PEDS Test 2

Adequate hearing depends on intact auditory structures and quality of sound. Failure to hear at 40 to 69 dB would be categorized as a __________ hearing loss.

Moderate

The nurse is preparing new parents for discharge home with their well newborn. The nurse explains that the newborn cannot be discharged until the mandatory hearing screening is performed. Is this statement true or false?

True

Which statement made by an adolescent girl indicates an understanding about the prevention of sexually transmitted diseases (STDs)? a. "I know the only way to prevent STDs is to not be sexually active." b. "I practice safe sex because I wash myself right after sex." c. "I won't get any kind of STD because I take the pill." d. "I only have sex if my boyfriend wears a condom."

a. "I know the only way to prevent STDs is to not be sexually active."

A parent of a child with a chronic illness is complaining about "all these care planning meetings." What response by the home health care nurse is best? a. "Our plan will change with your child's growth and development." b. "We have legal regulations and company policies to follow." c. "Do you want to change the frequency of our meetings?" d. "If you don't want to come to the meetings you don't have to."

a. "Our plan will change with your child's growth and development."

The nurse getting an end-of-shift report on a child with status asthmaticus should question which intervention? a. Administer oxygen by nasal cannula to keep oxygen saturation at 100%. b. Assess intravenous (IV) maintenance fluids and site every hour. c. Notify provider for signs of increasing respiratory distress. d. Organize care to allow for uninterrupted rest periods.

a. Administer oxygen by nasal cannula to keep oxygen saturation at 100%.

A nurse is planning care for an asymptomatic child with a positive tuberculin test. What should the nurse include in the plan? (Select all that apply.) a. Administration of daily isoniazid (INH) b. Instructing family members about administration of INH to all close contacts of the child c. Administration of the bacillus Calmette-Guérin vaccine d. Reporting the case to the health department e. Administration of INH and rifampin (Rifadin) simultaneously

a. Administration of daily isoniazid (INH) b. Instructing family members about administration of INH to all close contacts of the child d. Reporting the case to the health department

A nurse is working with a child who has a sudden, serious illness. To best support the parents, what action by the nurse is best? a. Assess the parents' usual coping methods. b. Give them information about the unit protocols. c. Tell them to stay with the child as much as desired. d. Reassure them about how common this illness is.

a. Assess the parents' usual coping methods.

When assessing the child with atopic dermatitis, the nurse should ask the parents about a history of which of the following? a. Asthma b. Nephrosis c. Lower respiratory tract infections d. Neurotoxicity

a. Asthma

An infant's parents ask the nurse about preventing OM. What should be recommended? a. Avoid tobacco smoke. b. Use nasal decongestant. c. Avoid children with OM. d. Bottle feed or breastfeed in supine position.

a. Avoid tobacco smoke.

Which play activity should the nurse implement to enhance deep breathing exercises for a toddler? a. Blowing bubbles b. Throwing a Nerf ball c. Using a spirometer d. Keeping a chart of deep breathing

a. Blowing bubbles

Where do the lesions of atopic dermatitis most commonly occur in the infant? (Select all that apply.) a. Cheeks b. Buttocks c. Extensor surfaces of arms and legs d. Back e. Scalp

a. Cheeks c. Extensor surfaces of arms and legs e. Scalp

A nurse is teaching parents about prevention of diaper dermatitis. Which should the nurse include in the teaching plan? (Select all that apply.) a. Clean the diaper area gently after every diaper change with a mild soap. b. Use a protective ointment to clean dry intact skin. c. Use a steroid cream after each diaper change. d. Use rubber or plastic pants over the diaper. e. Wash cloth diapers in hot water with a mild soap and double rinse.

a. Clean the diaper area gently after every diaper change with a mild soap. b. Use a protective ointment to clean dry intact skin. e. Wash cloth diapers in hot water with a mild soap and double rinse.

The management of a child who has just been stung by a bee or wasp should include the application of which of the following? a. Cool compresses b. Warm compresses c. Antibiotic cream d. Corticosteroid cream

a. Cool compresses

The nurse is assessing a child for epiglottitis. What findings are consistent with this condition? (Select all that apply.) a. Drooling b. Dysphagia c. Dysphonia d. Distressed inspiratory efforts e. Decreased oxygenation

a. Drooling b. Dysphagia c. Dysphonia d. Distressed inspiratory efforts

A nurse working in a trauma center would facilitate referrals to a burn center for which of the following children? (Select all that apply.) a. Electrical burn b. Chemical burn c. Burn from child abuse d. Burn in the perineal area e. 5% second-degree burn

a. Electrical burn b. Chemical burn d. Burn in the perineal area

What nursing intervention holds the highest priority in the initial care of a child with a major burn injury? a. Establishing and maintaining the child's airway b. Establishing and maintaining intravenous access c. Inserting a catheter to monitor hourly urine output d. Inserting a nasogastric tube to supply adequate nutrition

a. Establishing and maintaining the child's airway

A nurse suspects possible visual impairment in a child who displays which problem? a. Excessive tearing of the eyes b. Rapid lateral movement of the eyes c. Delay in speech development d. Lack of interest in casual conversation with peers

a. Excessive tearing of the eyes

The nurse should assess a child who has had a tonsillectomy for which of the following as the priority? a. Frequent swallowing b. Inspiratory stridor c. Swelling of the throat d. Abnormal lung sounds

a. Frequent swallowing

A patient who has a hyphema is at risk for developing which condition? a. Glaucoma b. Strabismus c. Diplopia d. Astigmatism

a. Glaucoma

The nurse should know that the results of untreated amblyopia ("lazy eye") in the child may include which of the following? a. Impaired depth perception b. Strabismus c. Color deficiency d. Ptosis

a. Impaired depth perception

Initial care of the child with a chemical burn to the eye(s) is focused on which of the following? a. Irrigation of the affected eye(s) b. Application of topical steroids c. Administration of an analgesic d. Administration of medication to constrict the pupils

a. Irrigation of the affected eye(s)

What explanation should the nurse give to the parent of a child with asthma about using a peak flow meter? a. It is used to monitor the child's breathing capacity. b. It measures the child's lung volume. c. It will help the medication reach the child's airways. d. It measures the amount of air the child breathes in.

a. It is used to monitor the child's breathing capacity.

A child has small red macules and vesicles that become pustules around the child's mouth and cheek. Older lesions are crusted and honey-colored. What should the nurse teach the parents about this condition? a. Keep the child home from school for 24 hours after starting antibiotics. b. Clean the rash vigorously with Betadine three times a day. c. Notify the physician for any itching. d. Keep the child home from school until the lesions are healed.

a. Keep the child home from school for 24 hours after starting antibiotics.

The mother of a newborn asks the nurse what causes the baby to begin to breathe after delivery. What changes in the respiratory system stimulating respirations postnatally can the nurse explain to the mother? (Select all that apply.) a. Low oxygen levels in the infant's blood b. Rubbing the newborn with a towel or blanket c. Surfactant, a special lubricant in the lungs d. Increased blood flow to the infant's lungs e. Cold environment in the delivery room

a. Low oxygen levels in the infant's blood b. Rubbing the newborn with a towel or blanket e. Cold environment in the delivery room

What is the earliest recognizable clinical manifestation(s) of CF? a. Meconium ileus b. History of poor intestinal absorption c. Foul-smelling, frothy, greasy stools d. Recurrent pneumonia and lung infections

a. Meconium ileus

A nurse is caring for four infants. Which one should the nurse assess first? a. Nasal flaring b. Respiratory rate of 55 breaths/min c. Irregular respiratory pattern d. Abdominal breathing

a. Nasal flaring

A nurse should plan to implement which interventions for a child admitted with inorganic failure to thrive? (Select all that apply.) a. Observation of parent-child interactions b. Assignment of different nurses to care for the child from day to day c. Use of 28-calorie-per-ounce concentrated formulas d. Administration of daily multivitamin supplements e. Role-modeling appropriate adult-child interactions

a. Observation of parent-child interactions d. Administration of daily multivitamin supplements e. Role-modeling appropriate adult-child interactions

A child has a chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration. What action by the nurse is most appropriate? a. Prepare to administer a bronchodilator. b. Give ordered antibiotics on time. c. Provide oxygen via face tent. d. Assess the airway for a foreign body.

a. Prepare to administer a bronchodilator.

Which activity should the nurse implement for the toddler hospitalized with a chronic illness to promote autonomy? a. Provide opportunities for play b. Making play dates with other toddlers in the unit c. Give the toddler art supplies d. Turn the television on to cartoons

a. Provide opportunities for play

A child experiences frostbite of the fingers after prolonged exposure to the cold. Which intervention should the nurse implement first? a. Rapid rewarming of the fingers by placing in warm water b. Placing the hand in cool water c. Slow rewarming by wrapping in warm cloth d. Using an ice pack to keep cold until medical intervention is possible

a. Rapid rewarming of the fingers by placing in warm water

How should the nurse advise parents whose preschooler used to sleep through the night and now awakens at intervals after a short hospitalization? a. Regressive behavior after a hospitalization is normal and usually short term. b. The child is probably expressing anger. c. Egocentric behavior often manifests itself when the child is left alone to sleep. d. The child is probably feeling pain and needs further evaluation.

a. Regressive behavior after a hospitalization is normal and usually short term.

What information should the nurse teach families about reducing exposure to pollens and dust? (Select all that apply.) a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses. d. Keep humidity in the house above 60%. e. Keep pets outside.

a. Replace wall-to-wall carpeting with wood and tile floors. b. Use an air conditioner. c. Put dust-proof covers on pillows and mattresses.

What should be the major consideration when selecting toys for a child with an intellectual or developmental disability? a. Safety b. Age appropriateness c. Ability to provide exercise d. Ability to teach useful skills

a. Safety

A 5-year-old diagnosed with chlamydial conjunctivitis should be carefully assessed for which of the following? a. Sexual abuse b. Immune deficiency c. Congenital cataract d. Secondary glaucoma

a. Sexual abuse

A nurse is assessing a newborn for facial feature characteristics associated with fetal alcohol syndrome. Which characteristics should the nurse expect to assess? (Select all that apply.) a. Short palpebral fissures b. Smooth philtrum c. Low-set ears d. Inner epicanthal folds e. Thin upper lip

a. Short palpebral fissures b. Smooth philtrum c. Low-set ears e. Thin upper lip

Which classification of drugs is used to relieve an acute asthma episode? a. Short-acting beta2-adrenergic agonist b. Inhaled corticosteroids c. Leukotriene blockers d. Long-acting bronchodilators

a. Short-acting beta2-adrenergic agonist

The nurse should implement which interventions for an infant experiencing apnea? (Select all that apply.) a. Stimulate the infant by gently tapping the foot. b. Shake the infant vigorously. c. Have resuscitative equipment available. d. Suction the infant. e. Maintain a neutral thermal environment.

a. Stimulate the infant by gently tapping the foot. c. Have resuscitative equipment available. e. Maintain a neutral thermal environment.

The nurse should teach parents of a child with cystic fibrosis to adjust enzyme dosage according to which indicator? a. Stool formation b. Vomiting c. Weight d. Urine output

a. Stool formation

An infant has laryngomalacia. What assessment finding correlates with this condition? a. Stridor b. High-pitched cry c. Nasal congestion d. Spasmodic cough

a. Stridor

The nurse is assessing a 3-year-old child who has characteristics of autism. Which observed behaviors are associated with autism? (Select all that apply.) a. The child flicks the light in the examination room on and off repetitiously. b. The child has a flat affect. c. The child demonstrates imitation and gesturing skills. d. The mother reports the child has no interest in playing with other children. e. The child is able to make eye contact.

a. The child flicks the light in the examination room on and off repetitiously. b. The child has a flat affect. d. The mother reports the child has no interest in playing with other children.

When changing an infant's diaper, the nurse notices small bright red papules with satellite lesions on the perineum, anterior thigh, and lower abdomen. This rash is characteristic of a. candidiasis. b. irritant contact dermatitis. c. intertrigo. d. seborrheic dermatitis.

a. candidiasis.

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called a. conductive. b. sensorineural. c. mixed conductive-sensorineural. d. central auditory imperceptive.

a. conductive.

Parents have learned that their 6-year-old child has autism. The nurse may help the parents to cope by explaining that the child may a. have an extremely developed skill in a particular area. b. outgrow the condition by early adulthood. c. have average social skills. d. have age-appropriate language skills.

a. have an extremely developed skill in a particular area.

Impetigo ordinarily results in a. no scarring. b. pigmented spots. c. slightly depressed scars. d. atrophic white scars.

a. no scarring.

The correct position for the postoperative child who has had a cataract removed from the right eye is the ________ position. a. supine b. prone c. knee-chest d. right lateral Sims

a. supine

Which statement made by a parent indicates an understanding about the genetic transmission of cystic fibrosis (CF)? a. "Only one parent carries the cystic fibrosis gene." b. "Both parents are carriers of the cystic fibrosis gene." c. "The presence of the disease is most likely the result of a genetic mutation." d. "The mother is usually the carrier of the cystic fibrosis gene."

b. "Both parents are carriers of the cystic fibrosis gene."

A parent of a child with asthma asks if his child can still participate in sports. What response by the nurse is best? a. "Children with asthma are usually restricted from physical activities." b. "Children can usually play any type of sport if their asthma is well controlled." c. "Avoid swimming because exhaling underwater is dangerous for people with asthma." d. "Even with good asthma control, I would advise limiting the child to one athletic activity per school year."

b. "Children can usually play any type of sport if their asthma is well controlled."

Which statement indicates that a parent of a toddler needs more education about preventing foreign body aspiration? a. "I keep objects with small parts out of reach." b. "My toddler loves to play with balloons." c. "I won't permit my child to have peanuts." d. "I never leave coins where my child could get them."

b. "My toddler loves to play with balloons."

A parent brings an 18-month-old to the pediatrician for a routine well-child visit and reports the child has been babbling and cooing since 6 months of age but is not yet saying any words. Which response by the nurse is the most appropriate? a. "Don't worry, your child should catch up soon." b. "The doctor will want to refer your child to an audiologist and speech pathologist." c. "This is normal speech development for an 18-month-old child." d. "Your child has an expressive language disorder and needs further evaluation."

b. "The doctor will want to refer your child to an audiologist and speech pathologist."

Based on concepts related to the normal growth and development of children, which child would have the most difficulty with separation from family during hospitalization? a. A 5-month-old infant b. A 15-month-old toddler c. A 4-year-old child d. A 7-year-old child

b. A 15-month-old toddler

What should the nurse teach an adolescent who is taking tretinoin (Retin-A) to treat acne? a. The medication should be taken with meals. b. Apply sunscreen before going outdoors. c. Wash with benzoyl peroxide before application. d. The effect of the medication should be evident within 1 week.

b. Apply sunscreen before going outdoors.

Teaching parents about the use and application of an eye patch to treat strabismus should include which instruction? a. Check under the patch four times a day. b. Apply the patch directly to the face. c. Sometimes patching alone will straighten the eye. d. Negotiate the number of hours per day that the patch is to be worn.

b. Apply the patch directly to the face.

The nurse should suspect a hearing impairment in an infant who demonstrates which of the following? a. Absence of intelligible speech by 12 months b. Cessation of babbling at age 7 months c. Lack of eye contact when being spoken to d. Lack of gesturing to indicate wants after age 15 months

b. Cessation of babbling at age 7 months

Why is observation for 24 hours in an acute-care setting often appropriate for children? a. Longer hospital stays are more costly. b. Children become ill quickly and recover quickly. c. Children feel less separation anxiety when hospitalized for 24 hours. d. Families experience less disruption during short hospital stays.

b. Children become ill quickly and recover quickly.

The nurse is caring for an infant with bronchopulmonary dysplasia (BPD) who has RSV. Which treatment measure does the nurse prepare to provide? a. Pancreatic enzymes b. Cool humidified oxygen c. Erythromycin intravenously d. Intermittent positive pressure ventilation

b. Cool humidified oxygen

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of a. microcephaly. b. Down syndrome. c. cerebral palsy. d. fragile X syndrome.

b. Down syndrome.

Which type of croup is always considered a medical emergency? a. Laryngitis b. Epiglottitis d. Spasmodic croup e. Laryngotracheobronchitis (LTB)

b. Epiglottitis

Parents of a 4-year-old child are concerned because the child continues to stutter. What nursing intervention is correct? a. Remind the parents that stuttering is normal in children younger than 10 years. b. Facilitate a speech evaluation performed if the stuttering continues beyond age 5 years. c. Reinforce the fact that this common speech defect requires no treatment. d. Tell the parents that speech problems are most treatable during the child's teen years.

b. Facilitate a speech evaluation performed if the stuttering continues beyond age 5 years.

A nurse is providing anticipatory guidance to parents of a child with an intellectual disability. Which safety information is correct based on the child's age? (Select all that apply.) a. Elementary age: safe use of grooming products b. High school age: safety while cooking c. Preschool age: keep hands inside car d. High school age: stranger danger e. Elementary age: water safety

b. High school age: safety while cooking c. Preschool age: keep hands inside car e. Elementary age: water safety

On the second postoperative day of an eye surgery, the child has puffy eyes, increased tearing, and fever. What is the most applicable nursing diagnosis? a. Risk for Infection related to surgical procedure b. Infection related to surgical procedure c. Disturbed Sensory Perception (Visual) related to surgical procedure d. Acute Pain related to recent surgical intervention

b. Infection related to surgical procedure

Which interventions should the nurse plan when caring for a child with a visual impairment? (Select all that apply.) a. Touch the child upon entering the room before speaking. b. Keep items in the room in the same location. c. Describe the placement of the eating utensils on the meal tray. d. Face the child when speaking. e. Identify noises for the child.

b. Keep items in the room in the same location. c. Describe the placement of the eating utensils on the meal tray. e. Identify noises for the child.

A child has allergies to animal dander but is distraught at having to give away the family dog. What actions could the nurse suggest that might avoid this? (Select all that apply.) a. Choose a dander-free pet like a lizard. b. Keep the dog outside as much as possible. c. Install air cleaners in the house. d. Use dust-proof pillow covers. e. Keep the windows closed in the summer.

b. Keep the dog outside as much as possible. c. Install air cleaners in the house. d. Use dust-proof pillow covers.

The nurse is caring for a child with acute respiratory distress syndrome (ARDS) associated with sepsis. Nursing actions should include which of the following? a. Forcing fluids b. Monitoring pulse oximetry c. Instituting seizure precautions d. Encouraging a high-protein diet

b. Monitoring pulse oximetry

Parents of a child with lice infestation should be instructed carefully in the use of antilice products because of which potential side effect? a. Nephrotoxicity b. Neurotoxicity c. Ototoxicity d. Bone marrow depression

b. Neurotoxicity

A home health care nurse is doing a home assessment for a family whose child is oxygen dependent. What finding by the nurse requires intervention? a. Tanks are stored only in an upright position. b. Oxygen tank is placed 3 feet away from the heater. c. Smoking is not allowed in the house. d. Fire extinguisher expires at the end of the month.

b. Oxygen tank is placed 3 feet away from the heater.

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which of the following? a. Taping the eye shut b. Patching the affected eye with any reasonable item c. Applying ice until the physician is seen d. Irrigating the eye copiously with a sterile saline solution

b. Patching the affected eye with any reasonable item

A child just returned from cataract eye surgery. What is the most significant nursing intervention to prevent increasing intraocular pressure in this child? a. Monitor for hypertension. b. Prevent coughing and vomiting. c. Lower the head of the bed slightly. d. Avoid use of steroids after the surgery.

b. Prevent coughing and vomiting.

A school-age child had an upper respiratory tract infection for several days and then began having a persistent dry, hacking cough that was worse at night. The cough has become productive in the past 24 hours. What home care measure does the nurse educate parents about? a. Taking the full course of antibiotics b. Providing humidity and increased fluids c. Treating any fever with aspirin d. Isolation from family until symptoms resolve

b. Providing humidity and increased fluids

The nurse is caring for a 2-year-old child who has a history of meningitis as an infant. The child is not speaking and does not turn the head to the sound of a rattle. Which type of hearing loss in a child may have resulted from a previous infection with meningitis? a. Conductive b. Sensorineural c. Central d. Mixed

b. Sensorineural

Which interventions should the nurse plan when caring for a child with a hearing loss? (Select all that apply.) a. Speak loudly. b. Speak slowly. c. Have the child's full attention. d. Use visual aids. e. Eliminate background noise.

b. Speak slowly. c. Have the child's full attention. d. Use visual aids. e. Eliminate background noise.

A nurse is giving a parent information about autism. Which statement made by the parent indicates understanding of the teaching? a. Autism is characterized by periods of remission and exacerbation. b. The onset of autism usually occurs before 3 years of age. c. Children with autism have imitation and gesturing skills. d. Autism can be treated effectively with medication.

b. The onset of autism usually occurs before 3 years of age.

Which nursing assessment is applicable to the care of a child with herpetic gingivostomatitis? a. Comparison of range of motion of the extremities b. Urine output, mucous membranes, and skin turgor c. Growth pattern since birth d. Bowel elimination pattern

b. Urine output, mucous membranes, and skin turgor

A nurse is providing anticipatory guidance to parents of a 2 1/2-year-old. What instruction is best to help the child's language development? a. Have the child's hearing tested at 3 years. b. Use clear speech and avoid baby talk. c. Speak with different voice inflections. d. Insist the child listen when you are talking.

b. Use clear speech and avoid baby talk.

Which vitamin supplements are necessary for children with cystic fibrosis? a. Vitamin C b. Vitamin D c. Vitamin A d. Vitamin E e. Vitamin K

b. Vitamin D c. Vitamin A d. Vitamin E e. Vitamin K

A child with autism is hospitalized with asthma. The nurse should plan care so that the a. parents' expectations are met. b. child's routine habits and preferences are maintained. c. child is supported through the autistic crisis. d. parents need not be at the hospital.

b. child's routine habits and preferences are maintained.

Ringworm, frequently found in schoolchildren, is caused by a(n) a. virus. b. fungus. c. allergic reaction. d. bacterial infection.

b. fungus.

Developmental delays, self-injury, fecal smearing, and severe temper tantrums in a preschool child are symptoms of a. Down syndrome. b. intellectual disability. c. psychosocial deprivation. d. separation anxiety.

b. intellectual disability.

The primary treatment for warts is a. vaccination. b. local destruction. c. corticosteroids. d. specific antibiotic therapy.

b. local destruction.

A parent whose child has been diagnosed with a cognitive deficit should be counseled that intellectual impairment a. is usually due to a genetic defect. b. may be caused by a variety of factors. c. is rarely due to first trimester events. d. is usually caused by parental intellectual impairment.

b. may be caused by a variety of factors.

Appropriate interventions to facilitate socialization of the cognitively impaired child include a. providing age-appropriate toys and play activities. b. providing peer experiences, such as scouting, when older. c. avoiding exposure to strangers who may not understand cognitive development. d. emphasizing mastery of physical skills because they are the most delayed.

b. providing peer experiences, such as scouting, when older.

Anticipatory guidance for the family of a preadolescent with a cognitive dysfunction should include information about a. institutional placement. b. sexual development. c. sterilization. d. appropriate clothing.

b. sexual development.

The depth of a burn injury may be classified as a. localized or systemic. b. superficial, superficial partial thickness, deep partial thickness, or full thickness. c. electrical, chemical, or thermal. d. minor, moderate, or major.

b. superficial, superficial partial thickness, deep partial thickness, or full thickness.

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit. The nurse answers based on the knowledge that routine developmental assessments during well-child visits are a. not necessary unless the parents request them. b. the best method for early detection of cognitive disorders. c. frightening to parents and children and should be avoided. d. valuable in measuring intelligence in children.

b. the best method for early detection of cognitive disorders.

Rocky Mountain spotted fever is caused by the bite of a a. flea. b. tick. c. mosquito. d. mouse or rat.

b. tick.

With what beverage should the parents of a child with ringworm be taught to give griseofulvin? a. Water b. A carbonated drink c, Milk d. Fruit juice

c, Milk

Which statement made by parents of a child with cystic fibrosis indicates that they understood the nurse's teaching on pancreatic enzyme replacement? a. "Enzymes will improve my child's breathing." b. "I should give the enzymes 1 hour after meals." c. "Enzymes should be given with meals and snacks." d. "The enzymes are stopped if my child begins wheezing."

c. "Enzymes should be given with meals and snacks."

Which statement by a parent indicates understanding of instructions on the care of a child with conjunctivitis? a. "I should treat my other children with these eye drops to prevent spread of the disease." b. "My child must remain home from school until she has received 72 hours of antibiotic drops." c. "I should avoid touching the tip of the ointment tube to my child's eye." d. "My child may go back to wearing her contact lenses 24 hours after treatment has started."

c. "I should avoid touching the tip of the ointment tube to my child's eye."

A 13-year-old adolescent is suspected to have a visual deficit and is scheduled for further evaluation. The teen asks the nurse to tell "the truth" about the tests. What is the nurse's best response? a. "Don't worry about anything. We're here to take good care of you." b. "Ask your parents. They have talked with the physicians." c. "Most of the vision tests are painless and noninvasive." d. "Trust the doctors. They know what is best for you."

c. "Most of the vision tests are painless and noninvasive."

Which statement by a parent about conjunctivitis indicates that further teaching is needed? a. "I'll have separate towels and washcloths for each family member." b. "I'll notify my doctor if the eye gets redder or the drainage increases." c. "When the eye drainage improves, we'll stop giving the antibiotic ointment." d. "After taking the antibiotic for 24 hours, my child can return to school."

c. "When the eye drainage improves, we'll stop giving the antibiotic ointment."

At what 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

c. 9 to 11 years

A small child with cystic fibrosis cannot swallow pancreatic enzyme capsules. The nurse should teach parents to mix enzymes with which food? a. Macaroni and cheese b. Tapioca c. Applesauce d. Hot chocolate

c. Applesauce

A parent brings a child to the emergency department and reports fever, foul smell coming from the throat, and a gray covering over the tonsils. What action by the nurse takes priority? a. Place the child on a cardiac monitor. b. Attach a pulse oximeter to the child. c. Assess respiratory status immediately. d. Start an IV and draw blood cultures.

c. Assess respiratory status immediately.

The child with Down syndrome should be evaluated for which condition before participating in some sports? a. Hyperflexibility b. Cutis marmorata c. Atlantoaxial instability d. Speckling of iris (Brushfield spots)

c. Atlantoaxial instability

Which is an important nursing consideration when caring for a child with impetigo? a. Apply topical corticosteroids to decrease inflammation. b. Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris. c. Carefully wash hands and maintain cleanliness when caring for an infected child. d. Examine child under a Wood lamp for possible spread of lesions.

c. Carefully wash hands and maintain cleanliness when caring for an infected child.

What best describes a full-thickness (third-degree) burn? a. Erythema and pain b. Skin showing erythema followed by blister formation c. Destruction of all layers of skin evident with extension into subcutaneous tissue d. Destruction injury involving underlying structures such as muscle, fascia, and bone

c. Destruction of all layers of skin evident with extension into subcutaneous tissue

Teaching safety precautions with the administration of antihistamines is important because of what common side effect? a. Dry mouth b. Excitability c. Drowsiness d. Dry mucous membranes

c. Drowsiness

What action is contraindicated when a child with Down syndrome is hospitalized? a. Determine the child's vocabulary for specific body functions. b. Assess the child's hearing and visual capabilities. c. Encourage parents to leave the child alone to encourage adaptation. d. Have meals served at the child's usual meal times.

c. Encourage parents to leave the child alone to encourage adaptation.

What is a common trigger for asthma attacks in children? a. Febrile episodes b. Dehydration c. Exercise d. Seizures

c. Exercise

Which statement best describes fragile X syndrome? a. Chromosomal defect affecting only females. b. Chromosomal defect that follows the pattern of X-linked recessive disorders. c. It is a common genetic cause of cognitive impairment. d. Most common cause of noninherited cognitive impairment.

c. It is a common genetic cause of cognitive impairment.

Discharge planning for an 8-year-old child with a patched eye after a large corneal abrasion should include which instruction? a. Removing the patch after 8 hours for instillation of antibiotic ointment b. Gently massaging the affected eye to prevent edema c. Keeping the patch in place for 24 hours d. Returning after 7 days of patching for reassessment

c. Keeping the patch in place for 24 hours

A child has painful, fluid-filled vesicles on the upper lip. What medication does the nurse anticipate teaching parents about? a. Corticosteroids b. Oral griseofulvin c. Oral antiviral agent d. Topical antibiotic

c. Oral antiviral agent

A nurse is instructing parents on the treatment of pediculosis (head lice). Which should the nurse include in the teaching plan? (Select all that apply.) a. Bedding should be washed in warm water and dried on a low setting. b. After treating the hair and scalp with a pediculicide, shampoo the hair with regular shampoo. c. Retreat the hair and scalp with a pediculicide in 7 to 10 days. d. Items that cannot be washed should be dry cleaned or sealed in plastic bags for 2 to 3 weeks. e. Combs and brushes should be boiled in water for at least 10 minutes.

c. Retreat the hair and scalp with a pediculicide in 7 to 10 days. d. Items that cannot be washed should be dry cleaned or sealed in plastic bags for 2 to 3 weeks. e. Combs and brushes should be boiled in water for at least 10 minutes.

What manifestation in a 5-month-old child could indicate visual problems? a. Lack of binocularity b. Visual acuity of 20/50 c. Strabismus d. Hyperopia

c. Strabismus

Which finding confirms a diagnosis of cystic fibrosis? a. Chest radiograph shows alveolar hyperinflation. b. Stool analysis indicates significant amounts of fecal fat. c. Sweat chloride is greater than 60 mEq/L. d. Liver function levels are abnormal.

c. Sweat chloride is greater than 60 mEq/L.

The teaching plan for a 7-year-old boy with color deficiency should include what instruction? a. Buy only one color of clothing to ensure the child's ability to match items himself. b. Patching the weaker eye will improve his color vision. c. Teach him an alternate way to distinguish between the colors of traffic signals. d. Botulism toxin drops must be administered every 2 months to improve color vision.

c. Teach him an alternate way to distinguish between the colors of traffic signals.

What should the nurse keep in mind when planning to communicate with a child who has autism? a. The child has normal verbal communication. b. Expect the child to use sign language. c. The child may exhibit monotone speech and echolalia. d. The child is not listening if she is not looking at the nurse.

c. The child may exhibit monotone speech and echolalia.

Which child requires a Mantoux test? a. The child who has episodes of nighttime wheezing and coughing b. The child who has a history of allergic rhinitis c. The child whose babysitter has received a tuberculosis diagnosis d. The premature infant who is being treated for apnea of infancy

c. The child whose babysitter has received a tuberculosis diagnosis

What assessment finding best indicates that a 66-pound child with a serious burn has met goals for the priority nursing diagnosis? a. Distal pulses are equal and strong bilaterally. b. Oxygen saturation is 94% on room air. c. Urine output is 45 mL/hour. d. Mucous membranes are pink and moist.

c. Urine output is 45 mL/hour.

What should the nurse teach a child about using an albuterol metered-dose inhaler for exercise-induced asthma? a. Take two puffs every 6 hours around the clock. b. Use the inhaler only when the child is short of breath. c. Use the inhaler 30 minutes before exercise. d. Take one to two puffs every morning upon awakening.

c. Use the inhaler 30 minutes before exercise.

Which teaching guideline helps prevent eye injuries during sports and play activities? a. Restrict helmet use to those who wear eye glasses or contact lenses. b. Discourage the use of goggles with helmets so the child can see better. c. Wear eye protection when participating in high-risk sports such as paintball. d. Wear a face mask when playing any sport or playing roughly.

c. Wear eye protection when participating in high-risk sports such as paintball.

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses. The child states that the other children at school call her "four-eyes." Contact lenses should be prescribed for a child who is a. at least 12 years of age. b. able to read all the written information and instructions. c. able to independently care for the lenses in a responsible manner. d. confident that she really wants contact lenses.

c. able to independently care for the lenses in a responsible manner.

A mother calls the emergency department nurse because her child was stung by a scorpion. The nurse should recommend a. administering antihistamine. b. cleansing with soap and water. c. keeping child quiet and coming to emergency department. d. removing stinger and applying cool compresses.

c. keeping child quiet and coming to emergency department.

Throughout their life span, cognitively impaired children are less capable of managing environmental challenges and are at risk for a. nutritional deficits. b. visual impairments. c. physical injuries. d. psychiatric problems.

c. physical injuries.

The primary clinical manifestation of scabies is a. edema. b. redness. c. pruritus. d. maceration.

c. pruritus.

The most appropriate nursing diagnosis for a child with a cognitive dysfunction is a. impaired social interaction. b. deficient knowledge. c. risk for injury d. ineffective coping.

c. risk for injury

A father calls the clinic nurse because his 2-year-old child was bitten by a black widow spider. The nurse should advise the father to a. apply warm compresses. b. carefully scrape off the stinger. c. take the child to the emergency department. d. apply a thin layer of corticosteroid cream.

c. take the child to the emergency department.

What is the most appropriate response to a school-age child who asks if she can talk to her dying sister? a. "You need to talk loudly so she can hear you." b. "Holding her hand would be better because at this point she can't hear you." c. "Although she can't hear you, she can feel your presence so sit close to her." d. "Even though she will probably not answer you, she can still hear what you say to her."

d. "Even though she will probably not answer you, she can still hear what you say to her."

Which statement made by a parent indicates an understanding about the management of a child with cellulitis on the arm? a. "I am supposed to continue the antibiotic until the redness and swelling disappear." b. "I have been putting ice on my son's arm to relieve the swelling." c. "I should call the doctor if the redness disappears." d. "I have been putting a warm soak on my son's arm every 4 hours."

d. "I have been putting a warm soak on my son's arm every 4 hours."

A burned child is in the emergency department. The nurse calculates the fluid requirement for the next 24 hours to be 2700 mL. At what rate does the nurse set the pump for initially? a. 50 mL/hour b. 100 mL/hour c. 152.1 mL/hour d. 168.8 mL/hour

d. 168.8 mL/hour

Which is the best setting for daytime care for a 5-year-old autistic child whose mother works? a. Private day care b. Public school c. His own home with a sitter d. A specialized program that uses behavioral methods

d. A specialized program that uses behavioral methods

Which action is initiated when a child has been scratched by a potentially rabid animal? a. No intervention unless the child becomes symptomatic b. Administration of immune globulin around the wound c. Administration of rabies vaccine on days 3, 7, 14, and 28 d. Administration of both immune globulin and vaccine as soon as possible after exposure

d. Administration of both immune globulin and vaccine as soon as possible after exposure

The process of burn shock continues until what physiologic mechanism occurs? a. Heart rate returns to normal. b. Airway swelling decreases. c. Body temperature regulation returns to normal. d. Capillaries regain their seal.

d. Capillaries regain their seal.

The infant with Down syndrome is closely monitored during the first year of life for what serious condition? a. Thyroid complications b. Orthopedic malformations c. Dental malformation d. Cardiac abnormalities

d. Cardiac abnormalities

The home health 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

d. Child, family, and all professionals involved

The teaching plan for the parents of a 3-year-old child with amblyopia ("lazy eye") should include what instruction? a. Apply a patch to the child's eyeglass lenses. b. Apply a patch only during waking hours. c. Apply a patch over the "bad" eye to strengthen it. d. Cover the "good" eye completely with a patch.

d. Cover the "good" eye completely with a patch.

An adolescent has been diagnosed with the Epstein-Barr virus. What discharge information should the nurse give to the parents? a. It is important to protect the adolescent's head during physical activities. b. The teen will feel like himself and be back to his usual routines in a week. c. Treatment of the Epstein-Barr virus is several months of prolonged bed rest. d. Fatigue may persist, so increase school activities gradually.

d. Fatigue may persist, so increase school activities gradually.

A3 1/2-year-old child who is toilet trained has had several "accidents" since hospital admission. What is the nurse's best action in this situation? a. Find out how long the child has been toilet trained at home. b. Encourage the parents to scold the child. c. Explain how to use a bedpan and place it close to the child. d. Follow home routines of elimination.

d. Follow home routines of elimination.

Which intervention is appropriate for the infant hospitalized with bronchiolitis? a. Position on the side with neck slightly flexed. b. Administer antibiotics as ordered. c. Restrict oral and parenteral fluids if tachypneic. d. Give cool, humidified oxygen.

d. Give cool, humidified oxygen.

A 2-year-old has excessive tearing and corneal haziness. The nurse knows that these symptoms may indicate which of the following? a. Viral conjunctivitis b. Paralytic strabismus c. Congenital cataract d. Infantile glaucoma

d. Infantile glaucoma

Which statement is characteristic of acute otitis media (AOM)? a. The etiology is unknown. b. Permanent hearing loss often results. c. It can be treated by intramuscular (IM) antibiotics. d. It is treated with a broad range of antibiotics.

d. It is treated with a broad range of antibiotics.

Which statement best describes how a cataract affects a child's vision? a. It increases intraocular pressure. b. It alters the ability to distinguish among colors. c. It causes double vision. d. It prevents a clear image from forming on the retina.

d. It prevents a clear image from forming on the retina.

What procedure is contraindicated in the care of a child with a minor partial-thickness burn injury wound? a. Cleaning the affected area with mild soap and water b. Applying antimicrobial ointment to the burn wound c. Changing dressings daily d. Leaving all loose tissue or skin intact

d. Leaving all loose tissue or skin intact

Why do infants and young children quickly have respiratory distress in acute and chronic alterations of the respiratory system? a. They have a widened, shorter airway. b. There is a defect in their sucking ability. c. The gag reflex increases mucous production. d. Mucus and edema obstruct small airways.

d. Mucus and edema obstruct small airways.

An adolescent goes to the primary care provider complaining of difficulty with vision. When the nurse asks the adolescent to explain the visual deficits, the adolescent states, "I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has?a. Hyphema b. Astigmatism c. Amblyopia d. Myopia

d. Myopia

. What should the nurse advise the mother of a 4-year-old child to bring with her child to the outpatient surgery center on the day of surgery? a. Snacks b. Fruit juice boxes c. All of the child's medications d. One of the child's favorite toys

d. One of the child's favorite toys

What should be included in the care for a neonate who was diagnosed with pertussis? a. Monitoring hemoglobin level b. Hearing test before discharge c. Serial platelet counts d. Prophylactic antibiotics for all close contacts

d. Prophylactic antibiotics for all close contacts

When taking a history on a child with a possible diagnosis of cellulitis, what should be the priority nursing assessment to help establish a diagnosis? a. Any pain the child is experiencing b. Enlarged, mobile, and nontender lymph nodes c. Child's urinalysis results d. Recent infections or signs of infection

d. Recent infections or signs of infection

The pediatric nurse understands that cellulitis is most often caused by a. herpes zoster. b. Candida albicans. c. human papillomavirus. d. Streptococcus or Staphylococcus organisms.

d. Streptococcus or Staphylococcus organisms.

What should the parents of an infant with thrush (oral candidiasis) be taught about medication administration? a. Give nystatin suspension with a syringe without a needle. b. Apply nystatin cream to the affected area twice a day. c. Give nystatin before the infant is fed. d. Swab nystatin suspension onto the oral mucous membranes after feedings.

d. Swab nystatin suspension onto the oral mucous membranes after feedings.

The father of a child recently diagnosed with developmental delay is very rude and hostile toward the nurses. This father was cooperative during the child's evaluation a month ago. What is the best explanation for this change in parental behavior? a. The father is exhibiting symptoms of a psychiatric illness. b. The father may be abusing the child. c. The father is resentful of the time he is missing from work for this appointment. d. The father is experiencing a symptom of grief.

d. The father is experiencing a symptom of grief.

What is the priority goal for the child with a chronic illness? a. To maintain the intactness of the family b. To eliminate all stressors c. To achieve complete wellness d. To obtain the highest level of wellness

d. To obtain the highest level of wellness

The skin condition commonly known as "warts" is the result of an infection by which organism? a. Bacteria b. Fungus c. Parasite d. Virus

d. Virus

. Many of the physical characteristics of Down syndrome present feeding problems. Care of the infant should include a. delaying feeding solid foods until the tongue thrust has stopped. b. modifying diet as necessary to minimize the diarrhea that often occurs. c. providing calories appropriate to child's age. d. using special bottles that may assist the infant with feeding.

d. using special bottles that may assist the infant with feeding.

The nurse is providing counseling to the mother of a child diagnosed with fragile X syndrome. She explains to the mother that fragile X syndrome is a. most commonly seen in girls. b. acquired after birth. c. usually transmitted by the male carrier. d. usually transmitted by the female carrier.

d. usually transmitted by the female carrier.

What information should the nurse teach workers at a daycare center about RSV? a. RSV is transmitted through particles in the air. b. RSV can live on skin or paper for up to a few seconds after contact. c. RSV can survive on nonporous surfaces for about 60 minutes. d. Frequent handwashing can decrease the spread of the virus.

d. Frequent handwashing can decrease the spread of the virus.

What is the best nursing response to the mother of a 4-year-old child who asks what she can do to help the child cope with a sibling's repeated hospitalizations? a. Recommend that the child be sent to visit the grandmother until the sibling returns home. b. Inform the parent that the child is too young to visit the hospital. c. Assume the child understands that the sibling will soon be discharged because the child asks no questions. d. Help the mother give the child a simple explanation of the treatment, and encourage the mother to have the child visit the hospitalized sibling.

d. Help the mother give the child a simple explanation of the treatment, and encourage the mother to have the child visit the hospitalized sibling.

What intervention will best help the siblings of a child with special needs? a. Explaining to the siblings that embarrassment is unhealthy b. Encouraging the parents not to expect siblings to help them care for the child with special needs c. Providing information to the siblings about the child's condition only as they request it d. Suggesting to the parents ways of maintaining the siblings' usual routine and participation in activities.

d. Suggesting to the parents ways of maintaining the siblings' usual routine and participation in activities.

A child taking oral corticosteroids for asthma is exposed to varicella. The child has not had the varicella vaccine and has never had the disease. What intervention should be taken to prevent varicella from developing? a. No intervention is needed unless varicella develops. b. Administer the varicella vaccine as soon as possible. c. The child should begin a course of oral antibiotics. d. The child should be prescribed acyclovir.

d. The child should be prescribed acyclovir.

The traditional areas of school health nursing that are still prevalent in many school systems include which of the following? (Select all that apply.) a. Health screening b. Emergency care c. Intensive care d. Communicable disease management e. Health care advice

a. Health screening b. Emergency care d. Communicable disease management e. Health care advice

Which indicators of imminent death in a child should the nurse expect to assess? (Select all that apply.) a. Heart rate increases. b. Blood pressure increases. c. Respirations become rapid and shallow. d. The extremities become warm. e. Peripheral pulses become stronger.

a. Heart rate increases. c. Respirations become rapid and shallow.

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 which response? a. Denial b. Anger c. Social reintegration d. Acceptance of child's limitations

b. Anger

For which problem should the child with chronic otitis media with effusion be evaluated? a. Brain abscess b. Meningitis c. Hearing loss d. Perforation of the tympanic membrane

c. Hearing loss

Which intervention helps a hospitalized toddler feel a sense of control? a. Assign the same nurses to care for the child. b. Put a cover over the child's crib. c. Require parents to stay with the child. d. Follow the child's usual routines for feeding and bedtime.

d. Follow the child's usual routines for feeding and bedtime.

The parents of a chronic illness say, "Living with this disease is really hard; it's not fair." What response by the nurse is best? a. "Tell me about what is hard for you." b. "I know exactly how you must feel." c. "I know a local support group for families." d. "I am going to ask the grief counselor to meet with you."

a. "Tell me about what is hard for you."

What is a priority nursing diagnosis for the preschool child with chronic illness? a. Risk for delayed growth and development related to chronic illness or disability b. Chronic pain related to frequent injections and invasive procedures c. Anticipatory grieving related to impending death d. Anxiety related to frequent hospitalizations

a. Risk for delayed growth and development related to chronic illness or disability

The home health care nurse is working with a family with three children, one of whom has a chronic condition. What statement by a parent indicates that goals for a primary nursing diagnosis have been met? a. "We take turns going to soccer practice with our other two kids." b. "Each sibling has one night when he or she is in charge so we can go out." c. "We are looking into local support groups for parents." d. "We can't afford home health care, so one of us will quit our job."

a. "We take turns going to soccer practice with our other two kids."

A 3-year-old child cries, kicks, and clings to the father when the parents try to leave the hospital room. What is the nurse's best response to the parents about this behavior? a. "Your child is showing a normal response to the stress of hospitalization." b. "Your child is not coping effectively with hospitalization." c. "Parents should stay with children during hospitalization." d. "You can avoid this if you leave after your child falls asleep."

a. "Your child is showing a normal response to the stress of hospitalization."

Parents report their 3-year-old child appears restless at night and frequently scratches her anal area. What action by the nurse is best? a. Educate parents on the cellophane tape test. b. Review hygiene practices with the parents. c. Suggest the child sleep only in pajama tops. d. Ask parents to bring in a stool sample.

a. Educate parents on the cellophane tape test.

What are age-appropriate nursing interventions to facilitate psychological adjustment for an adolescent expected to have a prolonged hospitalization? (Select all that apply.) a. Encourage parents to bring in homework and schedule study times. b. Allow the adolescent to wear street clothes. c. Involve the parents in care. d. Follow home routines. e. Encourage parents to bring in favorite foods.

a. Encourage parents to bring in homework and schedule study times. b. Allow the adolescent to wear street clothes. e. Encourage parents to bring in favorite foods.

Which is the most developmentally appropriate intervention when working with the hospitalized adolescent? a. Encourage peers to call and visit when the adolescent's condition allows. b. Encourage the adolescent's friends to continue with their daily activities; the adolescent has concrete thinking and will understand. c. Discourage questions and concerns about the effects of the illness on the adolescent's appearance. d. Ask the parents how the adolescent usually copes in new situations.

a. Encourage peers to call and visit when the adolescent's condition allows.

A nurse is caring for a dying child. What action by the nurse best meets the the primary concern of the parents? a. Giving the child pain medication on a schedule b. Placing the child on fall and safety precautions c. Providing the child with favorite foods when requested d. Ensuring the child gets the minimum fluid requirement

a. Giving the child pain medication on a schedule

The nurse is working with a child in the intensive care unit. The family is from out of town. There are two siblings, both of whom are acting out at home. What suggestions does the nurse provide the family? (Select all that apply.) a. Let the siblings call the ill child at scheduled times. b. Take photographs of the sick child to show the siblings. c. Suggest the parents take the siblings to counseling. d. Reassure the siblings that they will not get ill themselves. e. Stay at home with the siblings until their behavior improves.

a. Let the siblings call the ill child at scheduled times. b. Take photographs of the sick child to show the siblings. d. Reassure the siblings that they will not get ill themselves.

The nurse should provide which information to parents about preventing parasitic infections? (Select all that apply.) a. Perform good handwashing. b. Diaper a child when swimming. c. Avoid cleaning the bathroom facilities with bleach. d. Shoes should be worn outside. e. Fruits and vegetables should be washed before eating.

a. Perform good handwashing. d. Shoes should be worn outside. e. Fruits and vegetables should be washed before eating.

Which intervention is appropriate for a hospitalized child who has crops of lesions on the trunk that appear as a macular rash and vesicles? a. Place the child in strict isolation with airborne and contact precautions. b. Continue to practice Standard Precautions. c. Pregnant women should avoid contact with the child. d. Screen visitors for immunity to measles.

a. Place the child in strict isolation with airborne and contact precautions.

A preschooler is diagnosed with helminths. The child's mother is very upset and wants to know how her child could have contracted this illness. After obtaining a detailed history, the nurse identifies all possible transmission modes. What do they include? (Select all that apply.) a. Playing in the backyard sandbox b. Not washing hands before eating c. Placing hands in the mouth and nail biting d. Skin-to-skin contact with other children e. Scratches from a neighborhood cat

a. Playing in the backyard sandbox b. Not washing hands before eating c. Placing hands in the mouth and nail biting

A 5-year-old child is brought to the emergency department with copious drooling and a croaking sound on inspiration. Her mother states that the child is very agitated and only wants to sit upright. What action by the nurse takes priority? a. Prepare intubation equipment and call the provider. b. Examine the child's oropharynx and call the provider. c. Obtain a throat culture for respiratory syncytial virus (RSV). d. Obtain vital signs and listen to breath sounds.

a. Prepare intubation equipment and call the provider.

Which should a nurse identify as common chronic illnesses of childhood? (Select all that apply.) a. Reactive airway disease (asthma) b. Respiratory syncytial virus (RSV) c. Cerebral palsy d. Diabetes mellitus e. Human immunodeficiency virus infection (HIV)

a. Reactive airway disease (asthma) c. Cerebral palsy d. Diabetes mellitus e. Human immunodeficiency virus infection (HIV)

Which assessment finding after tonsillectomy should be reported to the surgeon? a. Vomiting bright red blood b. Pain at surgical site c. Pain on swallowing d. The ability to only take small sips of liquids

a. Vomiting bright red blood

The parents of a child born with disabilities ask the nurse for advice about discipline. The nurse's response should be based on knowledge that discipline is a. essential for the child. b. too difficult to implement with special-needs child. c. not needed unless the child becomes problematic. d. best achieved with punishment for misbehavior.

a. essential for the child.

The nurse expects the initial plan of care for a 9-month-old child with an acute otitis media infection to include a. symptomatic treatment and observation for 48 to 72 hours after diagnosis. b. an oral antibiotic, such as amoxicillin, five times a day for 7 days. c. pneumococcal conjugate vaccine. d. myringotomy with tympanoplasty tubes.

a. symptomatic treatment and observation for 48 to 72 hours after diagnosis.

The nurse comes into the room of a child who was just diagnosed with a chronic disability. The child's parents begin to yell at the nurse about a variety of concerns. The nurse's best response is a. "What is really wrong?" b. "Being angry is only natural." c. "Yelling at me will not change things." d. "I will come back when you settle down."

b. "Being angry is only natural."

Which question most likely elicits information about how a family is coping with a child's hospitalization? a. "Was this admission an emergency?" b. "How has your child's hospitalization affected your family?" c. "Who is taking care of your other children while you are here?" d. "Is this the child's first hospitalization?"

b. "How has your child's hospitalization affected your family?"

How should the nurse respond to a parent who asks, "How can I protect my baby from whooping cough?" a. "Don't worry; your baby will have maternal immunity to pertussis that will last until approximately 18 months old." b. "Make sure your child gets the pertussis vaccine." c. "See the doctor when the baby gets a respiratory infection." d. "Have your pediatrician prescribe erythromycin."

b. "Make sure your child gets the pertussis vaccine."

What is the best response to a parent of a 2-month-old infant who asks when the infant should first receive the measles vaccine? a. "Your baby can get the measles vaccine now." b. "The first dose is given any time after the first birthday." c. "She should be vaccinated between 4 and 6 years of age." d. "This vaccine is administered when the child is 11 years old."

b. "The first dose is given any time after the first birthday."

A hospitalized child has developed a methicillin-resistant Staphylococcus aureus (MRSA) infection. The nurse plans which interventions when caring for this child? (Select all that apply.) a. Airborne isolation b. Administration of vancomycin c. Contact isolation d. Administration of mupirocin ointment to the nares if colonized e. Administration of cefotaxime (Cefotetan)

b. Administration of vancomycin c. Contact isolation d. Administration of mupirocin ointment to the nares if colonized

Which STD should the nurse suspect when an adolescent girl comes to the clinic because she has a vaginal discharge that is white with a fishy smell? a. Human papillomavirus b. Bacterial vaginosis c. Trichomonas d. Chlamydia

b. Bacterial vaginosis

The student nurse learns the stages of grief according to Kübler-Ross. What stages does this include? (Select all that apply.) a. Shock b. Denial c. Anger d. Bargaining e. Acceptance

b. Denial c. Anger d. Bargaining e. Acceptance

Which situation poses the greatest challenge to the nurse working with a child and family? a. Twenty-four-hour observation b. Emergency hospitalization c. Outpatient admission d. Rehabilitation admission

b. Emergency hospitalization

The parent of a toddler calls the nurse, asking about croup. What is a distinguishing manifestation of spasmodic croup? a. Wheezing is heard audibly. b. It has a harsh, barky cough. c. It is bacterial in nature. d. The child has a high fever.

b. It has a harsh, barky cough.

What should the nurse expect to observe in the prodromal phase of rubeola? a. Macular rash on the face b. Koplik spots c. Petechiae on the soft palate d. Crops of vesicles on the trunk

b. Koplik spots

A child with a serious, chronic illness is hospitalized frequently. The parents are worried about the child's growth and development. What action by the nurse is best? a. Tell parents developmental delays are likely in this case. b. Make a referral to the play therapist for therapeutic play. c. Encourage the child to perform age-appropriate activities. d. Ask the parents if they want a child psychology referral.

b. Make a referral to the play therapist for therapeutic play.

What intervention can be taught to the parents of a 3-year-old child with pneumonia who is not hospitalized? a. Offer the child only cool liquids. b. Offer the child favorite warm liquid drinks. c. Use a warm mist humidifier. d. Report a respiratory rate less than 28 breaths/min.

b. Offer the child favorite warm liquid drinks.

Kelly, age 8 years, will soon be able to return to school after an injury that resulted in several severe, chronic disabilities. What action by the school nurse is most appropriate? a. Recommend that Kelly's parents attend school at first to prevent teasing. b. Prepare Kelly's classmates and teachers for changes they can expect. c. Refer Kelly to a school where the children have chronic disabilities similar to hers. d. Discuss the fact that her classmates will not accept her as they did before.

b. Prepare Kelly's classmates and teachers for changes they can expect.

In which age-group does the child's active imagination during unfamiliar experiences increase the stress of hospitalization? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

b. Preschoolers

What corresponds to a 5-year-old child's understanding of death? a. Loss of a caretaker b. Reversible and temporary c. Permanent d. Inevitable

b. Reversible and temporary

In order to minimize the negative effects of illness and hospitalization on an infant, the nurse focuses care on which of the following? a. Bodily injury and pain b. Separation from caregivers and fear of strangers c. Loss of control and altered body image d. The unknown and being left alone

b. Separation from caregivers and fear of strangers

A nurse is conducting a health education class for a group of school-age children. Which statement made by the nurse is correct about the body's first line of defense against infection in the innate immune system? a. Nutritional status b. Skin integrity c. Immunization status d. Proper hygiene practices

b. Skin integrity

A preschool-aged child tells the nurse "I was bad, that's why I got sick." What is the best rationale for this child's statement? a. The child has a fear that mutilation will lead to death. b. The child's imagination is very active, and he may believe the illness is a result of something he did. c. The child has a general understanding of body integrity at this age. d. The child will not have fear related to an IV catheter initiation but will have fear of an impending surgery.

b. The child's imagination is very active, and he may believe the illness is a result of something he did.

The nurse encourages the mother of a toddler with acute LTB to stay at the bedside as much as possible. Which of the following best explains the nurse's rationale? a. Mothers of hospitalized toddlers often experience guilt. b. The mother's 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.

b. The mother's presence will reduce anxiety and ease the child's respiratory efforts.

How can chronic illness and frequent hospitalizations affect the psychosocial development of a toddler? a. They can create a distortion or differentiation of self from parent. b. They can interfere with the development of autonomy. c. They can interfere with the acquisition of language, fine motor, and self-care skills. d. They can create feelings of inadequacy.

b. They can interfere with the development of autonomy.

What should be included in health teaching to prevent Lyme disease? a. Complete the immunization series in early infancy. b. Use insect repellant with DEET in heavily wooded areas. c. Give low-dose antibiotics to the child before exposure. d. Restrict activities that might lead to exposure for the child.

b. Use insect repellant with DEET in heavily wooded areas.

Many parents who have children diagnosed with a chronic illness experience recurrent feelings of grief, loss, and fear related to the child's condition and loss of the ideal healthy child. The nurse recognizes this process as a. anticipatory grieving. b. chronic sorrow. c. bereavement. d. illness trajectory.

b. chronic sorrow.

Which statement made by a parent indicates an understanding about treatment of streptococcal pharyngitis? a. "I guess my child will need to have his tonsils removed." b. "A couple of days of rest and some ibuprofen will take care of this." c. "I should give the penicillin three times a day for 10 days." d. "I am giving my child prednisone to decrease the swelling of the tonsils."

c. "I should give the penicillin three times a day for 10 days."

Which statement indicates that a father understands the treatment for his child who has scarlet fever? a. "I can stop the medicine when my child feels better." b. "I will apply antibiotic cream to her rash twice a day." c. "I will give the penicillin for the full 10 days." d. "My child can go back to school after 7 days of antibiotics."

c. "I will give the penicillin for the full 10 days."

Which therapeutic approach will best help a 7-year-old child cope with a lengthy course of intravenous antibiotic therapy? a. Arrange for the child to go to the playroom daily. b. Ask the child to draw you a picture of himself or herself. c. Allow the child to participate in injection play. d. Give the child stickers for cooperative behavior.

c. Allow the child to participate in injection play.

A child has had cold symptoms for more than 2 weeks, a headache, nasal congestion with purulent nasal drainage, facial tenderness, and a cough that increases during sleep. The nurse plans to teach the parents about which treatment regime? a. Antihistamine use b. Cold washcloths on the face for comfort c. Antibiotic treatment with amoxicillin d. Referral for a sinuplasty

c. Antibiotic treatment with amoxicillin

What should the nurse identify as major fears in the preschool child who is hospitalized with a chronic illness? (Select all that apply.) a. Altered body image b. Separation from peer group c. Bodily injury d. Mutilation e. Being left alone

c. Bodily injury d. Mutilation e. Being left alone

Once an allergen is identified in a child with allergic rhinitis, the treatment of choice the nurse educates the parents about is which of the following? a. Using appropriate medications b. Beginning desensitization injections c. Eliminating the allergen d. Removing the adenoids

c. Eliminating the allergen

What is an important focus of nursing care for the dying child and his or her family? a. Nursing care should be organized to minimize contact with the child. b. Adequate oral intake is crucial to the dying child. c. Families should be taught that hearing is the last sense to stop functioning before death. d. It is best for the family if nursing care takes place during periods when the child is alert.

c. Families should be taught that hearing is the last sense to stop functioning before death.

The nurse case manager is planning a care conference about a young child who has complex health care needs and will soon be discharged home. Who should the nurse invite to the conference? a. Family and nursing staff b. Social worker, nursing staff, and primary care physician c. Family and key health professionals involved in the child's care d. Primary care physician and key health professionals involved in the child's care

c. Family and key health professionals involved in the child's care

What is the predominant trait of the resilient family associated with chronic illness? a. Social separation b. Family flexibility c. Family cohesiveness d. Clear family boundaries

c. Family cohesiveness

The nurse in the pediatric clinic is caring for a child and assesses this skin rash. What action by the nurse is best? (measles) a. Inform parents the child will be contagious for one week. b. Arrange for immediate hospitalization and IV antibiotics. c. Instruct parents to offer the child a soft, bland diet. d. Advise parents the child can maintain normal activities.

c. Instruct parents to offer the child a soft, bland diet.

What is the primary disadvantage associated with outpatient and day facility care? a. Increased cost b. Increased risk of infection c. Lack of physical connection to the hospital d. Longer separation of the child from family

c. Lack of physical connection to the hospital

What is the best action for the nurse to take when a 5-year-old child who requires another 2 days of IV antibiotics cries, screams, and resists having the IV restarted? a. Exit the room and leave the child alone until he or she stops crying. b. Tell the child big boys and girls "don't cry." c. Let the child decide which color arm board to use with the IV. d. Administer an opioid analgesic for pain to quiet the child.

c. Let the child decide which color arm board to use with the IV.

The nurse is counseling the family of a 12-month-old child who has lost his mother in a car accident. How should you explain to the father what the child's understanding of death is, related to theories of growth and development? a. Temporary b. Permanent c. Loss of caretaker d. Punishment

c. Loss of caretaker

Which is an appropriate nursing intervention for the hospitalized neonate? a. Assign the neonate to a room with other neonates. b. Provide play activities in the hospital room. c. Offer the neonate a pacifier between feedings. d. Request that parents bring a security object from home.

c. Offer the neonate a pacifier between feedings.

Home care is being considered for a young child who is ventilator dependent. Which factor is most important in deciding whether home care is appropriate? a. Level of parents' education b. Presence of two parents in the home c. Preparation and training of family d. Family's ability to assume all health care costs

c. Preparation and training of family

The mother of an infant with multiple anomalies tells the nurse that she had a viral infection in the beginning of her pregnancy. Which viral infection is associated with fetal anomalies? a. Measles b. Roseola c. Rubella d. Herpes simplex virus (HSV)

c. Rubella

Having explanations for all procedures and selecting their own meals from hospital menus is an important coping mechanism for which age-group? a. Toddlers b. Preschoolers c. School-age children d. Adolescents

c. School-age children

The parents of a school-age child are told that their child is diagnosed with leukemia. As the nurse caring for this child, what is the expected first response of the parents to the diagnosis of chronic illness in their child? a. Anger and resentment b. Sorrow and depression c. Shock and disbelief d. Acceptance and adjustment

c. Shock and disbelief

Which intervention for treating croup at home should be taught to parents as possibly helpful? a. Have a decongestant available. b. Have the child sleep in a dry room. c. Take the child outside. d. Give the child an antibiotic at bedtime.

c. Take the child outside.

What is the best explanation for a 2-year-old child who is quiet and withdrawn on the fourth day of a hospital admission? a. The child is protesting her separation from her caregivers. b. The child has adjusted to the hospitalization. c. The child is experiencing the despair stage of separation. d. The child has reached the stage of detachment.

c. The child is experiencing the despair stage of separation.

How can chronic illness and frequent hospitalizations affect the psychosocial development of an adolescent? a. They can lead to feelings of inadequacy. b. They can interfere with parental attachment. c. They can block the development of identity. d. They can prevent the development of imagination.

c. They can block the development of identity.

The nurse is discussing toddler development with the mother of a 2 1/2-year-old child. Which statement by the mother indicates she has an understanding of how to help her daughter succeed in a developmental task while hospitalized? a. "I always help my daughter complete tasks to help her achieve a sense of accomplishment." b. "I provide many opportunities for my daughter to play with other children her age." c. "I consistently stress the difference between right and wrong to my daughter." d. "I encourage my daughter to do things for herself when she can."

d. "I encourage my daughter to do things for herself when she can."

Identify the most appropriate nursing response to a parent who tells the nurse, "I don't want my child to know she is dying." a. "I shall respect your decision. I won't say anything to your child." b. "Don't you think she has a right to know about her condition?" c. "Would you like me to arrange for the provider to speak with your child?" d. "I'll answer any questions she asks me as honestly as I can."

d. "I'll answer any questions she asks me as honestly as I can."

Which statement made by a parent about intervention for a child's fever shows the need for further education? a. "I should keep her covered lightly when she has a fever." b. "I'll give her plenty of liquids to keep her hydrated." c. "I can give her acetaminophen for a fever." d. "I'll look for over-the-counter aspirin or ibuprofen."

d. "I'll look for over-the-counter aspirin or ibuprofen."

At what 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

d. Adolescence

What is an appropriate beverage for the nurse to give to a child who had a tonsillectomy earlier in the day? a. Chocolate ice cream b. Orange juice c. Fruit punch d. Apple juice

d. Apple juice

A parent asks the nurse how she will know whether her child has fifth disease. The nurse should advise the parent to be alert for which manifestation? a. Bull's-eye rash at the site of a tick bite b. Lesions in various stages of development on the trunk c. Maculopapular rash on the trunk that lasts for 2 days d. Bright red rash on the cheeks that looks like slapped cheeks

d. Bright red rash on the cheeks that looks like slapped cheeks