Peds Practice Questions-CH 37, 43, 47, 48-#5
The nurse is reviewing the laboratory test results of a child with Addison disease. What would the nurse expect to find? A) Hypernatremia B) Hyperkalemia C) Hyperglycemia D) Hypercalcemia
B) Hyperkalemia
The nurse is providing home care instructions for a 13-year-old girl recently diagnosed with systemic lupus erythematosus. Which response by the girl indicates a need for further teaching? A) "I need to wear sunscreen in the summer to prevent rashes." B) "I need to eat a healthy diet, exercise, and get plenty of sleep." C) "I need an eye examination every year." D) "I need to be careful when it is cold; I should always wear gloves."
A) "I need to wear sunscreen in the summer to prevent rashes."
A child is diagnosed with scarlet fever. The nurse is reviewing the child's medical record, expecting which medication to be prescribed for this child? A. Ibuprofen B. Acyclovir C. Penicillin V D. Doxycycline
C. Penicillin V
The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing? A. Keeping the drainage tube taped in an upright position B. Administering antibiotics as ordered C. Administering analgesics as prescribed D. Using a double-diapering technique
D. Using a double-diapering technique
The nurse is administering an IV infusion of albumin to a child with nephrotic syndrome. What is the primary concern for the nurse when administering this medication to the child? A. Fluid overload B. Electrolyte imbalance C. Increased blood pressure D. Urine output
A. Fluid overload
The nurse determines that it is necessary to implement airborne precautions for children with which infection? A. Measles B. Streptococcus group A C. Rubella D. Scarlet fever
A. Measles
After teaching a class on the role of white blood cells in infection, the instructor determines that the teaching was successful when the class identifies which type of white blood cells as important in combating bacterial infections? A. Neutrophils B. Eosinophils C. Basophils D. Lymphocytes
A. Neutrophils
A mother brings her 8-year-old son for evaluation because of a rash on his lower leg. Which finding would support the suspicion that the child has Lyme disease? A. Playing in the woods about a week ago B. Rash is papular and vesicular C. High fever occurring about 4 days before the rash D. Reports of extreme pruritus with visible nits
A. Playing in the woods about a week ago
A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A) 9.0% B) 8.2% C) 7.3% D) 6.9%
B) 8.2%
While hospitalized, a child develops scarlet fever. Isolation has been prescribed by the health care provider. The nurse would place this child in what type of isolation? A. Airborne B. Droplet C. Contact D. Reverse
B. Droplet
The nurse is providing a class for a group of childcare providers. When discussing allergic reactions, which statement by a participant indicates the need for further instruction? A) "Most allergic reactions will happen within a few minutes of eating a problematic food." B) "If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it." C) "Allergic reactions can happen hours after eating something." D) "In addition to hives some children may also have vomiting and diarrhea when having an allergic reaction to a food."
B) "If a child has previously eaten a food and not had a reaction they are not 'truly' allergic to it."
After teaching the parents of a daughter with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? A) "She needs to use the nasal spray once every day." B) "She will start puberty again when the medication stops." C) "This medication will slow down the changes but not reverse them." D) "Once therapy is done, she'll need surgery."
B) "She will start puberty again when the medication stops."
A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. What would the nurse do next? A) Administer a sliding-scale dose of insulin. B) Give 10 to 15 g of a simple carbohydrate. C) Offer a complex carbohydrate snack. D) Administer glucagon intramuscularly.
B) Give 10 to 15 g of a simple carbohydrate.
A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify what as the primary function of this system? A) Regulation of water balance B) Hormonal secretion C) Cellular metabolism D) Growth stimulation
B) Hormonal secretion
When teaching a group of new parents about newborn care and development, which immunoglobulin would the nurse explain as being primarily responsible for the passive immunity exhibited by newborns? A) IgA B) IgG C) IgM D) IgE
B) IgG
A 15-year-old client presents to the emergency room reporting an abrupt onset of severe, sudden pain on the right side of the scrotum while playing football. The nurse notes a blue-black swelling of the affected scrotum. Which action will the nurse complete next? A. Complete a head-to-toe assessment B. Have the client rate the pain C. Notify the primary health care provider D. Monitor the client's urine output
C. Notify the primary health care provider
A child is diagnosed with a helminthic infection. Which treatments would the nurse expect to be prescribed? Select all that apply. A. Erythromycin B. Albendazole C. Pyrantel pamoate D. Acyclovir E. Metronidazole F. Permethrin
B. Albendazole C. Pyrantel pamoate
A nurse is caring for a 12-year-old girl with a severe peanut allergy. The girl's parents are upset because the school does not permit her to carry her EpiPen with her. It must remain in the school's office per school regulations. Which response by the nurse would be most appropriate? A) "She is allowed by law to carry her EpiPen with her; I will talk to school authorities." B) "Let's file an action plan and keep it in the school office in the event of anaphylaxis." C) "Make sure she wears a medical alert bracelet so that school staff know she has allergies." D) "I will be happy to train school authorities and staff to recognize anaphylaxis."
A) "She is allowed by law to carry her EpiPen with her; I will talk to school authorities."
A nursing student is reviewing information about primary immunodeficiencies. The student demonstrates understanding of the material by identifying which immunodeficiencies as affecting only males? Select all that apply. A) X-linked agammaglobulinemia B) Wiskott--Aldrich syndrome C) Selective IgA deficiency D) X-linked hyper-IgM syndrome E) IgG subclass deficiency F) Severe combined immune deficiency
A) X-linked agammaglobulinemia B) Wiskott--Aldrich syndrome D) X-linked hyper-IgM syndrome
The nurse is assessing a 8-month-old infant who has symptoms of poor feeding, a poor gag reflex, listlessness and a weak cry. What is the most important question the nurse should ask the parent about these symptoms? A. "Have you given your infant any honey?" B. "When did these symptoms begin?" C. "Has your infant had any unpasteurized milk to drink?" D. "What is the source of your family's water supply?"
A. "Have you given your infant any honey?"
An infant has undergone a hypospadias repair. What intervention will the nurse teach the parents to keep the site clean and to reduce swelling? A. "It is important to use double diapering to keep stool off the site." B. "The compression dressing should be changed if it becomes soiled." C. "Keep the penis taped to the abdomen so stool cannot get to surgical site." D. "You can use a gauze dressing to cover the urethral stent."
A. "It is important to use double diapering to keep stool off the site."
The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate? A. "Let's put you in touch with some other girls who are also having the same body changes." B. "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C. "Your real friends do not care about your appearance and just want you to get well." D. "You are beautiful in your own way; what matters is what is on the inside."
A. "Let's put you in touch with some other girls who are also having the same body changes."
The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. What would the nurse most likely expect to assess after the first dose is administered? A. Fever with chills, chest tightness B. Cough, hyperkalemia C. Photosensitivity, gastrointestinal (GI) upset D. Urinary retention, decreased appetite
A. Fever with chills, chest tightness
The nurse is caring for a hospitalized, 1-week-old infant who appears very ill. Which assessment finding(s) will the nurse report to the health care provider? Select all that apply. A. Petchiae B. Heart rate 100 beats/min C. Respiratory rate 60 breaths/min D. Axillary temperature 97.6°F (36.5°C) E. Characteristic of cry
A. Petchiae B. Heart rate 100 beats/min C. Respiratory rate 60 breaths/min D. Axillary temperature 97.6°F (36.5°C) E. Characteristic of cry
The nurse is performing a physical examination of an 8-year-old girl who was bitten by her kitten. Which assessment would lead the nurse to suspect cat-scratch disease? A. Swollen lymph nodes B. Strawberry tongue C. Infected tonsils D. Swollen neck
A. Swollen lymph nodes
A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as a: A. vesicostomy. B. ureteral stent. C. continent urinary diversion. D. bladder augmentation.
A. vesicostomy.
A nurse is preparing a plan of care for a child with a primary immunodeficiency. Which nursing diagnosis is the priority? A) Imbalanced nutrition, less than body requirements related to poor appetite B) Ineffective protection related to impaired humoral defenses C) Acute pain related to inflammatory processes D) Risk for delayed growth and development related to chronic illness
B) Ineffective protection related to impaired humoral defenses
The nurse is caring for an 8-year-old girl with hyperpituitarism. What ordered treatment will the nurse expect to perform? A) Give desmopressin acetate intranasally B) Inject octreotide acetate C) Give 1 mg/kg/day of methimazole D) Administer glipizide orally
B) Inject octreotide acetate
The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. What care would the nurse expect to implement? A) Instructing the parents to report adverse reactions to the growth hormone treatment B) Teaching the parents how to administer the desmopressin acetate C) Informing the parents that treatment stops when puberty begins D) Educating the parents to report signs of acute adrenal crisis
B) Teaching the parents how to administer the desmopressin acetate
The nurse is caring for a child who is taking corticosteroids for systemic lupus erythematosus. The nurse closely monitors the child based on the understanding that corticosteroids exert which major action? A) They increase liver enzymes. B) They can mask signs of infection. C) They cause bone marrow suppression. D) They decrease renal function.
B) They can mask signs of infection.
While presenting a panel discussion to a group of parents about urinary tract infections (UTIs) in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate? A. "Girls have a smaller bladder size than boys do." B. "A girl's urethra is closer to the rectal opening." C. "A girl's urethra is longer than a boy's urethra." D. "Her kidneys are less well protected."
B. "A girl's urethra is closer to the rectal opening."
The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). In educating the parents, the nurse would recommend that the child avoid: A. a liberal fluid intake. B. caffeine. C. cranberry juice. D. cotton underwear.
B. caffeine.
A child has been prescribed growth hormone. When collecting data from this client, which report is of the greatest concern? A) "I sometimes have headaches." B) "I feel tired." C) "My hips often hurt." D) "I take this medication with food."
C) "My hips often hurt."
The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which assessment findings? A) Arrested height and increased weight B) Thin, fragile skin and multiple bruises C) Hyperpigmentation and hypotension D) Blurred vision and enuresis
C) Hyperpigmentation and hypotension
A group of nursing students are reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state: A) Endocrine glands begin developing in the third trimester of gestation. B) At birth, the endocrine glands are completely functional. C) Infants have difficulty balancing glucose and electrolytes. D) A child's endocrine system has little effect on growth and development.
C) Infants have difficulty balancing glucose and electrolytes.
The nurse is caring for a child who has undergone stem cell transplantation for severe combined immune deficiency. What finding would the nurse interpret as indicative of graft-versus-host disease? A) Presence of wheezing B) Splenomegaly C) Maculopapular rash D) Chronic or recurrent diarrhea
C) Maculopapular rash
The nurse is providing instruction to the parents of a newborn boy. The parents have decided not to circumcise the child. What information should be included in the discussion? Select all answers that apply. A. The foreskin should be pulled back for cleaning at least once per day. B. The foreskin should be pulled back gently with each diaper change. C. Clean the penis gently with soap and water. D. If the foreskin is not retractable do not force it. E. When the foreskin is retracted, gently replace it prior to completing diapering.
C. Clean the penis gently with soap and water. D. If the foreskin is not retractable do not force it. E. When the foreskin is retracted, gently replace it prior to completing diapering.
The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. What would the nurse least likely expect to find? A. Hyperlipidemia B. Hypoalbuminemia C. Decreased blood urea nitrogen (BUN) D. Hypoproteinemia
C. Decreased blood urea nitrogen (BUN)
The nurse is caring for a client with hemolytic-uremic syndrome (HUS). The cilent is demonstrating oliguria. What does the nurse expect to find when reviewing the client's records? A. A pattern of below-normal blood pressure B. Higher fluid output than fluid intake C. Elevated BUN and creatinine levels D. Increased glomerular filtration rate (GFR)
C. Elevated BUN and creatinine levels
The nurse is developing a teaching plan for the mother of a 4-year-old girl with cold and fever. What would the nurse include in this teaching plan? A. Keeping the child covered and warm B. Calling the doctor if the child's fever lasts more than 36 hours C. Ensuring fluid intake to prevent dehydration D. Observing for changes in alertness resulting from brain damage
C. Ensuring fluid intake to prevent dehydration
The nurse is caring for a neonate who is suspected of having sepsis. Which assessment findings would the nurse interpret as most indicative of sepsis? A. Rash on face B. Edematous neck C. Hypothermia D. Coughing
C. Hypothermia
The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which action would the nurse take first? A. Apply benzoin to the scrotal area. B. Tuck the bag downward inside the diaper. C. Pat the perineal area dry after cleaning. D. Apply the narrow portion of the bag on the perineal space.
C. Pat the perineal area dry after cleaning.
The nurse is performing a physical examination on a 9-year-old boy who has experienced a tick bite on his lower leg and is suspected of having Lyme disease. Which assessment finding would the nurse expect to find? A. Swelling in the neck B. Confusion and anxiety C. Ring-like rash on lower leg D. Hypersalivation
C. Ring-like rash on lower leg
While providing care to a 5-month-old girl whose family has a history of food allergies, the nurse instructs the parents about foods to be avoided in the first year of life. Which response by the parents indicates a need for further teaching? A) "She cannot have any cow's milk." B) "I should continue breastfeeding until at least 6 months." C) "Peanuts in any form should be avoided." D) "Any kind of fruit is acceptable."
D) "Any kind of fruit is acceptable."
The mother of a 5-year-old child with allergies to a variety of foods including eggs, milk, peanuts and shellfish, asks if her child will "always have these problems." What response by the nurse is most accurate? A) "Sadly, allergies to foods will persist." B) "Most children with allergies will outgrow them." C) "We cannot be sure at this point but most children who are allergic to peanuts will not have this allergy in adulthood." D) "In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear."
D) "In most cases allergies to peanuts and shellfish persist into adulthood but the others may diminish and disappear."
An 8-year-old girl is scheduled for a renal ultrasound. What would the nurse include in the plan of care when preparing the child for this test? A. Withholding food and fluids after midnight B. Checking the child for allergies to shellfish C. Ensuring the child has a full bladder D. Informing the child she should feel no discomfort
D. Informing the child she should feel no discomfort
The nurse is preparing a plan of care for a 5-year-old boy with chickenpox. Which nursing intervention should be questioned? A. Administer antipyretics as ordered. B. Keep the child's fingernails short. C. Monitor fluid intake and output. D. Provide alcohol baths as needed.
D. Provide alcohol baths as needed.
The nurse is preparing to obtain a blood specimen via capillary heel puncture. Which action would be most appropriate for the nurse to do? A. Apply a cool compress for several minutes before collection. B. Elevate the extremity used after puncturing it. C. Squeeze the area to facilitate specimen collection. D. Wipe away the first drop of blood with dry gauze.
D. Wipe away the first drop of blood with dry gauze.
A child is diagnosed with hyperthyroidism. Which agent would the nurse expect the healthcare provider to prescribe? A) Mineralocorticoid B) Methimazole C) Levothyroxine D) Dexamethasone
B) Methimazole
The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. What is the priority nursing diagnosis? A) Deficient fluid volume related to dehydration B) Excess fluid volume related to edema C) Deficient knowledge related to fluid intake regimen D) Imbalanced nutrition, more than body requirements related to excess weight
A) Deficient fluid volume related to dehydration
The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. What would the nurse identify as the initial goal for the teaching plan? A) Developing management and decision-making skills B) Educating the parents about diabetes mellitus type 1 C) Developing a nutritionally sound, 30-day meal plan D) Promoting independence with self-administration of insulin
A) Developing management and decision-making skills
What would the nurse expect to find in a male infant with Wiskott--Aldrich syndrome? A) Eczema B) Thrombocytosis C) Lymphadenopathy D) Pneumonia
A) Eczema
A child is diagnosed with a food allergy to milk. When teaching the parents about this allergy, what would the nurse suggest as possible substitutions for milk? Select all that apply. A) Fruit juice B) Rice milk C) Yogurt D) Nondairy creamers E) Soy milk
A) Fruit juice B) Rice milk E) Soy milk
The nurse is caring for a 9-year-old client newly diagnosed with diabetes. The client has polyuria, polydipsia, and weight loss. Which nursing diagnoses will the nurse include in the care plan? Select all that apply. A) Imbalanced nutrition: less than body requirements B) Deficient fluid volume C) Deficient knowledge regarding disease process D) Noncompliance E) Delayed growth and development
A) Imbalanced nutrition: less than body requirements B) Deficient fluid volume C) Deficient knowledge regarding disease process
While performing an assessment of a client who is immunocompromised, the nurse notes the child to have thrush in the mouth, tenderness over the spleen upon palpation, and a white blood cell count of 3,000. Which nursing diagnoses will the nurse include in the care plan of this child based on these findings? Select all that apply. A) Ineffective protection B) Risk for imbalanced nutrition, less than body requirements C) Pain D) Impaired skin integrity E) Delayed growth and development
A) Ineffective protection B) Risk for imbalanced nutrition, less than body requirements C) Pain
A nurse is assessing a child who may have a latex allergy. The nurse asks the child about allergic reactions to certain foods. Which foods if identified by the child as experiencing an allergic reaction would help support the suspected latex allergy? Select all that apply. A) Peaches B) Plums C) Carrots D) Tomatoes E) Milk F) Lettuce
A) Peaches B) Plums C) Carrots D) Tomatoes
The nurse is reviewing the laboratory test results of a child who is suspected of having systemic lupus erythematosus (SLE). What would the nurse identify as supporting this diagnosis? Select all that apply. A) Positive antinuclear antibody (ANA) B) Increased C3 levels C) Thrombocytopenia D) Decreased C4 levels E) Increased hematocrit
A) Positive antinuclear antibody (ANA) C) Thrombocytopenia D) Decreased C4 levels
A child with hypogammaglobulinemia is to receive intravenous immunoglobulin (IVIG). What action would not be correct to take? A) Shake the vial after reconstituting it B) Premedicate the child with acetaminophen C) Obtain preinfusion vital signs D) Check serum blood urea nitrogen and creatinine levels
A) Shake the vial after reconstituting it
The nurse is caring for a 4-year-old girl with vulvovaginitis. After instructing the girl's mother on how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching? A. "She tells me she wipes from front to back." B. "I will make sure she changes her underwear every day." C. "She should avoid bubble baths." D. "I will help supervise her wiping after bowel movements."
A. "She tells me she wipes from front to back."
A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which action would be the priority before the test? A. Checking with the parents for any allergies B. Ensuring adequate hydration C. Giving the girl an enema D. Screening her for pregnancy
A. Checking with the parents for any allergies
A child is being treated for pertussis and is prescribed azithromycin by the health care provider. Which finding is most important for the nurse to report to the health care provider before administering this drug? A. Child has had previous episodes of supraventricular tachycardia (SVT). B. Child has a potassium level of 3.7 mEq/l (3.7 mmol/l). C. Child is also prescribed a proton pump inhibitor (PPI). D. Child experienced a rash on the back taking this drug previously.
A. Child has had previous episodes of supraventricular tachycardia (SVT).
A nurse is instructing a parent on how to obtain a stool culture for ova and parasites from a child with diarrhea. What would the nurse include in the teaching plan? A. "Give the child bismuth and then collect the next specimen." B. "Obtain the specimen from the toilet after the child has a bowel movement." C. "Keep the specimen from coming into contact with any urine." D. "Bring the specimen to the laboratory on the third day."
C. "Keep the specimen from coming into contact with any urine."
The nurse is talking to the parents of a child who has been diagnosed with severe combined immune deficiency (SCID). Which statement by the parents best indicates that they understand their child's condition? A) "He'll need to receive intravenous immunoglobulin routinely." B) "We'll need to prepare him and ourselves for a bone marrow transplant." C) "He'll need to receive several different types of antiviral medications." D) "We'll make sure that he has his EpiPen with him at all times."
B) "We'll need to prepare him and ourselves for a bone marrow transplant."
After teaching a mother how to remove a tick from her 6-year-old boy's arm, the nurse determines that additional teaching is needed when the mother makes what statement? A. "I'll protect my fingers with a paper towel." B. "I'll grasp the tick and pull it away quickly." C. "I should put the tick in a plastic bag in the freezer." D. "I need to grasp the tick close to the child's skin."
B. "I'll grasp the tick and pull it away quickly."
The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which response by the client's parent will the nurse highlight for the primary health care provider as an indicator for this condition? A. "My child's has recently reported urinary frequency." B. "My child just got over a head cold with laryngitis." C. "My child's urine is pale yellow in color." D. "My child's eyes appear sunken to me."
B. "My child just got over a head cold with laryngitis."
After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? A. "If this gets worse and we don't treat it, our son could become infertile." B. "This condition should gradually go away on its own." C. "The surgeon is going to operate on him immediately." D. "It's going to be difficult putting ice packs on his scrotum."
B. "This condition should gradually go away on its own."
The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be mostappropriate to give to the child? A. "You need to make sure that you don't go to the bathroom before the test." B. "You might feel some burning when you go to the bathroom afterward." C. "I'm going to have to put a tube into your bladder to empty it." D. "I have to put a thick tight rubber band around your arm to get a blood specimen."
B. "You might feel some burning when you go to the bathroom afterward."
A child is hospitalized with acute poststreptococcal glomerulonephritis. What assessments should the nurse include in the plan of care for this child?? Select all that apply. A. Assess level of consciousness B. Assess pain C. Monitor blood pressure D. Auscultate lung sounds E. Inspect the urine
B. Assess pain C. Monitor blood pressure D. Auscultate lung sounds E. Inspect the urine
The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A. Cloudy yellow B. Cola colored C. Pale to almost clear urine D. Light orange to moderately yellow colored
B. Cola colored
A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which organism would the nurse incorporate into the presentation as the most common cause? A. Klebsiella B. Escherichia coli C. Staphylococcus aureus D. Pseudomonas
B. Escherichia coli
A teenage girl diagnosed with polycystic ovary syndrome tells the nurse, "I refuse to take oral contraceptives since I am not sexually active." What is the best response to the girl? A) "It's important for you to take the pills even if you're not sexually active in order to prevent unwanted symptoms of the disease." B) "The healthcare provider has prescribed these for you because it is an effective treatment method for the disease." C) "I know it's hard remembering to take those pills every day. Tell me more about what is making you not want to take the oral contraceptives." D) "Do your parents know that you are not taking the treatment medication your healthcare provider prescribed?"
C) "I know it's hard remembering to take those pills every day. Tell me more about what is making you not want to take the oral contraceptives."
A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant? A. "She's been constipated quite a few times." B. "We've noticed that her bed is wet in the morning." C. "She had surgery to repair a problem with her anus." D. "She had a bacterial skin infection about a week ago."
C. "She had surgery to repair a problem with her anus."
A nurse identifies a nursing diagnosis of Impaired urinary elimination related to infection in the urinary tract as manifested by dysuria for a preschooler. When developing the plan of care, what would be most important for the nurse to do first? A. Develop a schedule for bladder emptying. B. Encourage fluid intake. C. Assess usual voiding patterns. D. Monitor intake and output.
C. Assess usual voiding patterns.
The client has a heavily draining wound for which there is an order to change the dressing every 4 hours. The nurse becomes busy and does not change the dressing as ordered. Which link in the chain of infection has the nurse allowed to flourish? A. Susceptible host B. Portal of exit C. Reservoir D. Mode of transmission
C. Reservoir
When reviewing infectious diseases in the pediatric population, nursing students identify which disease as a common childhood exanthema? A. Mumps B. Rabies C. Rubella D. West Nile virus
C. Rubella
A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which complication? A. Weight loss B. Hypotension C. Signs of infection D. Hair loss
C. Signs of infection
The mother of a 4-year-old boy has contacted the physician's office. She reports her son was exposed to someone with chickenpox. She has inquired about when her son may show if he has gotten the disease. What information should be provided? A. The illness should be seen in a week if he has been exposed. B. Symptoms of the disease should show up within 24 to 48 hours of exposure. C. The incubation period for the disease is between 10 and 21 days. D. Younger children will have longer periods of incubation.
C. The incubation period for the disease is between 10 and 21 days.
The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse explains that the rationale is: A. to treat low calcium levels. B. to stimulate growth in stature. C. to stimulate red blood cell growth. D. to correct acidosis.
C. to stimulate red blood cell growth.
A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which of these insulins as having the longest duration? A) Lispro B) Regular C) NPH D) Glargine
D) Glargine
The nurse is administering intravenous immune globulin (IVIG). The nurse assesses vital signs and for adverse reactions every 15 minutes for the first hour of administration. After the first hour, the nurse most likely would continue to assess the child at which frequency? A) Every 30 minutes B) Every 45 minutes C) Every 60 minutes D) Every 2 hours
A) Every 30 minutes
The nurse is caring for a child undergoing highly active antiretroviral therapy (HAART) for HIV infection. The nurse is preparing to administer the prescribed medication. In addition to the nucleoside analog reverse transcriptase inhibitors (NRTIs) and the nonnucleoside analog reverse transcriptase inhibitors (NNRTIs), the nurse is cognizant that the child will be taking which additional medication as part of the three-drug regimen? A) Protease inhibitors B) Corticosteroids C) Cytotoxic drugs D) Disease-modifying antirheumatic drugs (DMARDs)
A) Protease inhibitors
A 16-year-old client has just been diagnosed with HIV. Which statement by the parent indicates understanding of the diagnosis? A) "It is important for our child to get started on drug therapy for a better chance of a cure of the infection." B) "I must be infected with HIV and passed it to our child while in the uterus for the infection to have occurred." C) "We don't want to face the fact that it is likely our child contracted HIV through sexual contact or IV drug use." D) "Infections as a result of being HIV positive are a low risk since the diagnosis came early."
C) "We don't want to face the fact that it is likely our child contracted HIV through sexual contact or IV drug use."
The nurse is caring for a child who is having an anaphylactic reaction with bronchospasm. The nurse would expect to administer what medication for bronchospasm as ordered? A) Epinephrine B) Corticosteroid C) Albuterol D) Diphenhydramine
C) Albuterol
The nurse is administering 10 units of NPH insulin to a child at 8 AM. The nurse would expect this insulin to begin acting at which time? A) By 8:15 AM B) Between 8:30 and 9 AM C) Between 9 and 11 AM D) Around 12 noon
C) Between 9 and 11 AM
The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. What finding would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? A) Hypernatremia B) Bradycardia C) Hypertension D) Hyperkalemia
D) Hyperkalemia
What finding would the nurse expect to assess in a child with hypothyroidism? A) Nervousness B) Heat intolerance C) Smooth velvety skin D) Weight gain
D) Weight gain
A 6-year-old child has been diagnosed with growth hormone deficiency. The child's mother requests more information about this condition. Which statements should be included in the nurse's response? Select all that apply. A) "The majority of children who have this condition are born of normal weight and length." B) "There are several potential causes of this condition." C) "This condition is most likely related to dwarfism in past generations of your family." D) "Most children with this condition are nutritionally deprived." E) "Your child most likely does not eat adequate amounts of protein."
A) "The majority of children who have this condition are born of normal weight and length." B) "There are several potential causes of this condition."
A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Thyroid storm C) Cushing syndrome D) Vitamin D toxicity
A) Syndrome of inappropriate antidiuretic hormone (SIADH)
When reviewing the history of a child with suspected primary immunodeficiency, what would the nurse be least likely to find? A) Weight appropriate for height B) Antibiotic therapy for the past 3 months without effect C) Ten episodes of otitis media in the last year D) Three bouts of sinusitis within a year's time
A) Weight appropriate for height
The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."
A. "I can't believe it. We're not unclean, poor people."
The parents of a 7-month-old child with an infection ask the nurse about how to treat their child's fever. After providing teaching, the parents voice understanding with which statements? Select all that apply. A. "If my child's fever is under 102°F , I don't need to make an appointment with the physician." B. "Having a temperature over 38°C puts my child at risk for the infection spreading to the bloodstream." C. "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." D. "Even though people get frightened, fevers are not a bad thing during an infection unless it gets too high." E. "Any fever is dangerous and can cause serious damage to brain cells if it goes on too long."
A. "If my child's fever is under 102°F , I don't need to make an appointment with the physician." C. "I can use acetaminophen to help with the symptoms of the infection but it won't get rid of the infection." D. "Even though people get frightened, fevers are not a bad thing during an infection unless it gets too high."
A nurse suspects that an adolescent may have community-acquired methicillin-resistant Staphylococcus aureus (CAMRSA). What would the nurse expect to assess? Select all that apply. A. Participation in contact sport B. Recent cut on the lower leg C. History of a recent sore throat D. Raised fluctuant lesions E. Erythematous rash over the trunk and face
A. Participation in contact sport B. Recent cut on the lower leg D. Raised fluctuant lesions
The nurse is caring for a 4-year-old with a suspected urinary tract infection. What would be most appropriate to say to the child when obtaining a urine specimen from him? A. "I will need a urine sample." B. "Let your mom help you tinkle in this cup." C. "Please tinkle in this cup right now." D. "Please void in this cup instead of the toilet."
B. "Let your mom help you tinkle in this cup."
The nurse is assessing a child with pauciarticular-type juvenile idiopathic arthritis. What would the nurse expect to assess? A) Fever B) Rash C) Eye inflammation D) Splenomegaly
C) Eye inflammation
A child with growth hormone deficiency is receiving growth hormone. What result would the nurse interpret as indicating effectiveness of this therapy? A) Rapid weight gain B) Complaints of headaches C) Height increase of 4 in D) Growth plate closure
C) Height increase of 4 in
A nursing instructor is teaching a group of students about the action of antipyretic agents in children. The instructor determines that the teaching has been successful when the students identify which action as the primary action? A. Cause vasodilation to promote heat loss B. Decrease the temperature set point C. Block release of histamine D. Promote prostaglandin production
B. Decrease the temperature set point
A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which finding? A. Decreased blood urea nitrogen (BUN) and creatinine B. Decreased platelets and leukocytosis C. Hypernatremia and hypokalemia D. Respiratory acidosis and proteinuria
B. Decreased platelets and leukocytosis
A group of nursing students are reviewing the six links in the chain of infection and the nursing implications for each. The students demonstrate understanding of the information when they identify which precaution as helping to break the chain of infection to the susceptible host? A. Keeping linens dry and clean B. Maintaining skin integrity C. Washing hands frequently D. Coughing into a handkerchief
B. Maintaining skin integrity
A nurse is conducting a health history for a 1-month-old with an infectious disorder. Which segment of the maternal health history would be most helpful for the nurse when determining if the infant developed the infection from the mother? A. Family history B. Past medical history C. Home treatments D. Present illness history
B. Past medical history
The nurse is assessing a 5-year-old child's genitourinary system. Which findings would the nurse document as normal? Select all that apply. A. Labial fusion B. Round abdomen C. Positive bowel sounds D. Dullness over the spleen E. Undescended testicles
B. Round abdomen C. Positive bowel sounds D. Dullness over the spleen
A nurse is preparing a presentation for a group of parents of adolescents diagnosed with type 1 diabetes. What issues would the nurse need to address? Select all that apply. A) Self-monitoring of blood glucose levels B) Feelings of being different C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence
C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence
The school nurse is walking through the lunchroom when one of the children says she started to feel strange after trading lunches with a friend. Which assessment would be most important? A) Asking if she has a rash anywhere B) Checking if she has any nausea C) Determining if her throat itches D) Asking if she has abdominal pain
C) Determining if her throat itches
The nurse suspects that a 4 year old with type 1 diabetes is experiencing hypoglycemia based on what findings? Select all that apply. A) Blurred vision B) Dry, flushed skin C) Diaphoresis D) Slurred speech E) Fruity breath odor F) Tachycardia
C) Diaphoresis D) Slurred speech F) Tachycardia
The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism. What information would the nurse include in the plan? A) Describing surgery to remove an anterior pituitary tumor B) Teaching her parents to give injections of growth hormone C) Explaining about the radioactive iodine procedure D) Showing her parents how to give DDAVP intranasally
C) Explaining about the radioactive iodine procedure
Which exercise would the nurse suggest as most helpful to maintain mobility in a child with juvenile idiopathic arthritis? A) Jogging every other day B) Using a treadmill C) Swimming D) Playing basketball
C) Swimming
The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder? A) The parents report that their child had "a cold or flu" recently. B) Blood pressure is decreased when checking vital signs. C) The parents report that their son "can't drink enough water." D) Auscultation reveals Kussmaul breathing.
C) The parents report that their son "can't drink enough water."
After teaching a class about humoral and cellular immunity, the nurse recognizes that additional teaching is needed when the class states that: A) humoral immunity crosses the placenta. B) cellular immunity involves the T lymphocytes. C) cellular immunity recognizes antigens. D) humoral immunity does not destroy the foreign cell.
C) cellular immunity recognizes antigens.
A child with systemic lupus erythematosus is receiving high-dose corticosteroid therapy over the long term. The nurse would instruct the parents and child to report: A) difficulty urinating. B) visual changes. C) joint pain. D) rash.
C) joint pain.
The nurse is providing education to the parents of a child diagnosed with pinworms. Which statement is most important for the nurse to include in the teaching? A. "Seal the child's clothing in a plastic bag for at least 10 days." B. "Be sure your child wears shoes at all times." C. "Make sure your child washes hands before eating." D. "After applying this special cream, leave it on for about 8 to 10 hours."
C. "Make sure your child washes hands before eating."
A school-aged child with an infectious disease is placed on transmission-based precautions. If the child is not dehydrated or otherwise in distress, which nursing diagnosis would be the priority? A. Impaired skin integrity related to trauma secondary to pruritus and scratching B. Fluid volume deficit related to increased metabolic demands and insensible losses C. Social isolation related to infectivity and inability to go to the playroom D. Deficient knowledge related to how infection is transmitted
C. Social isolation related to infectivity and inability to go to the playroom
The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse's knowledge of this condition, the nurse would include which nursing diagnosis in the child's plan of care? A) Disabled family coping related to the child's disorder B) Imbalanced nutrition, less than body requirements related to the child's short stature C) Noncompliance related to the need for lifelong hormone therapy D) Deficient knowledge related to the administration of estradiol
D) Deficient knowledge related to the administration of estradiol
The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. What would the nurse most likely assess? A) The child has above-normal growth for his age. B) The child is active and playful. C) The skin is pink and healthy looking. D) It is difficult to keep the child awake.
D) It is difficult to keep the child awake.
A child is diagnosed with juvenile idiopathic arthritis and is receiving several different medications listed in the medication administration record. Which agent would the nurse identify as being used to prevent disease progression? A) Aspirin B) Prednisone C) Ibuprofen D) Methotrexate
D) Methotrexate
A nurse is teaching the parents of an infant with congenital adrenal hyperplasia about the signs and symptoms of adrenal crisis. The nurse determines that the teaching was successful when the parents correctly identify what sign of adrenal crisis? A) Bradycardia B) Constipation C) Fluid overload D) Persistent vomiting
D) Persistent vomiting
A group of nursing students are reviewing information about humoral and cellular immunity. The students demonstrate understanding of this material when they identify what as being involved in cellular immunity? A) B cells B) Antibodies C) Antigens D) T cells
D) T cells
The parents of a 7-year-old girl with type 1 diabetes has been recording her blood glucose measurements before meals and at bedtime for the past 4 days; they are as follows: Monday Tuesday Wednesday Thursday B: 120 mg/dL 135 mg/dL 124 mg/dL 200 mg/dL L: 110 mg/dL 120 mg/dL 140 mg/dL 220 mg/dL D: 90 mg/dL140 mg/dL 130 mg/dL 200 mg/dL Bed: 110 mg/dL 110 mg/dL 160 mg/dL 240 mg/d The parents bring the child in for a follow-up visit and show the nurse the results. Based on the results, the nurse would need to obtain additional information from the parents and child about which day? A) Monday B) Tuesday C) Wednesday D) Thursday
D) Thursday
The nurse is caring for a newborn whose mother is HIV positive. The nurse would expect to administer a 6-week course of which medication? A) Lopinavir B) Ritonavir C) Nevirapine D) Zidovudine
D) Zidovudine
The nurse is assessing the tympanic temperature of several children. The nurse documents that the child with which temperature reading has a fever? A. 98.2° F (36.8° C) B. 99.2° F (37.3° C) C. 100° F (37.8° C) D. 100.8° F (38.2° C)
D. 100.8° F (38.2° C)
After teaching the parents of a child with chickenpox (varicella zoster), the nurse determines that the parents have understood the teaching when they state that their child can return to school at which time? A. After day 5 of the rash B. When the rash is completely healed C. Once the rash appears D. After the lesions have crusted
D. After the lesions have crusted
A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure? A. Vancomycin B. Gentamicin C. Co-trimoxazole D. Amoxicillin
D. Amoxicillin