little or no control over their children. This style of parenting is called which? A.) Permissive B.) Dictatorial C.) Democratic D.) Authoritarian

When assessing blood pressure in a child: A.) Knowledge of normal mean is important: newborn, 65/41 mmHg; 1 month to 2 years 95/58 mmHg; and 2 to 5 years 101/57 mmHg B.) Cuff size is the most important variable and should be measured using limb length C.) The child is considered normotensive if the BP is below the 95th percentile D.) Check upper and lower extremity BP to look for abnormalities such as aortic stenosis, which causes lower-extremity BP to be higher than upper-extremity BP

When caring for a child after a tonsillectomy, what intervention should the nurse do? A.) Watch for continuous swallowing B.) Encourage gargling to reduce discomfort C.) Apply warm compresses to the throat D.) Position the child on the back for sleeping

When discussing discipline with the mother of a 4-year-old child, which should the nurse include? A.) Parental control should be consistent B.) Withdrawal of love and approval is effective at this age C.) Children as young as 4 years rarely need to be disciplined D.) One should expect rules to be followed rigidly and unquestioningly

When is an autopsy required? A.) In the case of a suspected suicide B.) When a person has a known terminal illness C.) With a hospice patient who dies at home D.) With the victim of a motor vehicle collision

When is it appropriate to shift the goals of treatment for a child who has a chronic or complex disease toward preparation for death? A.) When a cure is no longer possible B.) When health care workers are offering supportive care C.) When the child is responding well to the current treatment plan, but the future is unknown D.) When the child is responding well to the current treatment plan, but the results of one recent research study have demonstrated positive results with a new medication

Where in the health history does a record of immunizations belong? A.) History B.) Present illness C.) Review of systems D.) Physical assessment

Which activity is associated with a nontherapeutic relationship between a patient or family and the nurse? A.) The nurse's actions and communication with a patient and family raise concern among staff members B.) Assignments are structures to allow nurses to care for the same patients over the extent of the hospital stay C.) The nurse engages in appropriate small talk with the patients and family members after performing the morning assessment D.) The nurse is able to emotionally withdraw when emotional overload occurs but still remain committed to providing quality care

Which condition is appropriate for a preschooler that keeps the head very close to the table when coloring? A.) Myopia B.) Hyperopia C.) Astigmatism D.) Anisometropia

Which condition is appropriate for the child who has difficulty reading, performs poorly in school, and complains of frequent headaches? A.) Myopia B.) Hyperopia C.) Cateracts D.) Glaucoma

Which data should be included in a health history? A.) Review of systems B.) Physical assessment C.) Growth measurements D.) Record of vital signs

Which factors will decrease iron absorption and should not be given at the same time as an iron supplement? A.) Milk B.) Fruit juice C.) Multivitamin D.) Meat, fish, poultry

Which finding regarding a female with Down syndrome is correct? A.) Rapid weight gain by 3 years old B.) Rapid increase in height in 18 months C.) Menstruation occurs at a delayed age D.) Infertility happens in postpubertal women

Which intervention by the nurse can help ease negative feelings and fear in a 5-year old child being admitted to the hospital? A.) Preparing the child for the hospital experience B.) Not intervention because children this age cannot be prepared C.) No intervention because preparation will increase the child's stress D.) Preparing the child for the potential negative effects of hospitalization

Which intervention by the nurse would help reduce injuries among school-age children? A.) Promote helmet use while riding a bicycle B.) Promote physical exercises after school each day C.) Encourage swimming along rather than in groups D.) Provide education about the risks associated with smoking

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

Which is the leading cause of death in infants younger than 1 year in the United States? A.) Congenital anomalies B.) Sudden infant death syndrome C.) Disorders related to short gestation and low birth weight D.) Maternal complications specific to the perinatal period

Which is the most frequently used test for measuring visual acuity? A.) Snellen letter chart B.) Ishihara vision test C.) Allen picture card test D.) Denver eye screening test

Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? A.) Tactile stimulation B.) Commercial warm packs C.) Doing procedure during infant sleep D.) Oral sucrose and nonnutritive sucking

Which nursing advice is appropriate for the parents of a baby with Down Syndrome regarding solid feedings? A.) Tongue thrusting is a physiologic response to feeding B.) A protruding tongue is an indication that the child does not like the food C.) Use a small, short, straight-handled spoon to place food in the front of the mouth D.) Use a small, short, round-handled spoon to place food in the side of the mouth

Which nursing behavior is not consistent with family centered care in pediatrics? A.) Competing with parents for their child's affection B.) Allowing the family to be more involved in the child's care C.) Asking questions when the family is not participating in care D.) Treating all the patients equally in providing care and listening

Which nursing recommendation is appropriate for the parents of a cognitively impaired child asking for guidance with discipline? A.) Behavior modification is an excellent for of discipline B.) Discipline if ineffective with cognitively impaired children C.) Discipline is not necessary for cognitively impaired children D.) Physical punishment is the most appropriate form of discipline

Which nursing response is appropriate when asked by the parents what toys or presents would provide comfort for their child who is admitted to the health care facility for temporary loss of vision? A.) "Bring old toys from home" B.) "Bring floating toys for water play" C.) "Avoid musical or stuffed toys" D.) "Read from new books to the child"

Which parenting style would the nurse document in a family where the parents have little to no control over the children? A.) Permissive B.) Democratic C.) Authoritarian D.) Authoritative

Which patient has fragile X syndrome? - Patient A: Long, wide ears; prominent jaw; macroorchidism - Patient B: Small ears; hypoplastic mandible; cryptorchidism - Patient C: Microdontia; self-biting; dreamy - Patient D: Hyperopia; cracked skin; short foot A.) Patient A B.) Patient B C.) Patient C D.) Patient D

Which role should nurses play in ensuring that spiritual health care practices do not negatively affect the therapeutic relationship between the nurse and the patient? A.) Maintain open communication between the family and health care team B.) Assume the patient will freely communicate personal religious needs C.) Provide a traditional western diet and allow the patient to choose what to eat D.) Assume the patient adheres to all of the common practices of the documented religion

Which statement is appropriate regarding X-linked dominant patterns with reduced penetrance? A.) Female carriers may exhibit learning disabilities B.) Male carriers do not exhibit learning disabilities C.) Sons of all affected males will have fragile X syndrome D.) Males with full mutation do not exhibit intellectual disabilities

Which type of breath sound is normally heard over the entire surface of the lungs except for the upper intrascapular area and the area beneath the manubrium? A.) Vesicular B.) Bronchial C.) Adventitious D.) Bronchovesicular

Which type of hearing loss is characterized by interference with the loudness of sound? A.) Conductive B.) Sensorineural C.) Central auditory imperceptive D.) Mixed conductive-sensorineural

While interacting with a hospitalized child, the nurse learns that the child lives with foster parents and a fost brother. Which type of family is this? A.) Nuclear B.) Blended C.) Extended D.) Binuclear

Why are cool-mist vaporizers rather than steam vaporizers recommended in the home treatment of respiratory infections? A.) They are safer B.) They are less expensive C.) Respiratory secretions are dried by steam vaporizers D.) A more comfortable environment is produced

In what condition should the nurse be alert for altered fluid requirements in children (select all that apply): A.) Oliguric renal failure B.) Increased intracranial pressure C.) Mechanical ventilation D.) Compensated hypotension E.) Tetralogy of Fallot F.) Type 1 diabetes mellitus

A, B, C

The nurse has administered a dose of epinephrine to a 12-month-old infant. For which adverse reactions of epinephrine should the nurse monitor (select all that apply): A.) Nausea B.) Tremors C.) Irritability D.) Bradycardia E.)Hypotension

A, B, C

The nurse is caring for a child after cardiac surgery. What interventions should the nurse implement with regard to chest tubes placed to a water-seal drainage system (select all that apply): A.) Maintain sterility B.) Check for tube patency C.) Do not interrupt the water-seal drainage system D.) Clamp the chest tube when ambulating the child E.) Measure the drainage by emptying the collection chamber every shift

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): A.) Homelessness B.) Lower income C.) Migrant status D.) Working parents E.) Single parent status

A, B, C

The nurse is preparing to admit a 4-year-old child with chronic benign neutropenia. What clinical features of chronic benign neutropenia should the nurse recognize (select all that apply): A.) Gingivitis is present B.) Anemia is not present C.) Monocytosis is present D.) It has an autosomal recessive pattern E.) Treatment is by bone marrow transplantation

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): A.) Advertising of unhealthy food can increase snacking B.) Increased screen time may be related to unhealthy sleep C.) There is a link between the amount of screen time and obesity D.) Increased screen time can lead to better knowledge of nutrition E.) Physical activity increases when children increase the amount of screen time

A, B, C

The nurse is teaching the family with a child with cerebral palsy (CP) strategies to prevent constipation. What should the nurse include in the teaching session (select all that apply): A.) Increase fluid intake B.) Increase fiber in the diet C.) Administer stool softeners daily as prescribed D.) Increase the amount of dairy products in the diet E.) Allow the child to decide when to try to have a bowel movement

A, B, C

The nurse teaches the parents of a preschool child techniques to minimize misbehavior. Which actions taken by the parents show an understanding of the instructions given (select all that apply): A.) Recognizing when the child is tired to prevent conflicts B.) Setting limits for the child with some friendly reminders C.) Reprimanding the child in a firm but normal tone of voice D.) Not allowing the child to have any kind of power or control E.) Waiting 30 minutes to punish the child after an incident of misbehavior

A, B, C

The parents of a child with a seizure disorder tell the nurse that the child's illness has changed their routine and is creating stress. Which nursing interventions are most important (select all that apply): A.) Normalize the life of the child B.) Identify effective coping strategies C.) Identify appropriate support systems D.) Encourage the parents to meditate often E.) Ask the parents to avoid thinking of the future

A, B, C

What are the goals of organized athletics for preadolescent children (select all that apply): A.) Physical fitness B.) Basic motor skills C.) A positive self-image D.) Commitment to winning

A, B, C

What behavior does the nurse expect when caring for a preschool-age child admitted to the hospital (select all that apply): A.) Develops trust in adults B.) Cries quietly for the parents C.) Tolerates brief periods of separation D.) Refuses to comply with the usual routines E.) Attempts to physically keep the parents near

A, B, C

What functional goal should the nurse expect for a child who has a T1 to T10 spinal cord injury (select all that apply): A.) May be braced for standing B.) Able to drive automobile with hand controls C.) Can manage adapted public transportation D.) Some able to use regular public transportation E.) Ambulates well, often with short leg braces with or without cane

A, B, C

What strategies should the nurse implement to increase nutritional intake for the child receiving chemotherapy (select all that apply): A.) Allow the child any food tolerated B.) Fortify foods with nutritious supplements C.) Allow the child to be involved in food selection D.) Encourage the parents to place pressure on the importance of eating E.) Encourage the child to eat favorite foods during infusion of chemotherapy medications

A, B, C

The nurse is preparing a staff education program about growth and development of an 18-month-old toddler. Which characteristics should the nurse include in the staff education program (select all that apply): A.) Eats well with a spoon and cup B.) Runs clumsily and can walk up stairs C.) Points to common objects D.) Builds a tower of three or four blocks E.) Has a vocabulary of 300 words F.) Dresses self in simple clothes

A, B, C, D

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): A.) Dark tufts of hair B.) Skin depression or dimple C.) Port-wine angiomatous nevi D.) Soft, subcutaneous lipomas E.) Bladder and sphincter paralysis

A, B, C, D

The nurse is teaching coping strategies to parents of a child with a chronic illness. What coping strategies should the nurse include (select all that apply): A.) Listen to the child B.) Accept the child's illness C.) Establish a support system D.) Learn to care for the child's illness one day at a time E.) Do not share information with the child about the illness

A, B, C, D

The school nurse is teaching a group of adolescents about avoiding contaminated water during a mission trip. What should the nurse include in the teaching (select all that apply): A.) Ice B.) Meats C.) Raw vegetables D.) Unpeeled fruits E.) Carbonated beverages

A, B, C, D

What are some of the associated disabilities seen with cerebral palsy (select all that apply): A.) Visual impairment B.) Hearing impairment C.) Speech difficulties D.) Intellectual impairment E.) Associated heart defects

A, B, C, D

What are supportive interventions that can assist a preschooler with a chronic illness to meet developmental milestones (select all that apply): A.) Encourage socialization B.) Encourage mastery of self-help skills C.) Provide devices that make tasks easier D.) Clarify that the cause of the child's illness is not his or her fault E.) Discuss planning for the future and how the condition can affect choices

A, B, C, D

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

A, B, C, D

Which of the following conditions may lead to the development of obesity in children (select all that apply): A.) Physical inactivity B.) Low socioeconomic status C.) Use of food as a positive reinforcement of desired behaviors D.) Consumption of energy-dense foods and drinks E.) Positive self-esteem

A, B, C, D

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): A.) High-pitched cry B.) Poor feeding C.) Setting-sun sign D.) Sunken fontanel E.) Distended scalp veins F.) Decreased head circumference

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 D.) Nuchal rigidity E.) Poor sucking ability

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): A.) Fever B.) Chills C.) Headache D.) Poor tone E.) Drowsiness

A, B, C, E

A family you are caring for on the pediatric unit asks you about nutrition for their baby. What facts will you want to include in this nutritional information (select all that apply): A.) Breastfeeding provides micronutrients and immunologic properties B.) Eating preferences and attitudes related to food are established by family influences and culture C.) Most children establish lifelong eating habits by 18 months old D.) During adolescence, parental influence diminishes and adolescents E.) Because of the stress of returning to work, most mothers use this as a time to stop breastfeeding

A, B, D

A mother comments to a nurse working on the pediatric unit, "My second child just does not seem to be acting like or responding the same way as my first child." Nursing interventions to respond to this inquiry should include which of the following (select all that apply): A.) Assessment for dysmorphic syndrome (e.g., multiple congenital anomalies, microcephaly) B.) Inquiring about temperament: irritability or lethargy C.) Explaining that all children are different and that it can be detrimental to compare them D.) Noting language development appropriate for the child's age E.) Meeting the siblings to assess similarities that may be familial rather than problematic

A, B, D

The nurse is preparing to feed a 10-month-old child diagnosed with failure to thrive (FTT). Which actions should the nurse plan to implement (select all that apply): A.) Be persistent B.) Introduce new foods slowly C.) Provide a stimulating atmosphere D.) Maintain a calm, even temperament E.) Feed the infant only when signs of hunger are exhibited

A, B, D

The nurse is reviewing the Healthy People 2020 leading health indicators for a child health promotion program. Which are included in the leading health indicators (select all that apply): A.) Decrease tobacco use B.) Improve immunization rates C.) Reduce incidences of cancer D.) Increase access to health care E.) Decrease the number of eating disorders

A, B, D

The parents of a 5-year-old child ask the nurse how they can minimize misbehavior. Which responses should the nurse give (select all that apply): A.) Set clear and reasonable goals. B.) Praise your child for desirable behavior C.) Don't call attention to unacceptable behavior D.) Teach desirable behavior through your own example E.) Don't provide an opportunity for your child to have any control

A, B, D

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

A, B, D

What are supportive interventions that can assist an infant with a chronic illness to meet developmental milestones (select all that apply): A.) Encourage consistent caregivers B.) Encourage periodic respite from demands of care C.) Encourage one family member to be the primary caretaker D.) Encourage parental rooming in during hospitalization E.) Withhold age-appropriate developmental tasks until the child is older

A, B, D

Which actions by the nurse demonstrate overinvolvement with patients and their families (select all that apply): A.) Buying clothes for the patients B.) Showing favoritism toward a patient C.) Focusing on technical aspects of care D.) Spending off-duty time with patients and families E.) Asking questions if families are not participating in care

A, B, D

Which are included in the evaluation step of the nursing process (select all that apply): A.) Determination if the outcome has been met B.) Ascertaining if the plan requires modification C.) Establish priorities and selecting expected patient goals D.) Selecting alternative interventions if the outcome has not been met E.) Determining if a risk or actual dysfunctional health problem exists

A, B, D

Which factors will influence self-care in the chronically ill hospitalized child (select all that apply): A.) Child's level of interest B.) Child's physical ability C.) The parent doing all care D.) Child's developmental age E.) Child's interest in spirituality

A, B, D

Which of the following are the primary causes of mortality among adolescents in the US (select all that apply): A.) Injuries B.) Suicide C.) Congenital anomalies D.) Homicide E.) Chronic illness

A, B, D

An adolescent asks the nurse about the safety of getting a tattoo. The nurse explains to the adolescent that it is important to find a qualified operator using proper sterile technique because an unsterilized needle or contaminated tattoo ink can cause what (select all that apply): A.) Hepatitis C virus B.) Hepatitis B virus C.) Hepatitis E virus D.) Human immunodeficiency virus (HIV) E.) Mycobacterium chelonae skin infections

A, B, D, E

The nurse is assisting with application of a synthetic cast on a child with a fractured humerus. What are the advantages of a synthetic cast over a plaster of Paris cast (select all that apply): A.) Less bulky B.) Drying time is faster C.) Molds readily to body part D.) Permits regular clothing to be word E.) Can be cleaned with small amount of soap and water

A, B, D, E

The nurse is providing care to a school-age-child in an ambulatory setting. What are the benefits of ambulatory care (select all that apply): A.) Increased cost savings B.) Reduces chances of infection C.) Reduced time for preparation D.) No separation anxiety in the child E.) Minimized stressors compared to hospitalization

A, B, D, E

What signs and symptoms are indicative of a urinary tract disorder in the infancy period (124 months) (select all that apply): A.) Pallor B.) Poor feeding C.) Hypothermia D.) Excessive thirst E.) Frequent urination

A, B, D, E

Which of the following factors should a nurse consider when managing the pain of a terminally ill child (select all that apply): A.) Pain medications are given on an as-needed schedule, and extra doses for breakthrough pain are available to maintain comfort B.) Opioid drugs, such as morphine, are given for severe pain and the dosage is increased as necessary to maintain optimum pain relief C.) Addiction is a factor in managing terminal pain in a child, and the nurse plays an important role in educating parents that their child may become addicted D.) Nurses often express concern that administering dosages of opioids that exceed those with which they are familiar will hasten the child's death; in the principles of double effect E.) In addition to pain medication, techniques such as music therapy, distraction and guided imagery should be combined with medications to provide the child and family strategies to control pain

A, B, D, E

A 5 year old is recovering from a tonsillectomy and adenoidectomy and is being discharged home with his mother. Home care instructions should include which of the following (select all that apply): A.) Observe the child for continuous swallowing B.) Encourage the child to take sips of cool, clear liquids C.) Administer codeine elixir as necessary for throat pain D.) Observe the child for restlessness or difficulty breathing E.) Encourage the child to cough every 4 to 5 hours to prevent pneumonia F.) Administer an analgesic such as acetaminophen for pain F.) Adm

A, B, D, F

A school nurse in middle school (grades 6, 7, and 8) is preparing an outline for a sex education class. Which of these statements represent important concepts to be covered in discussing this topic with this age group (select all that apply): A.) Consider separating the boys and girls into same-sex groups with a leader of the same sex B.) Answer questions matter-of-factly and honestly and appropriate to the children's level of understanding C.) Use vernacular or slang terms to describe human physiologic functions D.) Avoid discussing sexually transmitted diseases in this age group E.) Discuss common myths and misconceptions associated with sex and the reproductive process F.) Avoid controversial topics such as birth control

A, B, E

Parents of an adolescent ask the school nurse, It is OK for our adolescent to get a job? The nurse should answer telling the parents the effects of adolescents who work more than 20 hours a week are what (select all that apply): A.) Can lead to fatigue B.) Can lead to poorer grades C.) Improves an interest in school D.) Enhances development and identity E.) Can reduce extracurricular involvement

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): A.) Encourage fluids B.) Monitor urinary output C.) Monitor sodium serum levels D.) Monitor potassium serum levels E.) Monitor serum peak and trough levels

A, B, E

The nurse is caring for a child with a urinary tract infection who is on trimethoprimsulfamethoxazole (Bactrim). What side effects of this medication should the nurse teach to the parents and the child (select all that apply): A.) Rash B.) Urticaria C.) Pneumonitis D.) Renal toxicity E.) Photosensitivity

A, B, E

The nurse is evaluating a 7-month-old infants cognitive development. Which behaviors should the nurse anticipate evaluating (select all that apply): A.) Imitates sounds B.) Shows interest in a mirror image C.) Comprehends simple commands D.) Actively searches for a hidden object E.) Attracts attention by methods other than crying

A, B, E

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): A.) Wide-based gait B.) Rapid, repetitive movements performed poorly C.) Slow, twisting movements of the trunk or extremities D.) Hypertonicity with poor control of posture, balance, and coordinated motion E.) Disintegration of movements of the upper extremities when the child reaches for objects

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): A.) Keep baby powder out of reach B.) Inspect toys for removable parts C.) Allow the infant to take a bottle to bed D.) Teething biscuits can be used for teething discomfort E.) The infant should not be fed hard candy, nuts, or foods with pits

A, B, E

The nurse keeps which things in mind when communicating bad news to families (select all that apply): A.) Determine what the parent knows B.) Providing a setting conducive to communication C.) Recognize and make the family aware of their denial D.) Give all details of the situation to all families to build trust E.) Acknowledge all reactions and feelings, particularly using an empathetic response

A, B, E

What are supportive interventions that can assist a toddler with a chronic illness to meet developmental milestones (select all that apply): A.) Give choices B.) Provide sensory experiences C.) Avoid discipline and limit setting D.) Discourage negative and ritualistic behaviors E.) Encourage independence in as many areas as possible

A, B, E

What are symptoms of abusive head trauma (AHT) in the more severe form that may be present (select all that apply): A.) Seizures B.) Posturing C.) Tachypnea D.) Tachycardia E.) Altered level of consciousness

A, B, E

What are the different stages of separation anxiety in children (select all that apply): A.) Protest B.) Despair C.) Approval D.) Regression E.) Detachment

A, B, E

What growth and development milestones are expected between the ages of 8 and 9 years (select all that apply): A.) Can help with routine household tasks B.) Likes the reward system for accomplished tasks C.) Uses the telephone for practical purposes D.) Chooses friends more selectively E.) Goes about home and community freely, alone or with friends F.) Enjoys family time and is respectful of parents

A, B, E

What guidelines should the nurse use when interviewing adolescents (select all that apply): A.) Ensure privacy B.) Use open-ended questions C.) Share your thoughts and assumptions D.) Explain that all interactions will be confidential E.) Begin with less sensitive issues and proceed to more sensitive ones

A, B, E

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

A, B, E

Which nursing actions are most appropriate when building a therapeutic relationship with a hospitalized child and family (select all that apply): A.) Learning about the religious beliefs of the child B.) Assessing the family's feelings of anxiety or fear C.) Focusing on the technical aspects of providing care D.) Working overtime to care for the child and the family E.) Encouraging family involvement in the caring process

A, B, E

Which nursing actions foster therapeutic relationships with children and families (select all that apply): A.) Striving to empower families B.) Having a calming influence on the family C.) Working overtime frequently to care for a family D.) Becoming critical when parents do not visit their children E.) Being able to separate the family's needs from the nurse's own needs

A, B, E

In teaching a 16-year-old adolescent who was recently diagnosed with systemic lupus erythematosus (SLE), what statements should the nurse include (select all that apply): A.) You should use a moisturizer with a sun protection factor (SPF) of 30 B.) You should avoid pregnancy because this can cause a flare-up C.) You should not receive any immunizations in the future D.) You may need to be on a low-protein, high-carbohydrate diet E.) You should expect to lose weight while taking steroids F.) You may need to modify your daily recreational activities

A, B, F

What are signs and symptoms of the stage of despair in relation to separation anxiety in young children (select all that apply): A.) Withdrawn from others B.) Uncommunicative C.) Clings to parents D.) Physically attacks strangers E.) Forms new but superficial relationships F.) Regresses to early behaviors

A, B, F

The nurse is planning care for an infant with eczema. Which interventions should the nurse include in the care plan (select all that apply): A.) Avoid giving the infant a bubble bath B.) Avoid the use of a humidifier in the infants room C.) Avoid overdressing the infant D.) Avoid the use of topical steroids on the infants skin E.) Avoid wet compresses on the infants most affected areas

A, C

The nurse is planning to administer immunizations to a 6-month-old infant. Which interventions should the nurse implement to minimize local reactions from the vaccines (select all that apply): A.) Select a needle length of 1 inch B.) Administer in the deltoid muscle C.) Inject the vaccine into the vastus lateralis D.) Draw the vaccine up from a vial with a filter needle E.) Change the needle on the syringe after drawing up the vaccine and before injecting

A, C

Which of the following hormones have the most impact on the development of puberty in females and males (select all that apply): A.) Follicle-stimulating hormone (FSH) B.) Insulin C.) Luteinizing hormone (LH) D.) Estrogen E.) Testosterone

A, C

A school-age child has been a victim of bullying. What characteristics does the nurse assess for in this child (select all that apply): A.) Anxiety B.) Outgoing C.) Low self-esteem D.) Psychosomatic complaints E.) Good academic performance

A, C, D

The clinic nurse is evaluating causes for iron deficiency caused by inadequate supply of iron. What should the nurse recognize as causes for iron deficiency caused by an inadequate iron supply (select all that apply): A.) Prematurity B.) Slow growth rate C.) Excessive milk intake D.) Severe iron deficiency in the mother E.) Exclusive breastfeeding of infant from birth to 3 months

A, C, D

The nurse is assessing a family's use of complementary medicine practices. What practices are classified as mindbody control therapies (select all that apply): A.) Relaxation B.) Acupuncture C.) Prayer therapy D.) Guided imagery E.) Herbal medicine

A, C, D

The nurse is preparing to admit a 5-year-old child with a lower motor neuron syndrome. What clinical manifestations of a lower motor neuron syndrome should the nurse expect to observe (select all that apply): A.) Loss of hair B.) Babinski reflex present C.) Skin and tissue changes D.) Marked atrophy of atonic muscle E.) Hyperreflexia with tendon reflexes exaggerated

A, C, D

The nurse is preparing to admit a 7-year-old child with type 2 diabetes. What clinical features of type 2 diabetes should the nurse recognize (select all that apply): A.) Oral agents are effective B.) Insulin is usually needed C.) Ketoacidosis is infrequent D.) Diet only is often effective E.) Chronic complications frequently occur

A, C, D

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): A.) Citrus B.) Bananas C.) Spicy foods D.) Peppermint E.) Whole wheat bread

A, C, D

The nurse is teaching parents of a toddler how to handle temper tantrums. What should the nurse include in the teaching (select all that apply): A.) Provide realistic expectations B.) Avoid using rewards for good behavior C.) Ensure consistency among all caregivers in expectations D.) During tantrums, ignore the behavior and continue to be present E.) Use time-outs for managing temper tantrums, starting at 12 months

A, C, D

The nurse understands that blocks to therapeutic communication include what (select all that apply): A.) Socializing B.) Use of silence C.) Using cliches D.) Defending a situation E.) Using open-ended questions

A, C, D

What are common respiratory symptoms dying children experience (select all that apply): A.) Cough B.) Eupnea C.) Wheezing D.) Shortness of breath E.) Decrease in secretions

A, C, D

What are supportive interventions that can assist an adolescent with a chronic illness to meet developmental milestones (select all that apply): A.) Encourage activities appropriate for age B.) Avoid discussing planning for the future C.) Provide instruction on interpersonal and coping skills D.) Emphasize good appearance and wearing of stylish clothes E.) Understand that the adolescent will not have the same sexual needs

A, C, D

What factors can negatively affect parents reactions to their child's illness (select all that apply): A.) Additional stresses B.) Previous coping abilities C.) Lack of support systems D.) Seriousness of the threat to the child E.) Previous experience with hospitalization

A, C, D

Which factors should school nurses include when educating children and reducing bicycle-associated injuries (select all that apply): A.) Encourage peer leaders to act as role models B.) Discuss optional helmet use if the rider is competent C.) Stress the importance of wearing helmets when riding D.) Address issues related to noncompliance for helmet use E.) Suggest avoiding bicycles because their use is associated with injuries

A, C, D

A child is diagnosed with active pulmonary tuberculosis. What medications does the nurse anticipate to be prescribed for the first 2 months (select all that apply): A.) Isoniazid (INH) B.) Cefuroxime (Ceftin) C.) Rifampin (Rifadin) D.) Pyrazinamide (PZA) E.) Ethambutol (Myambutol)

A, C, D, E

Parents tell the nurse that siblings of their hospitalized child are feeling left out. What suggestions should the nurse make to the parents to assist the siblings to adjust to the hospitalization of their brother or sister (select all that apply): A.) Arrange for visits to the hospital B.) Limit information given to the siblings C.) Encourage phone calls to the hospitalized child D.) Make or buy inexpensive toys or trinkets for the siblings E.) Identify an extended family member to be their support system

A, C, D, E

The nurse is preparing to admit a 10-year-old child with Duchenne muscular dystrophy. What clinical features of Duchenne muscular dystrophy should the nurse recognize (select all that apply): A.) Calf muscle hypertrophy B.) Late onset, usually between 6 and 8 years of age C.) Progressive muscular weakness, wasting, and contractures D.) Loss of independent ambulation by 9 to 12 years of age E.) Slowly progressive, generalized weakness during adolescence

A, C, D, E

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): A.) Spitting up B.) Bilious vomiting C.) Failure to thrive D.) Excessive crying E.) Respiratory problems

A, C, D, E

The nurse is preparing to complete documentation on a patient's chart. Which should be included in documentation of nursing car (select all that apply): A.) Reassessments B.) Incident reports C.) Initial assessments D.) Nursing care provided E.) Patients response of care provided

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): A.) Fence swimming pools B.) Keep bathroom doors open C.) Eliminate unnecessary pools of water D.) Keep one hand on the child while in the tub E.) Supervise the child when near any source of water

A, C, D, E

The nurse should teach the family that which residual disabilities can occur for a child being treated for a brain tumor (select all that apply): A.) Ataxia B.) Anorexia C.) Dysphagia D.) Sensory deficits E.) Crania nerve palsies

A, C, D, E

What characterizes a preschoolers concept of death (select all that apply): A.) Belief their thoughts can cause death B.) They have a concrete understanding of death C.) Death is seen as temporary and gradual D.) Death is seen as a departure, a kind of sleep E.) They usually have some sense of the meaning of death

A, C, D, E

Which are some major conditions contributing to childhood death (select all that apply): A.) Cancer B.) Asthma C.) Trauma D.) Cystic fibrosis E.) Muscular dystrophy

A, C, D, E

Which clinical manifestations are appropriate for myopia in children (select all that apply): A.) Dizziness B.) Amblyopia C.) Headaches D.) Clumsiness E.) Eye-rubbing

A, C, D, E

Which clinical symptoms are appropriate with spinal cord compression from atlantoaxial instability (select all that apply): A.) Loss of motor skills B.) Persistent back pain C.) Persistent neck pain D.) Changes in sensation E.) Loss of bladder control

A, C, D, E

A 2-month old formerly healthy infant born at term is seen in the urgent care clinic with intercostal retractions, respiratory rate of 62, heart rate of 128, refusal to breastfeed, abundant nasal secretions and a pulse oximeter reading of 88% in room air. The diagnosis of respiratory syncytial virus is made. The infant's oxygen saturation remains 95% in room air and the respiratory rate is 54 with intercostal retractions; heart rate is 120 bpm. After 2 hours of observation and an intravenous bolus of fluids, the infant is being discharged home. The nurse provides which of the following home care instructions for this infant (select all that apply): A.) Continue breastfeeding infant B.) Discontinue breastfeeding and administer Pedialyte for 24 hours C.) Observe infant for labored breathing or apnea (cessation of breathing) D.) Instill normal saline drops in both nares and suction thoroughly before feeding and before placing to sleep E.) Place infant to sleep on his side with the head of the bed slightly elevated to facilitate breathin F.) Keep the infant out of day care or nursery

A, C, D, F

When interacting with a parent at her child's well visits, which statement by the mother would be an indication for a speech referral (select all that apply): A.) Failure to speak any meaningful words spontaneously in a 2 year old child B.) Using different words or nicknames for certain people C.) Failure to use sentences of three or more words in a 3 year old D.) Stuttering or any other type of dysfluency E.) Omission of word endings (e.g., plurals, tenses of verbs) in a 3 year old F.) Frequent omission of final consonants in a 3 year old

A, C, D, F

An adolescent is being placed on an ACE inhibitor. What should the nurse inform the adolescent with regard to this medication (select all that apply): A.) Stay well hydrated B.) Increase intake of potassium C.) Avoid rapid position changes D.) Take the medication with meals E.) Side effects may include a cough

A, C, E

In terms of social development, the school-age child does which of the following (select all that apply): A.) Begins to explore the environment beyond the family B.) Has an increased interest in persons of the opposite gender (gender) C.) May actively participate in same-sex groups or clubs D.) Strives to be different from those in the peer group E.) Begins to form strong relationships with person of the same sex (gender)

A, C, E

Parents are concerned about their child riding an all-terrain vehicle. What should the nurse tell the parents about safe use of all-terrain vehicles (select all that apply): A.) Restrict riding to familiar terrain B.) Limit street use to the neighborhood C.) Nighttime riding should not be allowed D.) Vehicles should not carry more than two persons E.) Vehicles should include seat belts, roll bars, and automatic headlights

A, C, E

The nurse is assessing heart sounds on a school-age child. Which should the nurse document as abnormal findings if found on the assessment (select all that apply): A.) S4 heart sound B.) S3 heart sound C.) Grade II murmur D.) S1 louder at the apex of the heart E.) S2 louder than S1 in the aortic area

A, C, E

The nurse is caring for a child with meningitis. What acute complications of meningitis should the nurse continuously assess the child for (select all that apply): A.) Seizures B.) Cerebral palsy C.) Cerebral edema D.) Hydrocephalus E.) Cognitive impairments

A, C, E

The nurse is preparing to admit a 6-year-old child with celiac disease. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Steatorrhea B.) Polycythemia C.) Malnutrition D.) Melena stools E.) Foul-smelling stools

A, C, 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): A.) Do not place pillows in the infants crib B.) Crib slats should be 4 inches or less apart C.) Keep all plastic bags stored out of the infants reach D.) Plastic over the mattress is acceptable if it is covered with a sheet E.) A pacifier should not be tied on a string around the infant's neck

A, C, E

The nurse is teaching an adolescent with hypertension foods recommended on the DASH diet. What foods should the nurse include in the teaching session (select all that apply): A.) Green beans B.) Energy drinks C.) Low-fat yogurt D.) Chocolate milk E.) Whole grain bread

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): A.) Back up a child's right to say no B.) Don't take what your child says too seriously C.) Take a second look at signals of potential danger D.) Don't be too detailed about examples of sexual assault E.) Remind children that even nice people sometimes do mean things

A, C, E

What are signs and symptoms of a possible kidney transplant rejection in a child (select all that apply): A.) Fever B.) Hypotension C.) Diminished urinary output D.) Decreased serum creatinine E.) Swelling and tenderness of graft area

A, C, E

What are supportive interventions that can assist a school-age child with a chronic illness to meet developmental milestone (select all that apply): A.) Encourage socialization B.) Discourage sports activities C.) Encourage school attendance D.) Provide instructions on assertiveness E.) Educate teachers and classmates about the child's condition

A, C, E

What conditions are physical complications of obesity (select all that apply): A.) Type 2 diabetes mellitus B.) QT interval prolongation C.) Fatty liver disease D.) Gastrointestinal dysfunction E.) Abnormal growth acceleration F.) Dental erosion

A, C, E

What does the nurse recognize as physical signs of approaching death (select all that apply): A.) Mottling of skin B.) Decreased sleeping C.) Cheyne-Stokes respirations D.) Loss of the sense of hearing E.) Decreased appetite and thirst

A, C, E

When a child with a visual impairment is hospitalized, the nurse should ensure that which of the following interventions are carried out to decrease stress for the child during the hospitalization (select all that apply): A.) Because the child cannot see what may be taking place, the nurse needs to reassure the child and family throughout the every phase of treatment B.) The nurse will make sure that the parents are comfortable with the placement of objects in the room C.) Whenever possible, the same nurse should care for the child to ensure consistency in the approach D.) To help the child feel safe, the nurses should take over most of the routine care of the child, unless the parent is present E.) Each health care provider should identify himself or herself, as soon as entering the child's room

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): A.) Type 1 DM has an abrupt onset B.) Type 1 DM is often controlled with oral glucose agents C.) Type 1 DM occurs primarily in whites D.) Type 2 DM always requires insulin therapy E.) Type 2 DM frequently has a familial history F.) Type 2 DM occurs in people who are overweight

A, C, E, F

Which responsibilities are included in the pediatric nurses promotion of the health and well-being of children (select all that apply): A.) Promoting disease prevention B.) Providing financial assistance C.) Providing support and counseling D.) Establishing lifelong friendships E.) Establishing a therapeutic relationship F.) Participating in ethical decision making

A, C, E, F

The clinic nurse is reviewing the immunization guidelines for hepatitis B. Which are true of the guidelines for this vaccine (select all that apply): A.) The hepatitis B vaccination series should be begun at birth B.) The adolescent not vaccinated at birth does not have a need to be vaccinated C.) Any child not vaccinated at birth should receive two doses at least 4 months apart D.) An unimmunized 10-year-old child should receive three doses administered 4 weeks apart.

A, D

A parent tells the nurse, My toddler tries to undo the car seat harness and climb out of the seat. What strategies should the nurse recommend to the parent to encourage the child to stay in the seat (select all that apply): A.) Allow your child to hold a favorite toy B.) Allow your child out of the seat occasionally C.) Avoid using rewards to encourage cooperative behavior D.) When child tries to unbuckle the seat harness, firmly say, "No" E.) It may be necessary to stop the car to reinforce the expected behavior

A, D, E

Growth measurement is a key element in children of their health status. One measurement for height is linear growth measurement. What should the nurse do to perfect this technique (select all that apply): A .) Understand the difference in measurement for children who can stand alone and for those who must lie recumbent. B.) Use a length board and footboard or a standiometer, which is the best technique, or use a tape measure. C.) Two measurers are usually required for a recumbent child, although one measurer may be sufficient for a cooperative child. D.) Reposition the child and repeat the procedure. Measure at least twice (ideally three times). Average the measurements for the final value. E.) Demonstrate competency when measuring the growth of infants, children, and adolescents. Refresher sessions should be taken when a lack of standardization occurs.

A, D, E

The nurse is caring for a child immobilized because of Russel traction. What interventions should the nurse implement to prevent renal calculi (select all that apply): A.) Monitor output B.) Encourage the patient to drink apple juice C.) Encourage milk intake D.) Ensure adequate fluids E.) Encourage the patient to drink cranberry juice

A, D, E

The nurse is planning strategies to assist a slow-to-warm child to try new experiences. What strategies should the nurse plan (select all that apply): A.) Attend after-school activities with a friend B.) Suggest the child move quickly into a new situation C.) Avoid trying new experiences until the child is ready D.) Allow the child to adapt to the experience at his or her own pace E.) Contract for permission to withdraw after a trial of the experience

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): A.) Weight loss B.) Bilious vomiting C.) Abdominal pain D.) Projectile vomiting E.) The infant is hungry after vomiting

A, D, E

The nurse is teaching parents about potential causes of colic in infancy. Which should the nurse include in the teaching session (select all that apply): A.) Overeating B.) Understimulation C.) Frequent burping D.) Parental smoking E.) Swallowing excessive air

A, D, E

The parents tell a nurse our child is having some short-term negative outcomes since the hospitalization. The nurse recognizes that what can negatively affect short-term negative outcomes (select all that apply): A.) Parent's anxiety B.) Consistent nurses C.) Number of visitors D.) Length of hospitalization E.) Multiple invasive procedures

A, D, E

The school nurse recognizes that the adverse effects of performance-enhancing substances can include what (select all that apply): A.) Depression B.) Dehydration C.) Hypotension D.) Aggressiveness E.) Changes in libido

A, D, E

What activity should the school nurse recommend for a child with hemophilia A (select all that apply): A.) Golf B.) Soccer C.) Rugby D.) Jogging E.) Swimming

A, D, E

What are signs and symptoms of the stage of detachment in relation to separation anxiety in young children (select all that apply): A.) Appears happy B.) Lacks interest in the environment C.) Regresses to an earlier behavior D.) Forms new but superficial relationships E.) Interacts with strangers or familiar caregivers

A, D, E

What characterizes a toddlers concept of death (select all that apply): A.) They are unable to comprehend an absence of life B.) They may recognize the fact of physical death C.) They understand the universality and inevitability of death D.) The are affected more by the change in lifestyle than the concept of death E.) They can only think about events in terms of their own frame of reference-living

A, D, E

What signs and symptoms are indicative of a urinary tract disorder in the childhood period (2 to 14 years) (select all that apply): A.) Fatigue B.) Dehydration C.) Hypotension D.) Growth failure E.) Blood in the urine

A, D, E

The nurse is caring for a 14-year-old child with disseminated intravascular coagulation (DIC). What clinical manifestations should the nurse expect to observe (select all that apply): A.) Petechiae B.) Chronic diarrhea C.) Hepatosplenomegaly D.) Bleeding from openings in the skin E.) Hypotension F.) Purpura

A, D, E, F

A 5-year-old child is being prepared for surgery to remove a brain tumor. Preparation for surgery should be based on which information? A.) Removal of the tumor will stop the various signs and symptoms B.) Usually the postoperative dressing covers the entire scalp C.) He is not old enough to be concerned about his head being shaved D.) He is not old enough to understand the significance of the brain

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? A.) This is a sign the parents are in denial B.) This is a normal anticipated time of parental stress C.) The parents need to learn more about cerebral palsy D.) The parents expectations are too high

A 6-year-old child has had a tonsillectomy. The child is spitting up small amounts of dark brown blood in the immediate postoperative period. The nurse should take what action? A.) Notify the health care provider B.) Continue to assess for bleeding C.) Give the child a red flavored ice pop D.) Position the child in a Trendelenburg position

A 6-year-old child is scheduled for a cardiac catheterization. What consideration is most important in planning preoperative teaching? A.) Preoperative teaching should be directed at his parents because he is too young to understand B.) Preoperative teaching should be adapted to his level of development so that he can understand C.) Preoperative teaching should be done several days before the procedure so he will be prepared D.) Preoperative teaching should provide details about the actual procedures so he will know what to expect

A 7-year-old child has just had a cast applied for a fractured arm with the wrist and elbow immobilized. What information should be included in the home care instructions? A.) No restrictions of activity are indicated B.) Elevate casted arm when both upright and resting C.) The shoulder should be kept as immobile as possible to avoid pain D.) Swelling of the fingers is to be expected. Notify a health professional if it persists more than 48 hour

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? A.) Administer TAC (tetracaine, adrenalin, and cocaine) 15 minutes before the procedure B.) Use a combination of fentanyl and midazolam for conscious sedation C.) Apply EMLA (eutectic mixture of local anesthetics) 1 hour before the procedure D.) Apply a transdermal fentanyl (Duragesic) patch immediately before the procedure

A bottle-fed infant has been diagnosed with cows milk allergy. Which formula should the nurse expect to be prescribed for the infant? A.) Similac B.) Pregestimil C.) Enfamil with iron D.) Gerber Good Start

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

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? A.) Cyanosis B.) Heart failure C.) Decreased pulmonary blood flow D.) Bounding pulses in upper extremities

A child has just returned from surgery for repair of a fractured femur. The child has a long-leg cast on. The toes on the leg with the cast are edematous, but they have color, sensitivity, and movement. What action should the nurse take? A.) Call the health care provider to report the edema B.) Elevate the foot and leg on pillows C.) Apply a warm moist pack to the foot D.) Encourage movement of toe

A child in the terminal stage of cancer has frequent breakthrough pain. Nonpharmacologic methods are not helpful, and the child is exceeding the maximum safe dose for opiate administration. What approach should the nurse implement? A.) Add acetaminophen for the breakthrough pain B.) Titrate the opioid medications to control the child's pain as specified in the protocol C.) Notify the practitioner that immediate hospitalization is indicated for pain management D.) Help the parents and child understand that no additional medication can be given because of the risk of respiratory depression

A child is admitted to the hospital with lesions on his abdomen that appear like cigarette burns. What should accurate documentation by the nurse include? A.) Two unhealed lesions are on the child's abdomen B.) Two round 4-mm lesions are on the child's lower abdomen C.) Two round symmetrical lesions are on the child's lower abdomen D.) Two round lesions on the child's abdomen that appear to be cigarette burns

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

A child is in the hospital for cystic fibrosis. What health care providers prescription should the nurse clarify before implementing? A.) Dornase alfa (Pulmozyme) nebulizer treatment bid B.) Pancreatic enzymes every 6 hours C.) Vitamin A, D, E, and K supplements daily D.) Proventil (albuterol) nebulizer treatments tid

A child is on phenytoin (Dilantin). What should the nurse encourage? A.) Fluid restriction B.) Good dental hygiene C.) A decrease in vitamin D intake D.) Taking the medication with milk

A child is recovering from Kawasaki disease (KD). The child should be monitored for which? A.) Anemia B.) Electrocardiograph (ECG) changes C.) Elevated white blood cell count D.) Decreased platelets

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? A.) Turn every 8 hours B.) Specially designed car restraints are necessary C.) Diapers should be avoided to reduce soiling of the cast D.) Use an abduction bar between the legs to aid in turning

A child with acute glomerulonephritis is in the playroom and experiences blurred vision and a headache. What action should the nurse take? A.) Check the urine to see if hematuria has increased B.) Obtain the child's blood pressure and notify the health care provider C.) Obtain serum electrolytes and send urinalysis to the laboratory D.) Reassure the child and encourage bed rest until the headache improves

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

A child with cystic fibrosis is receiving recombinant human deoxyribonuclease (DNase). What statement about DNase is true? A.) Given subcutaneously B.) May cause voice alterations C.) May cause mucus to thicken D.) Not indicated for children younger than age 12 years

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

A child with osteosarcoma is experiencing phantom limb pain after an amputation. What prescribed medication is effective for short-term phantom pain relief? A.) Phenytoin (Dilantin) B.) Gabapentin (Neurontin) C.) Valproic Acid (Depakote) D.) Phenobarbital (Phenobarbital)

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? A.) Administer 100% oxygen to relieve hypoxia B.) Notify the practitioner because chest syndrome is suspected C.) Infuse intravenous antibiotics as soon as cultures are obtained D.) Give ordered pain medication to relieve symptoms of pain episode

A child with sickle cell disease is in a vaso-occlusive crisis. What nonpharmacologic pain intervention should the nurse plan? A.) Exercise as a distraction B.) Heat to the affected area C.) Elevation of the extremity D.) Cold compresses to the affected area

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? A.) Bottle or tube feed him a specialized formula until he gains sufficient weight B.) Stabilize his jaw with caregivers hand (either from a front or side position) to facilitate swallowing C.) Place him in a well-supported, semi-reclining position D.) Place him in a sitting position with his neck hyperextended to make use of gravity flow

A feeling of guilt that the child caused the disability or illness is especially common in which age group? A.) Toddler B.) Preschooler C.) School-age child D.) Adolescent

A foster parent is talking to the nurse about the health care needs for the child who has been placed in the parents care. Which statement best describes the health care needs of foster children? A.) Foster children always come from abusive households and are emotionally fragile B.) Foster children tend to have a higher than normal incidence of acute and chronic health problems C.) Foster children are usually born prematurely and require technologically advanced health care D.) Foster children will not stay in the home for an extended period, so health care needs are not as important as emotional fulfillment

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

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

A male school-age student asks the school nurse, How much with my height increase in a year? The nurse should give which response? A.) Your height will increase on average 1 inch a year B.) Your height will increase on average 2 inches a year C.) Your height will increase on average 3 inches a year D.) Your height will increase on average 4 inches a year

A parent brings a 12-month-old infant into the emergency department and tells the nurse that the infant is allergic to peanuts and was accidentally given a cookie with peanuts in it. The infant is dyspneic, wheezing, and cyanotic. The health care provider has prescribed a dose of epinephrine to be administered. The infant weighs 24 lb. How many milligrams of epinephrine should be administered? A.) 0.11 to 0.33 mg B.) 0.011 to 0.3 mg C.) 1.1 to 3.3 mg D.) 11 to 33 mg

A parent of a school-age child tells the school nurse that the parents are going through a divorce. The child has not been doing well in school and sometimes has trouble sleeping. The nurse should recognize this as what? A.) Indicative of maladjustment B.) A common reaction to divorce C.) Suggestive of a lack of adequate parenting D.) An unusual response that indicates a need for referral

A parent tells the nurse that 80% of children with the same type of leukemia as his sons have a 5-year survival. He believes that because another child on the same protocol as his son has just died, his son now has a better chance of success. What is the best response by the nurse? A.) It is sad for the other family but good news for your child B.) Each child has an 80% likelihood of 5-year survival C.) The data suggest that 20% of the children in the clinic will die. There are still many hurdles for your son D.) You should avoid the grieving family because you will be benefiting from their loss

A pediatric cardiologist suggest surgical repair for a ventricular septal defect to prevent what? A.) Pulmonary embolism B.) Pulmonary hypertension C.) Right to left shunt of blood D.) Left ventricular hypertrophy

A preadolescent has maintained good glycemic control of his type 1 diabetes through the school year. During summer vacation, he has had repeated episodes of hypoglycemia. What additional teaching is needed? A.) Carbohydrates in the diet need to be replaced with protein B.) Additional snacks are needed to compensate for increased activity C.) The child needs to decrease his activity level to minimize episodes of hypoglycemia D.) Insulin dosage should be increased to compensate for a change in activity level

A recommendation to prevent neural tube defects (NTDs) is the supplementation of what? A.) Vitamin A throughout pregnancy B.) Folic acid for all women of childbearing age C.) Folic acid during the first and second trimesters of pregnancy D.) Multivitamin preparations as soon as pregnancy is suspected

A registered nurse is explaining to a nursing student about atraumatic care in a pediatric care facility. Which example would the nurse cite to illustrate this process? A.) Recording blood pressure B.) Administering pain medications C.) Administering intravenous fluids D.) Providing diet as listed in the diet chart

A school-age child has asthma. The nurse should teach the child that if a peak expiratory flow rate is in the yellow zone, this means that the asthma control is what? A.) 80% of a personal best, and the routine treatment plan can be followed B.) 50% to 79% of a personal best and needs an increase in the usual therapy C.) 50 % of a personal best and needs immediate emergency bronchodilators D.) Less than 50% of a personal best and needs immediate hospitalization

A school-age child has begun to sleepwalk. What does the nurse advise the parents to perform? A.) Wake the child and help determine what is wrong B.) Leave the child alone unless he or she is in danger of harming him- or herself or others C.) Arrange for psychologic evaluation to identify the cause of stress D.) Keep the child awake later in the evening to ensure sufficient tiredness for a full night of sleep

A school-age child with leukemia experienced severe nausea and vomiting when receiving chemotherapy for the first time. What is the most appropriate nursing action to prevent or minimize these reactions with subsequent treatments? A.) Administer the chemotherapy between meals B.) Give an antiemetic before chemotherapy begins C.) Have the child bring favorite foods for snacks D.) Keep the child NPO (nothing by mouth) until nausea and vomiting subside

A toddler is admitted to the pediatric unit with presumptive bacterial meningitis. The initial orders include isolation, intravenous access, cultures, and antimicrobial agents. The nurse knows that antibiotic therapy will begin when? A.) After the diagnosis is confirmed B.) When the medication is received from the pharmacy C.) After the child's fluid and electrolyte balance is stabilized D.) As soon as the practitioner is notified of the culture results

A toddlers mother calls the nurse because she thinks her son has swallowed a button type of battery. He has no signs of respiratory distress. The nurses response should be based on which premise? A.) An emergency laparotomy is very likely B.) The location needs to be confirmed by radiographic examination C.) Surgery will be necessary if the battery has not passed in the stool in 48 hours D.) Careful observation is essential because an ingested battery cannot be accurately detected

After the family, which has the greatest influence on providing continuity between generations? A.) Race B.) School C.) Social class D.) Government

After the introduction of the Back to Sleep campaign in 1992, an increased incidence has been noted of which pediatric issues? A.) Sudden infant death syndrome (SIDS) B.) Plagiocephaly C.) Failure to thrive D.) Apnea of infancy

An 8-year-old girl has been uncooperative and angry since the diagnosis of cancer was made. Her parents tell the nurse that they do not know what to do because she is always so mad at us. What nursing action is most appropriate at this time? A.) Explain to child that anger is not helpful B.) Help the parents deal with her anger constructively C.) Ask the parents to find out what she is angry about D.) Encourage the parents to ignore the anger at this time

An adolescent comes to the school nurse after experiencing shin splints during a track meet. What reassurance should the nurse offer? A.) Shin splints are expected in runners B.) Ice, rest, and nonsteroidal antiinflammatory drugs (NSAIDs) usually relieve pain C.) It is generally best to run around and work the pain out D.) Moist heat and acetaminophen are indicated for this type of injury

An adolescent patient wants to make decisions about treatment options, along with his parents. Which moral value is the nurse displaying when supporting the adolescent to make decisions? A.) Justice B.) Autonomy C.) Beneficence D.) Nonmaleficence

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which method? A.) Bone grafting B.) Intravenous infusion C.) Bone marrow injection D.) Intraabdominal infusion

An adolescent with irritable bowel syndrome comes to see the school nurse. What information should the nurse share with the adolescent? A.) A low-fiber diet is required B.) Stress management may be helpful C.) Milk products are a contributing factor D.) Pantoprazole (a proton pump inhibitor) is effective in treatment

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

An infant is born with one lower limb deficiency. When is the optimum time for the child to be fitted with a functional prosthetic device? A.) As soon as possible after birth B.) When the infant is developmentally ready to stand up C.) At about ages 12 to 15 months, when most children are walking D.) At about 4 years, when the healthy limb is not growing so rapidly

An infant is diagnosed with transposition of the great vessels. Prostaglandin E1 is given intravenously. The parents ask how long the child will remain on the prostaglandin E1. What is the appropriate response by the nurse? A.) Prostaglandin E1 will be given intermittently until corrective surgery is performed B.) Prostaglandin E1 will be given continuously until corrective surgery is performed C.) Prostaglandin E1 will be given continuously throughout the preoperative and postoperative periods until the child is stable D.) Prostaglandin E1 will be given intermittently throughout the preoperative and postoperative periods until the child is stable

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? A.) Wean the infant from TPN the next day B.) Stimulate adaptation of the small intestine C.) Give additional nutrients that cannot be included in the TPN D.) Provide parents with hope that the child is close to discharge

As the nurse is getting Nathan ready for surgery, his doctor asked you to explain preemptive analgesic to Nathan's mother. Which response leads you to believe his mother needs more teaching? A.) "I understand that preemptive analgesia is giving Nathan pain medication before he has pain and could be given before surgery." B.) "This medication will control Nathan's pain so he doesn't feel anything." C.) "Giving this medicine early may help prevent complications after surgery." D.) "By controlling Nathan's pain, he will be more comfortable and may be able to go home sooner."

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

Characteristics of bullying include: A.) Unintentional harm inflicted on another person that is part of the socialization process in children B.) The infliction of repetitive physical, verbal or emotional abuse on another person with intent to harm C.) An attempt to gain acceptance and be liked by same-sex peers D.) An early sign of severely disturbed personality disorder that escalated in early childhood

During discharge teaching the parents of a child with (CHD) are nervous to administer digoxin is based on what: A.) They lack the expertise for administration B.) Parents must know specific guidelines for administration C.) Difficult to over or under medicate patient D.) It is a frequently used safe medication

Essential postoperative nursing management of a child after removal of a brain tumor includes which nursing care? A.) Turning and positioning every 2 hours B.) Measuring all fluid intake and output C.) Changing the dressing when it becomes soiled D.) Using maximum lighting to ensure accurate observations

Evidence-based practice (EBP), a decision-making model, is best described as which? A.) Using information in textbooks to guide care B.) Combining knowledge with clinical experience and intuition C.) Using a professional code of ethics as a means for decision making D.) Gathering all evidence that applies to the child's health and family situation

Families progress through various stages of reactions when a child is diagnosed with a chronic illness or disability. After the shock phase, a period of adjustment usually follows. This is often characterized by what response? A.) Denial B.) Guilt and anger C.) Social reintegration D.) Acceptance of the child's limitations

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

Identification and treatment of cryptorchid testes should be done by age 2 years. What is an important consideration? A.) Medical therapy is not effective after this age B.) Treatment is necessary to maintain the ability to be fertile when older C.) The younger child can tolerate the extensive surgery needed D.) Sexual reassignment may be necessary if treatment is not successful

Immobilization causes what effect on metabolism? A.) Hypocalcemia B.) Decreased metabolic rate C.) Positive nitrogen balance D.) Increased levels of stress hormones

In addition to injuries, what are the leading causes of death in adolescents ages 15 to 19 years? A.) Suicide and cancer B.) Suicide and homicide C.) Drowning and cancer D.) Homicide and heart disease

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

Intranasal administration of desmopressin acetate (DDAVP) is used to treat which condition? A.) Hypopituitarism B.) Diabetes insipidus (DI) C.) Syndrome of inappropriate antidiuretic hormone (SIADH) D.) Acute adrenocortical insufficiency

Iron overload is a side effect of chronic transfusion therapy. What treatment assists in minimizing this complication? A.) Magnetic therapy B.) Infusion of deferoxamine C.) Hemoglobin electrophoresis D.) Washing red blood cells (RBCs) to reduce iron

Melena, the passage of black, tarry stools, suggests bleeding from which source? A.) The perianal or rectal area B.) The upper gastrointestinal (GI) tract C.) The lower GI tract D.) Hemorrhoids or anal fissures

Nursing strategies to improve the growth and development of the child with human immunodeficiency virus (HIV) infection should include what? A.) Provide only those foods that the child feels like eating B.) Fortify foods with nutritional supplements to maximize quality of intake C.) Weigh the child and measure height and muscle mass on a daily basis D.) Provide high-fat and high-calorie meals and snacks to meet body requirements for growth

Nutritional management of the child with Crohn disease includes a diet that has which component? A.) High fiber B.) Increased protein C.) Reduced calories D.) Herbal supplements

One of the goals for children with asthma is to maintain the child's normal functioning. What principle of treatment helps to accomplish this goal? A.) Limit participation in sports B.) Reduce underlying inflammation C.) Minimize use of pharmacologic agents D.) Have yearly evaluations by a health care provider

One of the major differences in clinical presentation between Crohn disease (CD) and ulcerative colitis (UC) is that UC is more likely to cause which clinical manifestation? A.) Pain B.) Rectal bleeding C.) Perianal lesions D.) Growth retardation

Pain scales for infants and their uses include but are not limited to: A.) CRIES: Crying, Requiring increased oxygen, Inability to console, Expression and Sleeplessness B.) FLACC: child's face, legs, activity, cry and consolability C.) NCCPC: parent and health caregiver questionnaire assessing acute and chronic pain D.) NPASS: neonatal pain, agitation and sedation scale for infants from 3 to 6 months

Parents are concerned that their 6-year-old son continues to occasionally wet the bed. What does the nurse explain? A.) This is likely because of increased stress at home B.) Enuresis usually ceases between 6 and 8 years of age C.) Drug therapy will be prescribed to treat the enuresis D.) Testing will be necessary to determine what type of kidney problem exists

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? A.) In the front passenger seat B.) In the middle of the rear seat C.) In the rear seat behind the driver D.) In the rear seat behind the passenger

Rectal temperatures are indicated in which situation? A.) In the newborn period B.) Whenever accuracy is essential C.) Rectal temperatures are never indicated D.) When rapid temperature changes are occurring

The American Academy of Pediatrics (AAP) recommends that children younger than the age of 16 years be prohibited from participating in what? A.) Skateboarding B.) Snowmobiling C.) Trampoline use D.) Horseback riding

The Asian parent of a child being seen in the clinic avoids eye contact with the nurse. What is the best explanation for this considering cultural differences? A.) The parent feels inferior to the nurse B.) The parent is showing respect for the nurse C.) The parent is embarrassed to seek health care D.) The parent feels responsible for her child's illness

The clinic nurse is evaluating lab results for a child. What recorded hematocrit (Hct) result is considered within the normal range? A.) 30% B.) 40% C.) 50% D.) 60%

The clinic nurse is teaching parents about physiologic anemia that occurs in infants. What statement should the nurse include about the cause of physiologic anemia? A.) Maternally derived iron stores are depleted in the first 2 months B.) Fetal hemoglobin results in a shortened survival of red blood cells C.) The production of adult hemoglobin decreases in the first year of life D.) Low levels of fetal hemoglobin depress the production of erythropoietin

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

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? A.) Use of protective equipment at the family's discretion B.) Education of adults to recognize signs that indicate a risk for injury C.) Sports medicine program to help student athletes work through overuse injuries D.) Arrangements for multiple sports to use same athletic fields to accommodate more children

The most important nursing intervention when caring for an infant with myelomeningocele in the preoperative stage is which? A.) Take vital signs every hour B.) Place the infant on the side to decrease pressure on the spinal sac C.) Watch for signs that might indicate developing hydrocephalus D.) Apply a heat lamp to facilitate drying and toughening of the sac

The mother of a 20-month-old boy tells the nurse that he has a barking cough at night. His temperature is 37 C (98.6 F). The nurse suspects mild croup and should recommend which intervention? A.) Admit to the hospital and observe for impending epiglottitis B.) Provide fluids that the child likes and use comfort measures C.) Control fever with acetaminophen and call if cough gets worse tonight D.) Try over-the-counter cough medicine and come to the clinic tomorrow if no improvement

The mother of a 6-month-old infant has returned to work and is expressing breast milk to be frozen. She asks for directions on how to safely thaw the breast milk in the microwave. What should the nurse recommend? A.) Heat only 10 oz or more B.) Do not thaw or heat breast milk in a microwave oven C.) Always leave the bottle top uncovered to allow heat to escape D.) Shake the bottle vigorously for at least 30 seconds after heating

The mother of an infant tells the nurse that sometimes there is a whitish glow in the pupil of his eye. The nurse should suspect which condition? A.) Brain tumor B.) Retinoblastoma C.) Neuroblastoma D.) Rhabdomyosarcoma

The nurse asks a child of Jewish ancestry about a blister noted on the wrist. The child tells the nurse, "My grandmother rubbed garlic there." Which condition is the grandmother treating? A.) Poor eyesight B.) A skin infection C.) Digestive problems D.) A respiratory illness

The nurse can expect a grieving family to experience certain behaviors. Which common grief reaction might the nurse prepare the parents to experience? A.) Feeling especially close to others B.) Having the deceased child's voice C.) Feeling content with the lift the child had D.) Feeling thankful for the time they spend with their child

The nurse discovers welts on the back of a Vietnamese child during a home health visit. The child's mother says she has rubbed the edge of a coin on her childs oiled skin. The nurse should recognize this as what? A.) Child abuse B.) Cultural practice to rid the body of disease C.) Cultural practice to treat enuresis or temper tantrums D.) Child discipline measure common in the Vietnamese culture

The nurse encourages the mother of a toddler with acute laryngotracheobronchitis to stay at the bedside as much as possible. What is the primary rationale for this action? A.) Mothers of hospitalized toddlers often experience guilt B.) The mothers presence will reduce anxiety and ease the child's respiratory efforts. C.) Separation from the mother is a major developmental threat at this age D.) The mother can provide constant observations of the child's respiratory efforts

The nurse has attended a professional development program about palliative care for the pediatric population. What statement by the nurse should indicate a correct understanding of the program? A.) Palliative care provides interventions that hasten death B.) Palliative care promotes the optimal functioning and quality of life C.) Palliative care does not provide pain and symptom management like hospice care D.) Palliative care is not well received in hospitals that provide end-of-life care for children

The nurse has been assigned as a home health nurse for a child who is technology dependent. The nurse recognizes that the family's background differs widely from the nurses own. The nurse believes some of their lifestyle choices are less than ideal. What nursing intervention is most appropriate to institute? A.) Change the family B.) Respect the differences C.) Assess why the family is different D.) Determine whether the family is dysfunctional

The nurse has been visiting an adolescent with recently acquired tetraplegia. The teens mother tells the nurse, Im sick of providing all the care while my husband does whatever he wants to, whenever he wants to do it. What reaction should be the nurses initial response? A.) Refer the mother for counseling B.) Listen and reflect the mothers feelings C.) Ask the father in private why he does not help D.) Suggest ways the mother can get her husband to help

The nurse has just started assessing a young child who is febrile and appears ill. There is hyperextension of the child's head (opisthotonos) with pain on flexion. Which is the most appropriate action? A.) Ask the parent when the neck was injured B.) Refer for immediate medical evaluation C.) Continue assessment to determine the cause of the neck pain D.) Record head lag on the assessment record and continue the assessment of the child

The nurse is administering an intravenous chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. What nursing action is most appropriate to initiate? A.) Recheck the rate of drug infusion B.) Stop the drug infusion immediately C.) Observe the child closely for next 10 minutes D.) Explain to the child that this is an expected side effect

The nurse is assessing the coping behaviors of the parents of a child recently diagnosed with a chronic illness. What behavior should the nurse consider an approach behavior that results in movement toward adjustment? A.) Being unable to adjust to a progression of the disease or condition B.) Anticipating future problems and seeking guidance and answers C.) Looking for new cures without a perspective toward possible benefit D.) Failing to recognize the seriousness of the child's condition despite physical evidence

The nurse is aware that if patients different cultures are implied to be inferior, the emotional attitude the nurse is displaying is what? A.) Acculturation B.) Ethnocentrism C.) Cultural shock D.) Cultural sensitivity

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 childs 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? A.) Withhold feedings B.) Notify the health care provider C.) Put the infant in an infant seat D.) Keep the infant in the plastic hood

The nurse is caring for a 10-year-old child during a long hospitalization. What intervention should the nurse include in the care plan to minimize loss of control and autonomy during the hospitalization? A.) Allow the child to skip morning self-care activities to watch a favorite television program B.) Create a calendar with special events such as a visit from a friend to maintain a routine C.) Allow the child to sleep later in the morning and go to bed later at night to promote control D.) Create a restrictive environment so the child feels in control of sensory stimulation

The nurse is caring for a 6-year-old child with acute lymphoblastic leukemia (ALL). The parent states, My child has a low platelet count, 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

The nurse is caring for a child dying of cancer. Which physical sign would prompt the nurse to call the family to the bedside? A.) Rapid pulse B.) Change in respiratory pattern C.) Sensation of cold although the body feels hot D.) Loss of hearing followed by loss of the other senses

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? A.) Rinsing mouth with water B.) Daily toothbrushing and flossing C.) Lemon glycerin swabs for cleansing D.) Wiping teeth with moistened gauze or Toothettes

The nurse is caring for a child with a terminal illness who is approaching death. What physical signs can the nurse expect the child to demonstrate? A.) Loss of hearing before sight B.) Cheyne-Stokes respirations C.) Increased appetite and thirst D.) Increased pulse and blood pressure

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. What nursing action should be included in the care of the child? A.) Force fluids B.) Monitor pulse oximetry C.) Institute seizure precautions D.) Encourage a high-protein diet

The nurse is caring for a child with carbon monoxide (CO) poisoning associated with smoke inhalation. What intervention is essential in this child's care? A.) Monitor pulse oximetry B.) Monitor arterial blood gases C.) Administer oxygen if respiratory distress develops D.) Administer oxygen if childs lips become bright, cherry-red in color

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? A.) Minimize seizures B.) Prevent dehydration C.) Promote cardiac output D.) Reduce energy expenditure

The nurse is caring for a family whose infant was just born with anencephaly. What is the most important nursing intervention? A.) Implement measures to facilitate the attachment process B.) Help the family cope with the birth of an infant with a fatal defect C.) Prepare the family for extensive surgical procedures that will be needed D.) Provide emotional support so the family can adjust to the birth of an infant with problems

The nurse is caring for a school-age child with severe anemia and activity intolerance. What diversional activity should the nurse plan for this child? A.) Playing a musical instrument B.) Playing board or card games C.) Participating in a game of table tennis D.) Participating in decorating the hospital room

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

The nurse is conducting discharge teaching with the parent of a 7-year-old child with minimal change nephrotic syndrome (MCNS). What statement by the parent indicates a correct understanding of the teaching? A.) My child needs to stay home from school for at least 1 more month B.) I should not add additional salt to any of my child's meals C.) My child will not be able to participate in contact sports while receiving corticosteroid therapy D.) I should measure my child's urine after each void and report the 24-hour amount to the health care provider

The nurse is conveying some bad news to parents about their child, who is chronically ill. Which action by the nurse needs correction? A.) Providing information slowly B.) Using medical terms to explain in-depth information C.) Acknowledging the parents' reactions and feelings D.) Stopping regularly to check if the parents understand

The nurse is discussing development and play activities with the parent of a 2-month-old boy. Which statement by the parent would indicate a correct understanding of the teaching? A.) I can give my baby a ball of yarn to pull apart or different textured fabrics to feel B.) I can use a music box and soft mobiles as appropriate play activities for my baby C.) I should introduce a cup and spoon or push-pull toys for my baby at this age D.) I do not have to worry about appropriate play activities at this age

The nurse is discussing issues that are important with parents considering a cross-racial adoption. Which statement made by the parents indicates further teaching is needed? A.) We will try to preserve the adopted childs racial heritage B.) We are glad we will be getting full medical information when we adopt our child C.) We will make sure to have everyone realize this is our child and a member of the family D.) We understand strangers may make thoughtless comments about our child being different from us

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

The nurse is evaluating research studies according to the GRADE criteria and has determined the quality of evidence on the subject is moderate. Which type of evidence does this determination indicate? A.) Strong evidence from unbiased observational studies B.) Evidence from randomized clinical trials showed inconsistent results C.) Consistent evidence from well-performed randomized clinical trials D.) Evidence for at least one critical outcome from randomized clinical trials had serious flaws

The nurse is evaluating the laboratory results of a stool sample. What is a normal finding? A.) The laboratory reports a stool pH of 5.0 B.) The laboratory reports a negative guaiac C.) The laboratory reports low levels of enzymes D.) The laboratory reports reducing substances present

The nurse is explaining different parenting styles to a group of parents. The nurse explains that an authoritative parenting style can lead to which child behavior? A.) Shyness B.) Self-reliance C.) Submissiveness D.) Self-consciousness

The nurse is having difficulty communicating with a hospitalized 6-year-old child. Which technique should be most helpful? A.) Recommend that the child keep a diary B.) Provide supplies for the child to draw a picture C.) Suggest that the parent read fairy tales to the child D.) Ask the parent if the child is always uncommunicative

The nurse is interviewing the father of a 10-month-old girl. The child is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says no firmly and moves her away from the outlet. The nurse should use this opportunity to teach the father what? A.) That the child should be given a time-out B.) That the child is old enough to understand the word no C.) That the child will learn safety issues better if she is spanked D.) That the child should already know that electrical outlets are dangerous

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? A.) Give contraceptive information B.) Provide information on the grief process C.) Reassure parents that SIDS is not likely to occur again D.) Thoroughly investigate the home situation to verify SIDS as the cause of death

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

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? A.) Children with dyskinetic CP have a wide-based gait and repetitive movements B.) Children with spastic pyramidal CP have a positive Babinski sign and ankle clonus C.) Children with hemiplegia CP have mouth muscles and one lower limb affected D.) Children with ataxic CP have involvement of pharyngeal and oral muscles with dysarthria

The nurse is preparing to admit a child to the hospital with a diagnosis of acute poststreptococcal glomerulonephritis. The nurse understands that the peak age at onset for this disease is what? A.) 2 to 4 years B.) 5 to 7 years C.) 8 to 10 years D.) 11 to 13 years

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? A.) Mix the dose with juice to disguise its taste B.) Do not give the dose; suspect a dosage error C.) Check the heart rate; administer digoxin if the rate is greater than 100 beats/min D.) Check the heart rate; administer digoxin if the rate is greater than 80 beats/min

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? A.) Your other children need you to be strong B.) You have been through a very tough time C.) His suffering is over; you should be happy D.) God never gives us more than we can handle

The nurse is taking a health history of an adolescent. Which best describes how the chief complaint should be determined? A.) Request a detailed listing of symptoms B.) Ask the adolescent, "Why did you come here today?" C.) Interview the parent away from the adolescent to determine the chief complaint D.) Use what the adolescent says to determine, in correct medical terminology, what the problem is

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

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

The nurse is teaching a group of new nursing graduates about identifiable qualities of strong families that help them function effectively. Which quality should be included in the teaching? A.) Lack of congruence among family members B.) Clear set of family values, rules, and beliefs C.) Adoption of one coping strategy that always promotes positive functioning in dealing with life events D.) Sense of commitment toward growth of individual family members as opposed to that of the family unit

The nurse is teaching parents about administering digoxin (Lanoxin). What instructions should the nurse tell the parents? A.) If the child vomits, give another dose B.) Give the medication at regular intervals C.) If a dose is missed, give a give an extra dose D.) Give the medication mixed with the child's formula

The nurse is teaching the parent of a 4-year-old child with a cast on the arm about care at home. What statement by the parent indicates a correct understanding of the teaching? A.) I should have the affected limb hang in a dependent position B.) I will use an ice pack to relieve the itching C.) I should avoid keeping the injured arm elevated D.) I will expect the fingers to be swollen for the next 3 days

The nurse is teaching the parent of a preschool child how to administer the child's insulin injection. The child will be receiving 2 units of regular insulin and 12 units of NPH insulin every morning. What should the parent be taught? A.) Draw the insulin in separate syringes B.) Draw the regular insulin first and then the NPH into the same syringe C.) Draw the NPH insulin first and then the regular into the same syringe D.) Check blood sugar first, and if below 120, hold the regular insulin and give the NPH

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 doesn't have to perform at a band concert if a headache occurs

The nurse knows that parents need further teaching with regard to the treatment of congenital clubfoot when they state what? A.) We'll keep the cast dry B.) Were happy this is the only cast our baby will need C.) We'll watch for any swelling of the foot while the cast is on D.) We're getting a special car seat to accommodate the cas

The nurse needs to take the blood pressure of a small child. Of the cuffs available, one is too large and one is too small. The best nursing action is which? A.) Use the small cuff B.) Use the large cuff C.) Use either cuff using the palpation method D.) Wait to take the blood pressure until a proper cuff can be located

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? A.) Poor appetite B.) Reduction of edema C.) Restriction to bed rest D.) Increased potassium intake

The nurse notices that a child is increasingly apprehensive and has tachycardia after heart surgery. The chest tube drainage is now 8 ml/kg/hr. What should be the nurses initial intervention? A.) Apply warming blankets B.) Notify the practitioner of these findings C.) Give additional pain medication per protocol D.) Encourage child to cough, turn, and deep breathe

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 B.) My 4-month-old doesn't lift his head when on his tummy C.) My 8-month-old can sit without support D.) My 10-month-old is not walking

The nurse stops to assist an adolescent who has experienced severe trauma when hit by a motorcycle. The emergency medical system (EMS) has been activated. The first person who provided assistance applied a tourniquet to the child's leg because of arterial bleeding. What should the nurse do related to the tourniquet? A.) Loosen the tourniquet B.) Leave the tourniquet in place C.) Remove the tourniquet and apply direct pressure if bleeding is still present D.) Remove the tourniquet every 5 minutes, leaving it off for 30 seconds each time

The nurse understands that which guideline should be followed to determine serving sizes for toddlers? A.) 1/2 tbsp of solid food per year of age B.) 1 tbsp of solid food per year of age C.) 2 tbsp of solid food per year of age D.) 2 1/2 tbsp of solid food per year of age

The parent of an 8.2-kg (18-lb) 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? A.) Front facing in back seat B.) Rear facing in back seat C.) Front facing in front seat with airbag on passenger side D.) Rear facing in front seat if an airbag is on the passenger side

The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. What is the nurse's best response? A.) Allow him to cry for no longer than 15 minutes and then pick him up B.) Babies need comforting and cuddling. Meeting these needs will not spoil him C.) Babies this young cry when they are hungry. Try feeding him when he cries D.) If he isn't soiled or wet, leave him, and hell cry himself to sleep

The parents of a 3-year-old child with congenital heart disease are afraid to let their child play with other children because of possible overexertion. How should the nurse reply to this concern? A.) The parents should meet all the child's needs B.) The child needs opportunities to play with peers C.) Constant parental supervision is needed to avoid overexertion D.) The child needs to understand that peers activities are too strenuous

The parents of a 4-month-old infant cannot visit except on weekends. What action by the nurse indicates an understanding of the emotional needs of a young infant? A.) Place her in a room away from other children B.) Assign her to the same nurse as much as possible C.) Tell the parents that frequent visiting is unnecessary D.) Assign her to different nurses so she will have varied contacts

The parents of a 7-year-old boy tell the nurse that lately he has been cruel to their family pets and actually caused physical harm. The nurses recommendation should be based on remembering what? A.) This is an expected behavior at this age B.) This is a warning sign of a serious problem C.) This is harmless venting of anger and frustration D.) This is common in children who are physically abused

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

The parents of a newborn with an umbilical hernia ask about treatment options. The nurses response should be based on which knowledge? A.) Surgery is recommended as soon as possible B.) The defect usually resolves spontaneously by 3 to 5 years of age C.) Aggressive treatment is necessary to reduce its high mortality D.) Taping the abdomen to flatten the protrusion is sometimes helpful

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

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

The school nurse is providing guidance to families of children who are entering elementary school. What is essential information to include? A.) Meet with teachers only at scheduled conferences B.) Encourage growth of a sense of responsibility in children C.) Provide tutoring for children to ensure mastery of material D.) Homework should be done as soon as child comes home from school

To avoid a fall from a crib, the nurse recommends to parents that their toddler should sleep in a bed rather than a crib when reaching what height? A.) 30 in B.) 35 in C.) 40 in D.) 45 in

What amount of fluid loss occurs with moderate dehydration? A.) <50 ml/kg B.) 50 to 90 ml/kg C.) <5% total body weight D.) >15% total body weight

What aspects of cognition develop during adolescence? A.) Ability to see things from the point of view of another B.) Capability of using a future time perspective C.) Capability of placing things in a sensible and logical order D.) Progress from making judgments based on what they see to making judgments based on what they reason

What blood flow pattern occurs in a ventricular septal defect? A.) Mixed blood flow B.) Increased pulmonary blood flow C.) Decreased pulmonary blood flow D.) Obstruction to blood flow from ventricles

What childhood cancer may demonstrate patterns of inheritance that suggest a familial basis? A.) Leukemia B.) Retinoblastoma C.) Rhabdomyosarcoma D.) Osteogenic sarcoma

What clinical manifestation is a common sign of digoxin toxicity? A.) Seizures B.) Vomiting C.) Bradypnea D.) Tachycardia

What clinical manifestations suggest hydrocephalus in an infant? A.) Closed fontanel and high-pitched cry B.) Bulging fontanel and dilated scalp veins C.) Constant low-pitched cry and restlessness D.) Depressed fontanel and decreased blood pressure

What condition is the leading cause of death after heart transplantation? A.) Infection B.) Rejection C.) Cardiomyopathy D.) Heart failure

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

What consideration is most important in managing tuberculosis (TB) in children? A.) Skin testing B.) Chemotherapy C.) Adequate rest D.) Adequate hydration

What diagnostic test for allergies involves the injection of specific allergens? A.) Phadiatop B.) Skin testing C.) Radioallergosorbent tests (RAST) D.) Blood examination for total immunoglobulin E (IgE)

What do mortality statistics describe? A.) Disease occurring regularly within a geographic location B.) The number of individuals who have died over a specific period C.) The prevalence of specific illness in the population at a particular time D.) Disease occurring in more than the number of expected cases in a community

What drug is an angiotensin-converting enzyme (ACE) inhibitor? A.) Furosemide (Lasix) B.) Captopril (Capoten) C.) Chlorothiazide (Diuril) D.) Spironolactone (Aldactone)

What finding is characteristic of fractures in children? A.) Fractures rarely occur at the growth plate site because it absorbs shock well B.) Rapidity of healing is inversely related to the child's age C.) Pliable bones of growing children are less porous than those of adults D.) The periosteum of a child's bone is thinner, is weaker, and has less osteogenic potential compared to that of an adult

What is a high-fiber food that the nurse should recommend for a child with chronic constipation? A.) White rice B.) Popcorn C.) Fruit juice D.) Ripe bananas

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

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

What is descriptive of the social development of school-age children? A.) Identification with peers is minimum B.) Children frequently have best friends C.) Boys and girls play equally with each other D.) Peer approval is not yet an influence for the child to conform

What is the best age to introduce solid food into an infant's diet? A.) 2 to 3 months B.) 4 to 6 months C.) When birth weight has tripled D.) When tooth eruption has started

What is the common fear of hospitalized adolescents? A.) Pain B.) Altered body image C.) Restricted motor activity D.) Separation from material things

What is the earliest age at which a satisfactory radial pulse can be taken in children? A.) 1 year B.) 2 years C.) 3 years D.) 6 years

What is the major health concern of children in the United States? A.) Acute illness B.) Chronic illness C.) Congenital disabilities D.) Nervous system disorders

What is the most common form of child maltreatment? A.) Sexual abuse B.) Child neglect C.) Physical abuse D.) Emotional abuse

What is the narrowing of preputial opening of foreskin called? A.) Chordee B.) Phimosis C.) Epispadias D.) Hypospadias

What is the overriding goal of atraumatic care? A.) Prevent or minimize the child's separation from the family B.) Do not harm C.) Promote a sense of control D.) Prevent or minimize bodily injury and pain

What is the primary nursing goal for a hospitalized toddler? A.) Providing privacy B.) Encouraging parents to room in C.) Explaining procedures and routines D.) Encouraging contact with children of the same age

What is the rationale for orthopedic surgery for a child with cerebral palsy? A.) To cure spasticity B.) To improve function C.) For cosmetic purposes D.) To prevent the need of physical therapy

What is the recommended drink for athletes during practice and competition? A.) Sports drinks to replace carbohydrates B.) Cold water for gastrointestinal tract rapid absorption C.) Carbonated beverages to help with acid-base balance C.) Enhanced performance carbohydrate-electrolyte drinks

What is the single most prevalent cause of disability in children and responsible for the recent increase in childhood disability? A.) Cancer B.) Asthma C.) Seizures D.) Heart disease

What preparation should the nurse consider when educating a school-age child and the family for heart surgery? A.) Unfamiliar equipment should not be shown B.) Let the child hear the sounds of a cardiac monitor, including alarms C.) Explain that an endotracheal tube will not be needed if the surgery goes well D.) Discussion of postoperative discomfort and interventions is not necessary before the procedure

What procedure is most appropriate for assessment of an abdominal circumference related to a bowel obstruction? A.) Measuring the abdomen after feedings B.) Marking the point of measurement with a pen C.) Measuring the circumference at the symphysis pubis D.) Using a new tape measure with each assessment to ensure accuracy

What should preoperative care of a newborn with an anorectal malformation include? A.) Frequent suctioning B.) Gastrointestinal decompression C.) Feedings with sterile water only D.) Supine position with head elevated

What should the nurse do if she finds a post cardiac catheterization child with a blood saturated dressing and bed? A.) Put the patient in trandelenburg B.) Apply direct pressure at the cardiac catheterization site C.) Apply a new dressing D.) Call respiratory for a blood gas

What sign/symptom is a major clinical manifestation of rheumatic fever (RF)? A.) Fever B.) Polyarthritis C.) Osler nodes D.) Janeway spots

What signs or symptoms are most commonly associated with the prodromal phase of acute viral hepatitis? A.) Bruising and lethargy B.) Anorexia and malaise C.) Fatigability and jaundice D.) Dark urine and pale stools

What statement is descriptive of most cases of hemophilia? A.) X-linked recessive deficiency of platelets causing prolonged bleeding B.) X-linked recessive inherited disorder in which a blood clotting factor is deficient C.) Autosomal dominant deficiency of a factor involved in the blood-clotting reaction D.) Y-linked recessive inherited disorder in which the red blood cells become moon shaped

What statement is most descriptive of Meckel diverticulum? A.) It is acquired during childhood B.) Intestinal bleeding may be mild or profuse C.) It occurs more frequently in females than in males D.) Medical interventions are usually sufficient to treat the problem

What statement is the most descriptive of asthma? A.) It is inherited B.) There is heightened airway reactivity C.) There is decreased resistance in the airway D.) The single cause of asthma is an allergic hypersensitivity

What statement is true concerning osteogenesis imperfecta (OI)? A.) It is easily treated B.) It is an inherited disorder C.) Braces and exercises are of no therapeutic value D.) Later onset disease usually runs a more difficult course

What type of cerebral palsy (CP) is the most common type? A.) Ataxic B.) Spastic C.) Dyskinetic D.) Mixed type

When assessing a child's injury in the emergency department. a nurse suspects physical abuse. Based on this suspicion, the nurse's primary legal responsibility is to: A.) Assist the family in identifying resources for support B.) Report the case in which the physical abuse is suspected to the local authorities C.) Document the child's physical assessment findings accurately and thoroughly D.) Refer the family to the hospital support group

When caring for a child with a disability, the nurse notes that while encouraging the child to take part in his own care, the mother constantly gives into the child, allowing him to have his own way. Which anticipatory guidance can the nurse give to promote normalization in this relationship? A.) "Giving in" is not a detriment to the child when he or she has disabilities or limitations B.) Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations C.) Advise the parent to wait to explain any procedure to the child until they are at the health care setting or just before the procedure D.) Have the parent realize that it would be unfair to the siblings to expect similar rules to apply to all of the children in the family

When communicating with dying children, what should the nurse remember? A.) Adolescent children tend to be concrete thinkers B.) Games, art, and play provide a good means of expression C.) When children can recite facts, they understand the implications of those facts D.) If children's questions direct the conversation, the assessment will be incomplete

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

When the nurse interviews an adolescent, which is especially important? A.) Focus the discussion on the peer group B.) Allow an opportunity to express feelings C.) Use the same type of language as the adolescent D.) Emphasize that confidentiality will always be maintained

Which definition of the term autonomy by the nurse is accurate? A.) The concepts of fairness B.) The patient's right to self-governing C.) The obligation to prevent or minimize harm D.) The obligation to promote the patient's well being

Which describes a preschooler's concept of death? A.) It is surrounded by guilt and shame B.) Death is a departure, a kind of sleep C.) Preschoolers have no understanding of death D.) It is associated with misdeeds or bad behavior

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

Which explains the importance of detecting strabismus in young children? A.) Color vision deficit may result B.) Amblyopia, a type of blindness, may result C.) Epicanthal folds may develop in the affected eye D.) Corneal light reflexes may fall symmetrically within each pupil

Which family theory explains how families react to stressful events and suggests factors that promote adaptation to these events? A.) Interactional theory B.) Family stress theory C.) Erikson's psychosocial theory D.) Developmental systems theory

Which family theory is described as a series of tasks for the family throughout its life span? A.) Exchange theory B.) Developmental theory C.) Structural-functional theory D.) Symbolic interactional theory

Which intervention is most appropriate regarding a child's attendance at a sibling's funeral service? A.) The parents for the sibling to attend the funeral B.) The parents expire how the deceased child will look C.) The parents do not allow the sibling to stay for a long time D.) The parents bring the sibling to the funeral service after the relatives arrive

Which is an appropriate recommendation in preventing tooth decay in young children? A.) Substitute raisins for candy B.) Substitute sugarless gum for regular gum C.) Use honey or molasses instead of refined sugar D.) When sweets are to be eaten, select a time not during meals

Which is considered a block to effective communication? A.) Using silence B.) Using cliches C.) Directing the focus D.) Defining the problem

Which is the most consistent and commonly used data for assessment of pain in infants? A.) Self-report B.) Behavioral C.) Physiologic D.) Parental report

Which muscle is contraindicated for the administration of immunizations in infants and young children? A.) Deltoid B.) Dorsogluteal C.) Ventrogluteal D.) Anterolateral thigh

Which nursing intervention is appropriate to include when working with the parents of a 2 year old child with Down syndrome to teach the child feeding skills? A.) Holding the spoon for the child B.) Encouraging the use of adaptive utensils C.) Including new feeding skills when on vacation D.) Offering pureed foods to the child to make chewing easier

Which one of the following strategies might be recommended for an infant with failure to thrive (FTT) to increase caloric intake? A.) Vary the schedule for routine activities on a daily basis B.) Be persistent through 10 to 15 minutes of food refusal C.) Avoid solids until after the bottle is well accepted D.) Use developmental stimulation by a specialist during feedings

Which situation denotes a non-therapeutic nurse-patient-family relationship? A.) The nurse is planning to read a favorite fairy tale to a patient. B.) During shift report, the nurse is criticizing parents for not visiting their child C.) The nurse is discussing with a fellow nurse the emotional draw to a certain patient D.) The nurse is working with a family to find ways to decrease the family's dependence on health care providers

Which statement by the nurse may result in a poor outcome in a child who has behavioral problems? A.) "Please put that book down" B.) "Let's talk about it and see what we can decide" C.) "I am sorry, but I can't read you a story right now" D.) "When the television show is over, it will be time for dinner"

Which statement is correct about toilet training? A.) Bladder training is usually accomplished before bowel training B.) Wanting to please the parent helps motivate the child to use the toilet C.) Watching older siblings use the toilet confuses the child D.) Children must be forced to sit on the toilet when first learning

The nurse is preparing to admit a 1-month-old infant with severe congenital neutropenia (Kostmann disease). What clinical features of severe congenital neutropenia should the nurse recognize (select all that apply): A.) Anemia is present B.) Neutropenia is present C.) The illness is severe D.) It has a dominant inheritance pattern E.) There are decreased eosinophils in the bone marrow

B, C

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

B, C

Which of the following immunization booster vaccine should be considered for a 13 year old adolescent who has completed all recommended routine childhood vaccinations (select all that apply): A.) DTaP vaccine B.) Tdap vaccine C.) Meningococcal vaccine D.) Pneumococcal vaccine E.) Hepatitis B vaccine F.) Hib vaccine

B, C

A child is hospitalized in acute renal failure and has a serum potassium greater than 7 mEq/L. What temporary measures that will produce a rapid but transient effect to reduce the potassium should the nurse expect to be prescribed (select all that apply): A.) Dialysis B.) Calcium gluconate C.) Sodium bicarbonate D.) Glucose 50% and insulin E.) Sodium polystyrene sulfonate (Kayexalate)

B, C, D

A parent asks the nurse, When will I know my child is ready for toilet training? The nurse should include what in the response (select all that apply): A.) The child should be able to stay dry for 1 hour B.) The child should be able to sit, walk, and squat C.) The child should have regular bowel movements D.) The child should express a willingness to please

B, C, D

A toddler is in the sensorimotor, tertiary circular reactions stage of cognitive development. What behavior should the nurse expect to assess (select all that apply): A.) Refers to self by pronoun B.) Gestures up and down C.) Able to insert round object into a hole D.) Can find hidden objects but only in the first location E.) Uses future-oriented words, such as tomorrow

B, C, D

According to Jean Piaget, adolescent cognitive development is represented by the stage of formal operational thought that includes which of the following (select all that apply): A.) Believing that thoughts are all-powerful B.) Thinking in abstract terms C.) Thinking about hypothesis D.) Using a future time perspective E.) Thinking in the here and now

B, C, D

Parents of a 12 year old report to the nurse that the child watches 6 hours of television per day. Which conditions is the child at risk for (select all that apply): A.) Depression B.) Drug abuse C.) Alcoholism D.) Eating disorder E.) Attention-deficit disorder

B, C, D

Parents of a child who will need hemodialysis ask the nurse, What are the advantages of a fistula over a graft or external access device for hemodialysis? What response should the nurse give (select all that apply): A.) It is ready to be used immediately B.) There are fewer complications with a fistula C.) There is less restriction of activity with a fistula D.) It produces dilation and thickening of the superficial vessels E.) The fistula does not require a needle insertion at each dialysis

B, C, D

The clinic nurse is assessing a 6-month-old infant during a well-child appointment. The nurse should use which approaches to alleviate the infants stranger anxiety (select all that apply): A.) Talk in a loud voice B.) Meet the infant at eye level C.) Avoid sudden intrusive gestures D.) Maintain a safe distance initially E.) Pick up the infant and hold him or her closely

B, C, D

The family of a child with a terminal illness has been informed of the option of palliative care for the child. Which hallmark principles does the nurse draw on to further educate the family (select all that apply): A.) The child patient is the unit of care B.) The child patient and family are the unit of care C.) An interdisciplinary team of health care professionals are part of the child's care D.) Focus is on relief of suffering, but curative treatments will be used if appropriate E.) Focus in on curative treatment and disease-modifying treatments from the interdisciplinary team

B, C, D

The hospice nurse is planning care for a child with a terminal illness. Which nursing interventions does the nurse include in the plan of care (select all that apply): A.) Discontinue eye and mouth care B.) Maintain skin with skin lotion as tolerated C.) Maintain good hygiene by giving baths as tolerated D.) Discontinue unnecessary medications and procedures E.) Continue administering oral medications to manage symptoms

B, C, D

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): A.) Hematuria B.) Anorexia C.) Hypertension D.) Purpura E.) Proteinuria F.) Periorbital edema

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): A.) Reflexology B.) Macrobiotics C.) Megavitamins D.) Health risk reduction E.) Chiropractic medicine

B, C, D

The nurse is planning to use an interpreter with a non-English-speaking family. What should the nurse plan with regard to the use of an interpreter (select all that apply): A.) Use a family member B.) The nurse should speak slowly C.) Use an interpreter familiar with the family's culture D.) The nurse should speak only a few sentences at a time E.) The nurse should speak to the interpreter during interactions

B, C, D

The nurse is teaching parents strategies to manage their child's refusal to go to sleep. Which should the nurse include in the teaching session (select all that apply): A.) Keep bedtime early B.) Enforce consistent limits C.) Use a reward system with the child D.) Have a consistent before bedtime routine

B, C, D

The school nurse recognizes that children respond to stress by using which tactics (select all that apply): A.) Passivity B.) Delinquency C.) Daydreaming D.) Delaying tactics E.) Becoming outgoing

B, C, D

What are favorable prognostic criteria for acute lymphoblastic leukemia (select all that apply): A.) Male gender B.) CALLA positive C.) Early preB cell D.) 2 to 10 years of age E.) Leukocyte count ?7?50,000/mm3

B, C, D

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

B, C, D

What findings should the nurse expect to observe in a 7-month-old infant with Werdnig-Hoffman disease (select all that apply): A.) Noticeable scoliosis B.) Absent deep tendon reflexes C.) Abnormal tongue movements D.) Failure to thrive E.) Prominent pectus excavatum F.) Significant leg involvement

B, C, D

What functional goal should the nurse expect for a child who has a C7 spinal cord injury (select all that apply): A.) Able to drive automobile with hand controls B.) Complete independence within limitations of a wheelchair C.) Can roll over in bed, sit up in bed, and eat independently D.) Requires some assistance in transfer and lower extremity dressing E.) Ambulation with bilateral long braces using four-point or swing-through crutch gait

B, C, D

When teaching a 6-year-old child with sickle cell disease and his family about pain management, which of the following should the nurse discuss (select all that apply): A.) When pain medications are used, all pain will be eliminated. B.) Nonpharmacologic methods of pain relief, including heat, massage, physical therapy, humor, and distraction. C.) It is helpful to use a "passport card" that includes information about the diagnosis, any previous complications, and the pain regimen. D.) Only the physician can decide the best course of treatment, and the other health care providers follow that plan. E.) Long-term medication use considers many factors.

B, C, D

While interviewing parents who have just arrived in the health care clinic, the nurse begins the interview. Which of the following statements involve therapeutic communication techniques (select all that apply): A.) Allow the parents to direct conversation so that they feel comfortable and in control B.) Use broad, open-ended questions so that parents can feel open to discuss issues C.) Redirect by asking guided questions to keep the parents on task D.) Using careful listening, which relies on the use of clues and verbal leads to help move the conversation along E.) Ask carefully worded, detailed questions to get accurate information

B, C, D

A child has had a short-arm synthetic cast applied. What should the nurse teach to the child and parents about cast care (select all that apply): A.) Relieve itching with heat B.) Elevate the arm when resting C.) Observe the fingers for any evidence of discoloration D.) Do not allow the child to put anything inside the cast E.) Examine the skin at the cast edges for any breakdown

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): A.) Erythema over joints B.) Soft tissue contractures C.) Swelling in multiple joints D.) Morning stiffness of the joints E.) Loss of motion in the affected joints

B, C, D, E

What characterizes a school-aged child's concept of death (select all that apply): A.) Have a mature understanding of death B.) Can respond to logical explanations of death C.) Personify death as the devil or the bogeyman D.) Have a deeper understanding of death in a concrete sense E.) Fear the mutilation and punishment associated with death

B, C, D, E

What effects of an altered pituitary secretion in a child with meningitis indicates syndrome of inappropriate antidiuretic hormone (SIADH) (select all that apply): A.) Hypotension B.) Serum sodium is decreased C.) Urinary output is decreased D.) Evidence of overhydrationE E.) Urine specific gravity is increased

B, C, D, E

What guidelines should the nurse follow when handling chemotherapeutic agents (select all that apply): A.) Use clean technique B.) Prepare medications in a safety cabinet C.) Wear gloves designed for handling chemotherapy D.) Wear face and eye protection when splashing is possible E.) Discard gloves and protective clothing in a special container

B, C, D, E

What influences a child's reaction to the stressors of hospitalization (select all that apply): A.) Gender B.) Separation C.) Support systems D.) Developmental age E.) Previous experience with illness

B, C, D, E

Which actions by the nurse demonstrate clinical reasoning (select all that apply): A.) Basing decisions on intuition B.) Considering alternative action C.) Using formal and informal thinking to gather data D.) Giving deliberate thought to a patient's problem E.) Developing an outcome focused on optimum patient care

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): A.) Fear of strangers B.) Minimal smiling C.) Avoidance of eye contact D.) Meeting developmental milestones E.) Wide-eyed gaze and continual scan of the environment

B, C, E

An adolescent is being placed on a calcium channel blocker. What should the nurse inform the adolescent with regard to this medication (select all that apply): A.) The medication may cause fatigue B.) The medication may increase heart rate C.) The medication may cause constipation D.) The medication may cause cold extremities E.) The medication may cause peripheral edema

B, C, E

Because injuries are the most common cause of death and disability in children in the United States, which stage of development correctly determines the type of injury that may occur (elect all that apply): A.) A newborn may roll over and fall off an elevated surface. B.) The need to conform and gain acceptance from his peers may make a child accept a dare. C.) Toddlers who can run and climb may be susceptible to burns, falls, and collisions with objects. D.) A preschooler may ride her two-wheel bike in a reckless manner. E.) A crawling infant may aspirate due to the tendency to place objects in his mouth.

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): A.) Gastric acidity B.) Chronic diarrhea C.) Lactose intolerance D.) Absence of phosphates E.) Inflammatory bowel disease

B, C, E

The nurse is caring for a child with Kawasaki disease in the acute phase. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Osler nodes B.) Cervical lymphadenopathy C.) Strawberry tongue D.) Chorea E.) Erythematous palms F.) Polyarthritis

B, C, E

The nurse is performing an otoscopic examination on a child. Which are normal findings the nurse should expect (select all that apply): A.) Ashen gray areas B.) A well-defined light reflex C.) A small, round, concave spot near the center of the drum D.) The tympanic membrane is a nontransparent grayish color E.) A whitish line extending from the umbo upward to the margin of the membrane

B, C, E

The nurse is preparing to admit a 3-year-old child with acute spasmodic laryngitis. What clinical features of hepatitis B should the nurse recognize (select all that apply): A.) High fever B.) Croupy cough C.) Tendency to recur D.) Purulent secretions E.) Occurs sudden, often at night

B, C, E

The nurse is preparing to admit a 7-year-old child with acute laryngotracheobronchitis (LTB). What clinical manifestations should the nurse expect to observe (select all that apply): A.) Dysphagia B.) Brassy cough C.) Low-grade fever D.) Toxic appearance E.) Slowly progressive

B, C, E

The parent of a child with a chronic illness tells the nurse, I feel so hopeless in this situation. The nurse should take which actions to foster hopefulness for the family (select all that apply): A.) Avoid topics that are lighthearted B.) Convey a personal interest in the child C.) Be honest when reporting on the child's condition D.) Do not initiate any playful interaction with the child E.) Demonstrate competence and gentleness when delivering care

B, C, E

What are reasons for children to require very high doses of opioids to control pain in palliative care (select all that apply): A.) Addition to opioids B.) Tolerance of opioids C.) Progression of the disease D.) Psychological dependence E.) Other physiologic causes of pain

B, C, E

The nurse is teaching a group of parents at a community education program about introducing solid foods to their infants. Which recommendations should the nurse include (select all that apply): A.) Spoon feeding should be introduced after an entire milk feeding B.) It is best to introduce a wide variety of foods during the first year C.) As solid food consumption increases, the quantity of milk should decrease D.) Introduction of low-calorie milk and food should be done by the end of the first year E.) Introduction of citrus fruits, meats, and eggs should be delayed until after 6 months of age F.) Each new food item should be introduced at 5- to 7-day intervals

B, C, E, F

What are the goals associated with hospice care (select all that apply): A.) Life life without medical support B.) Life life with choices and dignity C.) Live life to the fullest without pain D.) Live life to the fullest without cancer E.) Live life with the support of family F.) Life life with the familiar environment of home

B, C, E, F

A 4 month old infant is brought to the well-child clinic for immunizations. The mother indicates that the infant often strains to have a bowel movement, so she has been giving him honey and has stopped feeding him iron fortified formula, based on her sister's recommendations. The nurse recognizes that the infant is at risk for the development of which of the following (select all that apply): A.) Obseity B.) Iron deficiency anemia C.) Rickets D.) Infant botulism E.) Cow's milk allergy

B, D

The National Children's Study is the largest prospective, long-term study of children's health and development in the United States. Which of these options are the goals of this study (select all that apply): A.) Ensure that every child is immunized at the appropriate age B.) Provide information for families to eradicate unhealthy diets, dental caries and childhood obesity C.) Enlist the help of school lunch programs to reach the goal of vegetables and fruits at 30% of each lunch D.) Significantly reduces violence, substance abuse and mental health disorders among the nation's children E.) Decrease tardiness and truancy and increase the high school graduation rate in each state over the next 5 years

B, D

The nurse understands which goals are appropriate goals of care in palliative care for a dying child (select all that apply): A.) Palliative care seeks to lengthen the life of a person with life-limiting conditions B.) Palliative care seeks to assist in complex decision making surrounding life-liming conditions C.) Palliative care involved being hopeful for a cure and setting goals to encourage patients to live D.) Palliative care seeks to relieve the physical, emotional, social and spiritual distress produced by life-limiting conditions E.) Palliative care seeks to limit interruptions by health provides to once monthly so the family can be with the patient as much as possible

B, D

The nurse understands which goals are appropriate goals of care in palliative care for a dying child (select all that apply): A.) Palliative care seeks to lengthen the life of the person with life-limiting conditions B.) Palliative care seeks to assist in complex decision making surrounding life-limiting conditions C.) Palliative care involved being hopeful for a cure and setting goals to encourage patients to live D.) Palliative care seeks to relieve the physical, emotional, social and spiritual distress produced by life-limiting conditions E.) Palliative care seeks to limit interruptions by health providers to once monthly so the family can be with the patient as much as possible

B, D

You are working with a family whose 7 year old has just been diagnosed with attention-deficit/hyperactivity disorder. Which statements by the mother indicate a need for further teaching (select all that apply): A.) "My child will respond best to verbal instructions, since that will help him learn to pay attention and listen actively." B.) "A consistent schedule for homework and activities will help him be organized." C.) "I need to bring him for routine checkups while he is taking his medication because the medication can affect his appetite and growth." D.) "I am going to ask the principal if my son can change classrooms because his current teacher has too many rules and he seems to get in trouble." E.) "We may consider counseling because this has been stressful for the whole family."

B, D

A family request giving nutrition and hydration to their terminally ill child. Why would a hospice nurse hesitate to provide nutrition and hydration to a terminally ill child (select all that apply): A.) Supplemental feeding may decrease the tumor growth B.) Supplemental feeding may cause more nausea and vomiting C.) Supplemental feeding relieves the hunger or third the child is experiencing D.) Increasing fluids may contribute to congestive heart failure or increased respiratory secretions E.) Withholding supplemental feeding or hydration is believed to provide a more comfortable and natural death

B, D, E

A good understanding of enuresis will help the nurse work with the children and their families. Which of the following teaching points should be included (select all that apply): A.) Enuresis is primarily an alteration of neuromuscular bladder functioning and as such is benign and self-limiting B.) Spontaneous remission of nocturnal enuresis occurs in approximately 35% of cases C.) Normal bladder capacity (in ounces) is the child's age plus four; therefore normal bladder capacity for a 6-year old is 10 oz (600 mL) D.) Success has also been achieved with desmopressin acetate nasal spray, which reduces nighttime urinary output to a volume less than functional bladder capacity E.) Parents need reassurance that bed-wetting is not a manifestation of emotional disturbances but just represents willful misbehavior

B, D, E

Children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have resilience that is to be admired. Which of these statements reflect ways that they foster this resilience (select all that apply): A.) Protect the child from having to learn about his or her own disabilities or illness on a repeated basis B.) Develop relationships with other children and their families with similar circumstanced to build support C.) The parents set long term goals to create a sense of hope D.) Focus on the child's strengths and encourage independence E.) Accept that chronic illness is part of living

B, D, E

How can the nurse prepare a child for a painful procedure (select all that apply): A.) Be honest and use correct terms so that the child trusts the nurse B.) Involve the child in the use of distraction, such as using bubbles, music or playing a game C.) Kindly ask parents to leave the room so they don't have to watch the painful procedure D.) Use positive self-talk such as, "When I go home, I will feel better and be able to see my friends." E.) Use guided imagery that involves recalling a previous pleasurable event

B, D, E

The community health nurse is reviewing risk factors for vitamin D deficiency. Which children are at high risk for vitamin D deficiency (select all that apply): A.) Children with fair pigmentation B.) Children who are overweight or obese C.) Children who are exclusively bottle fed D.) Children with diets low in sources of vitamin D E.) Children of families who use milk products not supplemented with vitamin D

B, D, E

The nurse is caring for a child with celiac disease. The nurse understands that what may precipitate a celiac crisis (select all that apply): A.) Exercise B.) Infections C.) Fluid overload D.) Electrolyte depletion E.) Emotional disturbance

B, D, E

The nurse is caring for a child with retinoblastoma that was treated with an enucleation. What interventions should the nurse plan for care of an eye socket after enucleation (select all that apply): A.) Clean the prosthesis B.) Change the eye pad daily C.) Keep the opposite eye covered initially D.) Irrigate the socket daily with a prescribed solution E.) Apply a prescribed antibiotic ointment after irrigation

B, D, E

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): A.) No motor impairment B.) Lack of bowel control C.) Soft, subcutaneous lipomas D.) Flaccid, partial paralysis of lower extremities E.) Overflow incontinence with constant dribbling of urine

B, D, E

The nurse is teaching the family of a child with type 1 diabetes about insulin. What should the nurse include in the teaching session (select all that apply): A.) Unopened vials are good for 60 days B.) Diabetic supplies should not be left in a hot environment C.) Insulin can be placed in the freezer if not used every day D.) After it has been opened, insulin is good for up to 28 to 30 days E.) Insulin bottles that have been opened should be stored at room temperature or refrigerated

B, D, E

The school nurse is teaching bicycle safety to a group of school-age children. What should the nurse include in the session (select all that apply): A.) Ride double file when possible B.) Watch for and yield to pedestrians C.) Only ride double with someone your own size D.) Ride bicycles with traffic away from parked cars E.) Keep both hands on the handlebars except when signaling

B, D, E

The school nurse teaches adolescents that the detrimental long-term effects of tanning are what (select all that apply): A.) Vitamin D deficiency B.) Premature aging of the skin C.) Exacerbates acne outbreaks D.) Increased risk for skin cancer E.) Possible phototoxic reactions

B, D, E

What are characteristics of dating relationships in early adolescence (select all that apply): A.) One-on-one dating B.) Follow ritualized scripts C.) Are psychosocially intimate D.) Involve playing stereotypic roles E.) Participating in mixed-gender group activities

B, D, E

What are characteristics of diabetic ketoacidosis (select all that apply): A.) Pallor B.) Acidosis C.) Bradypnea D.) Dehydration E.) Electrolyte imbalance

B, D, E

What cerebrospinal fluid (CSF) analysis should the nurse expect with viral meningitis (select all that apply): A.) Color is turbid B.) Protein count is normal C.) Glucose is decreased D.) Gram stain findings are negative E.) White blood cell (WBC) count is slightly elevated

B, D, E

What dietary instructions should the nurse give to parents of a child undergoing chronic hemodialysis (select all that apply): A.) High protein B.) Fluid restriction C.) High phosphorus D.) Sodium restriction E.) Potassium restriction

B, D, E

What identified characteristics occur more frequently in parents who abuse their children (select all that apply): A.) Older parents B.) Socially isolated C.) Middle class parents D.) Single-parent families E.) Few supportive relationships

B, D, E

What interventions should the nurse anticipate being administered to a child with supraventricular tachycardia (SVT) (select all that apply): A.) Bed rest B.) Applying ice to the face C.) Administration of atropine D.) Administration of adenosine (Adenocor) E.) Having the child perform a Valsalva maneuver

B, D, E

What is the purpose of palliative chemotherapy of palliative radiotherapy (select all that apply): A.) To cure the disease process of the patient B.) To enhance the quality of life of the patient C.) To change the outcome of cancer for the patient D.) To increase comfort by slowing the progression of an incurable tumor E.) To increase comfort by reducing swelling or pressure from a tumor that is causing pain

B, D, E

A 16 month old has a history of diarrhea for 3 days with poor oral intake. He received intravenous fluids, has tolerated some oral fluids in the emergency department, and is being discharged home. Instruction for diet for this child should include: A.) BRAT diet (bananas, rice, applesauce and toast) for 24 hours, then a soft diet as tolerated B.) Chicken or beef broth for 24 hours, then resume a soft diet C.) Offer a regular diet as child's appetite warms D.) Keep on clear liquids and toast for 24 hours

A 20-kg (44-lb) child in ketoacidosis is admitted to the pediatric intensive care unit. What order should the nurse not implement until clarified with the physician? A.) Weigh on admission and daily B.) Replace fluid volume deficit over 48 hours C.) Begin intravenous line with D5 0.45% normal saline with 20 mEq of potassium chloride D.) Give intravenous regular insulin 2 units/kg/hr after initial rehydration bolus

A 3 year old boy is seen in the clinic at 8:30 pm with a history of vomiting for 2 days and poor oral intake; he has voided once since the previous day. Examination reveals a lethargic child sitting on the mother's lap. He has a capillary refill of 4 seconds, apical heart rate of 128, respiratory rate of 32 and poor skin turgor. Stated body weight is 25 kg. Based on this information, the nurse anticipates performing which of the following? A.) Demonstrating to the mother how to give 5 to 10 mL of Pedialyte PO every 5 to 10 min B.) Administering an intravenous fluid bolus of 450 mL of 5% dextrose in water over 60 min C.) Administering an intravenous fluid bolus of 500 mL of 0.9% normal saline over 20 minutes D.) Administering an intravenous fluid bolus of 1000 mL of 5% dextrose and 0.45% normal saline over 30 minutes

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

A 3-year-old child is experiencing pain after a tonsillectomy. The child has not taken in any fluids and does not want to drink anything, saying, My tummy hurts. The following health care prescriptions are available: acetaminophen (Tylenol) PO (orally) or PR (rectally) PRN, ice chips, clear liquids. What should the nurse implement to relieve the child's pain? A.) Ice chips B.) Tylenol PO C.) Tylenol PR D.) Popsicle

A 4 day old infant is seen in the emergency department for a possible seizure earlier in the day. The infant was being breastfed but without much success, and so an aunt gave him a bottle of water. The infant continued to cry, and the mother was too exhausted to breastfeed, so another bottle of water was given while someone went to the store to purchase infant formula. The pregnancy, delivery and postpartum history reveal no particular problems for this term infant that might contribute to seizures. The physical examination is unremarkable, with the exception of hypertonic reflexes. The infant is awake, alert and sucking on his fists. Diagnostic studies are obtained, including an electrocardiogram. The nurse anticipates which of the following as the possible explanation for the infant's condition? A.) Serum potassium of 3.9 mEq B.) Serum glucose of 69 mg C.) Serum sodium of 118 mEq D.) Arterial pH of 7.34

A 5-year old is seen in the urgent care clinic with the following history and symptoms: - sudden onset of severe sore throat after going to bed - drooling and difficulty swallowing - axillary temperature of 102.2 F - clear breath sounds - absence of cough The child appears anxious and is flushed. Based on these symptoms and history, the nurse anticipates a diagnosis of: A.) Group A beta-hemolytic streptococcus (GABHS) pharyngitis B.) Acute tracheitis C.) Acute epiglottitis D.) Acute laryngotracheobroncitis

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? A.) The child will continue to sleep and be pain free B.) Parents cannot administer additional medication with the button C.) The pump can deliver baseline and bolus dosages D.) There is a high risk of overdose, so monitoring is done every 15 minutes

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? A.) An ambulance for transport home B.) Verbal information about follow-up care C.) Prescribed pain medication before discharge D.) Driving instructions for a route with less traffic

A Hispanic toddler has pneumonia. The nurse notices that the parent consistently feeds the child only the broth that comes on the clear liquid tray. Food items, such as Jell-O, Popsicles, and juices, are left. Which statement best explains this? A.) The parent is trying to feed the child only what the child likes most B.) Hispanics believe the evil eye enters when a person gets cold C.) The parent is trying to restore normal balance through appropriate hot remedies D.) Hispanics believe an innate energy called chi is strengthened by eating soup

A child has a streptococcal throat infection and is being treated with antibiotics. What should the nurse teach the parents to prevent infection of others? A.) The child can return to school immediately B.) The organism cannot be transmitted through contact C.) The child can return to school after taking antibiotics for 24 hours D.) The organism can only be transmitted if someone uses a personal item of the sick child

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 take 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

A child is admitted in acute renal failure (ARF). Therapeutic management to rapidly provoke a flow of urine includes the administration of what medication? A.) Propranolol (Inderal) B.) Calcium gluconate C.) Mannitol (Osmitrol) or furosemide (Lasix) (or both) D.) Sodium, chloride, and potassium

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? A.) Give only an opioid analgesic at this time B.) Increase dosage of analgesic until the child is adequately sedated C.) Plan a preventive schedule of pain medication around the clock D.) Give the child a clock and explain when she or he can have pain medications

A child with cancer is pronounced dead by the primary care provider. The parents are upset and request some private time with the child. What does the nurse do in this situation? A.) Give photographs of the child to the parents B.) Allow the parents to spent 15 minutes in private with the child C.) Allow the parents to spend as much time as they want in private with the child D.) Perform post mortem bathing and legacy making prior to letting the parents view the child

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

A child with leukemia is receiving intrathecal chemotherapy to prevent which condition? A.) Infection B.) Brain tumor C.) Central nervous system (CNS) disease D.) Drug side effects

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? A.) Allow her parents to come visit her B.) Fight the infection that she now has C.) Increase her energy so she will not be so tired D.) Help her body stop bleeding by forming a clot (scab)

A couple with a seven year old child get divorces. Which factor is considered when determining who gets custody of the child? A.) Financial resources B.) The preference of the child C.) Ability to best provide for the child's welfare D.) Familiarity with the existing care of the child

A critically injured child has died and is being removed from a ventilator in the pediatric intensive care unit. What is a priority nursing intervention for the family at this time? A.) Ensure that parents are in the waiting room while the ventilator is removed B.) Help the parents understand that the child is already dead and no further interventions are necessary C.) Control the environment around the child and family to provide privacy D.) Encourage them to wait to see their child until the funeral home has prepared the body

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? A.) Feeding pureed foods B.) Placing food on the tongue C.) Placing food at the side of the tongue D.) Placing food directly into the mouth with a spoon

A female school-age child asks the school nurse, How many pounds should I expect to gain in a year? The nurse should give which response? A.) You will gain about 2.4 to 4.6 lb per year B.) You will gain about 3.4 to 5.6 lb per year C.) You will gain about 4.4 to 6.6 lb per year D.) You will gain about 5.5 to 7.6 lb per year

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)

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

A mother brings 6-month-old Eric to the clinic for a well-baby checkup. She comments, I want to go back to work, but I don't want Eric to suffer because I'll have less time with him. Which is the nurses most appropriate answer? A.) I'm sure he'll be fine if you get a good babysitter B.) You will need to stay home until Eric starts school C.) Let's talk about the child care options that will be best for Eric D.) You should go back to work so Eric will get used to being with others

A mother states that she brought her child to the clinic because the 3-year-old girl was not keeping up with her siblings. During physical assessment, the nurse notes that the child has pale skin and conjunctiva and has muscle weakness. The hemoglobin on admission is 6.4 g/dl. After notifying the practitioner of the results, what nursing priority intervention should occur next? A.) Reduce environmental stimulation to prevent seizures B.) Have the laboratory repeat the analysis with a new specimen C.) Minimize energy expenditure to decrease cardiac workload D.) Administer intravenous fluids to correct the dehydration

A mother tells the clinic nurse that she often puts honey on her infants pacifier to soothe the infant. What response should the nurse make to the mother? A.) That is a good way to soothe your baby B.) Honey does not have any soothing effects C.) There is still a risk for infant botulism from honey D.) Honey is OK, but it should not be put on the pacifier

A neonate is born with mild clubfeet. When the parents ask the nurse how this will be corrected, what should the nurse explain? A.) Traction is tried first B.) Surgical intervention is needed C.) Frequent, serial casting is tried first D.) Children outgrow this condition when they learn to walk

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

A new parent relates to the nurse that the family has many known food allergies. Which is considered a primary strategy for feeding the infant with many family food allergies? A.) Using soy formula for feeding B.) Maternal avoidance of cows milk protein C.) Exclusive breastfeeding for 4 to 6 months D.) Delaying the introduction of highly allergenic foods past 6 months

A nurse looks over her assignment for the day that includes an infant, a preschool-age child, a third-grader, and a sophomore in high school. Which techniques take into consideration developmental stages when working with pediatric patients? A.) Being aware that infants will become agitated due to stranger anxiety around age 4 months B.) When a preschooler is getting blood drawn, giving a detailed explanation will be helpful C.) Explaining and demonstrating what the blood pressure machine does to the third-grader before taking her blood pressure D.) Using a single consistent approach with the adolescent will help allay anger and hostility

A parent asks about whether a 7-year-old child is able to care for a dog. Based on the child's age, what does the nurse suggest? A.) Caring for an animal requires more maturity than the average 7-year-old possesses. B.) This will help the parent identify the child's weaknesses C.) A dog can help the child develop confidence and emotional health D.) Cats are better pets for school-age children

A parent brings a child to the clinic for a regular checkup and is questioned about the family's medical history. The parent privately explains that the child is adopted, and does not want the child to know. Which guidance would the nurse give to this parent? A.) Instruct the parent to never reveal the information to the child B.) Divulge the information to the child in a very sensitive manner C.) Advise the parent to speak openly to the child and tell the truth D.) Ask the parent to withhold the information until the child is an adult

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

A preadolescent has been diagnosed with scoliosis. The planned therapy is the use of a thoracolumbosacral orthotic. The preadolescent asks how long she will have to wear the brace. What is the appropriate response by the nurse? A.) For as long as you have been told B.) Most preadolescents use the brace for 6 months C.) Until your vertebral column has reached skeletal maturity D.) It will be necessary to wear the brace for the rest of your life

A pregnant woman asks about prenatal diagnosis of hydrocephalus. The nurses response should be based on which knowledge? A.) It can be diagnosed only after birth B.) It can be diagnosed by chromosome studies C.) It can be diagnosed with fetal ultrasonography D.) It can be diagnosed by measuring the lecithin-to-sphingomyelin ratio

A preschooler is found digging up a pet bird that was recently buried after it died. What is the best explanation for this behavior? A.) He has a morbid preoccupation with death B.) He is looking to see if a ghost took it away C.) He needs reassurance that the pet has not gone somewhere else D.) The loss is not yet resolved, and professional counseling is needed

A school nurse delivering a lecture on oral health for children to a group of student nurses. Which is the most common dental condition in children that the nurse would specifically address? A.) Gingivitis B.) Peridonititis C.) Dental caries D.) Oral candidiasis

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? A.) This attitude is helpful to give parents time to cope B.) This will help the child cope effectively by denial C.) Terminally ill children know when they are seriously ill D.) Terminally ill children usually choose not to discuss the seriousness of their illness

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? A.) Bring the child to the hospital for intravenous fluids B.) Alternate giving ORS and carbonated drinks C.) Continue to give ORS frequently in small amounts D.) Keep child NPO (nothing by mouth) for 8 hours and resume ORS if vomiting has subsided

A term infant is delivered, and before delivery, the medical team was notified that a congenital diaphragmatic hernia (CDH) was diagnosed on ultrasonography. What should be done immediately at birth if respiratory distress is noted? A.) Give oxygen B.) Suction the infant C.) Intubate the infant D.) Ventilate the infant with a bag and mask

A toddler with spastic cerebral palsy needs to be transported to the radiology department. What transportation method should the nurse use to take the toddler to the radiology department? A.) A stretcher B.) A wheelchair C.) A wagon with pillows D.) Carried in the nurse's arms

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

After returning from cardiac catheterization, the nurse determines that the pulse distal to the catheter insertion site is weaker. How should the nurse respond? A.) Elevate the affected extremity B.) Notify the practitioner of the observation C.) Record data on the assessment flow record D.) Apply warm compresses to the insertion site

After spinal fusion surgery the nurse should check for signs of what? A.) Seizure activity B.) Increased intracranial pressure C.) Impaired color, sensitivity, and movement to the lower extremities D.) Impaired pupillary response during neurologic checks

Although a 14-month-old girl received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which is the best interpretation of this behavior? A.) Her cognitive development is delayed B.) This is typical behavior because toddlers are not very developed C.) This is typical behavior because of toddlers inability to transfer remembering to new situations D.) This is not typical behavior because toddlers should know better than to repeat an act that caused pain

An 8-year-old child is hit by a motor vehicle in the school parking lot. The school nurse notes that the child is responding to verbal stimulation but is not moving his extremities when requested. What is the first action the nurse should take? A.) Wait for the child's parents to arrive B.) Move the child out of the parking lot C.) Have someone notify the emergency medical services (EMS) system D.) Help the child stand to return to play

An adolescent diabetic is admitted to the emergency department for treatment of hyperglycemia and pneumonia. What are characteristics of diabetic hyperglycemia? A.) Cold, clammy skin and lethargy B.) Hunger and hypertension C.) Thirst, being flushed, and fruity breath D.) Disorientation and pallor

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? A.) Families adjust better to life-threatening injuries when information is given over time B.) Immediate loss of function is indicative of the long-term consequences of the injury C.) Extent and severity of damage cannot be determined for several weeks or even months D.) Numerous diagnostic tests will be done immediately to determine extent and severity of damage

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 development B.) Severe depression that will require long-term counseling C.) 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

An adolescent with long-term, complex health care needs will soon be discharged from the hospital. The nurse case manager has been assigned to the teen and family. The adolescents care involves physical therapy, occupational therapy, and speech therapy in addition to medical and nursing care. Who should be the decision maker in the adolescents care? A.) Adolescent B.) Nurse case manager C.) Adolescent and family D.) Multidisciplinary health care team

An important milestone in the infant's life is the development of object permanence. This milestone is represented by which of these statements? A.) The infant smiles at the mother when she talks to him B.) The infant repeatedly flexes and extends his arms and legs when the mother picks him up C.) The infant turns and looks for his mother when she walks out of the room D.) The infant cries when the mother hands him to a babysitter

An infant had a gastrostomy tube placed for feedings after a Nissen fundoplication and bolus feedings are initiated. Between feedings while the tube is clamped, the infant becomes irritable, and there is evidence of cramping. What action should the nurse implement? A.) Burp the infant B.) Withhold the next feeding C.) Vent the gastrostomy tube D.) Notify the health care provider

An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of defective utilization. The nurse understands that the reason for the FTT is most likely related to what? A.) Cystic fibrosis B.) Hyperthyroidism C.) Congenital infection D.) Breastfeeding problems

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? A.) Water excess B.) Sodium excess C.) Water depletion D.) Potassium excess

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? A.) Reverse isolation B.) Airborne isolation C.) Contact Precautions D.) Standard Precautions

As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by: A.) Asking the parents how their extended families feel about their child's illness B.) Exploring the use of alternative medicines and therapies C.) Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition D.) Acknowledging that language constraints may make it necessary for the health care team to make some decisions

At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection? A.) Developmentally appropriate toys B.) Nutritious snacks served to the children C.) Handwashing by providers after diaper changes D.) Certified caregivers for each of the age groups at the facility

At what age is it safe to give infants whole milk instead of commercial infant formula? A.) 6 months B.) 9 months C.) 12 months D.) 18 months

At which age do most infants begin to fear strangers? A.) 2 months B.) 4 months C.) 6 months D.) 12 months

At which age does an infant start to recognize familiar faces and objects, such as his or her own hand? A.) 1 month B.) 2 months C.) 3 months D.) 4 months

At which age should the nurse expect most infants to begin to say mama and dada with meaning? A.) 4 months B.) 6 months C.) 10 months D.) 14 months

By which age should the nurse expect that an infant will be able to pull to a standing position? A.) 5 to 6 months B.) 7 to 8 months C.) 11 to 12 months D.) 14 to 15 months

Chemotherapeutic agents are classified according to what feature? A.) Side effects B.) Effectiveness C.) Mechanism of action D.) Route of administration

Children are taught the values of their culture through observation and feedback relative to their own behavior. In teaching a class on cultural competence, the nurse should be aware that which factor may be culturally determined? A.) Ethnicity B.) Racial variation C.) Status D.) Geographic boundaries

Children who are taking long-term inhaled steroids should be assessed frequently for what potential complication? A.) Cough B.) Osteoporosis C.) Slowed growth D.) Cushing syndrome

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

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? A.) Irritability when awake B.) Capillary refill of more than 5 seconds C.) Appropriate weight gain for age D.) Positioned in high Fowler position to maintain oxygen saturation at 90%

During a routine health assessment, the nurse notes that an 8-month-old infant has a significant head lag. Which is the most appropriate action? A.) Recheck head control at next visit B.) Teach the parents appropriate exercises C.) Schedule the child for further evaluation D.) Refer the child for further evaluation if the anterior fontanel is still open

During a well-child visit, the mother tells the nurse that her 4-month-old infant is constipated, is less active than usual, and has a weak-sounding cry. The nurse suspects botulism and questions the mother about the child's diet. What factor should support this diagnosis? A.) Breastfeeding B.) Commercial formula C.) Infant cereal with honey D.) Improperly sterilized bottles

During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner? A.) Respond to name B.) React to loud noise with Moro reflex C.) Turn his or her head to side when sound is at ear level D.) Locate sound by turning his or her head in a curving arc

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

In a child with sickle cell anemia (SCA), adequate hydration is essential to minimize sickling and delay the vaso-occlusion and hypoxia-ischemia cycle. What information should the nurse share with parents in a teaching plan? A.) Encourage drinking B.) Keep accurate records of output C.) Check for moist mucous membranes D.) Monitor the concentration of the child's urine

In girls, what is the initial indication of puberty? A.) Menarche B.) Growth spurt C.) Breast development D.) Growth of pubic hair

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

In relation to developmental milestones, the infant can be expected to roll over from back to abdomen at approximately: A.) 2 months B.) 4 months C.) 6 months D.) 8 months

In teaching the parent of a newly diagnosed 2-year-old child with pyelonephritis related to vesicoureteral reflux (VUR), the nurse should include which information? A.) Limit fluids to reduce reflux B.) Give cranberry juice twice a day C.) Have siblings examined for VUR D.) Surgery is indicated to reverse scarring

In terms of gross motor development, what should the nurse expect an infant age 5 months to do? A.) Sit erect without support B.) Roll from the back to the abdomen C.) Turn from the abdomen to the back D.) Move from a prone to a sitting position

Nursing care for a child in the hospital with suspected abuse should include which of the following actions? A.) Assign a variety of nurses to the child so that he can get to know and trust the whole staff B.) Praise the child's ability to minimize feelings of shame and guilt C.) Treat the child as someone with a specific problem, not as an "abuse" victim, to promote self-esteem and minimize feelings of guilt D.) Talk with and ask questions as often as possible to show interest and get to know the child better

Nursing care of the child with myelosuppression from leukemia or chemotherapeutic agents should include which therapeutic intervention? A.) Restrict oral fluids B.) Institute strict isolation C.) Use good hand-washing technique D.) Give immunizations appropriate for age

Parents ask the nurse, "When should palliative care be initiated?" What is the best response by the nurse? A.) When curative care is not feasible B.) When the child's prognosis is uncertain C.) It should be included along the continuum of care D.) It should begin when curative treatments are no longer appropriate

Parents ask the nurse, How should we deal with our toddlers regression since our new baby has come home? The nurse should give the parents which response? A.) Introduce new areas of learning B.) Use time-out as punishment when regression occurs C.) Ignore the behavior and praise appropriate behavior D.) Explain to the toddler that the behavior is not acceptable

Parents ask the nurse, When should palliative care be initiated? What is the best response by the nurse? A.) When curative care is not feasible B.) When the child's prognosis is uncertain C.) It should be included along the continuum of care D.) It should begin when curative treatments are no longer appropriate

Parents bring a 7-year-old child to the clinic for evaluation of an injured wrist after a bicycle accident. The parents and child are upset, and the child will not allow an examination of the injured arm. What priority nursing intervention should occur at this time? A.) Send the child to radiology so radiography can be performed B.) Initiate an intravenous line and administer morphine for the pain C.) Calmly ask the child to point to where the pain is worst and to wiggle fingers D.) Have the parents hold the child so that the nurse can examine the arm thoroughly

Parents of a hospitalized toddler ask the nurse, What is meant by family-centered care? The nurse should respond with which statement? A.) Family-centered care reduces the effect of cultural diversity on the family B.) Family-centered care encourages family dependence on the health care system C.) Family-centered care recognizes that the family is the constant in a child's life D.) Family-centered care avoids expecting families to be part of the decision-making process

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 sons illness

Parents whose child recently died tell the nurse that they are able to hear the voice of their dead child. What is the nurse's best explanation for this behavior? A.) Poor coping B.) Mental breakdown C.) Normal grief reaction D.) Complicated grief reaction

Several nurses tell their nursing supervisor that they want to attend the funeral of a child for whom they had cared. Which is the supervisor's best response? A.) It is inappropriate because it worsens burnout on the nursing staff B.) It is appropriate because families expect this expression of concern C.) It is appropriate because it can assist in the resolution of personal grief D.) It is inappropriate because it is considered unprofessional behavior on the part of the nurses

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

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

The health care provider has prescribed a medical treatment for a child with an injury. Which is the priority nursing action in this case? A.) Assess other potential risk factors of the child B.) Explain about injury prevention to the family and the child C.) Explain the treatment at the family's level of understanding D.) Use clinical reasoning to plan interventions after the treatment

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

The most common type of dehydration in children occurs when electrolyte and water deficits are present in approximately balanced proportions. This is called ____________ dehydration: A.) Hypotonic B.) Hypertonic C.) Isotonic D.) Hyponatremic

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? A.) Gastrointestinal perforation may have occurred B.) The object may have been aspirated C.) The object may be lodged in the esophagus D.) The object may be embedded in stomach wall

The nurse asks the mother of a child with a chronic illness many questions as part of the assessment. The mother answers several questions, then stops and says, "I don't know why you ask me all this?" Who gets to know this information? The nurse should respond in what manner? A.) Determine why the mother is so suspicious B.) Determine what the mother does not want to tell C.) Explain who will have access to the information D.) Explain that everything is confidential and that no one else will know what is said

The nurse at a summer camp recognizes the signs of heatstroke in an adolescent girl. Her temperature is 40 C (104 F). She is slightly confused but able to drink water. Nursing care while waiting for transport to the hospital should include what intervention? A.) Administer antipyretics B.) Administer salt tablets C.) Apply towels wet with cool water D.) Sponge with solution of rubbing alcohol and water

The nurse finds that a 6-month-old infant has an apical pulse of 166 beats/min during sleep. What nursing intervention is most appropriate at this time? A.) Administer oxygen B.) Record data on the nurses notes C.) Report data to the practitioner D.) Place the child in the high Fowler position

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

The nurse is admitting a 7-year-old child to the pediatric unit for abdominal pain. To determine what the child understands about the reason for hospitalization, what should the nurse do? A.) Find out what the parents have told the child B.) Review the note from the admitting practitioner C.) Ask the child why he came to the hospital today D.) Question the parents about why they brought the child to the hospital

The nurse is assessing a child with croup in the emergency department. The child has a sore throat and is drooling. Examining the child's throat using a tongue depressor might precipitate what condition? A.) Sore throat B.) Inspiratory stridor C.) Complete obstruction D.) Respiratory tract infection

The nurse is assessing a child's functional self-care level for feeding, bathing and hygiene, dressing, and grooming and toileting. The child requires assistance or supervision from another person and equipment or device. What code does the nurse assign for this child? A.) I B.) II C.) III D.) IV

The nurse is assessing the Tanner stage in an adolescent female. The nurse recognizes that the stages are based on which? A.) The stages of vaginal changes B.) The progression of menstrual cycles to regularity C.) Breast size and the shape and distribution of pubic hair D.) The development of fat deposits around the hips and buttocks

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? A.) Playing pat-a-cake with the child B.) None so the child does not become overstimulated C.) Putting a colorful mobile with music on the bed D.) Giving the child a coloring book and crayons

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? A.) Place in the Trendelenburg position B.) Apply moist heat to the abdomen C.) Allow the child to assume a position of comfort D.) Administer a saline enema to cleanse the bowel

The nurse is caring for a child belonging to the Asian culture. The child is unwilling to eat the food provided in the hospital. Which action would the nurse take? A.) Explain to the child the benefits of having the food provided by the hospital B.) Ask the family members to bring food from a restaurant based on the diet plan C.) Ask the family member to bring homemade food based on the child's diet plan D.) Ask the patient food services of the hospital to prepare the child's favorite food

The nurse is caring for a hospitalized adolescent whose femur was fractured 18 hours ago. The adolescent suddenly develops chest pain and dyspnea. The nurse should suspect what complication? A.) Sepsis B.) Osteomyelitis C.) Pulmonary embolism D.) Acute respiratory tract infection

The nurse is caring for a neonate with a suspected tracheoesophageal fistula. What should nursing care include? A.) Feed glucose water only B.) Elevate the patients head for feedings C.) Raise the patients head and give nothing by mouth D.) Avoid suctioning unless the infant is cyanotic

The nurse is caring for a non-English-speaking child and family. Which should the nurse consider when using an interpreter? A.) Pose several questions at a time B.) Use medical jargon when possible. C.) Communicate directly with family members when asking questions D.) Carry on some communication in English with the interpreter about the family's needs

The nurse is caring for an infant who had surgical repair of a tracheoesophageal fistula 24 hours ago. Gastrostomy feedings have not been started. What do nursing actions related to the gastrostomy tube include? A.) Keep the tube clamped B.) Suction the tube as needed C.) Leave the tube open to gravity drainage D.) Lower the tube to a point below the level of the stomach

The nurse is discussing parenting in reconstituted families with a new stepparent. The nurse is aware that the new stepparent understands the teaching when which statement is made? A.) I am glad there will be no disruption in my lifestyle B.) I don't think children really want to live in a two-parent home C.) I realize there may be power conflicts bringing two households together D.) I understand contact between grandparents should be kept to a minimum

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? A.) Impetigo B.) Urine and feces C.) Candida albicans infection D.) Infrequent diapering

The nurse is explaining about the developmental sequence in children's capacity to conserve matter to a group of parents. What type of matter is last in the sequence for a child to develop? A.) Mass B.) Length C.) Volume D.) Numbers

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? A.) It is time for a booster vaccine B.) It is past the time for a booster vaccine C.) This vaccine will provide pertussis immunity D.) This vaccine will be the last booster you will need

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? A.) Academic subjects should be taught in the afternoon B.) Low-interest activities in the classroom should be minimized C.) Visual references should accompany verbal instruction D.) The child's environment should be visually stimulating

The nurse is often the individual who is in the optimum position to suggest tissue donation to a family (after consultation with the practitioner). What will occur if a family chooses organ or tissue donation? A.) The funeral will be delayed B.) Cremation is the preferred method of burial C.) Written consent is required for tissue or organ donation D.) An open casket cannot be used subsequent to this procedure

The nurse is performing an assessment on a 10-week-old infant. The nurse understands that the developmental characteristic of hearing at this age is which? A.) The infant responds to his own name B.) The infant localizes sounds by turning his head directly to the sound C.) The infant turns his head to the side when sound is made at the level of the ear D.) The infant locates sound by turning his head to the side and then looking up or down

The nurse is performing an assessment on a 12-month-old infant. Which fine or gross motor developmental skill demonstrates the proximodistal acquisition of skills? A.) Standing B.) Sitting without assistance C.) Fully developed pincer grasp D.) Taking a few steps holding onto something

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

The nurse is planning to administer a non-opioid for pain relief to a child. Which timing should the nurse plan so the nonopioid takes effect? A.) 15 minutes until maximum effect B.) 30 minutes until maximum effect C.) 1 hour until maximum effect D.) 1 1/2 hours until maximum effect

The nurse is planning to counsel family members as a group to assess the familys group dynamics. Which theoretic family model is the nurse using as a framework? A.) Feminist theory B.) Family stress theory C.) Family systems theory D.) Developmental theory

The nurse is preparing a child for possible alopecia from chemotherapy. What information should the nurse include? A.) Wearing hats or scarves is preferable to a wig B.) Expose head to sunlight to stimulate hair regrowth C.) Hair may have a slightly different color or texture when it regrows D.) Regrowth of hair usually begins 12 months after chemotherapy ends

The nurse is providing education to a group of parents at a local kindergarten school health fair. The nurse would inform the group about which cause of death is the most common among children ages 5 to 9 years? A.) The obesity epidemic B.) Childhood immunizations C.) Inappropriate use of bike helmets and seat belts D.) Lack of hand washing in the prevention of communicable diseases

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? A.) Consuming a regular diet B.) Increasing protein C.) Restricting fluids D.) Decreasing calories

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? A.) My child does not need to eat a variety of foods, just his favorite food groups B.) My child can add salt and sugar to foods to make them taste better C.) I will serve foods that are low in saturated fat and cholesterol D.) I will continue to serve red meat three times per week for extra iron

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

The nurse is teaching a group of nursing students about involvement with children and their parents while providing health care education. Which statement by the nursing student would indicate a need for additional education? A.) "I will clarify any information about patient care to the family" B.) "I will ask questions of the family members if they do not participate in care" C.) "I will try to influence the family's decisions regarding health care decisions" D.) "I will help the family decrease their dependence on the nurse for activities of daily living"

The nurse is teaching a parent of an infant to limit the amount of formula to encourage the intake of iron-rich food. What amount should the nurse teach to the parent? A.) 500 ml B.) 750 ml C.) 1000 ml D.) 1250 ml

The nurse is teaching infant care to parents with an infant who has been diagnosed with osteogenesis imperfecta (OI). What should the nurse include in the teaching session? A.) Bisphosphonate therapy is not beneficial for OI B.) Physical therapy should be avoided as it may cause damage to bones C.) Lift the infant by the buttocks, not the ankles, when changing diapers D.) The infant should meet expected gross motor development without assistive devices

The nurse is teaching parents about the types of behaviors children exhibit when living with chronic violence. Which statement made by the parents indicates further teaching is needed? A.) We should watch for aggressive play B.) Our child may show lasting symptoms of stress C.) We know that our child will show caring behaviors D.) Our child may have difficulty concentrating in school

The nurse is teaching parents guidelines for feeding their 8-month-old infant with failure to thrive (FTT). Which statement by the parents indicates a need for further teaching? A.) We will continue to use the 24-kcal/oz formula B.) We will be sure to follow the formula preparation instructions C.) We will be sure to give our infant at least 8 oz of juice every day D.) We will be sure to feed our infant according to the written schedule

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? A.) Administer nonsteroidal anti-inflammatory drugs (NSAIDs) B.) Administer DDAVP (synthetic vasopressin) C.) Provide intravenous (IV) infusion of factor VIII concentrates D.) Encourage elevation and application of ice to the involved joint

The nurse is teaching the girls varsity sports teams about the female athlete triad. What is essential information to include? A.) They should take low to moderate calcium to avoid hypercalcemia B.) They have strong bones because of the athletic training C.) Pregnancy can occur in the absence of menstruation D.) A diet high in carbohydrates accommodates increased training

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? A.) I should attempt to restrain my child during a seizure B.) My child will need to avoid contact sports until adulthood C.) I should place a pillow under my child's head during a seizure D.) My child will need to be taken to the emergency department [ED] after each seizure

The nurse is testing an infants visual acuity. By which age should the infant be able to fix on and follow a target? A.) 1 month B.) 1 to 2 months C.) 3 to 4 months D.) 6 months

The nurse manager is compiling a report for a hospital committee on the quality of nursing-sensitive indicators for a nursing unit. Which does the nurse manager include in the report? A.) The average age of the nurses on the unit B.) The salary ranges for the nurses on the unit C.) The education and certification of the nurses on the unit D.) The number of nurses who have applied but were not hired for the unit

The nurse observes that a newborn is having problems after birth. What should indicate a tracheoesophageal fistula? A.) Jitteriness B.) Meconium ileus C.) Excessive frothy saliva D.) Increased need for sleep

The nurse observes that a seriously ill child passively accepts all painful procedures. The nurse should recognize that this is most likely an indication that the child is experiencing what emotional response? A.) Hopefulness B.) Chronic sorrow C.) Belief that procedures are a deserved punishment D.) Understanding that procedures indicate impending death

The nurse removes an intravenous (IV) needle from a toddler's hand and quickly covers the area with a bandage. Why is a bandage particularly important in this age group? A.) Because the bandage promotes independence B.) Because the bandage promotes freedom of movement C.) Because toddlers have poorly defined body boundaries D.) Because the bandage demonstrates respect to the child

The nurse suspects fluid overload in an infant receiving intravenous fluids. What clinical manifestation is suggestive of water intoxication? A.) Oliguria B.) Weight loss C.) Irritability and seizures D.) Muscle weakness and cardiac dysrhythmias

The nurse uses the five Ps to assess ischemia in a child with a fracture. What finding is considered a late and ominous sign? A.) Petaling B.) Posturing C.) Paresthesia D.) Positioning

The nurse working in an outpatient surgery center for children understands which concept? A.) Children's anxiety is minimal in such a center B.) Waiting is not stressful for parents in such a center C.) Families need to be prepared for what to expect after discharge D.) Accurate and complete discharge teaching is the responsibility of the surgeon

The parent of 2-week-old infant asks the nurse if fluoride supplements are necessary because the infant is exclusively breastfed. What is the nurse's best response? A.) The infant needs to begin taking them now B.) Supplements are not needed if you drink fluoridated water C.) The infant may need to begin taking them at age 6 months D.) The infant can have infant cereal mixed with fluoridated water instead of supplements

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? A.) The antibiotic therapy contributes to labile blood pressure values B.) Hypotension leading to sudden shock can develop at any time C.) Acute hypertension is a concern that requires monitoring. D.) Blood pressure fluctuations indicate that the condition has become chronic

The parent of an infant with nasopharyngitis should be instructed to notify the health professional if the infant shows signs or symptoms of which condition? A.) Has a cough B.) Becomes fussy C.) Shows signs of an earache D.) Has a fever higher than 37.5 C (99 F)

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? A.) Indicative of giftedness B.) Indicative of typical twin behavior C.) Characteristic of cognitive development at this age D.) Characteristic of psychosocial development at this age

The parents of a 2-year-old boy who had a repair of exstrophy of the bladder at birth ask when they can begin toilet training their son. The nurse replies based on what knowledge? A.) Most boys in the United States can be toilet trained at age 3 years B.) Training can begin when he has sufficient bladder capacity C.) Additional surgery may be necessary to achieve continence D.) They should begin now because he will require additional time

The parents of a 3-year-old admitted for recurrent diarrhea are upset that the practitioner has not told them what is going on with their child. What is the priority intervention for this family? A.) Answer all of the parents questions about the child's illness B.) Immediately page the practitioner to come to the unit to speak with the family C.) Help the family develop a written list of specific questions to ask the practitioner D.) Inform the family of the time that hospital rounds are made so that they can be present

The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven and will be able to heat the baby's formula faster. What should the nurse recommend? A.) Heat only 8 oz or more B.) Do not heat a plastic bottle in a microwave oven C.) Leave the bottle top uncovered to allow heat to escape D.) Shake the bottle vigorously for at least 30 seconds after heating

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

The parents of a toddler ask the nurse for suggestions about discipline. When discussing the use of time-outs, which suggestions would the nurse include? A.) Send the child to the child's room B.) The general rule is one hour of time-out per year of age C.) Select an area that is safe and non stimulating, such as a hallway D.) If the child cries, refuses, or is more disruptive, try another method of discipline

The parents of a young child ask the nurse for suggestions about discipline. When discussing the use of time-outs, which should the nurse include? A.) Send the child to his or her room if the child has one B.) A general rule for length of time is 1 hour per year of age C.) Select an area that is safe and non-stimulating, such as a hallway D.) If the child cries, refuses, or is more disruptive, try another approach

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? A.) Affected children have some degree of cognitive impairment B.) Around 20% of affected children have normal intelligence C.) About 45% of affected children have normal intelligence D.) Cognitive impairment is expected if motor and sensory deficits are severe

The registered nurse is teaching a student nurse about how parents should tell a child that the child is terminally ill. Which statement made by the student nurse requires correction? A.) "Allow the child's questions to guide the discussion" B.) "Encourage the parents to approach the discussion gently" C.) "Encourage the parents not to speak openly about death" D.) "Use nonthreatening examples to begin to conversation with the child"

The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize? A.) Questions need to be discouraged in this setting B.) 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

The school nurse is presenting sexual information to a group of school-age girls. What approach should the nurse take when presenting the information? A.) Put off answering questions B.) Give technical terms when giving the presentation C.) Treat sex as a normal part of growth and development D.) Plan to give the presentation with boys and girls together

The school nurse is teaching an adolescent about social networking and texting on phones. What statement by the adolescent indicates a need for further teaching? A.) Social networking can help me develop interpersonal skills B.) I will have an opportunity to interact with people like myself C.) My text messaging during class time in school will not cause any disruption D.) I should be cautious, as the online environment can create opportunities for cyberbullying

The school nurse is teaching female school-age children about the average age of puberty. What is the average age of puberty for girls? A.) 10 years B.) 11 years C.) 12 years D.) 13 years

The school nurse is teaching male school-age children about the average age of puberty. What is the average age of puberty for boys? A.) 12 years B.) 13 years C.) 14 years D.) 15 years

The school nurse recognizes that pubertal delay in boys is considered if no enlargement of the testes or scrotal changes have occurred by what age? A.) 11 1/2 to 12 years B.) 12 1/2 to 13 years C.) 13 1/2 to 14 years D.) 14 1/2 to 15 years

The school nurse understands that children are impacted by divorce. Which has the most impact on the positive outcome of a divorce? A.) Age of the child B.) Gender of the child C.) Family characteristics D.) Ongoing family conflict

The sibling of a 4-year-old girl dies from sudden infant death syndrome. The parents are concerned because the 4-year-old girl showed more outward grief when her cat died than now. How should the nurse explain this reaction to the parents? A.) The child is not old enough to have a concept of death B.) This suggests maladaptive coping, and referral is needed for counseling C.) The death may be so painful and threatening that the child must deny it for now D.) The child is not old enough to have formed a significant attachment to her sibling

To help an adolescent deal with diabetes, the nurse needs to consider which characteristic of adolescence? A.) Desire to be unique B.) Preoccupation with the future C.) Need to be perfect and similar to peers D.) Awareness of peers that diabetes is a severe disease

Two hospitalized adolescents are playing pool in the activity room. Neither of them seems enthusiastic about the game. How should the nurse interpret this situation? A.) Playing pool requires too much concentration for this age group B.) Pool is an activity better suited for younger children C.) The adolescents may be enjoying themselves but have lower energy levels than healthy children D.) The adolescents lack of enthusiasm is one of the signs of depression

Understanding autism spectrum disorders (ASDs) is very important for those who care for children. Goals of treatment for these children include: A.) Helping with placement in a long term care setting because most children cannot remain at home B.) Putting the child hospitalized with ASD in a room with another child to help him or her feel more comfortable in the strange environment C.) Providing a structured routine, whether at home or in the health care setting D.) Providing comfort for young children by holding or cuddling when able because the disruption of routine can be frightening

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

What action by the school nurse is important in the prevention of rheumatic fever (RF)? A.) Encourage routine cholesterol screenings B.) Conduct routine blood pressure screenings C.) Refer children with sore throats for throat cultures D.) Recommend salicylates instead of acetaminophen for minor discomforts

What behavior seen in children should be addressed by the nurse who is providing care to a child with a chronic illness? A.) An infant who is uncooperative B.) A toddler who expresses loneliness C.) A preschooler who refuses to participate in self-care D.) An adolescent who is showing independence

What behavior should most likely be manifested in an infant experiencing the protest phase of separation anxiety? A.) Inactivity B.) Depression and sadness C.) Inconsolable and crying D.) Regression to earlier behavior

What chemotherapeutic agent can cause an anaphylactic reaction? A.) Prednisone (Deltasone) B.) Vincristine (Oncovin) C.) L-Asparaginase (Elspar) D.) Methotrexate (Trexall)

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

What child has a decreased pulmonary blood flow congenital heart disease? A.) 1 year old with an atrial septal defect B.) A 6 month old with a repaired ventricular septal defect C.) 2 month old with Tetralogy of Fallot D.) An infant with a patent ductus arteriosus

What condition is an acquired hemorrhagic disorder that is characterized by excessive destruction of platelets? A.) Aplastic anemia B.) Thalassemia major C.) Idiopathic thrombocytopenic purpura D.) Disseminated intravascular coagulation

What condition is the most common cause of acute renal failure in children? A.) Pyelonephritis B.) Tubular destruction C.) Severe dehydration D.) Upper tract obstruction

What description identifies the pathophysiology of leukemia? A.) Increased blood viscosity B.) Abnormal stimulation of the first stage of coagulation process C.) Unrestricted proliferation of immature white blood cells (WBCs) D.) Thrombocytopenia from an excessive destruction of platelets

What developmental characteristic does not occur until a child reaches age 2 1/2 years? A.) Birth weight has doubled B.) Anterior fontanel is still open C.) Primary dentition is complete D.) Binocularity may be established

What does the nurse understand about caloric needs for school-age children? A.) The caloric needs for the school-age children are the same as for other age groups B.) The caloric needs for school-age children are more than they were in the preschool years C.) The caloric needs for school-age children are lower than they were in the preschool years D.) The caloric needs for school-age children are greater than they will be in the adolescent years

What explanation best describes how preschoolers react to the death of a loved one? A.) Grief is acute but does not last long at this age B.) Children this age are too young to have a concept of death C.) Preschoolers may feel guilty and responsible for the death D.) They express grief in the same way that the adults in the preschoolers life are expressing grief

What factor predisposes an infant to fluid imbalances? A.) Decreased surface area B.) Lower metabolic rate C.) Immature kidney functioning D.) Decreased daily exchange of extracellular fluid

What finding is a clinical manifestation of increased intracranial pressure (ICP) in children? A.) Low-pitched cry B.) Sunken fontanel C.) Diplopia, blurred vision D.) Increased blood pressure

What immunoglobulin pattern does the nurse expect in a child recently diagnosed with Wiskott-Aldrich syndrome? A.) Diminished levels of IgG B.) Diminished levels of IgA C.) Diminished levels of IgM D.) Diminished levels of IgE

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

What inheritance pattern is inappropriate for full-mutation fragile X-syndrome? A.) The cause is unknown B.) The carrier father passes his mutation to his offspring C.) The carrier mother passes the mutation to her offspring D.) The carrier mother or father passes the mutation on to the couple's offspring

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

What is a major premise of family-centered care? A.) The child is the focus of all interventions B.) Nurses are the authorities in the child's care C.) Parents are the experts in caring for their child D.) Decisions are made for the family to reduce stress

What is a physiologic effect of immobilization on children? A.) Metabolic rate increases B.) Venous return improves because the child is in the supine position C.) Circulatory stasis can lead to thrombus and embolus formation D.) Bone calcium increases, releasing excess calcium into the body (hypercalcemia)

What is a priority of care when a child has an external ventricular drain (EVD)? A.) Irrigation of drain to maintain flow B.) As-needed dressing changes if dressing becomes wet C.) Frequent assessment of amount and color of drainage D.) Maintaining the EVD below the level of the child's head

What is an appropriate action when an infant becomes apneic? A.) Shake vigorously B.) Roll the infant's head to the side. C.) Gently stimulate the trunk by patting or rubbing D.) Hold the infant by the feet upside down with the head supported

What is an appropriate nursing intervention for a child with minimal change nephrotic syndrome (MCNS) who has scrotal edema? A.) Place an ice pack on the scrotal area B.) Place the child in an upright sitting position C.) Elevate the scrotum with a rolled washcloth D.) Place a warm moist pack to the scrotal area

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

What is an important nursing consideration when caring for a child with juvenile idiopathic arthritis (JIA)? A.) Apply ice packs to relieve acute swelling and pain B.) Administer acetaminophen to reduce inflammation C.) Teach the child and family correct administration of medications D.) Encourage range of motion exercises during periods of inflammation

What is an important priority in dealing with the child suspected of having Wilms tumor? A.) Intervening to minimize bleeding B.) Monitoring temperature for infection C.) Ensuring the abdomen is protected from palpation D.) Teaching parents how to manage the parenteral nutrition

What is characteristic of dishonest behavior in children ages 8 to 10 years? A.) Cheating during games is now more common B.) Stealing can occur because their sense of property rights is limited C.) Lying is used to meet expectations set by others that they have been unable to attain D.) Dishonesty results from the inability to distinguish between fact and fantasy

What is considered a key factor in the higher neonatal mortality rate in the united states in other countries? A.) Infections B.) Parasitic disease C.) Low birth weight D.) High birth weight

What is descriptive of the play of school-age children? A.) They like to invent games, making up the rules as they go B.) Individuality in play is better tolerated than at earlier ages C.) Knowing the rules of a game gives an important sense of belonging D.) Team play helps children learn the universal importance of competition and winning

What is marasmus? A.) Deficiency of protein with an adequate supply of calories B.) Syndrome that results solely from vitamin deficiencies C.) Not confined to geographic areas where food supplies are inadequate D.) Characterized by thin, wasted extremities and a prominent abdomen resulting from edema (ascites)

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

What is the initial clinical manifestation of generalized seizures? A.) Confusion B.) Feeling frightened C.) Loss of consciousness D.) Seeing flashing lights

What is the initial treatment of a child admitted for a sickle cell crisis? A.) Demerol and toradol B.) NSAIDs only C.) Fluid and dilaudid D.) No pain meds will be administered

What is the major cause of death for children older than 1 year in the United States? A.) Heart disease B.) Childhood cancer C.) Unintentional injuries D.) Congenital anomalies

What is the major stressor of hospitalization for children from middle infancy throughout the preschool years? A.) Fear of pain B.) Loss of control C.) Separation anxiety D.) Fear of bodily injury

What is the most common reaction of many parents to their child's hospitalization? A.) Relief B.) Anger C.) Helplessness D.) Depression

What is the primary method of treating osteomyelitis? A.) Joint replacement B.) Bracing and casting C.) Intravenous antibiotic therapy D.) Long-term corticosteroid therapy

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

What is the required number of milliliters of fluid needed per day for a 14-kg child? A.) 800 B.) 1000 C.) 1200 D.) 1400

What major complication is associated with a child with chronic renal failure? A.) Hypokalemia B.) Metabolic alkalosis C.) Water and sodium retention D.) Excessive excretion of blood urea nitrogen

What medication is classified as an antiretroviral? A.) Dapsone (Aczone) B.) Pentamidine (Pentam) C.) Didanosine (Videx) D.) Trimethoprimsulfamethoxazole (Bactrim)

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

What most accurately describes bowel function in children born with a myelomeningocele? A.) Incontinence cannot be prevented B.) Enemas and laxatives are contraindicated C.) Some degree of fecal continence can usually be achieved D.) Colostomy is usually required by the time the child reaches adolescence

What needs to be included as essential teaching for adolescents with systemic lupus erythematosus (SLE)? A.) High calorie diet because of increased metabolic needs B.) Home schooling to decrease the risk of infections C.) Protection from sun and fluorescent lights to minimize rash D.) Intensive exercise regimen to build up muscle strength and endurance

What nursing intervention is appropriate when caring for an unconscious child? A.) Avoid using narcotics or sedatives to provide comfort and pain relief B.) Change the child's position infrequently to minimize the chance of increased intracranial pressure (ICP) C.) Monitor fluid intake and output carefully to avoid fluid overload and cerebral edema D.) Give tepid sponge baths to reduce fevers above 38.3 C (101 F) because antipyretics are contraindicated

What nursing intervention is most appropriate when caring for the child with osteomyelitis? A.) Encourage frequent ambulation B.) Administer antibiotics with meals C.) Move and turn the child carefully and gently to minimize pain D.) Provide active range of motion exercises for the affected extremity

What parents should have the most difficult time coping with their child's hospitalization? A.) Parents of a child hospitalized for juvenile arthritis B.) Parents of a child hospitalized with a recent diagnosis of bronchiolitis C.) Parents of a child hospitalized for sepsis resulting from an untreated injury D.) Parents of a child hospitalized for surgical correction of undescended testicles

What pre-op instructions for a 9 year old is important to prepare them and family for CHD surgical intervention? A.) Let child hear the cardiac monitor sounds and alarms B.) Explain that an endotracheal tube is not needed for surgery C.) Unfamiliar equipment should be shown D.) There is no need to discuss post operative pain and interventions

What should the nurse consider when providing support to a family whose infant has just been diagnosed with biliary atresia? A.) The prognosis for full recovery is excellent B.) Death usually occurs by 6 months of age C.) Liver transplantation may be needed eventually D.) Children with surgical correction live normal lives

What statement accurately describes physical development during the school-age years? A.) The child's weight almost triples B.) Muscles become functionally mature C.) Boys and girls double strength and physical capabilities D.) Fat gradually increases, which contributes to children's heavier appearance

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

What statement best describes b-thalassemia major (Cooley anemia)? A.) It is an acquired hemolytic anemia B.) Inadequate numbers of red blood cells (RBCs) are present C.) Increased incidence occurs in families of Mediterranean extraction D.) It commonly occurs in individuals from West Africa

What statement best describes fear in school-age children? A.) Increasing concerns about bodily safety overwhelm them B.) They should be encouraged to hide their fears to prevent ridicule by peers C.) Most of the new fears that trouble them are related to school and family D.) Children with numerous fears need continuous protective behavior by parents to eliminate these fears

What statement best describes the relationship school-age children have with their families? A.) Ready to reject parental controls B.) Desire to spend equal time with family and peers C.) Need and want restrictions placed on their behavior by the family D.) Peer group replaces the family as the primary influence in setting standards of behavior and rules

What statement is an advantage of peritoneal dialysis compared with hemodialysis? A.) Protein loss is less extensive B.) Dietary limitations are not necessary C.) It is easy to learn and safe to perform D.) It is needed less frequently than hemodialysis

What statement is descriptive of renal transplantation in children? A.) It is an acceptable means of treatment after age 10 years B.) Children can receive kidneys only from other children. C.) It is the preferred means of renal replacement therapy in children D.) The decision for transplantation is difficult because a relatively normal lifestyle is not possible

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

What statement related to clinical trials developed for pediatric cancers is most accurate? A.) Are accessible only in major pediatric centers B.) Do not require consent for standard therapy C.) Provide the best available therapy compared with an expected improvement D.) Are standardized to provide the same treatment to all children with the disease

What term is used to describe an abnormally increased convex angulation in the curvature of the thoracic spine? A.) Scoliosis B.) Lordosis C.) Kyphosis D.) Ankylosis

What term refers to seizures that involve both hemispheres of the brain? A.) Absence B.) Acquired C.) Generalized D.) Complex partial

What therapeutic intervention provides the best chance of survival for a child with cirrhosis? A.) Nutritional support B.) Liver transplantation C.) Blood component therapy D.) Treatment with corticosteroids

What type of chemotherapeutic agent alters the function of cells by replacing a hydrogen atom of a molecule? A.) Plant alkaloids B.) Antimetabolites C.) Alkylating agents D.) Antitumor antibiotics

When auscultating an infants lungs, the nurse detects diminished breath sounds. What should the nurse interpret this as? A.) Suggestive of chronic pulmonary disease B.) Suggestive of impending respiratory failure C.) An abnormal finding warranting investigation D.) A normal finding in infants younger than 1 year of age

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

When communicating with other professionals about a child with a chronic illness, what is important for nurses to do? A.) Ask others what they want to know B.) Share everything known about the family C.) Restrict communication to clinically relevant information D.) Recognize that confidentiality is not possible in home care

When developing a plan of care, which activity is a part of the implementation phase of the nursing process? A.) Establishing patient outcomes B.) Collecting related data from various sources C.) Putting the selected interventions into action D.) Identifying the problems and formulating a diagnosis

When does idiopathic scoliosis become most noticeable? A.) In the newborn period B.) When the child starts to walk C.) During the preadolescent growth spurt D.) During adolescence

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? A.) Lacking in protein B.) Indicating they live in poverty C.) Providing sufficient amino acids D.) Needing enrichment with meat and milk

Where is the best place to observe for the presence of petechiae in dark-skinned individuals? A.) Face B.) Buttocks C.) Oral mucosa D.) Palms and soles

Which action should the nurse implement when taking an axillary temperature? A.) Take the temperature through one layer of clothing B.) Add a degree to the result when recording the temperature C.) Place the tip of the thermometer under the arm in the center of the axilla D.) Hold the child's arm away from the body while taking the temperature

Which clinical manifestations are appropriate for the child with Down Syndrome? A.) Small nose, large ears and hypertonia B.) Large nose, large ears, and short, broad neck C.) Short stature, protruding tongue, and hypotonia D.) Short stature, narrow space between the big and second toes, and hypotonia

Which description of foster care is accurate? A.) Living permanently with an adoptive family B.) An institutional setting where many children live together C.) An approved living situation away from the family of origin D.) Living with grandparents but away from the biologic parents

Which heart sound is produced by vibrations within the heart chambers or in the major arteries from the back-and-forth flow of blood? A.) S1 and S2 B.) S3 and S4 C.) Murmur D.) Physiologic splitting

Which initial nursing action is appropriate for the child that sprayed deodorant into the eyes? A.) Instill antimicrobial eye drops B.) Irrigate with copious amounts of hot water C.) Irrigate with lukewarm water for 20 minutes D.) Bandage the child's eye tightly and rush to the hospital

Which instruction is appropriate for parents who are preparing to tell their children about their decision to divorce? A.) Avoid crying in front of children B.) Avoid discussing the reason for the divorce C.) Give reassurance that the divorce is not the children's fault D.) Give reassurance that the divorce will not affect most aspects of the children's lives

Which instruction would the nurse provide to the parent of a child who is overweight? A.) "Weigh the child weekly" B.) "Put the child on a temporary fast" C.) "Physical activity is important for your child" D.) "Reduce the quantity of food supplied to your child"

Which intervention is the most appropriate recommendation for relief of teething pain? A.) Rub gums with aspirin to relieve inflammation B.) Apply hydrogen peroxide to gums to relieve irritation C.) Give the infant a frozen teething ring to relieve inflammation D.) Have the infant chew on a warm teething ring to encourage tooth eruption

Which is the single most important factor to consider when communicating with children? A.) Presence of the child's parent B.) Child's physical condition C.) Child's developmental level D.) Child's nonverbal behaviors

Which primary goal is appropriate when caring for a child with cognitive impairment? A.) Encouraging play B.) Developing vocational skills C.) Promoting optimal development D.) Helping families develop a care plan and having them stay with it

Which recommendation about discipline is appropriate to give the parents of a cognitively impaired 6 year old child? A.) Discipline is ineffective with cognitively impaired children B.) Discipline is not necessary for cognitively impaired children C.) Behavior modification is an appropriate way to discipline this child D.) Physical punishment is appropriate discipline for cognitively impaired children

Which skill is appropriate when discussing the important of a young child to hear sounds? A.) Communication B.) Social development C.) Speech development D.) Behavior modification

Which statement best describes the concept of death of 8 year old children? A.) They have a mature understanding of death B.) They have no understanding of the universality and inevitability of death C.) They particularly fear the mutilation and punishment they associate with death D.) They are likely to see deviations from accepted behavior as reasons for their illness

Which statement made by the student nurse about the guidelines for integrating spiritual care into pediatric nursing practice indicates a need for further education? A.) "Each patient should be treated as an individual" B.) "The nurse should listen to what a family says about specific rituals" C.) "Refrain from allowing children to tell you about the specifics of their religious beliefs" D.) "The institution's chaplaincy department should be contacted to request specific rituals"

Which symptom is appropriate when confirming hearing loss in a 5 year old child? A.) Limps while walking B.) Appears malnourished C.) Asks to have questions repeated D.) Is not able to complete a long sentence

Which term is appropriate when describing reduce visual acuity in one eye despite appropriate optical correction? A.) Myopia B.) Hyperopia C.) Amblyopia D.) Astigmatism

Which term refers to a shared culture, social, and linguistic heritage? A.) Beliefs B.) Culture C.) Ethnicity D.) Socialization

Which type of family should the nurse recognize when the paternal grandmother, the parents, and two minor children live together? A.) Blended B.) Nuclear C.) Extended D.) Binuclear

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? A.) 10th percentile B.) 75th percentile C.) 85th percentile D.) 95th percentile

A child receiving chemotherapy is experiencing mucositis. Which prescriptions should the nurse plan to administer for initial treatment (select all that apply): A.) Scope mouth rinse B.) Listerine antiseptic mouth rinse C.) Carafate suspension (Sucralfate) D.) Nystatin oral suspension (Nystatin) E.) Lidocaine viscous (Lidocaine hydrochloride solution)

C, D, E

The nurse is assessing breath sounds on a child. Which are expected auscultated breath sounds (select all that apply): A.) Wheezes B.) Crackles C.) Vesicular D.) Bronchial E.) Bronchovesicular

C, D, E

The nurse is educating parents about behavior modification techniques. Which instruction would the nurse provide to help with disciplining their children (select all that apply): A.) Use a moderate amount of spanking B.) Use corporal punishment whenever needed C.) Use rewards to encourage positive behavior D.) Promise a visit to the zoo for good behavior E.) Use time-outs to help the child become calm

C, D, E

The nurse is interpreting a tuberculin skin test. If the nurse finds a result of an induration 5 mm or larger, in which child should the nurse document this finding as positive (select all that apply): A.) A child with diabetes mellitus B.) A child younger than 4 years of age C.) A child receiving immunosuppressive therapy D.) A child with a human immunodeficiency virus (HIV) infection E.) A child living in close contact with a known contagious case of tuberculosis

C, D, E

The nurse is preparing to admit a 7-year-old child with complex partial seizures. What clinical features of complex partial seizures should the nurse recognize (select all that apply): A.) They last less than 10 seconds B.) There is usually no aura C.) Mental disorientation is common D.) There is frequently a postictal state E.) There is usually an impaired consciousness

C, D, E

The nurse is preparing to admit a 7-year-old child with pulmonary edema. What clinical manifestations should the nurse expect to observe (select all that apply): A.) Fever B.) Bradycardia C.) Diaphoresis D.) Pink frothy sputum E.) Respiratory crackles

C, D, E

The nurse is providing anticipatory guidance to parents of a 6-month-old on preventing an accidental poisoning injury. Which should the nurse include in the teaching (select all that apply): A.) Place plants on the floor B.) Place medications in a cupboard C.) Discard used containers of poisonous substances D.) Keep cosmetic and personal products out of the child's reach E.) Make sure that paint for furniture or toys does not contain lead

C, D, E

The nurse is teaching a parent of an 18-month-old about developmental milestones associated with feeding. What should the nurse include in the teaching (select all that apply): A.) The child will begin to use a fork B.) The child will be able use a straw and cup C.) The child will be able to hold a cup with both hands D.) The child will be able to drink from a cup with a lid E.) The child will begin to use a spoon but may turn it before reaching the mouth

C, D, E

The nurse is teaching parents about high-fiber foods that can prevent constipation. What foods should the nurse include in the teaching (select all that apply): A.) Oranges B.) Bananas C.) Lima beans D.) Baked beans E.) Raisin bran cereal

C, D, E

The nurse is teaching parents of a child being discharged from the hospital after a splenectomy about the risk of infection. What should the nurse include in the teaching session (select all that apply): A.) Avoid obtaining the pneumococcal vaccination for the child B.) Avoid obtaining the meningococcal vaccination for the child C.) The child should receive prophylactic penicillin for certain procedures D.) Have the child immunized with the Haemophilus influenzae type b vaccination E.) Notify the health care provider if your child develops a fever of 38.5 C (101.3 F)

C, D, E

The nurse is teaching the parents of a child with a seizure disorder about the triggers that can cause a seizure. What should the nurse include in the teaching session (select all that apply): A.) Cold B.) Sugared drinks C.) Emotional stress D.) Flickering lights E.) Hyperventilation

C, D, E

What are characteristics of early adolescence (1114 years) with regard to identity (select all that apply): A.) Mature sexual identity B.) Increase in self-esteem C.) Trying out of various roles D.) Conformity to group norms E.) Preoccupied with rapid body changes

C, D, E

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

C, D, E

What are risk factors for sudden infant death syndrome (select all that apply): A.) Postterm B.) Female gender C.) Low Apgar scores D.) Recent viral illness E.) Native American infants

C, D, E

What child behavior indicates to the nurse that temper tantrums have become a problem (select all that apply): A.) The child is 2 to 3 years old B.) Tantrums occur at bedtime C.) Tantrums occur past 5 years of age D.) Tantrums last longer than 15 minutes E.) Tantrums occur more than five times a day

C, D, E

What factors influence the effects of a child's hospitalization on siblings (select all that apply): A.) Older siblings B.) Experiencing minimal changes C.) Receiving little information about their ill brother or sister D.) Being cared for outside the home by care providers who are not relatives E.) Perceiving that their parents treat them differently compared with before their siblings hospitalization

C, D, E

What signs and symptoms are indicative of a urinary tract disorder in the neonatal period (birth to 1 month) (select all that apply): A.) Edema B.) Bradypnea C.) Frequent urination D.) Poor urinary stream E.) Failure to gain weight

C, D, E

Which are components of the FLACC scale (select all that apply): A.) Color B.) Capillary refill time C.) Leg position D.) Facial expression E.) Activity

C, D, E

The nurse is teaching parents about safety for their latchkey children. What should the nurse include in the teaching session (select all that apply): A.) Teach the child first-aid procedures B.) Keep the key in an easy place to find C.) Teach the child weather-related safety D.) Teach the child to open the door for delivery people E.) Emphasize fire safety rules and conduct practice fire drills

C, E

A 16-year-old adolescent boy tells the school nurse that he is gay. The nurses response should be based on what? A.) He is too young to have had enough sexual activity to determine this B.) The nurse should feel open to discussing his or her own beliefs about homosexuality C.) Homosexual adolescents do not have concerns that differ from those of heterosexual adolescents D.) It is important to provide a non-threatening environment in which he can discuss this

A 23-month-old child is admitted to the hospital with a diagnosis of meningitis. She is lethargic and very irritable with a temperature of 102 F. What should the nurses care plan include? A.) Observing the child's voluntary movement B.) Checking the Babinski reflex every 4 hours C.) Checking the Brudzinski reflex every 1 hour D.) Assessing the level of consciousness (LOC) and vital signs every 2 hours

A 3-month-old infant has a hypercyanotic spell. What should be the nurses first action? A.) Assess for neurologic defects B.) Prepare the family for imminent death C.) Begin cardiopulmonary resuscitation D.) Place the child in the knee-chest position

A 3-year-old child was adopted immediately after birth. The parents have just asked the nurse how they should tell the child that she is adopted. Which guideline concerning adoption should the nurse use in planning a response? A.) It is best to wait until the child asks about it B.) The best time to tell the child is between the ages of 7 and 10 years C.) It is not necessary to tell a child who was adopted so young D.) Telling the child is an important aspect of their parental responsibilities

A 3-year-old is brought to the emergency department with symptoms of stridor, fever, restlessness, and drooling. No coughing is observed. Based on these findings, the nurse should be prepared to assist with what action? A.) Throat culture B.) Nasal pharynx washing C.) Administration of corticosteroids D.) Emergency intubation

A 4-year-old girl is brought to the emergency department. She has a froglike croaking sound on inspiration, is agitated, and is drooling. She insists on sitting upright. The nurse should intervene in which manner? A.) Make her lie down and rest quietly B.) Examine her oral pharynx and report to the physician C.) Auscultate her lungs and prepare for placement in a mist tent D.) Notify the physician immediately and be prepared to assist with a tracheostomy or intubation

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 done that shows left-to-right shunting. This assessment data is characteristic of what? A.) Tetralogy of Fallot B.) Coarctation of the aorta C.) Pulmonary stenosis D.) Ventricular septal defect

A 6-year-old child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What sign or symptom does the child have that indicates a revision is necessary? A.) Tachycardia B.) Gastrointestinal upset C.) Hypotension D.) Alteration in level of consciousness

A 6-year-old child is admitted to the pediatric unit and requires bed rest. Having art supplies available meets which purpose? A.) Allows the child to create gifts for parents B.) Provides developmentally appropriate activities C.) Is essential for play therapy so the child can work on past problems D.) Let the child express thoughts and feelings through pictures rather than words

A 6-year-old child is in the hospital for status asthmaticus. Nursing care during this acute period includes which prescribed interventions? A.) Prednisolone (Pediapred) PO every day, IV fluids, cromolyn (Intal) inhaler bid B.) Salmeterol (Serevent) PO bid, vital signs every 4 hours, spot check pulse oximetry C.) Triamcinolone (Azmacort) inhaler bid, continuous pulse oximetry, vital signs once a shift D.) Methylprednisolone (Solumedrol) IV every 12 hours, continuous pulse oximetry, albuterol nebulizer treatments every 4 hours and prn

A 7-year-old child is in the end stages of cancer. The parents ask you how they will know when death is imminent. What physical sign is indicative of approaching death? A.) Hunger B.) Tachycardia C.) Increased thirst D.) Difficulty swallowing

A 9-year-old boy has an unplanned admission to the intensive care unit (ICU) after abdominal surgery. The nursing staff has completed the admission process, and his condition is beginning to stabilize. When speaking with the parents, the nurse should expect what additional stressor to be evident? A.) Usual day-night routine B.) Calming influence of staff C.) Adequate privacy and support D.) Insufficient remembering of his condition and routine

A chest radiography examination is ordered for a child with suspected cardiac problems. The child's parent asks the nurse, "What will the x-ray show about the heart?" The nurses response should be based on knowledge that the radiograph provides which information? A.) Shows bones of the chest but not the heart B.) Evaluates the vascular anatomy outside of the heart C.) Shows a graphic measure of electrical activity of the heart D.) Supplies information on heart size and pulmonary blood flow patterns

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

A child has a seizure disorder. What test should be done to gather the most specific information about the type of seizure the child is having? A.) Sleep study B.) Skull radiography C.) Serum electrolytes D.) Electroencephalogram (EEG)

A child has an absolute neutrophil count (ANC) of 500/mm3. The nurse should expect to be administering which prescribed treatment? A.) Platelets B.) Packed red blood cells C.) Zofran (ondansetron) D.) G-CSF (Neupogen) daily

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

A child is admitted for revision of a ventriculoperitoneal shunt for noncommunicating hydrocephalus. What is a common reason for elective revision of this shunt? A.) Meningitis B.) Gastrointestinal upset C.) Hydrocephalus resolution D.) Growth of the child since the initial shunting

A child with a serious chronic illness will soon go home. The case manager requests that the family provide total care for the child for a couple of days while the child is still hospitalized. How should the request be viewed? A.) Improper because of legal issues B.) Supportive because families are usually eager to get involved C.) Unacceptable because the family will have to assume the care soon enough D.) Important because it can be beneficial to the transition from hospital to home

A family requires home care teaching with regard to preventative measures to use at home to avoid an asthmatic episode. What strategy should the nurse teach? A.) Use a humidifier in the child's room B.) Launder bedding daily in cold water C.) Replace wood flooring with carpet D.) Use an indoor air purifier with HEPA filter

A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. The nurse should explain that this is what? A.) A sign the child is spoiled B.) An attempt to exert unhealthy control C.) Regression, which is common at this age D.) Ritualism, an expected behavior at this age

A graduate nurse was caring for a child in the intensive care unit under the guidance of a registered nurse. After the child's death, the graduate nurse admits to feeling low and relates this to the registered nurse. Which advice given by the registered nurse is the most appropriate in this situation? A.) "Spend some time alone until you feel better" B.) "Do not express grief for a patient. It is unprofessional" C.) "Focus on the positive aspects of your chosen profession" D.) "Talk to your colleagues and supervisor about your feelings"

A health care provider prescribes feedings of 1 to 2 oz Pedialyte every 3 hours and to advance to 1/2 strength Similac with iron as tolerated postoperatively for an infant who had a pyloromyotomy. The nurse should decide to advance the feeding if which occurs? A.) The infant's IV line has infiltrated B.) The infant has not voided since surgery C.) The infant's mother states the infant is tolerating the feeding okay D.) The infant is taking the Pedialyte without vomiting or distention

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? A.) This cannot be prevented B.) Infants do not feel pain as adults do C.) This is not a good reason for refusing immunizations D.) A topical anesthetic can be applied before injections are given

A nurse is developing a plan of care for a pediatric patient. Which activities would be included in the assessment phase? A.) Developing a care plan and establishing outcomes B.) Implementation of the care planned for the patient C.) Interpretation of data and formulation of a nursing diagnosis D.) Data collection, classification, analysis of gathered information

A nurse is evaluating the effectiveness of teaching regarding care of a child with minimal change nephrotic syndrome (MCNS) that is in remission after administration of prednisone. The nurse realizes further teaching is required if the parents state what? A.) We will keep our child away from anyone who is ill B.) We will be sure to administer the prednisone as ordered C.) We will encourage our child to eat a balanced diet, but we will watch his salt intake D.) We understand our child will not be able to attend school, so we will arrange for home schooling

A nurse is observing children playing in the playroom. What describes parallel play? A.) A child playing a video game B.) Two children playing a card game C.) Two children watching a movie on a television D.) A child playing with blocks next to a child playing with trucks

A parent asks the nurse about negativism in toddlers. What is the most appropriate recommendation? A.) Punish the child B.) Provide more attention C.) Ask child not to always say no D.) Reduce the opportunities for a no answer

A parent asks the nurse what would be the first indication that acute glomerulonephritis was improving. What would be the nurse's best response? A.) Blood pressure will stabilize B.) Your child will have more energy C.) Urine will be free of protein D.) Urine output will increase

A parent needs to leave a hospitalized toddler for a short period of time. What action should the nurse suggest to the parent to ease the separation for the toddler? A.) Bring a new toy when returning B.) Leave when the child is distracted C.) Tell the child when they will return D.) Leave a favorite article from home with the child

A patient is suspected of having a coarctation of the aorta. What clinical manifestations are consistent with this diagnosis? A.) Bounding pedal pulses B.) Frequent pneumonias C.) Shortness of breath D.) Upper and lower extremity blood pressure discrepancies

A preschool child has asthma, and a goal is to extend expiratory time and increase expiratory effectiveness. What action should the nurse implement to meet this goal? A.) Encourage increased fluid intake B.) Recommend increased use of a budesonide (Pulmicort) inhaler C.) Administer an antitussive to suppress coughing D.) Encourage the child to blow a pinwheel every 6 hours while awake

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

A registered nurse is teaching a student nurse about childhood injuries. Which statement made by the student nurse needs correction? A.) "The majority of deaths from injuries occur in boys" B.) "In infancy, more boys die from suffocation than girls" C.) "Most fetal injuries occur in children below 9 years of age" D.) "Children between 5 and 9 years are at the greatest risk of bicycle fatalities"

A registered nurse is teaching a student nurse about the therapeutic nurse-patient relationship. Which statement made by the student nurse requires future education? A.) "I engage in multidisciplinary rounds and listen to the family's concerns" B.) "I explain to the parent that the assignment changed based on needs of the unit" C.) "I answer politely when asked about my family, but I only give pertinent information" D.) "I realize that caring for the child means I can visit the child on my off days if the family asks me"

A school-age child with cystic fibrosis takes four enzyme capsules with meals. The child is having four or five bowel movements per day. The nurses action in regard to the pancreatic enzymes is based on the knowledge that the dosage is what? A.) Adequate B.) Adequate but should be taken between meals C.) Needs to be increased to increase the number of bowel movements per day D.) Needs to be increased to decrease the number of bowel movements per day

A school-age child with diarrhea has been rehydrated. The nurse is discussing the child's diet with the family. What food or beverage should be tolerated best? A.) Clear fluids B.) Carbonated drinks C.) Applesauce and milk D.) Easily digested foods

A spinal tap must be done on a 9-year-old boy. While he is waiting in the treatment room, the nurse observes that he seems composed. When the nurse asks him if he wants his mother to stay with him, he says, I am fine. How should the nurse interpret this situation? A.) This child is unusually brave B.) He has learned that support does not help C.) Nine-year-old boys do not usually want a parent present during the procedure D.) Children in this age group often do not request support even though they need and want it

A toddlers parent asks the nurse for suggestions on dealing with temper tantrums. What is the most appropriate recommendation? A.) Punish the child B.) Explain to child that this is wrong C.) Leave the child alone until the tantrum is over D.) Remain close by the child but without eye contact

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 nurses response should be based on what? A.) Prenatal detection is not possible yet B.) There is no genetic basis for the defect C.) Chromosome studies done on amniotic fluid can diagnose the defect prenatally D.) Open neural tube defects (NTDs) result in elevated concentrations of a-fetoprotein in amniotic fluid

According to Piaget, adolescents tend to be in what stage of cognitive development? A.) Concrete operations B.) Conventional thought C.) Postconventional thought D.) Formal operational thought

Adolescents often do not use reasoned decision making when issues such as substance abuse and sexual behavior are involved. What is this because of? A.) They tend to be immature B.) They do not need to use reasoned decision making C.) They lack cognitive skills to use reasoned decision making D.) They are dealing with issues that are stressful and emotionally laden

An 8-year-old child is hospitalized with infectious polyneuritis (Guillain-Barr syndrome [GBS]). When explaining this disease process to the parents, what should the nurse consider? A.) Paralysis is progressive with little hope for recovery B.) Disease is inherited as an autosomal, sex-linked, recessive gene C.) Disease results from an apparently toxic reaction to certain medications D.) Muscle strength slowly returns, and most children recover

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

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 B.) After-school activities usually result in extreme fatigue for children with CP C.) Trying to participate in activities such as Girl Scouts leads to lowered self-esteem in children with CP D.) Recreational activities often provide children with CP with opportunities for socialization and recreation

An infant has been diagnosed with bladder obstruction. What do symptoms of this disorder include? A.) Renal colic B.) Strong urinary stream C.) Urinary tract infections D.) Posturination dribbling

An infant has been diagnosed with failure to thrive (FTT) classified according to the pathophysiology of inadequate caloric intake. The nurse understands that the reason for the FTT is most likely related to what? A.) Cows milk allergy B.) Congenital heart disease C.) Metabolic storage disease D.) Incorrect formula preparation

An infant is born with a gastroschisis. Care preoperatively should include which priority intervention? A.) Prone position B.) Sterile water feedings C.) Monitoring serum laboratory electrolytes D.) Covering the defect with a sterile bowel bag

An infant, age 6 months, has six teeth. The nurse should recognize that this is what? A.) Normal tooth eruption B.) Delayed tooth eruption C.) Unusual and dangerous D.) Earlier than expected tooth eruption

At an 8-month-old well-baby visit, the parent tells the nurse that her infant falls asleep at night during the last bottle feeding but wakes up when moved to the infant's crib. What is the most appropriate response for the nurse to make? A.) You should put your baby to sleep 1 hour earlier without the nighttime feeding but with a pacifier for soothing B.) You could place rice cereal in the last bottle feeding of the day to ensure a longer sleep pattern C.) You should have your partner give the last bottle of the day and observe whether your infant stays awake for your partner D.) You could increase daytime feeding intervals to every 4 hours and put your baby in the crib while the baby is still awake

At which developmental period do children have the most difficulty coping with death, particularly if it is their own? A.) Toddlerhood B.) Preschool C.) School age D.) Adolescence

Because of their striving for independence and productivity, which age group of children is particularly vulnerable to events that may lessen their feeling of control and power? A.) Infants B.) Toddlers C.) Preschoolers D.) School-age children

Clinical manifestations of sodium excess (hypernatremia) include which signs or symptoms? A.) Hyperreflexia B.) Abdominal cramps C.) Cardiac dysrhythmias D.) Dry, sticky mucous membranes

Cognitive development influences response to pain. What age group is most concerned with the fear of losing control during a painful experience? A.) Toddlers B.) Preschoolers C.) School-age children D.) Adolescents

Congenital defects of the genitourinary tract, such as hypospadias, are usually repaired as early as possible to accomplish what? A.) Minimize separation anxiety B.) Prevent urinary complications C.) Increase acceptance of hospitalization D.) Promote development of normal body image

Cystic fibrosis (CF) may affect single or multiple systems of the body. What is the primary factor responsible for possible multiple clinical manifestations in CF? A.) Hyperactivity of sweat glands B.) Hypoactivity of autonomic nervous system C.) Atrophic changes in mucosal wall of intestines D.) Mechanical obstruction caused by increased viscosity of mucous gland secretions

Daily toothbrushing and flossing can be encouraged for the child on chemotherapy when the platelet count is above which? A.) 10,000/mm3 B.) 20,000/mm3 C.) 30,000/mm3 D.) 40,000/mm3

During a well-child visit, the nurse plots the child's BMI on the health record. What is the purpose of the BMI? A.) To determine medication dosages B.) To predict adult height and weight C.) To identify coping strategies used by the child D.) To provide a consistent measure of obesity

During examination of a toddlers extremities, the nurse notes that the child is bowlegged. The nurse should recognize that this finding is which? A.) Abnormal and requires further investigation B.) Abnormal unless it occurs in conjunction with knock-knee C.) Normal if the condition is unilateral or asymmetric D.) Normal because the lower back and leg muscles are not yet well developed

Examination of the abdomen is performed correctly by the nurse in which order? A.) Inspection, palpation, percussion, and auscultation B.) Inspection, percussion, auscultation, and palpation C.) Palpation, percussion, auscultation, and inspection D.) Inspection, auscultation, percussion, and palpation

For children who do not have a matched sibling bone marrow donor, the therapeutic management of aplastic anemia includes what intervention? A.) Antibiotics B.) Antiretroviral drugs C.) Iron supplementation D.) Immunosuppressive therapy

For minimal change nephrotic syndrome (MCNS), prednisone is effective when what occurs? A.) Appetite increases and blood pressure is normal B.) Urinary tract infection is gone and edema subsides C.) Generalized edema subsides and blood pressure is normal D.) Diuresis occurs as urinary protein excretion diminishes

How is family systems theory best described? A.) The family is viewed as the sum of individual members B.) A change in one family member cannot create a change in other members C.) Individual family members are readily identified as the source of a problem D.) When the family system is disrupted, change can occur at any point in the system

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

It is important that a child with acute streptococcal pharyngitis be treated with antibiotics to prevent which condition? A.) Otitis media B.) Diabetes insipidus (DI) C.) Nephrotic syndrome D.) Acute rheumatic fever

Pancreatic enzymes are administered to the child with cystic fibrosis. What nursing consideration should be included in the plan of care? A.) Give pancreatic enzymes between meals if at all possible B.) Do not administer pancreatic enzymes if the child is receiving antibiotics C.) Decrease the dose of pancreatic enzymes if the child is having frequent, bulky stools D.) Pancreatic enzymes can be swallowed whole or sprinkled on a small amount of food taken at the beginning of a meal

Parents ask for help for their other children to cope with the changes in the family resulting from the special needs of their sibling. What strategy does the nurse recommend? A.) Explain to the siblings that embarrassment is unhealthy B.) Encourage the parents not to expect siblings to help them care for the child with special needs C.) Provide information to the siblings about the child's condition only as requested D.) Invite the siblings to attend meetings to develop plans for the child with special needs

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? A.) Decongestants to ease stuffy nose B.) Antihistamines to help the child sleep C.) Aspirin for pain and fever management D.) Benzocaine ear drops for topical pain relief

Parents of a newborn with ambiguous genitalia want to know how long they will have to wait to know whether they have a boy or a girl. The nurse answers the parents based on what knowledge? A.) Chromosome analysis will be complete in 7 days B.) A physical examination will be able to provide a definitive answer C.) Additional laboratory testing is necessary to assign the correct gender D.) Gender assignment involves collaboration between the parents and a multidisciplinary team

Parents of a preschool child ask the nurse, Should we set rules for our child as part of a discipline plan? Which is an accurate response by the nurse? A.) It is best to delay the punishment if a rule is broken B.) The child is too young for rules. At this age, unrestricted freedom is best C.) It is best to set the rules and reason with the child when the rules are broken D.) Set clear and reasonable rules and expect the same behavior regardless of the circumstances

Superficial palpation of the abdomen is often perceived by the child as tickling. Which measure by the nurse is most likely to minimize this sensation and promote relaxation? A.) Palpate another area simultaneously B.) Ask the child not to laugh or move if it tickles C.) Begin with deeper palpation and gradually progress to superficial palpation D.) Have the child help with palpation by placing his or her hand over the palpating hand

The diagnosis of hypertension depends on accurate assessment of blood pressure (BP). What is the appropriate technique to measure a childs BP? A.) Assess BP while the child is standing B.) Compare left arm with left leg BP readings C.) Use a narrow cuff to ensure that the readings are correct D.) Measure BP with the child in the sitting position on three separate occasions

The home care nurse visits a family and notes a very strict parenting style, including rigid rule setting and frequent use of time-out when rules are broken. Which type of parental control is being practices? A.) Reasoning B.) Permissive C.) Authorative D.) Authoritarian

The majority of children in the United States with human immunodeficiency virus (HIV) infection acquired the disease by which means? A.) Through sexual contact B.) From a blood transfusion C.) By using intravenous (IV) drugs D.) Perinatally from their mothers

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

The nurse is assessing a 20-month-old toddler during a well-child visit and notices tooth decay. The nurse should understand that early childhood caries are caused by what? A.) Allowing the child to eat citrus foods at bedtime B.) A hereditary factor that cannot be prevented C.) Poor fluoride supply in the drinking water D.) Giving the child a bottle of juice or milk at naptime

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 B.) Vital signs C.) Focal neurologic signs D.) Level of consciousness

The nurse is assessing a child's capillary refill time. This can be accomplished by doing what? A.) Inspect the chest B.) Auscultate the heart C.) Palpate the apical pulse D.) Palpate the nail bed with pressure to produce a slight blanching

The nurse is assessing the Tanner stage in an adolescent male. The nurse recognizes that the stages are based on what? A.) Hair growth on the face and chest B.) Changes in the voice to a deeper timbre C.) Muscle growth in the arms, legs, and shoulders D.) Size and shape of the penis and scrotum and distribution of pubic hair

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

The nurse is caring for a 3-year-old child during a long hospitalization. The parent is concerned about how to support the child's siblings during the hospitalization. What statement is appropriate for the nurse to make? A.) You should choose one parent to spend every night in the hospital while the other parent stays at home with the other children B.) You could leave your hospitalized child for periods at night to be at home with the other children C.) You should discourage the siblings from visiting because this could upset everyone in the family D.) You could encourage a nightly phone call between the siblings as part of the bedtime routine

The nurse is caring for a child with hemophilia A. The child's activity is as tolerated. What activity is contraindicated for this child? A.) Ambulating to the cafeteria B.) Active range of motion C.) Ambulating to the playroom D.) Passive range of motion exercises

The nurse is caring for a child with myasthenia gravis (MG). What health care prescription should the nurse verify before administering? A.) Ceftizoxime (Cefizox) B.) Cefotaxime (Claforan) C.) Ceftriaxone (Rocephin) D.) Garamycin (gentamicin)

The nurse is caring for a child with tetanus during the acute phase. What should the nurse plan in the care for this child? A.) Playing music on a radio B.) Giving frequent back rubs C.) Providing bright lighting in the room D.) Clustering nursing care to limit distractions

The nurse is caring for a school-age girl who has had a cardiac catheterization. The child tells the nurse that her bandage is too wet. The nurse finds the bandage and bed soaked with blood. What nursing action is most appropriate to institute initially? A.) Notify the physician B.) Place the child in Trendelenburg position C.) Apply a new bandage with more pressure D.) Apply direct pressure above the catheterization site

The nurse is caring for an immobilized preschool child. What intervention is helpful during this period of immobilization? A.) Encourage wearing pajamas B.) Let the child have few behavioral limitations C.) Keep the child away from other immobilized children if possible D.) Take the child for a walk by wagon outside the room

The nurse is closely monitoring a child who is unconscious after a fall and notices that the child suddenly has a fixed and dilated pupil. How should the nurse interpret this? A.) Eye trauma B.) Brain death C.) Severe brainstem damage D.) Neurosurgical emergency

The nurse is developing a teaching pamphlet for parents of school-age children. What anticipatory guidelines should the nurse include in the pamphlet? A.) At age 6 years, parents should be certain that the child is reading independently with books provided by school B.) At age 8 years, parents should expect a decrease in involvement with peers and outside activities C.) At age 10 years, parents should expect a decrease in admiration of the parents with little interest in parent-child activities D.) At age 12 years, parents should be certain that the child's sex education is adequate with accurate information

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

The nurse is discussing with a child and family the various sites used for insulin injections. What site usually has the fastest rate of absorption? A.) Arm B.) Leg C.) Buttock D.) Abdomen

The nurse is doing a prehospitalization orientation for a girl, age 7 years, who is scheduled for cardiac surgery. As part of the preparation, the nurse explains that after the surgery, the child will be in the intensive care unit. How might the explanation by the nurse be viewed? A.) Unnecessary B.) The surgeon's responsibility C.) Too stressful for a young child d.) An appropriate part of the child's preparation

The nurse is instructing student nurses about the stress of hospitalization for children from middle infancy throughout the preschool years. What major stress should the nurse relate to the students? A.) Pain B.) Bodily injury C.) Loss of control D.) Separation anxiety

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? A.) Suffocation B.) Child abuse C.) Infantile apnea D.) Sudden infant death syndrome (SIDS)

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

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

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

The nurse is preparing to administer a measles, mumps, rubella, and varicella (MMRV) vaccine. Which is a contraindication associated with administering this vaccine? A.) The child has recently been exposed to an infectious disease B.) The child has symptoms of a cold but no fever C.) The child is having intermittent episodes of diarrhea D.) The child has a disorder that causes a deficient immune system

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 B.) Use blood within 1 hour of its arrival from the blood bank C.) Administer the blood with 5% glucose in a piggyback setup D.) Administer the first 50 ml of blood slowly and stay with the child

The nurse is teaching an adolescent about giving insulin injections. The adolescent asks if the disposable needles and syringes can be used more than once. The nurses response should be based on which knowledge? A.) It is unsafe B.) It is acceptable for up to 24 hours C.) It is acceptable for families with very limited resources D.) It is suitable for up to 3 days if stored in the refrigerator

The nurse is teaching parents about caring for their infant with seborrheic dermatitis (cradle cap). Which statement by the parents indicates understanding of the teaching? A.) We will rinse off the shampoo quickly and dry the scalp thoroughly. B.) We will shampoo the hair every other day with antiseborrheic shampoo C.) We will be sure to shampoo the hair without removing any of the crusts D.) We will use a fine-tooth comb to help remove the loosened crusts from the strands of hair

The nurse is teaching parents about expected language development for their 6-month-old infant. The nurse recognizes the parents understand the teaching if they make which statement? A.) Our baby should comprehend the word no B.) Our baby knows the meaning of saying mama C.) Our baby should be able to say three to five words D.) Our baby should begin to combine syllables, such as dada

The nurse is teaching parents about toilet training. What should the nurse include in the teaching session? A.) Bladder training is accomplished before bowel training B.) The mastery of skills required for toilet training is present at 18 months C.) By 12 months, the child is able to retain urine for up to 2 hours or longer D.) The physiologic ability to control the sphincters occurs between 18 and 24 months

The nurse is teaching parents the proper use of a hip-knee-ankle-foot orthosis (HKAFO) for their 4-year-old child. The parents demonstrate basic essential knowledge by making what statement? A.) Alcohol will be used twice a day to clean the skin around the brace B.) Weekly visits to the orthotist are scheduled to check screws for tightness C.) Initially, a burning sensation is expected and the brace should remain in place D.) Condition of the skin in contact with the brace should be checked every 4 hours

The nurse is teaching the parents of an infant who has started crawling about childhood injuries and how to prevent them. Which is the most important information the nurse would include in the teaching? A.) Do not place the infant on unprotected surfaces B.) Create a safe environment to minimize falls or burns C.) Take care that the child does not collide with objects D.) Observe the child to make certain the child does not place objects in the mouth

The nurse needs to assess a 15-month-old child who is sitting quietly on his father's lap. What initial action by the nurse would be most appropriate? A.) Ask the father to place the child on the exam table B.) Undress the child while he is still sitting on his father's lap C.) Talk softly to the child while taking him from his father D.) Begin the assessment while the child is in his father's lap

The nurse should assess which age group for suicide ideation since suicide in which age group is the third leading cause of death? A.) Preschoolers B.) Young school age C.) Middle school age D.) Late school age and adolescents

The parents of a 5-year-old child ask the nurse, How many hours of sleep a night does our child need? The nurse should give which response? A.) A 5-year-old child requires 8 hours of sleep B.) A 5-year-old child requires 9.5 hours of sleep C.) A 5-year-old child requires 10 hours of sleep D.) A 5-year-old child requires 11.5 hours of sleep

The parents of a child with Sickle Cell Anemia ask about a subsequent child having the disease. The nurse's best response is: A.) All siblings will have sickle cell anemia B.) Sickle cell anemia is contracted by mosquitoes C.) There is a 50% chance of siblings having sickle cell anemia D.) Each sibling has a 25% chance of having sickle cell

The parents of a child with cancer tell the nurse that a bone marrow transplant (BMT) may be necessary. What information should the nurse recognize as important when discussing this with the family? A.) BMT should be done at the time of diagnosis B.) Parents and siblings of the child have a 25% chance of being a suitable donor C.) If BMT fails, chemotherapy or radiotherapy will need to be continued D.) Finding a suitable donor involves matching antigens from the human leukocyte antigen (HLA) system

The parents of a newborn say that their toddler hates the baby. . . . He suggested that we put him in the trash can so the trash truck could take him away. What is the nurses best reply? A.) Lets see if we can figure out why he hates the new baby B.) That's a strong statement to come from such a small boy. C.) Lets refer him to counseling to work this hatred out. It's not a normal response D.) That is a normal response to the birth of a sibling. Let's look at ways to deal with this

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? A.) It is a safe, frequently used drug B.) Parents lack the expertise necessary to administer digoxin C.) It is difficult to either overmedicate or undermedicate with digoxin D.) Parents need to learn specific, important guidelines for administration of digoxin

The presence of which pair of factors is a good predictor of a fluid deficit of at least 5% in an infant? A.) Weight loss and decreased heart rate B.) Capillary refill of less than 2 seconds and no tears C.) Increased skin elasticity and sunken anterior fontanel D.) Dry mucous membranes and generally ill appearance

The psychosexual conflicts of preschool children make them extremely vulnerable to which threat? A.) Loss of control B.) Loss of identity C.) Separation anxiety D.) Bodily injury and pain

The recommendation to repair a patent ductus arteriosus (PDA) to prevent what complication? A.) Right to left shunting of blood B.) Hypoxemia C.) Decreased workload of the left side of the heart D.) Pulmonary vascular congestion

The school nurse is discussing after-school sports participation with parents of children age 10 years. The nurses presentation includes which important consideration? A.) Teams should be gender specific B.) Organized sports are not appropriate at this age C.) Competition is detrimental to the establishment of a positive self-image D.) Sports participation is encouraged if the type of sport is appropriate to the child's abilities

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 D.) Adolescence is the peak age for being a victim or offender in the case of injury involving a firearm

The school nurse recognizes that adolescents should get how many hours of sleep each night? A.) 6 hours B.) 7 hours C.) 8 hours D.) 9 hours

The school nurse recognizes that pubertal delay in girls is considered if breast development has not occurred by which age? A.) 10 years B.) 11 years C.) 12 years D.) 13 years

Total-body irradiation is indicated for what reason? A.) Palliative care B.) Lymphoma therapy C.) Definitive therapy for leukemia D.) Preparation for bone marrow transplant

What blood glucose measurement is most likely associated with diabetic ketoacidosis? A.) 185 mg/dl B.) 220 mg/dl C.) 280 mg/dl D.) 330 mg/dl

What change does the nurse teach the parents to expect in their child after prolonged hospitalization? A.) Anger toward parents B.) Jealousy toward siblings C.) Repressed feeling of resentment D.) Regression in newly learned skills

What chemotherapeutic agent is classified as an antitumor antibiotic? A.) Cisplatin (Platinol AQ) B.) Vincristine (Oncovin) C.) Methotrexate (Texall) D.) Daunorubicin (Cerubidine)

What choice of words or phrases would be inappropriate to use with a child? A.) Rolling bed for stretcher B.) Special medicine for dye C.) Make sleepy for deaden D.) Catheter for intravenous

What clinical manifestation is considered a cardinal sign of diabetes mellitus? A.) Nausea B.) Seizures C.) Impaired vision D.) Frequent urination

What clinical manifestation occurs with hypoglycemia? A.) Lethargy B.) Confusion C.) Nausea and vomiting D.) Weakness and dizziness

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

What condition is an inherited immunodeficiency disorder characterized by absence of both humoral and cell-mediated immunity? A.) Fanconi syndrome B.) Wiskott-Aldrich syndrome C.) Acquired immunodeficiency syndrome (AIDS) D.) Severe combined immunodeficiency syndrome (SCIDS)

What do nursing interventions to promote health during middle childhood include? A.) Stress the need for increased calorie intake to meet increased demands B.) Instruct parents to defer questions about sex until the child reaches adolescence C.) Advise parents that the child will need increasing amounts of rest toward the end of this period D.) Educate parents about the need for good dental hygiene because these are the years in which permanent teeth erupt

What do the clinical manifestations of minimal change nephrotic syndrome include? A.) Hematuria, bacteriuria, and weight gain B.) Gross hematuria, albuminuria, and fever C.) Hypertension, weight loss, and proteinuria D.) Massive proteinuria, hypoalbuminemia, and edema

What do the psychosocial developmental tasks of toddlerhood include? A.) Development of a conscience B.) Recognition of sex differences C.) Ability to get along with age mates D.) Ability to delay gratification

What drug is usually given first in the emergency treatment of an acute, severe asthma episode in a young child? A.) Ephedrine B.) Theophylline C.) Aminophylline D.) Short-acting b2-agonists

What factor is most important for parents implementing do not resuscitate (DNR) orders? A.) Parents beliefs about euthanasia B.) Presence of other children in the home C.) Experiences of the health care team with other children in this situation D.) Acknowledgment by health care team that child has no realistic chance for cure

What factor is most important in predisposing toddlers to frequent infections? A.) Respirations are abdominal B.) Pulse and respiratory rates in toddlers are slower than those in infants C.) Defense mechanisms are less efficient than those during infancy D.) Toddlers have short, straight internal ear canals and large lymph tissue

What finding by the nurse is most characteristic of chronic sorrow? A.) Lack of acceptance of childs limitation B.) Lack of available support to prevent sorrow C.) Periods of intensified sorrow when experiencing anger and guilt D.) Periods of intensified sorrow at certain landmarks of the child's development

What functional ability should the nurse expect in a child with a spinal cord lesion at C7? A.) Complete respiratory paralysis B.) No voluntary function of upper extremities C.) Inability to roll over or attain sitting position D.) Almost complete independence within limitations of wheelchair

What immunization should not be given to a child receiving chemotherapy for cancer? A.) Tetanus vaccine B.) Inactivated poliovirus vaccine C.) Diphtheria, pertussis, tetanus (DPT) D.) Measles, mumps, rubella (MMR)

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

What is a nursing intervention to reduce the risk of increasing intracranial pressure (ICP) in an unconscious child? A.) Suction the child frequently B.) Turn the child's head side to side every hour C.) Provide environmental stimulation D.) Avoid activities that cause pain or crying

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

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

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

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

What is the primary goal of care coordination? A.) Providing timely care B.) Ensuring access to a variety of services C.) Reducing the financial cost of health care D.) Ensuring continuity across various settings

What nursing consideration is most important when caring for a child with end-stage renal disease (ESRD)? A.) Children with ESRD usually adapt well to minor inconveniences of treatment B.) Children with ESRD require extensive support until they outgrow the condition C.) Multiple stresses are placed on children with ESRD and their families until the illness is cured D.) Multiple stresses are placed on children with ESRD and their families because children's lives are maintained by drugs and artificial means

What nursing intervention is especially helpful in assessing feelings of parental guilt when a disability or chronic illness is diagnosed? A.) Ask the parents if they feel guilty B.) Observe for signs of overprotectiveness C.) Talk about guilt only after the parents mention it D.) Discuss the meaning of the parents religious and cultural background

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

What pain management approach is most effective for a child who is having a bone marrow test? A.) Relaxation techniques B.) Administration of an opioid C.) EMLA cream applied over site D.) Conscious or unconscious sedation

What physiologic defect is responsible for causing anemia? A.) Increased blood viscosity B.) Depressed hematopoietic system C.) Presence of abnormal hemoglobin D.) Decreased oxygen-carrying capacity of blood

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

What refers to a hernial protrusion of a saclike cyst of meninges, spinal fluid, and a portion of the spinal cord with its nerves through a defect in the vertebral column? A.) Rachischisis B.) Meningocele C.) Encephalocele D.) Myelomeningocele

What should be the primary goal of a nurse while providing atraumatic care of a child? A.) Restrain the child B.) Repress the parents C.) Anesthetize the child D.) Do no harm to the child

What should the nurse determine to be the priority intervention for a family with an infant who has a disability? A.) Focus on the child's disabilities to understand care needs B.) Institute age-appropriate discipline and limit setting C.) Enforce visiting hours to allow parents to have respite care D.) Foster feelings of competency by helping parents learn the special care needs of the infant

What side effect commonly occurs with corticosteroid (prednisone) therapy? A.) Alopecia B.) Anorexia C.) Nausea and vomiting D.) Susceptibility to infection

What statement applies to the current focus of the dietary management of children with diabetes? A.) Measurement of all servings of food is vital for control B.) Daily calculate specific amounts of carbohydrates, fats, and proteins C.) The number of calories for carbohydrates remains constant on a daily basis; protein and fat calories are liberal D.) The intake ensures day-to-day consistency in total calories, protein, carbohydrates, and moderate fat while allowing for a wide variety of foods

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

What statement best represents infectious mononucleosis? A.) Herpes simplex type 2 is the principal cause B.) A complete blood count shows a characteristic leukopenia C.) A short course of ampicillin is used when pharyngitis is present D.) Clinical signs and symptoms and blood tests are both needed to establish the diagnosis

What statement characterizes moral development in the older school-age child? A.) Rule violations are viewed in an isolated context B.) Judgments and rules become more absolute and authoritarian C.) The child remembers the rules but cannot understand the reasons behind them D.) The child is able to judge an act by the intentions that prompted it rather than just by the consequences

What statement is correct regarding sports injuries during adolescence? A.) Conditioning does not help prevent many sports injuries B.) The increase in strength and vigor during adolescence helps prevent injuries related to fatigue C.) More injuries occur during organized athletic competition than during recreational sports participation D.) Adolescents may not possess insight and judgment to recognize when a sports activity is beyond their capabilities

What term describes invagination of one segment of bowel within another? A.) Atresia B.) Stenosis C.) Herniation D.) Intussusception

What term is defined as the volume of blood ejected by the heart in 1 minute? A.) Afterload B.) Cardiac cycle C.) Stroke volume D.) Cardiac output

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

What type of diarrhea is associated with an inflammation of the mucosa and submucosa in the ileum and colon caused by infectious agents? A.) Osmotic B.) Secretory C.) Cytotoxic D.) Dysenteric

What type of drug reduces hypertension by interfering with the production of angiotensin II? A.) Diuretics B.) Vasodilators C.) Beta-blockers D.) Angiotensin-converting enzyme (ACE) inhibitors

When a child develops latex allergy, which food may also cause an allergic reaction? A.) Yeast B.) Wheat C.) Peanuts D.) Bananas

When assessing a preschoolers chest, what should the nurse expect? A.) Respiratory movements to be chiefly thoracic B.) Anteroposterior diameter to be equal to the transverse diameter C.) Retraction of the muscles between the ribs on respiratory movement D.) Movement of the chest wall to be symmetric bilaterally and coordinated with breathing

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 hours D.) Therapeutic management includes administration of gamma globulin and salicylates

When caring for their infant, a patient asks you, "Is Emily in a lot of pain? How would you know since she can't really tell you?" The best answer to this question is: A.) "Infants don't feel pain as we do because their pain receptors are not fully developed yet." B.) "The nurses give pain medication before she really feels the pain." C.) "We assess her pain using an infant pain assessment tool and give the medicine as needed." D.) "Although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain."

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

Where do eczematous lesions most commonly occur in an infant? A.) Abdomen, cheeks, and scalp B.) Buttocks, abdomen, and scalp C.) Back and flexor surfaces of the arms and legs D.) Cheeks and extensor surfaces of the arms and legs

Which best describes signs and symptoms as part of a nursing diagnosis? A.) Description of potential risk factors B.) Identification of actual health problems C.) Human response to state of illness or health D.) Cues and clusters derived from patient assessment

Which degree of hearing loss is appropriate for the child who is able to hear a loud radio at home, but is not able to understand conversational speech unless it is loud? A.) Slight B.) Severe C.) Profound D.) Moderately severe

Which finding is appropriate when diagnosing a child with an intellectual disability? A.) An intelligence quotient (IQ) of 70 or less B.) An IQ of 75 or less C.) Subaverage intellectual function, deficits in adaptive skills, and onset at any age D.) Subaverage intellectual function, deficits in adaptive skills, and onset before 18 years of age

Which is a consequence of the physical punishment of children, such as spanking? A.) The psychologic impact is usually minimal B.) The child's development of reasoning increases C.) Children rarely become accustomed to spanking D.) Misbehavior is likely to occur when parents are not present

Which is a sign of complicated grief in a family member? A.) Sleep disturbances and feelings of emptiness 9 months after the death of a child B.) Pangs of severe emotions, sleep disturbances and feelings of excessive loneliness 6 months after the death of a child C.) Pangs of severe emotions, sleep disturbances, and feelings of excessive loneliness 8 months after the death of a child D.) Sleep disturbances, pangs of severe emotion and excessive feelings of loneliness 15 months after the death of a child

Which nursing action is appropriate for the parents of a child with fragile X syndrome wanting to have another baby, but worry that another child might be similarly affected? A.) Assessing for a family history of the syndrome B.) Recommending that they not have another child C.) Reassuring them that the syndrome is not inherited D.) Explaining that prenatal diagnosis of the syndrome is now available

Which nursing intervention is appropriate for the child who has just sustained a chemical burn to his right eye? A.) Keep the room well lit B.) Patch the affected eye C.) Have the child keep eyes open to reduce the chance of trauma D.) Irrigate the eye with copious amounts of tap water for 20 minutes

Which parameter correlates best with measurements of total muscle mass? A.) Height B.) Weight C.) Skinfold thickness D.) Upper arm circumference

Which patient is the best candidate for organ donation? A.) A child who died of sepsis B.) A child who died of metastatic cancer C.) A child who died of prolonged cardiac arrest D.) A child who died in a motor vehicle accident

Which sign does the nurse recognize as the most distressing for parents to observe in the final hours of their child's life? A.) Confusion B.) Loss of sensation C.) Changes in heart rate D.) Changes in respiratory pattern

Which statement accurately describes family system theory? A.) Family is viewed as the sum of the individual members within the family B.) Change in one family member cannot cause a change in other members C.) Individual family members are readily identified as the source of a problem D.) when the family system is disrupted, change may occur at any point in the system

Which statement best describes colic? A.) Periods of abdominal pain resulting in weight loss B.) Usually the result of poor or inadequate mothering C.) Periods of abdominal pain and crying occurring in infants older than age 6 months D.) A paroxysmal abdominal pain or cramping manifested by episodes of loud crying

Which symptom indicates unhealthy coping in a child whose parents are divorcing? A.) Body rash B.) Body aches C.) Increased sleep D.) Loss of appetite

Which term is defined as the emotional attitude that one's own ethnic group is superior to others? A.) Culture B.) Ethnicity C.) Socialization D.) Ethnocentrism

Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation? A.) Congenital lactase deficiency B.) Primary lactase deficiency C.) Secondary lactase deficiency D.) Developmental lactase deficiency

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