Unit 5 Exam

Superficial partial thickness/ deep partial thickness second degree

* damage to entire epidermis * blisters, mild-moderate edema, blanches with pressure * pain, heals 14-21 days, scarring , sensitive to temp changes and light touch

Full thickness Third degree

*damage to epidermis and dermis and maybe subq *nerve endings, hair follicles and sweat glands are destroyed * red, black, white *dry, leathery, no blanching * no pain, heals weeks- months * scarring *grafting required

superficial First degree

*damage to the epidermis *pink-red, no blisters *blanches with pressure *painful, heals 5-10 days, no scarring

Nursing actions for a skin graft

*maintain immobilization of the graft site *elevate extremity *provide wound care to donor site *give pain meds

Hydrotherapy

*pt placed in warm tube of water or use warm running water *done 1-2 times daily for 20 minutes *mild soap used to wash burns, rinse with room temp H2O *encourage ROM during * Monitor for cold stress and hypothermia *debridement

Minor burn care

*stop the burning process (DON'T use ice) cool water *DO NOT remove blisters *apply dressing *provide warmth

Pendiculosis capitis: - agent - manifestations - mgt

- head lice - intense itching, small red bumps and nits of white specks on hair shaft - 1% permethrin shampoo, spinosad 0.9%, use a Nit comb, wash everything in hot water and detergent

A pediatric nurse is performing a respiratory assessment on an 18-month-old child. The nurse will most likely use which recommended techniques? 1) Close the eyes and listen carefully for air moving in and out evenly from the lungs. 2) Assess the resonance of the lungs and underlying organs using auscultation. 3) Assess the child's respiratory status when fully awake and active. 4) Assess for normal breath sounds using palpation.

1

Based on the child's complaint of abdominal pain, the nurse suspects Wilms' tumor. An abdominal mass associated with Wilms' tumor would be detected in which location? 1) On the left side 2) On the front side 3) On both the left and right sides 4) On all sides of the abdomen

1

During the assessment of a child, the nurse notices the presence of vesicles on the lip and mouth that are oozing clear fluid. Which term will the nurse use when documenting this finding in the medical record? 1) Bullae 2) Pustule 3) Wheal 4) Nodule

1

The nurse educator is describing techniques for treating hematological issues. Which types of apheresis removes plasma containing harmful components such as circulating complexes, antibodies (IgM, IgG), cholesterol, and toxins? 1) Plasmapheresis 2) Erythrocytapheresis 3) Leukapheresis 4) Thrombosis

1

A nurse is caring for a client who has a major burn and is experiencing severe pain. Which of the following is an appropriate nursing intervention to manage this client's pain? 1. Give morphine sulfate IV continuous infusion 2. Give meperidine IM PRN 3. Give acetaminophen PO q4 hrs 4. Give hydrocodone PO q 6 hrs

1 Opioids via continuous infusion for major burn

A hematologist confirms a diagnosis of disseminated intravascular coagulation (DIC) for a pediatric patient in critical condition in the pediatric intensive care unit (PICU). Which laboratory results confirmed this diagnosis?SELECT ALL THAT APPLY. 1) Thrombocytopenia 2) Prolonged prothrombin time 3) Increased fibrinogen 4) Decreased D-dimer 5) Positive protein in the urine

1, 2

A nurse is caring for a client who has major burns and suspected shock. Which of the following findings are consistent with septic shock? SELECT ALL 1. Increased body temp 2. Altered sensorium 3. Decreased cap refill 4. Decreased urine output 5. Increased bowel sounds

1,2,4, S&S of septic shock * alterations in sensorium (confusion) * increased cap refill * spiking fever * decreased bowel sounds * decreased urine output

A nurse is caring for a client who has a skin graft. Which is a clinical manifestations indicate infection? SELECT ALL 1. green color to sub q 2. unstable body temp 3. generation of granulation tissue 4. subechar hemorrhage 5, change in skin color around the affected area

1,2,4,5

A pediatric nurse explains discharge instructions to the parents of a child who is postoperative from a tonsillectomy. Which instructions would the nurse stress?SELECT ALL THAT APPLY. 1) Avoid giving the child highly seasoned foods and "sharp" foods. 2) Give the child ice cream the first day to soothe the throat. 3) Avoid gargling. 4) Encourage coughing and clearing the throat. 5) Recommend vigorous tooth brushing.

1,3

A hematologist diagnoses a school-age child with thrombocytopenia. When educating the parents of the child about this condition, which description of this disease will the nurse include? 1) A decrease in platelets 2) An increase in red blood cells 3) A decrease in white blood cells 4) An increase in platelets

1.

A nurse examines the lungs of an infant with an upper respiratory tract infection. While performing the examination, the nurse explains to the student nurse how the respiratory system of a child differs from that of an adult. Which accurately describes one of these differences? 1) The nares in children are larger in size, shallow in depth, underdeveloped, and less easily occluded. 2) The epiglottis in the younger child is longer and flaccid, making it more susceptible to swelling that may lead to airway occlusion. 3) The larynx and the glottis are lower in the younger child's neck, which makes the child more prone to aspiration. 4) There are fewer functional muscles in the neck and the decreased amount of soft tissue makes the child more susceptible to infection and edema.

1.

The nurse educator presents information regarding hepatitis B, Epstein-Barr virus, and human herpes virus 8 to a group of nursing students. Which response by a student indicates an appropriate understanding of this information? 1) "These diseases can cause cancer." 2) "These diseases cause lactogenesis." 3) "These diseases increase DNA replication." 4) "These diseases increase the rate of metastases after the diagnosis of cancer."

1.

The nurse is providing care to a child diagnosed with impetigo. The child's parents ask what caused this to occur. Which organism will the nurse include when educating the parents about impetigo? 1) Staphylococcus aureus 2) Human papilloma virus 3) Pseudomonas aeruginosa 4) Escherichia coli

1.

The pediatric nurse explains to a parent that his child's sarcoma arises from which type of tissue? 1) Connective 2) Epithelial 3) Lymphatic 4) Glandular

1.

Upon assessment of a newborn, the neonatal nurse observes frothing and bubbling at the mouth and nose, coughing, cyanosis, and respiratory distress. The mother's obstetric history indicates polyhydramnios. Which conditions would the nurse suspect? 1) Esophageal atresia 2) Bilateral choanal atresia 3) Respiratory distress syndrome 4) Congenital diaphragmatic hernia

1.

The pediatric nurse plans care for a child experiencing a sickle cell crisis. Which nursing intervention(s) would be appropriate for this patient?SELECT ALL THAT APPLY. 1) Encourage rest. 2) Monitor respiratory status and oxygenation. 3) Provide fluid 2½ times above the patient's normal fluid requirements. 4) Use only nonpharmacological pain interventions to avoid an acute pulmonary event. 5) Implement fluid restrictions.

1. Encourage rest 2. Monitor respiratory status and oxygenation

The nurse is caring for a pediatric patient with viral pneumonia and expects the child's temperature to go up as far as _______ °F (38.9°C).

102

As part of health teaching for parents, the pediatric nurse describes childhood cancers as being different from adult cancers. Which is the major difference in childhood cancers? 1) They begin in epithelial tissue. 2) They begin in embryonic tissue. 3) They begin in the bone marrow. 4) They begin in the lymphatic tissue.

2

During the physical examination of a child's skin, the nurse notes that there is hypertrophic scar tissue from a previous surgery. When documenting this finding in the child's medical record, which term will the nurse use? 1) Lichenification 2) Keloids 3) Ulcers 4) Scaling

2

The nurse is collecting a blood sample specimen for an adolescent who has received a prescription for isotretinoin (Accutane) for acne. This weekly or biweekly blood test monitors which item? 1) Bone mineral density 2) Liver enzymes 3) Platelet count level 4) Follicle-stimulating hormone levels

2

When teaching a group of nursing students about red blood cells (RBCs), which will the educator state as the primary function of RBCs? 1) Mediating the immune system to decrease areas of serious inflammation 2) Transporting hemoglobin that carries oxygen from the lungs to the tissues 3) Migrating and providing a rapid defense against any foreign agent 4) Providing hemostasis and vascular repair following injury to a vessel wall

2

A nurse is caring for a pt. who has superficial partial thickness burn. Which of the following is an appropriate action for the nurse to take? 1. administer an IV infusion of 0.9% Sodium chloride 2. Apply cool, wet compresses to affected area 3. Clean the affected area using a soft bristle brush 4. administer morphine sulfate

2 Applying cool wet compresses stops the burn process *fluid replacement is for those with major burns *clean with tepid H2O, not brush * morphine given for major burns

A school-age African American male is brought to an emergency department (ED) by his parents with a vaso-occlusive crisis. When caring for this child, which will the nurse monitor for during the assessment?SELECT ALL THAT APPLY. 1) Uncontrolled bleeding 2) Acute chest syndrome 3) Splenic sequestration 4) Leg ulcerations 5) Diuresis

2, 3, 4

The clinic nurse conducts an interview with an adolescent, diagnosed with β-thalassemia, and his parents. Prior to planning the adolescent's care, which should the nurse take into consideration?SELECT ALL THAT APPLY. 1) There is no cure for β-thalassemia, but early remission is possible. 2) Hemosiderosis may occur as a result of chronic blood transfusion therapy. 3) Hand washing is essential because patients are often asplenic. 4) If the patient has a fever, antibiotic prophylaxis may be indicated. 5) Pain medication should be provided, per order, around the clock.

2, 3, 4

The pediatric nurse is aware that which factors lead to otitis media in children?SELECT ALL THAT APPLY. 1) The eustachian tubes are long, narrow, and straight and lie in a horizontal plane. 2) The cartilage lining is undeveloped, making the tubes more distensible. 3) The normally abundant pharyngeal lymphoid tissue readily obstructs the eustachian tube openings in the nasopharynx. 4) Immature humoral defense mechanisms increase the risk of infections. 5) It is caused by swimming in pools or lakes.

2, 3, 4

The pediatric nurse understands that the key to managing iron-deficiency anemia in infants is education and prevention. Which are accurate guidelines for patient teaching regarding this condition?SELECT ALL THAT APPLY. 1) Feed the infant commercial infant formula for the first 9 months of life. 2) Use iron-fortified cereal from 6 to 12 months of age. 3) Offer cow's milk prior to solids once solids are introduced. 4) Eliminate cow's milk before 12 months of age. 5) Encourage breastfeeding for the first 12 months of life.

2, 4, 5

A nurse examines the lungs of an infant with an upper respiratory tract infection. While performing the examination, the nurse explains to the student nurse how the respiratory system of a child differs from that of an adult. Which accurately describes one of these differences? 1) The nares in children are larger in size, shallow in depth, underdeveloped, and less easily occluded. 2) The epiglottis in the younger child is longer and flaccid, making it more susceptible to swelling that may lead to airway occlusion. 3) The larynx and the glottis are lower in the younger child's neck, which makes the child more prone to aspiration. 4) There are fewer functional muscles in the neck and the decreased amount of soft tissue makes the child more susceptible to infection and edema.

2.

The pediatric nurse explains to the parents of a school-age cancer patient that which is the most common cancer found in children? 1) Nasopharyngeal cancer 2) Acute lymphocytic leukemia 3) Chronic lymphocytic leukemia 4) Ewing sarcoma

2. Acute lymphocytic leukemia (ALL)

The nurse is teaching the parents of an infant diagnosed with candidiasis in the diaper area how to treat this occurrence and decrease the risk for future occurrences. Which teaching points will the nurse include in the teaching session?SELECT ALL THAT APPLY. 1) Finishing all of the antiviral medication as prescribed 2) Keeping the diaper area as dry as possible 3) Using a moisture barrier cream 4) Changing to a lactose-free formula 5) Administering an oral antifungal liquid for prevention of future occurrences

2.) Keeping the diaper area as dry as possible 3.) Using a moisture barrier cream

The nurse teaches a school-age child how to use a peak flow meter. Which steps will the nurse include in the teaching session with the child and parents? SELECT ALL THAT APPLY. 1) Before each use, make sure the sliding marker or arrow on the peak flow meter is at the top of the numbered scale (the highest number on the scale). 2) Blow a "fast, hard blast" rather than "slowly blowing" until all the air has emptied out of the lungs. 3) Repeat the entire routine three times, keeping in mind that the routine was done correctly when the numbers from all three tries are very close together. 4) Measure the peak flow rate each day, record all three ratings, and calculate an average rating for each session. 5) Measure the peak flow at different times of the day.

2., 3.

The nurse is providing care to a child diagnosed with cancer. Laboratory results indicate anemia. Based on the laboratory results, which clinical manifestations does the nurse anticipate? SELECT ALL THAT APPLY. 1) Fever 2) Fatigue 3) Bleeding 4) Headache 5) Tachycardia

2., 4, 5

The pediatric nurse recognizes that normal breath sounds are equal bilaterally in intensity, rhythm, and pitch. Which respiratory signs might indicate that a child has chronic hypoxia or pulmonary disease? 1) Rhonchi 2) Color changes 3) Clubbing 4) Stridor

3

A nurse is caring for a client who has a moderate burn. Which of the following is an appropriate action for the nurse to take? 1. Maintain immobilization of the affected area 2. expose affected area to the air 3. initiate a high protein, high calorie diet 4. implement contact isolation

3 This kind of diet can decrease the metabolic demands and promote healing *active ROM is needed to prevent contractures *dressings are used to prevent infection *reverse isolation is recommended to prevent infection

The pediatric nurse is providing a preschool-age child's mother with information regarding impetigo. The mother is concerned about the possibility of passing the infection on to her other toddler-age child. Which response by the nurse is the most appropriate in this situation? 1) "I know that you are concerned about the health of both of your children. Your child has been prescribed 7 days of antibiotic therapy. After 24 hours of antibiotic therapy you will not need to worry about the transmission of bacteria to your other child." 2) "Caring for both of your children right now will take more time than usual. Do you have anyone who can come and help you with their care?" 3) "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well." 4) "You only need to concern yourself with the child who has impetigo. It will be important to ensure that all of the medication is taken and that all toys and linens are washed in the next 24 hours."

3.

A neonatal nurse examines a newborn who presents with meconium ileus, where the meconium is so thick that it causes obstruction and requires surgical removal. Based on the data, which condition does the nurse suspect? 1) Bronchopulmonary dysplasia 2) Choanal atresia 3) Cystic fibrosis 4) Congenital diaphragmatic hernia

3. Cystic Fibrosis

A pediatric nurse evaluates the lung sounds of a child and determines that there are unexplained and persistent wheezes present. Which diagnostic procedure would most likely be ordered by the health-care provider? 1) Chest x-ray 2) CT scan 3) Fluoroscopy 4) Bronchoscopy

4

The pediatric nurse teaches the parents of a preschool-age child diagnosed with anemia that it is important to identify the cause of anemia so that treatment can be tailored to their child's specific needs. The nurse tells the parents that their child's anemia is caused by an increased destruction of red blood cells that occurs with which condition noted in the medical history? 1) Bone marrow failure 2) Acute blood loss 3) Myelodysplastic syndrome 4) Sickle cell anemia

4

A parents asks a nurse about the use of the Bacille Calmette-Guérin (BCG) vaccine in the prevention of tuberculosis. Which information is appropriate for the nurse to include in the education regarding this vaccine? 1) The BCG vaccine is recommended at 12 months of age. 2) The BCG vaccine will cause a negative PPD skin test for life. 3) The BCG vaccine is routinely administered in the United States. 4) The best use of BCG vaccination appears to be the prevention of life-threatening forms of tuberculosis in infants and young children.

4.

A school-age child is tentatively diagnosed with acute lymphocytic leukemia. The clinic nurse reviews the child's laboratory results and recognizes which finding to reflect the best prognosis? 1) WBC greater than 30,000/mm³ 2) WBC greater than 20,000/mm³ 3) WBC less than 10,000/mm³ 4) WBC less than 5,000/mm³

4.

The nurse educator is teaching a group of nursing students that blood is composed of two parts: the fluid portion called plasma and the cellular portion. Which is an element of the cellular portion that the educator will include in the teaching session? 1) Albumin 2) Electrolytes 3) Globulins 4) Red blood cells

4.

The pediatric nurse is providing health promotion teaching to the family of a preschool-age child following a diagnosis of herpes simplex I. Which topic is important for the nurse to include in the teaching for this child and family? 1) Encouraging the child to practice personal hygiene by bathing twice a day 2) Encouraging the child's understanding of information about the condition 3) Encouraging the child's diet planner to prevent excessive carbohydrate and iron intake 4) Encouraging the child to wash the hands by singing along during the process

4.

A nurse is caring for a child who has cellulitis on the hand.Which of the following actions should the nurse take? A. Administer oral antibiotics. B. Cleanse area using Burrow solution. C. Prepare for cryotherapy. D. Apply a topical antifungal medication.

A

A nurse is caring for an adolescent who has acne and a prescription for isotretinoin from the dermatologist. Which of the following laboratory findings should the nurse plan to monitor? A. Cholesterol and triglycerides B. BUN and creatinine C. Serum potassium D. Serum sodium

A

A nurse is providing teaching about the management of epistaxis to a child and his family. Which of thefollowing positions should the nurse instruct the child to take when experiencing a nosebleed? A. Sit up and lean forward. B. Sit up and tilt the head up. C. Lie in a supine position. D. Lie in a prone position.

A

A nurse is teaching the parent of an infant who has seborrheic dermatitis of the scalp. Which of the following instructions should the nurse include in the teaching? A. "You can use petrolatum to help soften and remove patches from your infant's scalp" B. "When patches are present, you should keep your infant away from others" C. "You should avoid washing your infant's hair while patches are present on the scalp" D. "When patches are present, it indicates that your infant has a systemic infection"

A

A nurse is planning care for a child who has tinea capitis. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Treat infected house pets. B. Use selenium sulfide shampoo. C. Cleanse area with Burrow solution. D. Administer antiviral medication. E. Use moist, warm compresses.

A,B

A nurse is assessing an infant who has eczema. Which of the following findings should the nurse expect? (Select all that apply) A. Generalized distribution of lesions B. Papules C. Ecchymosis in flexural areas D. Crusting lesions E. Keratosis pilaris

A,B,D

A nurse is providing teaching about epistaxis to the parent of a school-age child. Which of the followingshould the nurse include as an appropriate action to take when managing an episode of epistaxis?(Select all that apply.) A. Press the nares together at least 10 min. B. Breathe through the nose until bleeding stops. C. Pack cotton or tissue into the naris that is bleeding. D. Apply a warm cloth across the bridge of the nose. E. Insert petroleum into the naris after the bleeding stops.

A,C,E

A nurse is caring for a child who has contact dermatitis due to poison ivy. Which of the following actions should the nurse take? (Select all that apply) A. Remove the clothing over the rash B. Initiate contact isolation precautions while the rash is present C. Expose the rash to a heat lamp for 15 minutes D. Cleanse the affected skin with hydrogen peroxide solution E. Apply calamine lotion to the skin

A,E

What information about pediatric respiratory anatomy and physiology is important for nursing care? A. newborns are obligatory nose breathers. B. Sinuses are not developed until around age 10. C. Neonates are able to breathe from the diaphragm. D. Babies and children are not prone to aspiration

A. Newborns are obligatory nose breathers

A nurse is teaching an adolescent to self-administer a corticosteroid medication using a metered-dose inhaler (MDI). Which of the following instructions should the nurse include? (Select all that apply.) A. Shake the device prior to use. B. Rinse and expectorate after administration. C. Inhale slowly with medication administration. D. Exhale quickly after medication administration. E. Wait30secondsbetweenpuffs.

A. A DPI is a powder medication and should not be shaken prior to administration. B. CORRECT: Corticosteroids can cause an oral fungal infection. The client should rinse and expectorate following medication administration. C. CORRECT: The client should breathe in slowly (about 3 to 5 seconds) to administer the medication into the lungs. D. After inhalation of the medication, the client should hold his breath for 5 to 10 seconds. E. The client should wait 1 min between puffs.

A nurse is teaching a group of parents about influenza. Which of the following information should the nurse include in the teaching? A. "Amantadine will prevent the illness." B. "Rimantadine is administered intramuscularly." C."Zanamivir can be given to children 1 year and older." D."Oseltamivir should be given within 48 hours of onset of symptoms."

A. Amantadine can shorten the length of the illness. B. Rimantadine is administered orally two times per day for 7 days. C. Zanamivir is approved for children over the age of 5 years. D. CORRECT: Oseltamivir decrease flu manifestations in clients who have findings for less than 48 hr.

A nurse is caring for a 2-year-old child who has had three ear infections in the past 5 months. Which of the following long-term complications is the child at risk for developing? A. Balance difficulties B. Prolonged hearing loss C. Speech delays D. Mastoiditis

A. Balance difficulties can be present with otitis media. However, it is not a long-term complication. B. Prolonged hearing loss can be present with otitis media. However, it is not a long-term complication. C. CORRECT: Speech delay is a common complication of otitis media. D. Mastoiditis can be a result of otitis media. However, it is not a long-term complication.

A nurse is caring for a child in the postoperative period following a tonsillectomy. Which of the actions should the nurse take? A. Encourage the child to blow her nose gently. B. Administer analgesics on a schedule. C. Offer orange juice. D. Position the child supine.

A. Blowing the nose causes pressure and could increase the risk of bleeding. B. CORRECT: Analgesics should be administered on a scheduled basis to provide pain relief. C. Citrus juices such as orange juice can cause discomfort and should be avoided postoperatively. D. The client should be positioned on the abdomen or side-lying following a tonsillectomy.

A nurse in an outpatient facility is caring for an infant who has manifestations of acute otitis media (AOM). Which of the following factors places the infant at risk for otitis media? (Select all that apply.) A. Breastfeeding without formula supplementation. B. Attends day care 4 days per week. C. Immunizations are up to date. D. History of a cleft palate repair. E. Parents smoke cigarettes outside.

A. Breastfeeding helps to protect against AOM because breast milk contains secretory immunoglobulin A. B. CORRECT: Infants who attend day care have an increased risk of OM because of the exposure to multiple people. C. The pneumococcal conjugate vaccine decreases the incidence of OM. D. CORRECT: Infants born with cleft palate are more prone to AOM because micro-organisms can easily enter the Eustachian tubes. E. CORRECT: Exposure to secondhand smoke increases an infant's risk for AOM.

A nurse is discussing risk factors for asthma with a group of newly licensed nurses. Which of the following conditions should the nurse include in the teaching? (Select all that apply.)

A. CORRECT: A familial history of asthma is a risk factor for the development asthma. B. CORRECT: A familial history of allergies is a risk factor for the development of asthma. C. CORRECT: Exposure to smoke is a risk factor for the development of asthma. D. CORRECT: Low birth weight is a risk factor for the development of asthma. E. Being overweight is a risk factor for the

A nurse is reviewing the diagnostic findings for a preschool age child who is suspected of having cystic fibrosis. Which of the following findings should the nurse identify as an indication of cystic fibrosis? A. Sweat chloride content 85 mEq/L B. Increased serum levels of fat-soluble vitamins C. 72 hr stool analysis sample indicating hard, packed stools D. Chest x-ray negative for atelectasis

A. CORRECT: Children who have cystic fibrosis excrete an excessive amount of sodium and chloride in their sweat. A sweat chloride content of 85 mEq/L is above the expected reference range and is an indication of cystic fibrosis. B. Children who have cystic fibrosis are expected to have decreased serum levels of fat-soluble vitamins. C. Children who have cystic fibrosis are expected to have large, bulky, frothy, greasy, foul-smelling stools (steatorrhea). D. Children who have cystic fibrosis are expected to have obstructive emphysema and atelectasis on chest x-ray.

A nurse is admitting a child who has cystic fibrosis. Which of the following medications should the nurse anticipate including in the plan of care? (Select all that apply.) A. Tobramycin B. Loperamide C. Fat-soluble vitamins D. Albuterol E. Dornase alfa

A. CORRECT: Children who have cystic fibrosis have pulmonary infections. Administering antibiotics is an expected part of the plan of care. B. Children who have cystic fibrosis have constipation and are expected to have a laxative or stool softener as part of the plan of care. Loperamide is an antidiarrheal medication. C. CORRECT: Children who have cystic fibrosis have difficulty absorbing fat. Supplementation of the fat-soluble vitamins is an expected part of the plan of care. D. CORRECT: Children who have cystic fibrosis have mucus plugs. Administering a bronchodilator is an expected part of the plan of care. E. CORRECT: Children who have cystic fibrosis have mucus plugs. Administering dornase alfa, which decreases the viscosity of the mucus, is an expected part of the plan of care.

A nurse is assessing a child who has epiglottitis. Which of the following findings should the nurse expect? (Select all that apply.) A. Hoarseness and difficulty speaking B. Difficulty swallowing C. Low-grade fever D. Drooling E. Dry, barking cough F. Stridor

A. CORRECT: Hoarseness and difficulty speaking is a manifestation of epiglottitis. B. CORRECT: Difficulty swallowing is a manifestation of epiglottitis. C. A high fever is a manifestation of epiglottitis. D. CORRECT: Drooling is a manifestation of epiglottitis. E. Dry, barking cough is a manifestation of croup. F. CORRECT: Stridor is a manifestation of epiglottitis.

A nurse is teaching a child who has asthma how to use a peak flow meter. Which of the following information should the nurse include in the teaching? (Select all that apply.)

A. CORRECT: The nurse should instruct the child to zero the monitor before each use to achieve accurate results. B. The nurse should instruct the child to record the highest number reading. C. CORRECT: The child should perform three attempts to achieve accurate results. D. The nurse should instruct the child to breathe hard and fast when using the peak flow meter to measure airflow. E. The nurse should instruct the child to stand upright when using a peak flow meter.

A nurse is performing an admission assessment for a child who has cystic fibrosis. Which of the following findings should the nurse expect? (Select all that apply.) A. Wheezing B. Clubbing of fingers and toes C. Barrel-shaped chest D. Thin, watery mucus E. Rapid growth spurts

A. CORRECT: Wheezing is an expected finding of cystic fibrosis. B. CORRECT: Clubbing is an expected finding of cystic fibrosis. C. CORRECT: A barrel-shaped chest is an expected finding of cystic fibrosis. D. Thick, viscous mucus is an expected finding of cystic fibrosis. E. Delayed growth is an expected finding of cystic fibrosis.

A nurse is providing discharge teaching for a child who has cystic fibrosis. Which of the following instructions should the nurse include? A. Provide a low-calorie, low-protein diet. B. Administer pancreatic enzymes with meals and snacks. C. Implement a fluid restriction during times of infection. D. Restrict physical activity.

A. Children who have cystic fibrosis should eat a high-calorie, high-protein diet to allow for proper growth. B. CORRECT: Children who have cystic fibrosis have pancreatic insufficiency. The nurse should provide instruction about administering pancreatic enzymes within 30 min of a meal or snack. C. Children who have cystic fibrosis should increase fluids to assist in thinning thick mucus. D. Children who have cystic fibrosis should engage in daily aerobic activity to assist with lung expansion and to stimulate mucus expectoration.

A nurse is caring for a child who has bronchiolitis. Which of the following actions should the nurse take? (Select all that apply.) A. Administer oral prednisone. B. Initiate chest percussion and postural drainage. C. Administer humidified oxygen. D. Suction the nasopharynx as needed. E. Administer oral penicillin.

A. Corticosteroids are not indicated for a client who has bronchiolitis. B. Chest percussion and postural drainage are not indicated for a client who has bronchiolitis. C. CORRECT: Humidified oxygen provides moisture to the airway and is an appropriate action for the nurse to take. D. CORRECT: Suctioning the nasopharynx will assist the client to clear secretions and is an appropriate action for the nurse to take. E. Antibiotics are not indicated for a client who has bronchiolitis.

A nurse is caring for a child who is in the postoperative period following a tonsillectomy. Which of the following is a clinical finding of postoperative bleeding? A. Hgb 11.6 and Hct 37% B. Inflamed and reddened throat C. Frequent swallowing and clearing of the throat D. Blood-tinged mucus

A. Hgb 11.6 and Hct 37% are within the expected reference range. B. Inflamed and reddened throat is an expected finding following a tonsillectomy. C. CORRECT: Frequent swallowing and clearing of the throat indicates that there is an increased amount of fluid in the back of the throat, which is a clinical finding in the client who is experiencing postoperative bleeding. D. Blood-tinged mucus is an expected finding following a tonsillectomy.

A nurse is caring for a child who is receiving oxygen. Which of the following findings indicates oxygen toxicity? A. Increased blood pressure B. Hyperventilation C. Decreased PaCO2 D. Unconsciousness

A. Increased blood pressure is not a manifestation of oxygen toxicity. B. Hypoventilation is a manifestation of oxygen toxicity. C. An increased PaCO2 is a manifestation of oxygen toxicity. D. CORRECT: Children who exhibit oxygen toxicity progress into an unconscious state rapidly.

A nurse caring for a child who is receiving oxygen therapy and is on a continuous oxygen saturation monitor that is reading 89%. Which of the following actions should the nurse take first? A. Increase the oxygen flow rate. B. Encourage the child to take deep breaths. C. Ensure proper placement of the sensor probe. D. Place the child in the Fowler's position.

A. Increasing the oxygen flow rate for a child who has an oxygen saturation of 89% is important, but there is another action the nurse should take first. B. Encouraging the child to take deep breaths to increase oxygenation is important, but there is another action the nurse should take first. C. CORRECT: The first action the nurse should take using the nursing process approach is to assess. Ensuring the sensor probe is properly placed is the nurse's priority action. D. Placing the child in Fowler's position to increase oxygenation is important, but there is another action the nurse should take first.

A nurse is assessing an infant. Which of the following findings are clinical manifestations of acute otitis media? (Select all that apply.) A. Decreased pain in the supine position B. Rolling head side to side C. Loss of appetite D. Increased sensitivity to sound E. Crying

A. Infants who have acute otitis media will have an increase in pain in the supine position from the fluid and pressure in the ear. B. CORRECT: Infants who have acute otitis media will roll their head side to side because of the pain and pressure in the ear. C. CORRECT: Infants who have acute otitis media will exhibit a loss of appetite due to the pain and pressure in the ear. D. Infants who have acute otitis media have a decreased sensitivity to sound from the fluid and pressure in the ear. E. CORRECT: Infants who have acute otitis media will exhibit crying and irritability from the pain.

A nurse is caring for a child who is receiving a bronchodilator medication by nebulized aerosol therapy. Which of the following actions should the nurse take? (Select all that apply.) A. Instruct the child that the treatment will last 30 min. B. Obtain vital signs prior to the procedure. C. Tell the child to take slow deep breaths. D. Determine if the child should use a mask. E. Attach the device to an air source.

A. Nebulized medications take approximately 10 to 15 min to deliver. B. CORRECT: Baseline vital signs should be obtain prior to a nebulized medication for purposes of comparison with how the client tolerates the medication. C. CORRECT: The client should take slow, deep breaths to inhale the medication deeply into the respiratory tract. D. CORRECT: Nebulized medications can be delivered by mask, mouthpiece, or blow-by. The nurse should determine the best method of delivery. E. CORRECT: Nebulized medications need to have an air source to break the medication into small particles for inhalation.

A nurse in the emergency department is assessing a newly-admitted infant. Which of the following findings is an early indication of hypoxemia? A. Nonproductive cough B. Hypoventilation C. Cyanosis D. Nasal stuffiness

A. Nonproductive cough is a manifestation of a respiratory infection. B. Hypoventilation is a manifestation of oxygen toxicity. C. CORRECT: Cyanosis is an early indication of hypoxemia in an infant. D. Nasal stuffiness is a manifestation of a respiratory infection.

A nurse is caring for a toddler who has acute otitis media. Which of the following is the priority action for the nurse to take? A. Provide emotional support to the family. B. Educate the family on care of the child. C. Prevent clinical complications. D. Administer analgesics.

A. Providing emotional support to the family for psychological well-being is an important action for the nurse to take. However, it is not the priority action. B. Educating the family on the care of the child to promote recovery from illness is an important action for the nurse to take. However, it is not the priority action. C. Preventing clinical complications by administering antibiotics and monitoring the child's status is an important action for the nurse to take. However, it is not the priority action. D. CORRECT: The priority action the nurse should take when using Maslow's hierarchy of needs is to meet the toddler's physiological need first. Administering analgesics to alleviate or decrease physical pain is the priority action for the nurse to take.

A nurse is caring for a toddler who has rhinitis, cough, and diarrhea for 2 days. Upon assessment, it is noted that the tympanic membrane has an orange discoloration and decreased movement. Which of the following statements should the nurse to make? A. "Your child has an ear infection that requires antibiotics." B. "Your child could experience transient hearing loss." C."Your child will need to be on a decongestant until this clears." D."Your child will need to have a myringotomy."

A. Rhinitis, cough, diarrhea, and an orange discoloration of the tympanic membrane are findings of otitis media with effusion (OME). Therefore, antibiotics are not recommended. B. CORRECT: Rhinitis, cough, diarrhea, and an orange discoloration of the tympanic membrane are findings of OME. Transient hearing loss is a complication of OME. C. Rhinitis, cough, diarrhea, and an orange discoloration of the tympanic membrane are findings of OME. Therefore, decongestants are not recommended. D. Myringotomy is recommended for clients who have chronic OME.

A nurse is assessing a child who has asthma. Which of the following are indications of deterioration in the child's respiratory status? (Select all that apply.) A. Oxygen saturation 95% B. Wheezing C. Retraction of sternal muscles D. Warm extremities E. Nasal flaring

A. The nurse should expect a child experiencing respiratory difficulty to have an oxygen saturation below the expected reference range. B. CORRECT: Bronchoconstriction causes wheezing, which is an indicator of deterioration in a child's respiratory status. C. CORRECT: Increased work of breathing causes retraction of the sternal muscles, which is an indicator of deterioration in a child's respiratory status. D. The nurse should expect a child experiencing respiratory difficulty to exhibit restlessness and irritability. E. CORRECT: Increased work of breathing causes nasal flaring, which is an indicator of deterioration in a child's respiratory status.

A nurse is teaching an adolescent about the appropriate use of his asthma medications. Which of the following medications should the nurse instruct the client to use as needed before exercise? A. Fluticasone/salmeterol B. Montelukast C. Prednisone D. Albuterol

A. The nurse should instruct the adolescent that fluticasone/ salmeterol is a combination of LABA and corticosteroid medications, and to use it for maintenance control of asthma. B. The nurse should instruct the adolescent that montelukast is affects the immune response to prevent medication, and to use it for maintenance control of asthma. C. The nurse should instruct the adolescent that prednisone is an anti- inflammatory medication used short-term for exacerbations of asthma. D. CORRECT: Albuterol is a beta2-agonist used for bronchodilation. The nurse should instruct the adolescent the medicine is quick-acting, should be administered prior to exercise, and is used to provide immediate relief of bronchoconstriction.

A nurse is planning care for a child who has asthma. Which of the following interventions should the nurse include in the plan of care? (Select all that apply.) A. Perform chest percussion. B. Place the child in an upright position. C. Monitor oxygen saturation. D. Administer bronchodilators. E. Administer dornase alfa daily.

A. The nurse should use chest percussion to promote movement of mucus plugs for a child who has cystic fibrosis. B. CORRECT: Children who are experiencing an asthma exacerbation have decreased oxygenation. The nurse should place the child an upright position to promote ventilation. C. CORRECT: Children who are experiencing an asthma exacerbation have decreased oxygenation. The nurse should monitoring oxygen saturation to detect changes in the child's condition. D. CORRECT: Children who are experiencing an asthma exacerbation experience bronchoconstriction. The nurse should administer bronchodilators to promote ventilation. E. The nurse should administer dornase alfa to a child who has cystic fibrosis to help with removal of respiratory secretions.

As part of the health teaching session given to families, the pediatric nurse states that virtually all childhood brain tumors are _______ tumors, meaning that they originate in the brain.

Primary

A nurse is caring for an infant whose screening test reveals that he may have sickle cell disease. Whichof the following tests should be performed to distinguish if the infant has the trait or the disease? A. Sickle solubility test (Sickledex) B. Hemoglobin electrophoresis C. Complete blood count D. Transcranial Doppler

B

A nurse is preparing to administer iron dextran (Proferdex) IM to a school-age child who has irondeficiency anemia. Which of the following actions by the nurse is appropriate? A. Administer the dose in the deltoid muscle. B. Use the Z-track method when administering the dose. C. Avoid injecting more than 2 mL with each dose. D. Massage the injection site for 1 min after administering the dose.

B

The pediatric nurse is aware that the child with cystic fibrosis has discharge planning needs. Which is important to communicate to the family during discharge teaching A. Importance of a well-balanced, low protein, high calorie diet B. When and how to administer pancreatic enzymes C. Use of vitamins supplements is not needed with pancreatic enzymes D. Nature and course of the disease including self-limiting nature

B

A nurse is assessing an infant who has scabies. Which of thefollowing findings should the nurse expect? (Select all that apply.) A. Presence of nits on the hair shaft B. Pencil‑like marks on hands C. Blisters on the soles of the feet D. Small, red bumps on the scalpE. Pimples on the trunk

B, C, E

A nurse is teaching a group of parents about preventing insect bites. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Wear perfumes when outside. B. Avoid areas of tall grass. C. Wear bright‑colored clothing. D. Wear insect repellent. E. Check house pets frequently.

B,D,E

A nurse is planning care for an infant who has diaper dermatitis. Which of the following actions should the nurse include in the plan of care? (Select all that apply) A. Apply talcum powder with every diaper change B. Allow the buttocks to air dry C. Use commercial baby wipes to cleanse the area D. Use cloth diapers until the rash is gone E. Apply zinc oxide ointment to the affected area

B,E

And emergency department physician is preparing to directly visualize the larynx of a child suspected of having epiglottitis. What action by the nurse is most important? A. Allow the child to assume a position of comfort. B. Have an intubation tray at the bedside. C. Put on a face mask in addition to gloves. D. Have the parents sign an informed consent.

B. Have an intubation tray at the bedside

The nurse is caring for a 16-year-old admitted with suspected bacterial pneumonia. Which action by the nurse takes priority? A. administer antibiotics as ordered. B. Obtain a sputum sample for culture. C. Start an IV for maintenance fluids. D. Give acetaminophen (Tylenol) for fever.

B. Obtain a sputum sample for culture.

The pediatric nurse is aware that the child with cystic fibrosis has discharge planning needs. Which is important to communicate to the family during discharge teaching? A. Importance of well-balanced low protein high calorie diet B. When and how to administer pancreatic enzymes c. Use of vitamin supplements is not needed with pancreatic enzymes D. Nature and course of the disease including self limiting nature

B. When and how to administer pancreatic enzymes

A 2-year-old child is discharged from the outpatient surgical unit after having a tonsillectomy. What statement by the parents indicates to the nurse that discharge teaching as been effective A. "I will administer cherry flavored acetaminophen for pain." B. "It is important to have my child gargle to prevent an infection." C. "I will bring my child to the emergency department if I see excess swallowing." D. "I will offer my child ice cream to help soothe the pain in the throat."

C

A nurse is teaching a parents of a child who has pediculosis capitis. Which of the following should the nurse include in the teaching? a. Apply Mayo to the affected area at night b. Treat all household pets c. Use an over-the-counter medication containing 1% permethrin d. Discard the child's stuffed animals

C

A child has otitis externa with a swollen ear canal. What intervention does the nurse teach the parents for instilling ear drops? A. Use a warm moist pack prior to the eardrops. B. Have the child lay flat for 20 minutes afterwards. C. Drip the medication onto the cotton ear wick. D. Chill the ear drops before administering them.

C. Drop the medication onto the cotton ear wick

A two-year-old child is discharged from the outpatient surgical unit after having a tonsillectomy. What statement by the parent indicates to the nurse that the discharge teaching has been effective? A. "I will administer cherry flavored acetaminophen for pain." B. "It is important to have my child gargle to prevent an infection." C. "I will bring my child to the emergency department if I see excess swallowing." D. "I will offer my child ice cream to help soothe the pain in the throat."

C. I will bring my child to the emergency department if I see excess swallowing

The pediatric nurse recognizes that _______ are the primary causes of illness-related deaths in children.

Cancers

The pediatric nurse explains to a child and family that the dosages of the chemotherapy drugs will need to be increased when they reach the _____________ phase of treatment.

Consolidation

The clinic nurse knows that epiglottitis, supraglottitis, laryngitis, tracheitis, laryngotracheitis, and laryngotracheobronchitis encompass the _______ syndrome.

Croup

A nurse is providing teaching to the parent of a child who has a new prescription for liquid oral ironsupplements. Which of the following statements by the parent indicates an understanding of the teaching? A. "I should take my child to the emergency department if his stools become dark." B. "My child should avoid eating citrus fruits while taking the supplements." C. "I should give the iron with milk to help prevent an upset stomach." D. "My child should take the supplement through a straw."

D

The nurse is providing care to an infant being discharged after surgical correction of a choanal atresia. Which topic is appropriate for the nurse to include in the discharge teaching for this infant? A. gastrostomy feedings B. Direct observation therapy C. nebulizer treatments D. appropriate technique for cleaning nostrils

D. Appropriate technique for cleaning nostrils

A child is brought to the emergency department, and the parents report frequent episodes of harsh coughing that causes the child's face to turn red. The parents also report the child's eyes are red, and she frequently coughs so hard she vomits. What question by the nurse is most important? A. Is anyone else in the family sick? B. Is she allergic to anything known? C. Has she had a high fever lately? D. Are her immunizations up-to-date?

D. Are her immunizations up-to-date?

The nurse reads on a child's chart that she is having a 10 panel centesis. For what medical condition is this warranted? A. Conductive hearing loss B. Otitus externa C. Infected Eustachian tubes D. Otitis media

D. Otitis media

In talking to parents about their child's cancer and chances for survival, the pediatric nurse states that the survival rates are ______ in children than in adults.

Higher

17. The pediatric nurse confirming a diagnosis of ___________ in a patient knows that this condition is defined as an absolute neutrophil count of less than 1,000/ul for infants more than 1 year of age and 1,500/ul for those older than 1 year of age.

Neutropenia

The pediatric nurse is aware that _______ _______ is performed by an allergist to determine the presence of specific allergens.

Patch Testing

The nurse educator explains to the nursing students that __________ is a lower respiratory tract infection of the pulmonary parenchyma.

Pneumonia

Patient education to avoid the spread of skin infections

Proper hygiene Avoid sharing items Avoid touching affected areas Do NOT squeeze vesicles PO and topical medications

The pediatric nurse examines a child diagnosed with ______________. The nurse knows that this disease is usually diagnosed by an examination under anesthesia using an ophthalmoscope.

Retinoblastoma

Following an assessment, the pediatric nurse correctly documents ______ to describe the patient's skin condition, which manifests as slightly oily keratinized irregularly shaped cells.

Scales

The pediatric nurse transfusing a patient knows that, in general, most ___________ _________ occur during the initiation of a transfusion, although a reaction can occur at any time during this process.

Transfusion reactions

The pediatric nurse explains to the student nurse that a(n) __________ __________ __________ reaction is the most severe type of transfusion reaction, which occurs when the donor red blood cells (RBCs) and the recipient plasma are incompatible, and there is an ABO mismatch.

acute hemolytic transfusion

The student nurse studying respiratory diseases knows that the transmission of tuberculosis is from person to person through __________ ___________ ____________.

airborne droplet nuclei

The pediatric nurse teaches about the process of cancer cell growth and describes _________ as a loss of the normal pattern of cell growth.

anaplasia

The nurse is teaching a home care to parents of a child with chronic sinus infections. What information it does the nurse provide? A. Have the child blow his nose vigorously before using decongestant spray. B. Steroids are usually required and children who have sinus infections. C. Ice packs over inflamed sinuses will help with comfort and swelling D. Using decongestant spray for more than three days can cause rebound swelling.

d. Using a decongestant spray is for more than three days can cause rebound swelling.

How is scabies contracted

direct contact with an infected person - usually at long term care facilities, nursing facilities and day care settings

How is pediculosis capitis contracted

direct contact with an infected person, bedding, and objects- usually at day care, school, overcrowded conditions, sharing items