Ch 29, 31, 32, 33, & 34 Questions

The mother of a 9-year-old child with Down syndrome discusses the childs language abilities. The nurse is not surprised to learn which information about the childs language development? A. Can take turns during conversation B. Has good grammar C. Can speak a foreign language D. Has difficulty in carrying on a conversation

A. Can take turns during conversation

A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy? A. Cognitive therapy B. Behavioral therapy C. Milieu therapy D. Individual therapy

A. Cognitive therapy

An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a limited ability to anticipate danger is: A. Impaired social interaction. B. Deficient knowledge. C. Risk for injury. D. Ineffective coping.

C. Risk for injury.

When teaching about Turner's syndrome, what should the nurse include? A. Timing and use of growth hormone B. Use of hormone therapy to prevent infertility C. Long-term effects of decreased intellectual ability D. Treatment for gynecomastia

A. Timing and use of growth hormone

A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which action would be most appropriate? A. Ventilating the child with a bag-valve-mask B. Estimating the child's weight using a Broselow tape C. Providing therapy using automated external defibrillation D. Using rescue breathing and chest compressions

A. Ventilating the child with a bag-valve-mask

A pediatric client is hospitalized with a severe case of impetigo contagiosa. Which antibiotic does the nurse anticipate the healthcare provider will order for this client? A. Dicloxacillin (Pathocil) B. Rifampin (Rifadin) C. Sulfamethoxazole and trimethoprim (Bactrim) D. Metronidazole (Flagyl)

A. Dicloxacillin (Pathocil)

A 17-year-old girl has been diagnosed with bulimia nervosa. Which complication should the nurse carefully assess for in this client? A. Severe erosion of teeth B. Hypertension C. Diabetes mellitus D. Atherosclerosis

A. Severe erosion of teeth

The emergency department nurse notices that the mother of a young child is making a lot of phone calls and getting advice from her friends about what she should do. This behavior is an indication of which of the following? A. Stress B. Healthy coping skills C. Attention-getting behaviors D. Low self-esteem

A. Stress

A 6-year-old child has been diagnosed with growth hormone deficiency. The child's mother requests more information about this condition. Which statements should be included in the nurse's response? Select all that apply. A. "The majority of children who have this condition are born of normal weight and length." B. "There are several potential causes of this condition." C. "This condition is most likely related to dwarfism in past generations of your family." D. "Most children with this condition are nutritionally deprived." E. "Your child most likely does not eat adequate amounts of protein."

A, B ("The majority of children who have this condition are born of normal weight and length." & "There are several potential causes of this condition.") Growth hormone deficiency can result from a variety of causes. These causes may include genetic mutations, tumors, infection and birth trauma. Some cases have not identifiable causes. Most children diagnosed with this condition are of normal length and weight at birth but in childhood fall behind in growth. A small proportion of children may have nutritional concerns.

A nurse is teaching the parents of a child diagnosed with attention deficit/hyperactivity disorder about the condition. The nurse determines that the teaching was successful when the parents make which statements? Select all that apply. A. "We need to set clear limits for our child's behavior." B. "A reward system would be useful to give our child positive feedback." C. "We need to limit the number of choices our child has." D. "We need to give our child all directions at once in case the child gets distracted." E. "If the child acts out, we can explain that this is being bad."

A, B, C ("We need to set clear limits for our child's behavior"; "A reward system would be useful to give our child positive feedback;" & "We need to limit the number of choices our child has.")

A young child is brought to the emergency department and requires advanced life support. The nurse is preparing to administer medication to maintain the child blood pressure and systemic perfusion. Which of the following might the nurse administer? A. Epinephrine B. Dopamine C. Dobutamine D. Atropine E. Glucose

A, B, C (Epinephrine, dopamine, & dobutamine)

A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, what would the nurse include as being involved? Select all that apply. A. Impulsivity B. Inattention C. Distractibility D. Hyperactivity E. Defiance F. Anxiety

A, B, C, D (Impulsivity, inattention, distractibility, & hyperactivity)

The nurse is caring for a pediatric client diagnosed with eczema. Which topical medication order does the nurse anticipate for this client? A. Corticosteroids B. Retinoids C. Antifungals D. Antibacterials

A. Corticosteroids

The parents of a client recently diagnosed with Down syndrome relate to the nurse that they feel guilty about causing the condition. Which response by the nurse is the most appropriate? A. Down syndrome is a condition caused by an extra chromosome; the cause of it is unknown. B. Down syndrome is a condition that is genetically transmitted from both the father and the mother. C. Down syndrome is a condition that is carried on the X chromosome, so it came from the mother. D. Down syndrome is caused by birth trauma, not genetics.

A. Down syndrome is a condition caused by an extra chromosome; the cause of it is unknown.

1. The nurse is caring for a 1-year-old boy with Down syndrome. Which intervention would the nurse be least likely to include in the child's plan of care? A. Educating parents about how to deal with seizures B. Explaining developmental milestones to parents C. Promoting annual vision and hearing tests D. Describing the importance of a high-fiber diet

A. Educating parents about how to deal with seizures

The nurse is assessing the eyes of a 6-month-old and notices that she has wide-spaced eyes and bilateral epicanthal folds. Which condition associated with these findings should also be assessed for in this child? A. Low-set, malformed ears B. Amblyopia C. Strabismus D. Ptosis

A. Low-set, malformed ears

A 15-year-old boy visits his primary care physician's office with fever, headache, and malaise, along with complaints of pain on chewing and pain in the jawline just in front of the ear lobe. The boy asks his mother to leave the exam room for a minute and then tells the nurse that he is also experiencing testicular pain and swelling. The nurse recognizes that this client most likely has which condition? A. Mumps B. Infectious mononucleosis C. Poliomyelitis D. Herpes zoster

A. Mumps

A group of nursing students are reviewing information about neonatal screenings. The students demonstrate understanding of the information when the students identify which system of most consistently affected by metabolic disorders? A. Nervous system B. Cardiovascular system C. Gastrointestinal system D. Respiratory system

A. Nervous system Although any system can be affected, the nervous system is most consistently affected by metabolic disorders. The physical examination should focus on evaluating neurodevelopmental functions. Abnormalities commonly revealed include impaired states of alertness and arousal, tremors, posturing, clonic jerking, tonic spasms, or seizures.

A nurse is concerned about the safety of a suicidal adolescent client and wants to be prepared for the use of physical restraints, if necessary. Which action by the nurse is the most appropriate in this situation? A. Obtain a healthcare providers order, and follow the institutions policy for use of restraints. B. Apply the restraints, and then obtain a healthcare providers order later. C. Apply the restraints if parental permission is obtained. D. Ask for the childs permission before applying the restraints.

A. Obtain a healthcare providers order, and follow the institutions policy for use of restraints.

The nurse is reviewing the medical record of a child with a mental health disorder and finds that the child is receiving cognitive behavioral therapy. How does the nurse interprets this information? A. Process that requires the individual to view a situation from a different perspective B. Interventions that address family dynamics and family coping C. Individual exploration of the person's conflicts and stressors D. Use of play to explore problems, issues, and conflicts

A. Process that requires the individual to view a situation from a different perspective

A 12-year-old boy arrives at the emergency room experiencing nausea, vomiting, headache, and seizures. He is diagnosed with bacterial meningitis. Other findings include a decrease in urine production, hyponatremia, and water intoxication. Which pituitary gland disorder would be most associated with these symptoms? A. Syndrome of inappropriate antidiuretic hormone B. Diabetes insipidus C. Hyposecretion of somatotropin D. Hypersecretion of somatotropin

A. Syndrome of inappropriate antidiuretic hormone Syndrome of inappropriate antidiuretic hormone (SIADH) is a rare condition in which there is overproduction of antidiuretic hormone by the posterior pituitary gland. This results in a decrease in urine production and water intoxication. As sodium levels fall in proportion to water, the child develops hyponatremia or a lowered sodium plasma level. It can be caused by central nervous system infections such as bacterial meningitis. As the hyponatremia grows more severe, coma or seizures occur from brain edema. Diabetes insipidus is characterized by polyuria, not decreased urine production. Hyposecretion of somatotropin, or growth hormone, results in undergrowth; hypersecretion results in overgrowth.

Parents have learned that their 6-year-old child is autistic. The nurse may help the parents to cope by explaining that the child will: A. have abnormal ways of interacting with other children and adults. B. outgrow the condition by early adulthood. C. have average social skills. D. probably have age-appropriate language skills.

A. have abnormal ways of interacting with other children and adults.

A nurse is describing the underlying cause of trisomy 21 to a group of parents, integrating knowledge that the disorder is due to: A. nondisjunction. B. deletion. C. duplication. D. translocation.

A. nondisjunction. Trisomy 21 is a disorder caused by nondisjunction or error in cell division. It is not due to the loss of a portion of the chromosome (deletion), an extra segment being present (duplication), or transfer of one part of the chromosome to another (translocation).

A nurse is conducting developmental assessments on several children in the day-care setting. Which child(ren) does the nurse identify as having development delays? Select all that apply. A. An 18-month-old toddler who is unable to phrase sentences B. A 5-year-old who is unable to button his shirt C. A 6-year-old who is unable to sit still for a short story D. A 2-year-old who is unable to cut with scissors E. A 2-year-old who cannot recite her phone number

B, C (A 5-year-old who is unable to button his shirt & a 6-year-old who is unable to sit still for a short story)

1. Which of the following treatment guidelines would be contraindicated when counseling the family of an infant with fragile X syndrome? Select all that apply. A. Advise genetic testing for family members. B. Delay speech therapy until the child is 2 years of age. C. Educate the family that their child will probably have normal intelligence. D. Refer the family to an early intervention program.

B, C (Delay speech therapy until the child is 2 years of age & educate the family that their child will probably have normal intelligence)

A nurse is assessing a 5-year-old boy and suspects that the child may have an autism spectrum disorder. Which assessments would help support the nurse's suspicions? Select all that apply. A. Inability to make eye contact B. Hypersensitivity to touch C. Lack of facial expression D. Distinct interest in others around him E. Easily distracted from playing

B, C (Hypersensitivity to touch & lack of facial expression)

The nurse is caring for a child who is critically ill and requiring fluid resuscitation. Which intravenous fluids are appropriate for use? Select all that apply. A. 5% dextrose in water B. Normal saline C. Lactated Ringer's D. 10% dextrose in water E. 5% lactated Ringer's

B, C (Normal saline & Lactated Ringer's)

A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A. 9.0% B. 8.2% C. 7.3% D. 6.9%

B. 8.2% For a child 6 years of age and younger, the target HbA1C level should be less than 8.5% but greater than 7.5%. For children between the ages of 6 to 12 years, the target HbA1C level is less than 8%. For children and adolescents between 13 to 19 years of age, the target HbA1C level would be less than 7.5%.

A nurse is caring for four pediatric clients in the hospital. Which client should the nurse refer for play therapy? A. An adolescent with asthma B. A preschool-age child with a fractured femur C. A school-age child having an appendectomy D. An infant with sepsis

B. A preschool-age child with a fractured femur

A pregnant woman is to undergo testing to evaluate for chromosomal abnormalities. Which test would the nurse expect to be done the earliest? A. Amniocentesis B. Chorionic villi sampling C. Triple screen D. Fetal nuchal translucency

B. Chorionic villi sampling Chorionic villi sampling is performed at 7 to 11 weeks' gestation. Amniocentesis usually is performed after 15 weeks' gestation. A triple screen is usually done between 16 and 19 weeks' gestation. Fetal nuchal translucency must be performed between 11 and 14 weeks.

The nurse is caring for a newborn diagnosed with an inborn error of metabolism with several referrals ordered. What referral would the nurse place as the priority for the infant? A. Spiritual advisor B. Dietitian C. Community support group D. Genetic counseling

B. Dietitian

A 3-year-old child is brought to the emergency department after swallowing batteries taken from a grandparent's hearing aids. The parents believe that two batteries were swallowed. What should the nurse explain to the parents regarding the care that the child will need at this time? A. Activated charcoal so that the child will vomit the batteries B. Preparation for an emergency endoscopy to remove the batteries C. Oxygen to ensure that the child's blood is thoroughly oxygenated D. Emergency intubation to ensure that the child has an adequate airway

B. Preparation for an emergency endoscopy to remove the batteries

A pediatric client sustains a minor burn. When teaching the family the treatment for this burn, the nurse would teach that the clients diet should be high in which substance? A. Fats B. Protein C. Minerals D. Carbohydrates

B. Protein

A preschool child in the emergency department has a respiratory rate of 10 breaths per minute. How should the nurse interpret this finding? A. The child is relaxed. B. Respiratory failure is likely. C. This child is in respiratory distress. D. The childs condition is improving.

B. Respiratory failure is likely.

A school-age client is evaluated for depression. Which assessment tool does the nurse anticipate will be used by the psychologist? A. Denver Developmental Screening tool B. Revised Childrens Manifest Anxiety Scale C. Parent Developmental Questionnaire D. Disruptive Behavior Disorder Scale

B. Revised Childrens Manifest Anxiety Scale

The nurse suspects that a 4-year-old with type 1 diabetes is experiencing hypoglycemia based on what findings? Select all that apply. A. Blurred vision B. Dry, flushed skin C. Diaphoresis D. Slurred speech E. Fruity breath odor F. Tachycardia

C, D, F (Diaphoresis, slurred speech, & tachycardia)

Which of the following women has the greatest risk of having a child with Down syndrome? A. 25-year-old B. 30-year-old C. 42-year-old D. 35-year-old

C. 42-year-old

An infant is brought to the emergency department with acetaminophen poisoning. Which medication should the nurse expect to administer to this child? A. Iron B. Deferoxamine C. Acetylcysteine D. Dexamethasone

C. Acetylcysteine

After teaching a class about inborn errors of metabolism, the instructor determines that additional teaching is needed when the class identifies what as an example of an inborn error of metabolism? A. Galactosemia B. Maple syrup urine disease C. Achondroplasia D. Tay-Sachs disease

C. Achondroplasia Achondroplasia is an autosomal dominant genetic disorder, not an inborn error of metabolism. Galactosemia, maple syrup urine disease, and Tay-Sachs are considered inborn errors of metabolism.

For which child's behavior should the nurse identify as being characteristic of separation anxiety disorder? A. An 8-month-old who cries when left with strangers B. A 7-year-old who withdraws from contact with all strangers C. An 8-year-old who will not stay overnight at a friend's house D. A 10-year-old who reports headaches if there is to be a test in school

C. An 8-year-old who will not stay overnight at a friend's house

During the recovery-management phase of burn treatment, which is the most common complication seen in children? A. Shock B. Metabolic acidosis C. Burn-wound infection D. Asphyxia

C. Burn-wound infection

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which best describes a macule? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discoloured skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

C. Discoloured skin spot not elevated at the surface

An adolescent client diagnosed with panic disorder is prescribed paroxetine (Paxil), a selective serotonin reuptake inhibitor (SSRI). The client tells the nurse she often takes diet pills because she is trying to lose weight. Which response by the nurse is the most appropriate? A. You can continue with the paroxetine (Paxil) and the diet pills. B. It is important to stop both the paroxetine (Paxil) and the diet pills. C. Discontinue using the diet pills while taking the paroxetine (Paxil). D. You should discuss the safety of these two medications pills with a pharmacist.

C. Discontinue using the diet pills while taking the paroxetine (Paxil).

The nurse is completing the physical assessment of a 12-year-old child who has a series of bruises in various stages of healing. When asked about the bruises the child appears frightened and offers inconsistent accounts about how the child got the bruises. The nurse suspects abuse. Which initial action of the nurse is most appropriate? A. Take photographs of the bruises. B. Ask the child to provide a written statement of how he or she got the bruises. C. Document the bruises and any statements made by the child relating to them. D. Interview the child's parents about the origin of the bruises. E. Interview the child's parents about the origin of the bruises.

C. Document the bruises and any statements made by the child relating to them.

A child has been prescribed Stimate (esmopressin) acetate for the treatment of diabetes insipidus. The client and the parents ask the nurse how this drug works. What is the correct response by the nurse? A. Stimate (esmopressin) acetate works on your pancreas to stimulate insulin production B. Stimate (esmopressin) acetate is a synthetic form of insulin used to lower your blood sugar C. Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that will slow down your urine output D. Stimate (esmopressin) acetate works to help your kidneys work more efficiently

C. Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that will slow down your urine output Stimate (esmopressin) acetate is a synthetic antidiuretic hormone that promotes reabsorption of water by action on renal tubules; it is used to control diabetes insipidus by decreasing the amount of urine produced.

10. Which should the nurse keep in mind when planning to communicate with a child who is autistic? 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.

The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. What would the nurse correlate with disorder? A. The parents report that their child had "a cold or flu" recently. B. Blood pressure is decreased when checking vital signs. C. The parents report that their son "can't drink enough water." D. Auscultation reveals Kussmaul breathing.

C. The parents report that their son "can't drink enough water."

A nurse is teaching parents about erythema infectiosum and describing the progression of the disease from earliest to latest. Place the following manifestations in the order in which the nurse would describe them. A. Intense red rash on the face B. Rash on the flexor surfaces of extremities and trunk C. Rash on extremity extensor surfaces D. Fever and headache E. Lace-like lesion appearance

D, A, C, B, E 1. Fever and headache 2. Intense red rash on the face 3. Rash on extremity extensor surfaces 4. Rash on the flexor surfaces of extremities and trunk 5. Lace-like lesion appearance

The father of a child in the emergency department is yelling at the physician and nurses. Which action would be contraindicated in this situation? A. Provide a nondefensive response. B. Encourage the father to talk about his feelings. C. Speak in simple, short sentences. D. Tell the father he must wait in the waiting room.

D. Tell the father he must wait in the waiting room.

The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder? A. The child speaks in complete sentences. B. The child sleeps at least 12 out of every 24 hours. C. The child responds warmly to the father but not to the mother. D. The child constantly stares at a rotating wheel on the crib mobile.

D. The child constantly stares at a rotating wheel on the crib mobile.

The parents of a 1-year-old child with Down syndrome are at a follow-up clinic visit for their child. What information would the nurse review with the parents at this time? Select all that apply. A. Plan to have the child's vision and hearing tested at the age of 18 months B. The child should be consuming added calories now that he is growing more C. Dental visits should be scheduled yearly from this age to adolescence D. Cervical x-rays need to be scheduled for the next visit in 3 months E. Monitor for symptoms of respiratory infections and ear infections F. A thyroid test will be scheduled for this visit to monitor for high or low thyroid concerns

E, F (Monitor for symptoms of respiratory infections and ear infections & a thyroid test will be scheduled for this visit to monitor for high or low thyroid concerns)

A school-age client is prescribed Adderall (amphetamine mixed salts) for attention deficit hyperactivity disorder (ADHD). At which time is it most appropriate for the nurse to teach the parents to administer this medication? A. At bedtime B. Before lunch C. With the evening meal D. Early in the morning

D. Early in the morning

Which would be an appropriate nursing intervention for a 6-month-old infant in the emergency department? A. Distract the infant with noise or bright lights. B. Avoid warming the infant. C. Remove any pacifiers from the baby. D. Encourage the parent to hold the infant.

D. Encourage the parent to hold the infant.

The nurse is preparing the plan of care for a child experiencing respiratory distress. What action would be the top priority? A. Providing supplemental oxygen B. Monitoring for changes in status C. Assisting ventilation D. Maintaining a patent airway

D. Maintaining a patent airway

A 2-month-old client has a candidal diaper rash. Which medication does the nurse anticipate will be prescribed for this client? A. Bacitracin ointment B. Hydrocortisone ointment C. Desitin D. Nystatin given topically and orally

D. Nystatin given topically and orally

A 10-year-old child is newly diagnosed with type 1 diabetes. The child's hemoglobin A1C level is being monitored. The nurse determines that additional intervention is needed with the child based on which result? A. 8.5% B. 6.5% C. 7.5 % D. 7.0%

A. 8.5% The goal for hemoglobin A1C in children between the ages of 6 and 12 years is less than 8%. Therefore, a result of 8.5% would indicate that additional intervention is needed to achieve the recommended goal.

A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority? A. Administering 100% oxygen by mask B. Having the child sit up straight in a chair C. Checking his capillary refill time D. Providing sedation as ordered

A. Administering 100% oxygen by mask

The nurse is caring for a 24-month-old child with a fever of 101°F. The child also exhibits a toxic appearance. Which of the following would the nurse expect to implement? A. Administering antibiotics as ordered B. Performing a complete septic work up C. Obtaining a specimen for a complete blood count D. Replacing fluid deficits orally

A. Administering antibiotics as ordered

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride. What should the nurse instruct the parents regarding an adverse effect of this medication? A. Anorexia B. Sleepiness C. Garbled speech D. Rapid increase in height

A. Anorexia

The nurse is caring for a child admitted to the pediatric medical unit with chickenpox who has infected vesicles. What personal protective equipment should the nurse use when measuring the child's vital signs? A. Gloves B. Gown C. N95 respirator D. Face mask E. Eye wear

A, B, C (Gloves, gown, & N95 respirator)

A child comes to the clinic for evaluation of skin lesions and is diagnosed with impetigo. Which medications are potentially ordered with instructions placed on the discharge summary? Select all that apply. A. Penicillin B. Erythromycin C. Mupirocin D. Tetracycline E. Lindane

A, B, C (Penicillin, erythromycin, & mupirocin)

Diabetes insipidus a disorder of the posterior pituitary resulting in deficient secretion of which hormone? A. Antidiuretic hormone B. Adrenocorticotropic hormone C. Thyroid stimulating hormone D. Luteinizing hormone

A. Antidiuretic hormone Central diabetes insipidus (DI), also called neurogenic, vasopressin-sensitive, or hypothalamic DI, is a disorder of the posterior pituitary that results from deficient secretion of ADH. Nephrogenic DI is a result of the inability of the kidney to respond to ADH.

The nurse is called into a toddler's room. The child's mother says "he's having trouble breathing." What should the nurse do first? A. Assess patency of the child's airway. B. Place the child on 100% oxygen. C. Notify the physician. D. Apply a pulse oximeter to monitor oxygen levels.

A. Assess patency of the child's airway.

A child is exhibiting symptomatic bradycardia that has been unresponsive to ventilation and oxygenation. Which of the following would the nurse expect to be administered? A. Atropine B. Sodium bicarbonate C. Naloxone D. Calcium carbonate

A. Atropine

When describing the negative feedback system that controls endocrine function, the nurse explains that a decreased secretion of which correlates with a decrease in blood glucose levels? A. Insulin B. Glucagon C. Adrenocorticotropic hormone D. Glycogen

A. Insulin Feedback is seen in endocrine systems that regulate concentrations of blood components such as glucose. Glucose from the ingested lactose or sucrose is absorbed in the intestine and the level of glucose in blood rises. Elevation of blood glucose concentration stimulates endocrine cells in the pancreas to release insulin. Insulin has the major effect of facilitating entry of glucose into many cells of the body. As a result, blood glucose levels fall. When the level of blood glucose falls sufficiently, the stimulus for insulin release disappears and insulin is no longer secreted.

11. What is the best intervention when a child with autism is hospitalized? A. Limit the individuals who enter the childs room. B. Perform all of the childs activities of daily living for her. C. Make sure the nurses know this child may be violent. D. Assign the strongest nurse to control the child.

A. Limit the individuals who enter the childs room.

The nurse is doing an in-service training on clinical manifestations seen in communicable diseases. Which skin condition best describes erythema? A. Redness of the skin produced by congestion of the capillaries B. Small, circumscribed, solid elevation of the skin C. Discoloured skin spot not elevated at the surface D. Small elevation of epidermis filled with a viscous fluid

A. Redness of the skin produced by congestion of the capillaries

A 19-year-old client with hypothyroidism asks the nurse if she will need to take thyroid medication if she becomes pregnant. The nurse integrates understanding of which of the following when responding to the client? A. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy B. There is no need to take a thyroid medication because the fetus's thyroid produces thyroid stimulating hormone C. It is more difficult to maintain thyroid regulation during pregnancy due to the slowing of metabolism D. Fetal growth is arrested if the thyroid medications are continued during pregnancy.

A. Regulation of thyroid medication is more difficult because the thyroid gland increases in size during pregnancy During the pregnancy the thyroid gland triples in size which makes it more difficult to regulate thyroid medication. Thyroid function does not slow during pregnancy. The fetus might produce TSH but it does not reach the mother. Fetal growth is not arrested if medication is continued during the pregnancy.

A child with Addison's disease has been admitted with a history of nausea and vomiting for the past 3 days. The client is receiving IV glucocorticoids. Which intervention would the nurse implement? A. Take glucometer readings as ordered B. Measure intake and output C. Monitor sodium and potassium levels D. Weigh daily

A. Take glucometer readings as ordered IV glucocorticoids raise the glucose levels and often require coverage with insulin. Measuring the intake and output at this time is not necessary. Sodium and potassium would be monitored when the client is receiving mineralcorticoids. Daily weights are not necessary at this time.

A 25-year-old client wants to know if her baby boy is at risk for Down syndrome because one of her distant relatives was born with it. Which information would the nurse share with the client while counseling her about Down syndrome? A. Instances of Down syndrome in the family greatly increases the risk for the baby also having Down syndrome. B. Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg. C. Down syndrome occurs only in females, and there is no risk as the baby is male. D. Children with Down syndrome are usually born to older mothers.

B. Children with Down syndrome have extra genetic material in the 21 chromosome that occurs during development of the sperm or egg.

Which action should the nurse working in the emergency department initiate to decrease fear in a 2-year-old child? A. Keep the child physically restrained during nursing care. B. Allow the child to hold a favorite toy or blanket. C. Direct the parents to remain outside the treatment room. D. Let the child decide whether to sit up or lie down for procedures.

B. Allow the child to hold a favorite toy or blanket.

The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? A. Corticosteroids B. Antifungals C. Antibiotics D. Retinoids

B. Antifungals

The nurse is providing care to a child who is intubated and the child's condition is deteriorating. What would the nurse do first? A. Check if the tracheal tube is obstructed B. Assess for displacement of the tracheal tube C. Look for signs of a possible pneumothorax D. Check the equipment for malfunction

B. Assess for displacement of the tracheal tube The PALS mnemonic "DOPE" is useful for troubleshooting when the status of a child who is intubated deteriorates: D = Displacement: the tracheal tube is displaced from the trachea; O = Obstruction: the tracheal tube is obstructed (e.g., with a mucus plug); P = Pneumothorax: usually a pneumothorax results in a sudden change in the child's assessment manifested by decreased breath sounds and decreased chest expansion on the side of the pneumothorax, possible subcutaneous emphysema over the chest (with a tension pneumothorax, there may be a sudden drop in heart rate and blood pressure); E = Equipment failure: relatively simple problems such as a disconnected oxygen supply, leaks in the ventilator circuit, and loss of power can cause the child to deteriorate.

Which nursing action would facilitate care being provided to a child in an emergency situation? A. Encourage the family to remain in the waiting room. B. Assist parents in distracting the child during a procedure. C. Always reassure the child and family. D. Give explanations using professional terminology.

B. Assist parents in distracting the child during a procedure.

The nurse is reviewing the laboratory test results of a child with Addison disease. What would the nurse expect to find? A. Hypernatremia B. Hyperkalemia C. Hyperglycemia D. Hypercalcemia

B. Hyperkalemia With Addison disease, the child would exhibit hyperkalemia, hyponatremia, and hypoglycemia. Hypercalcemia would be associated with hyperparathyroidism.

The nurse explains to the parents of a child with a severe burn that wearing of an elastic pressure garment (Jobst stocking) during the rehabilitative stage can help with the prevention of which complication? A. Poor circulation B. Hypertrophic scarring C. Pain D. Formation of thrombus in the burn area

B. Hypertrophic scarring

A nurse is conducting a screening program for autism in infants and children. What would the nurse identify as a warning sign? A. Lack of babbling by 6 months B. Inability to say a single word by 16 months C. Lack of gestures by 8 months D. Inability to use two words by 18 months

B. Inability to say a single word by 16 months

The nurse is performing CPR on a child who is a victim of a near-drowning experience. How should the nurse open the child's airway to provide breaths? A. Head tilt-chin lift B. Jaw-thrust maneuver C. Two hands encircling method D. Tongue thrust

B. Jaw-thrust maneuver

A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be the priority? A. Evaluating pupils for equality and reactivity B. Monitoring oxygen saturation levels C. Asking the child if she knows where she is D. Using the appropriate pain assessment scale

B. Monitoring oxygen saturation levels

A child in the clinic has a fever and reports a sore neck. Upon assessment the nurse finds a swollen parotid gland. The nurse suspects which infectious disease? A. Measles B. Mumps C. Whooping cough D. Scabies

B. Mumps

A nurse is caring for a toddler client who is diagnosed with scabies and prescribed a 5 percent permethrin lotion. How will the nurse apply this lotion when administering it to the toddler? A. To the scalp only B. Over the entire body from the chin down, as well as on the scalp and forehead C. Only on the areas with evidence of scabies activity D. Only on the hands

B. Over the entire body from the chin down, as well as on the scalp and forehead

The parents of a child born at 36 weeks of gestation who had respiratory problems requiring 3 days of oxygen therapy are concerned that the infant may have an intellectual impairment. The best nursing statement to the parents is which of the following? A. A diagnosis of intellectual impairment is not made until the child enters school and experiences academic failure. B. Routine assessment of development during pediatric visits is the best method of early detection. C. The baby is not at risk for an intellectual impairment. D. Tests for intellectual impairments are not reliable for children younger than 3 years.

B. Routine assessment of development during pediatric visits is the best method of early detection.

An autistic child is hospitalized with asthma. The nurse should plan care so that the: A. parents expectations are met. B. childs routine habits and preferences are maintained. C. child is supported through the autistic crisis. D. parents need not be at the hospital.

B. childs routine habits and preferences are maintained.

Self-injury, fecal smearing, and severe temper tantrums in a preschool child are symptoms of: A. mild intellectual impairment. B. severe intellectual impairment. C. psychosocial deprivation. D. separation anxiety.

B. severe intellectual impairment.

The nurse is caring for a pediatric client who sustained a severe burn. Determine the order of what would be done for this child when the medical team arrives on the scene: A. Start intravenous fluids. B. Provide for relief of pain. C. Establish an airway. D. Place a Foley catheter.

C, A, B, D 1. Establish an airway 2. Start intravenous fluids 3. Provide for relief of pain 4. Place a Foley catheter

A 2-year-old client and the parents are at the office for a follow-up visit. The client has had excessive hormone levels in the recent blood work, and the parents question why this was not found sooner. Which response by the nurse would be most appropriate? A. "It takes time to determine the level of functioning of endocrine glands." B. "Have there been signs and symptoms that you should have reported to the doctor?" C. "As endocrine functions become more stable throughout childhood, alterations become more apparent." D. "Endocrine disorders are hard to detect and you are lucky that we have found it when we did."

C. "As endocrine functions become more stable throughout childhood, alterations become more apparent." The endocrine glands are all present at birth; however, endocrine functions are immature. As these functions mature and become stabilized during the childhood years, alterations in endocrine function become more apparent. Thus, endocrine disorders may arise at any time during childhood development.

An extremely thin preadolescent is being assessed by the nurse. Which client statement should the nurse identify as being consistent with that of a person with anorexia nervosa? A. "I'd like to grow up to be a model." B. "I'd like to gain weight but just can't." C. "I feel chubby no matter what I wear." D. "I'm afraid that someone is poisoning my food."

C. "I feel chubby no matter what I wear."

A nurse is assessing a child for possible obsessive-compulsive disorder. Which question would be most helpful for obtaining information from the child? A. "Are you having any recurring dreams about the trauma you experienced?" B. "Has anything happened at home recently that has upset you?" C. "Is there anything that you do over and over again and can't resist doing?" D. "Do you have times when you wake up during the night without any reason?"

C. "Is there anything that you do over and over again and can't resist doing?"

8. Which action is contraindicated when a child with Down syndrome is hospitalized? A. Determine the childs vocabulary for specific body functions. B. Assess the childs hearing and visual capabilities. C. Encourage parents to leave the child alone. D. Have meals served at the childs usual meal times.

C. Encourage parents to leave the child alone.

A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address what cause as the most common in pediatric injury? A. Sports B. Firearm use C. Falls D. Automobile accidents

C. Falls

As part of their orientation to their pediatric clinical rotation, an instructor is teaching a group of students how to perform cardiopulmonary resuscitation (CPR) on a child. Two students return demonstrate the skill using an infant manikin. What action indicates the proper technique? A. Compressing 30 times for every 2 breaths B. Placing the heel of the hand on the midsternum C. Giving 2 breaths followed by 15 compressions D. Using two hands to perform chest compressions

C. Giving 2 breaths followed by 15 compressions For two-person CPR on an infant, the rescuers would perform 15 compressions to 2 breaths, with two thumbs encircling the chest at the nipple line. The ratio of 30 compressions to 2 breaths is used for one-person CPR with an infant. The heel of the hand on the sternum at the nipple line is used for a child; two hands would be used for an older child.

The nurse is counseling a couple who suspect that they could bear a child with a genetic abnormality. What would be most important for the nurse to incorporate into the plan of care when working with this family? A. Gathering information from at least three generations B. Informing the family of the need for a wide range of information C. Maintaining the confidentiality of the information D. Presenting the information in a nondirective manner

D. Presenting the information in a nondirective manner

Which nursing action would be most appropriate to assist a preschool-age child in coping with the emergency department experience? A. Explain the procedures and give the child some time to prepare. B. Remind the child that she is a big girl. C. Avoid the use of bandages. D. Use positive terms and avoid terms such as shot and cut.

D. Use positive terms and avoid terms such as shot and cut.

The nurse is planning care for a school-age client, who is diagnosed with bipolar disorder and is having suicidal ideations. Which nursing diagnosis is the priority for this client? A. Powerlessness Related to Mood Instability B. Social Isolation Related to Disorder C. Risk for Injury Related to Suicidal Ideas D. Impaired Social Interaction

C. Risk for Injury Related to Suicidal Ideas

Throughout their life span, cognitively impaired children are less capable of managing environmental challenges and are at risk for which problem? A. Nutritional deficits B. Visual impairments C. Physical injuries D. Psychiatric problems

C. Physical injuries

The infant with Down syndrome is closely monitored during the first year of life for which condition? A. Thyroid complications B. Orthopedic malformations C. Dental malformation D. Cardiac abnormalities

D. Cardiac abnormalities

The nurse is performing a physical examination of a 5-year-old boy. Which documented findings would most strongly indicate maltreatment of the child? Select all that apply. A. Cuts and bruises on the hands B. Burns on the dorsal surface of the hand C. A curved laceration on the back D. Linear lesions across the chest and abdomen E. A bruise on the child's knee F. A scab on the child's elbow

A, B, C, D (Cuts and bruises on the hands, burns on the dorsal surface of the hand, a curved laceration on the back, & linear lesions across the chest and abdomen)

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, B, E (Short palpebral fissures, smooth philtrum, & thin upper lip)

The mother of a an 8-year-old boy with mumps tells the nurse that she does not understand how her son could have gotten mumps since he was immunized according to her physician's recommendations. What is the best response by the nurse? A. "I am sure it must be frustrating. Where did you have the immunizations performed?" B. "I am wondering if your physician followed the immunization schedule correctly?" C. "Are you sure your child received an immunization for mumps?" D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

D. "While immunizations are highly effective they aren't 100% effective at preventing infectious diseases."

A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all that apply. A. Face B. Upper chest C. Neck D. Back E. Shoulders

A, B, D (Face, upper chest, & back)

A child with a profound intellectual disability is admitted to the hospital for an appendectomy. Which IQ does the nurse anticipate to see documented when reviewing this childs medical record? A. Between 50 and 70 B. Below 20 C. Between 35 and 50 D. Between 20 and 35

B. Below 20

The father of a child recently diagnosed with developmental delay is very rude and hostile toward the nurses. This father was cooperative during the childs 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 in the anger stage of the grief process.

D. The father is in the anger stage of the grief process.

The best setting for daytime care for a 5-year-old autistic child whose mother works is: A. private day care. B. public school. C. his own home with a sitter. D. a specialized program that facilitates interaction by use of behavioral methods.

D. a specialized program that facilitates interaction by use of behavioral methods.

Parents usually ask when their child can return to school after having chickenpox. The correct answer would be: A. not until all lesions have completely faded. B. as soon as the temperature is normal. C. 10 days after the initial lesions appear. D. as soon as all lesions are crusted.

D. as soon as all lesions are crusted.

Intense stress and isolation as a result of caring for a child with developmental disabilities often lead parents to: A. heightened parental achievement. B. overuse of the healthcare system. C. overindulgence and obesity. D. child abuse.

D. child abuse.

Parents of a child with fragile X syndrome ask the nurse about genetic transmission of this syndrome. In response, the nurse correctly explains 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.

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. clothing.

B. sexual development.

The nurse is caring for a teenager recently diagnosed with Addison disease. Which findings can be anticipated by the nurse? Select all that apply. A. Sodium level 128 mEq/L B. Potassium level 5.6 mEq/L C. Muscular weakness D. Rapid weight gain E. Facial acne

A, B, C (Sodium level 128 mEq/L, potassium level 5.6 mEq/L, & muscular weakness) Hyponatremia, hyperkalemia and muscle weakness are all symptoms of Addison disease. Rapid weight gain and acne are present in Cushing disorder, not Addison.

During a routine well-child visit, the mother of a preadolescent patient asks the nurse to explain signs of sexual abuse. The mother is concerned because an older male neighbor has been making comments and overtly admiring the child when playing outdoors. What signs of sexual abuse should the nurse tell the mother to look out for? Select all that apply. A. Child reports abdominal pain. B. Child has a change in school performance. C. Child demonstrates anxiety or trouble sleeping. D. Child does not want to be left alone with a certain adult. E. Child spends a great deal of time with peer-group friends.

A, B, C, D (Child reports abdominal pain, has a change in school performance, demonstrates anxiety or trouble sleeping, & does not want to be left alone with a certain adult)

A 9-year-old girl has just been diagnosed with Grave's disease. Which symptom should the nurse expect in this child? Select all that apply. A. Exophthalmos (protruding eyes) B. Moist skin C. Nervousness D. Increased basal metabolic rate E. Obesity F. Lethargy

A, B, C, D (Exophthalmos [protruding eyes], moist skin, nervousness, & increased basal metabolic rate) In Grave's disease, children gradually experience nervousness, tremors, loss of muscle strength, and easy fatigue. Their basal metabolic rate, blood pressure, and pulse all increase. Their skin feels moist and they perspire freely. An exophthalmos-producing pituitary substance causes the prominent-appearing eyes that accompany hyperthyroidism in some children. Obesity and lethargy are symptoms of hypothyroidism, not of Graves disease (hyperthyroidism).

After an assessment, the nurse is concerned that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to develop an appropriate plan care? Select all that apply. A. The parents recently divorced B. The father is unemployed and mother is infrequently home C. The child is learning to play the clarinet in music class in school D. The child is expected to care for younger siblings while mother sleeps E. There is history of multiple injuries obtained from a motor vehicle crash

A, B, D, E (The parents recently divorced, the father is unemployed and mother is infrequently home, the child is expected to care for younger siblings while mother sleeps, & there is history of multiple injuries obtained from a motor vehicle crash)

A nurse is teaching parents of a child with a nursing diagnosis of pain related to pruritus from skin lesions. Which of the following would the nurse include in the instructions? Select all that apply. A. "Keep the child's fingernails short." B. "Wrap your child up snugly with blankets." C. "Bathe the child in lukewarm water and baking soda." D. "Have the child press on the itching area instead of scratching it." E. "Avoid having your child wear cotton clothing."

A, C, D (Keep the child's fingernails short, bathe the child in lukewarm water and baking soda, & have the child press on the itching area instead of scratching it)

The nurse is caring for a child who has been hospitalized for maltreatment. When reviewing the child's records which findings may have placed the child at an increased risk for abuse? Select all that apply. A. The child's mother has a history of substance use disorder. B. Both parents work outside of the home. C. The child was born prematurely. D. The child has cerebral palsy. E. The child's father is the primary care taker.

A, C, D (The child's mother has a history of substance use disorder, was born prematurely, & has cerebral palsy)

The nurse is teaching a group of adolescents about care for acne vulgaris. Which interventions will the nurse include in the teaching session? Select all that apply. A. Wash skin with mild soap and water twice a day. B. Use astringents and vigorous scrubbing. C. Avoid picking or squeezing the lesions. D. Apply tretinoin (Retin-A) liberally. E. Avoid sun exposure if on tetracycline

A, C, E (Wash skin with mild soap and water twice a day, avoid picking or squeezing the lesions, & avoid sun exposure if on tetracycline)

A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify what common causes of respiratory arrest involving the upper airway? Select all that apply. A. Croup B. Asthma C. Pertussis D. Epiglottitis E. Pneumothorax

A, D (Croup & epiglottitis) Common causes of respiratory arrest involving the upper airway include croup and epiglottitis. Asthma, pertussis, and pneumothorax are common causes involving the lower airway.

A 7-year-old child shows symptoms of anaphylactic shock. Which of the following would be most appropriate for the nurse to do immediately? Select all that apply. A. Administer epinephrine as ordered. B. Increase fluid intake. C. Teach the child how to use an EpiPen. D. Administer oxygen. E. Initiate intravenous access.

A, D, E (Administer epinephrine as ordered, administer oxygen, & initiate intravenous access)

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, D, E (Observation of parent-child interactions, administration of daily multivitamin supplements, & role-modeling appropriate adult-child interactions)

The parents of a 5-year-old have just found out that their child has head lice. Which statement by the parents would support the nursing diagnosis of deficient knowledge? A. "I can't believe it. We're not unclean, poor people." B. "We'll have to get that special shampoo." C. "Everybody in the house will need to be checked." D. "That explains his complaints of itching on his neck."

A. "I can't believe it. We're not unclean, poor people."

Which statement by the parent of a 12-month-old child diagnosed with Down syndrome shows the need for further education? A. "I will need to delay any further immunizations." B. "Thyroid testing is needed every year." C. "In a couple of years, my child will need an x-ray of the neck." D. "I will watch closely for development of respiratory infection."

A. "I will need to delay any further immunizations."

The nurse is speaking with the parents of a school-aged child recently diagnosed with diabetes mellitus regarding the differences between hypoglycemia and hyperglycemia. Which statement by a parent indicates a need for further teaching? A. "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." B. "When my son's breath smells fruity, it almost always indicates high blood sugar." C. "If my son says he feels shaky, his blood sugar may be low." D. "Dry flushed skin may be a sign if high blood sugar."

A. "If I notice changes in my son like tearfulness or irritability, his blood sugar may be high." Behavior changes such as tearfulness, irritability, confusion and slurred speech are indications of hypoglycemia, not hyperglycemia. Tremors and diaphoresis are also indications of low blood sugar. Dry flushed skin, fatigue, weakness, nausea, vomiting and fruity breath odor are all symptoms of hyperglycemia.

An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond? A. "Tell me what makes you think the medication is not working" B. "Do you want to try a different medication?" C. "Are you sure you are administering it properly" D. "Do you want to increase the dosage?"

A. "Tell me what makes you think the medication is not working"

The nurse is teaching the parents of a child with varicella about the disorder. The nurse determines that the teaching was successful when the parents state which of the following? A. "We will make sure to remind him not to scratch the lesions." B. "We can give him aspirin for fever." C. "We should put him in a warm bath if he is itchy." D. "We can use salt solutions to help heal his oral lesions."

A. "We will make sure to remind him not to scratch the lesions."

The nurse is assessing an 8-week-old infant in the clinic. The parent states the infant was feeding well and gaining weight until a few weeks ago and now is noted to have lost weight and "isn't doing well" per the parent. What action would the nurse take next? A. Assess the infant further for an inborn error of metabolism B. Advise the parent to decrease the feedings daily to every 6 hours C. Suggest the child be fed in a supine position, using a car seat or carrier D. Refer the parents to a dietitian for education on increasing the child's appetite

A. Assess the infant further for an inborn error of metabolism An infant who was otherwise healthy begins to show signs of deterioration, the nurse would further assess for an inborn error of metabolism. A dietary consult would be needed if a diagnosis of inborn error of metabolism was confirmed to educate the family on the appropriate diet, but not specifically for increasing the child's appetite.

A 17-year-old adolescent is found wandering around. The adolescent is confused, sweaty, and pale. Which test would the nurse expect to be performed first? A. Blood glucose level B. CT scan C. Arterial blood gases D. Blood cultures

A. Blood glucose level It is important to draw a blood glucose level on the adolescent because the client is exhibiting signs of hypoglycemia and needs to be treated as soon as possible. Once the adolescent is stabilized, a complete health history will need to be taken to determine the extent of the illness.

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided? A. Encourage rest and relaxation. B. Antibiotic therapy may be initiated. C. Antiviral medications can be prescribed. D. Range of motion to prevent contractures.

A. Encourage rest and relaxation.

After teaching a class of students about genetics and inheritance, the instructor determines that the teaching was successful when the students identify this as the basic unit of heredity. A. Gene B. Chromosome C. Allele D. Autosome

A. Gene A gene is the basic unit of heredity of all traits. A chromosome is a long, continuous strand of DNA that carries genetic information. An allele refers to one of two or more alternative versions of a gene at a given position on a chromosome that imparts the same characteristic of that gene. An autosome is a non-sex chromosome.

A nurse is planning preoperative teaching for a school-age client scheduled to have a tonsillectomy. The client has a history of attention deficit hyperactivity disorder (ADHD). Which intervention will the nurse include in the plan of care? A. Give instructions verbally and use a picture pamphlet, repeating points more than once. B. Ask other children who have had this procedure to talk to the child. C. Allow the child to lead the session to gain a sense of control. D. Play a television show in the background.

A. Give instructions verbally and use a picture pamphlet, repeating points more than once.

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation? A. Head lice are becoming very resistant to treatment. B. Send your child to school even if you suspect head lice, but have the school nurse check the child. C. Discourage the children from going to sleepovers. D. Wash the bed linens in hot water to kill the lice.

A. Head lice are becoming very resistant to treatment.

Which type of diet should be included in the plan of care for a child diagnosed with Addison disease? A. High-protein, low-carbohydrate, high-sodium diet B. High-protein, high-carbohydrate, low-sodium diet C. Low-calorie, low-carbohydrate, low-sodium diet D. Low-calorie, low-cholesterol, low-saturated fat diet

A. High-protein, low-carbohydrate, high-sodium diet In Addison disease, the body produces inadequate hepatic glucagons. A high-protein, low-carbohydrate, and high-sodium diet prevents fatigue, hypoglycemia, and hyponatremia. The child with Cushing syndrome needs low calories, carbohydrates, and sodium. The child with hypothyroidism needs low calories, cholesterol, and saturated fat.

A newborn was screened for hereditary metabolic disorder at 8 hours old. Which action by the nurse is most appropriate? A. Instruct the parent to have another screening in 1 to 2 weeks B. No further intervention is needed C. Repeat screening in 8 hours D. If the infant is premature, screening needs to be done every 8 hours for 48 hours

A. Instruct the parent to have another screening in 1 to 2 weeks

The nurse is educating an 18-year-old female client with Turner syndrome. What information will the nurse include in the teaching plan? A. Resources regarding infertility and family planning B. Requirements for post secondary educational needs C. The need to eliminate amino acids from the diet D. The options for a cure as the client enters adulthood

A. Resources regarding infertility and family planning

A 10-year-old boy has just arrived by ambulance at the emergency room following a motor vehicle accident, and a nurse is assessing him. Which three body systems should the nurse evaluate fist? A. Respiratory, cardiovascular, and neurologic B. Cardiovascular, gastrointestinal, and neurologic C. Respiratory, cardiovascular, and skeletal D. Neurologic, cardiovascular, and endocrine

A. Respiratory, cardiovascular, and neurologic

A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which condition? A. Syndrome of inappropriate antidiuretic hormone (SIADH) B. Thyroid storm C. Cushing syndrome D. Vitamin D toxicity

A. Syndrome of inappropriate antidiuretic hormone (SIADH) SIADH, although rare in children, is a potential complication of excessive administration of vasopressin. Thyroid storm may result from overadministration of levothyroxine (thyroid hormone replacement). Cushing syndrome is associated with corticosteroid use. Vitamin D toxicity may result from the use of vitamin D as treatment of hypoparathyroidism.

A 6-month-old child has developed skin irritation due to an allergic reaction. He has been prescribed a topical skin ointment. The nurse will consider which of the following before administering the drug? A. That the infant's skin has greater permeability than that of an adult B. That there is less body surface area to be concerned about. C. That there is decreased absorption rates of topical drugs in infants. D. That there is a lower concentration of water in an infant's body compared with an adult.

A. That the infant's skin has greater permeability than that of an adult

The nurse is caring for a child who is scheduled for bone scan. It is suspected that the child has a growth hormone deficiency. Which finding would support this medical diagnosis? A. The bone scan would show bone age would be two or more deviations below normal. B. The bone scan would show a brain tumor. C. The bone scan would show bone age would be three or more deviations above normal. D. The bone scan would a tumor on the child's kidney.

A. The bone scan would show bone age would be two or more deviations below normal. Diagnostic testing used in children with suspected GH deficiency include bone age will be two or more deviations below normal. CT or MRI scans would be used to rule out tumors or structural abnormalities, not bone scans.

The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contract or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion? A. The child constantly opens and closes the hands. B. The child is highly active and inattentive. C. The child has a slight decrease in head circumference. D. The child has a long face and prominent jaw.

A. The child constantly opens and closes the hands.

The parent of a child with mumps on one side of the face is concerned that the disease can develop on the other side in the future. How should the nurse respond to the mother about this concern? A. The child is immune to further attacks of the disease. B. It does not matter because mumps in adulthood is not serious. C. The child should receive active immunization against mumps. D. There is nothing that can be done to prevent another attack of mumps in the future.

A. The child is immune to further attacks of the disease.

The nurse is preparing teaching materials for a family whose child is prescribed somatropin for a growth hormone deficiency. What should the nurse instruct the parents about the administration of this medication? A. This medication must be given by injection. B. This medication must be given in the morning before school. C. Hip or knee pain is an expected adverse effect of this medication. D. This medication does not interact with any other types of medication.

A. This medication must be given by injection. Somatropin is administered by injection. It is best given at hour of sleep because that is when growth hormone is released. Hip or knee pain could indicate a slipped capital epiphysis and should be reported to the health care provider. The nurse should urge the parents to inform all health care providers that the child is receiving this medication to avoid medication interactions.

A child with Asperger syndrome has also been diagnosed with depression. The nurse understands that two or more disorders in an individual is termed: A. comorbidity. B. congenital syndrome. C. mental retardation. D. developmental impairment.

A. comorbidity.

A home care nurse provides health education to parents regarding the care of their toddler. Which precaution should the nurse suggest the parents take to protect the toddler from drowning? A. Instruct the toddler not to go near the pool. B. Avoid unattended baths for the toddler. C. Provide only partial baths to the toddler. D. Teach the child that water is dangerous.

B. Avoid unattended baths for the toddler.

The nurse is examining a 12-month-old who is brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with bright red scaly plaques and small papules. Satellite lesions are also present. What is the most likely cause of this clients diaper rash? A. Impetigo (staph) B. Candida albicans (yeast) C. Urine and feces D. Infrequent diapering

B. Candida albicans (yeast)

The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply. A. Hyperthermia B. Orthostatic hypotension C. Weak pulse D. Hypertension E. Hypothermia

B, C, E (Orthostatic hypotension, weak pulse, & hypothermia)

A child with a diagnosis of Down syndrome has had which of the following chromosome abnormalities occur? A. 1 copy of the chromosome 8 has occurred instead of 2 copies. B. 3 copies of trisomy 21 has occurred instead of 2 copies. C. 3 copies of trisomy 18 has occurred instead of 2 copies. D. 3 copies of trisomy 13 has occurred instead of 2 copies.

B. 3 copies of trisomy 21 has occurred instead of 2 copies.

The nurse is caring for a 7-year-old boy experiencing respiratory distress who is scheduled to have a chest radiograph. What would be most important for the nurse to include in the child's plan of care? A. Administering a sedative to help calm the child B. Assisting the child to lie still during the chest radiograph C. Accompanying the child to continue observation D. Informing the child that he might hear a loud banging noise

B. Assisting the child to lie still during the chest radiograph

The nurse is evaluating outcomes for teaching provided to the mother of a school-age child with an itchy rash. Which outcome indicates that teaching has been effective? A. Mother applies hot compresses to itchy skin areas every few hours B. Child drinks a glass of water every 1 to 2 hours throughout the day C. Child showers in hot water and uses soap on the rash every morning D. Child wearing long denim pants and a long-sleeve shirt while playing outside

B. Child drinks a glass of water every 1 to 2 hours throughout the day

An adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) is interested in playing the drums in the school band. Which action by the nurse is the most appropriate? A. Recommend the child take private lessons and not join the band. B. Encourage the child to join the band. C. Consult with the healthcare provider about allowing participation in band activities. D. Discourage the child from playing in the band.

B. Encourage the child to join the band.

A 12-year-old boy has broken his arm and is showing signs and symptoms of shock. Which of the following would the nurse do first? A. Begin hyperventilation. B. Establish a suitable IV site. C. Provide oral analgesics as ordered. D. Draw blood for type and crossmatch.

B. Establish a suitable IV site.

When providing support and education to the family of a child who is diagnosed with a serious genetic abnormality, what would be the priority? A. Assisting with scheduling follow-up visits B. Establishing a trusting relationship C. Teaching the family what to expect D. Using measures to promote growth and development

B. Establishing a trusting relationship

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 2 1/2 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 2 1/2 years of age.

A nurse is assessing the skin of a child with cellulitis. What would the nurse expect to find? A. Red, raised hair follicles B. Warmth at skin disruption site C. Papules progressing to vesicles D. Honey-colored exudate

B. Warmth at skin disruption site Cellulitis is manifested by erythema, pain, edema, and warmth at the site of skin disruption. Red raised hair follicles would indicate folliculitis. Papules progressing to vesicles and a honey-colored exudate would suggest nonbullous impetigo.

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.

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.

The nurse is examining a child with hypoparathyroidism. The nurse would expect to assess which signs and symptoms? Select all that apply. A. Capillary refill B. Polyphagia C. Chvostek D. Babinski E. Trousseau

C, E (Chvostek & Trousseau) A child with hypoparathyroidism would have a positive Chvostek or Trousseau sign, both of which indicate hypocalcemia. To test for the Chvostek sign, tap sharply over the facial nerve below the temple and anteriorly to the ear. The sign is positive when the mouth twitches (contraction of the lateral facial muscles). To check for the Trousseau sign, apply a blood pressure cuff to the child's upper arm. Inflate the cuff until the blood supply is occluded. If doing so causes carpal spasm (the fingers contract and the child is unable to open the hand), the Trousseau sign is positive. Capillary refill helps to evaluate tissue oxygenation. Polyphagia refers to excessive eating or hunger. Babinski refers to the Babinski reflex, which suggest neurologic dysfunction.

The nurse is educating parents of a child admitted to the hospital with rubella (German measles). Which statement by the parents indicates the further education is needed? A. "Our child is contagious for 1 week after the rash appeared." B. "Acetaminophen or ibuprofen can be given to help with pain." C. "Antibiotics are needed to help our child recover from rubella." D. "Family members should wear a mask when coming to visit us."

C. "Antibiotics are needed to help our child recover from rubella."

The nurse is caring for a 1-month-old girl with low-set ears and severe hypotonia who was diagnosed with trisomy 18. Which nursing diagnosis would the nurse identify as most likely? A. Interrupted family process related to the child's diagnosis B. Deficient knowledge deficit related to the genetic disorder C. Grieving related to the child's poor prognosis D. Ineffective coping related to stress of providing care

C. Grieving related to the child's poor prognosis Grieving related to the child's prognosis is a diagnosis specific to this child's care. The prognosis for trisomy 18 is that the child will not survive beyond the first year of life. Ineffective coping related to the stress of providing care, deficient knowledge related to the genetic disorder, and interrupted family process due to the child's diagnosis could be appropriate for any family of a child with a genetic disorder.

After teaching a group of nursing students about shock in children, the instructor determines that the teaching was successful when the students identify which type of shock as most common? A. Septic B. Cardiogenic C. Hypovolemic D. Distributive

C. Hypovolemic

The nurse is assessing a 4-year-old boy whose mother was 40 years old when he was born. Which finding suggests this child has a genetic disorder? A. Inquiry determines the child had feeding problems. B. Observation shows nasal congestion and excess mucus. C. Inspection reveals low-set ears with lobe creases. D. Auscultation reveals the presence of wheezing.

C. Inspection reveals low-set ears with lobe creases. Low-set ears are associated with numerous genetic dysmorphisms. Additionally, the mother's age during pregnancy is a risk factor for genetic disorders. Feeding problems could have been due to low birthweight, prematurity, or a variety of other reasons. The nasal congestion may be a cold. The wheezing could be bronchiolitis or asthma.

What should be included in the teaching plan for a child with type 1 diabetes mellitus who is going home on insulin therapy? A. Children show an increased need for insulin during the first months after glucose control is established. B. Once glucose control is established, there will never be a need for an increase in the amount of insulin administered. C. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. D. All children should be on at least two types of insulin to establish glucose control.

C. It is absolutely normal for the growing child to require an increase in insulin; this does not mean his/her condition is getting worse. Children show a decreased need for insulin shortly after glucose control has been established, which is referred to by some as the "honeymoon phase" and should be described to parents so that they do not get any false hope that the child does not need insulin. As children grow, they will require increased doses of insulin to maintain glucose control, and not all children need to receive two types of insulin. Insulin treatment should be based on each individual child.

When educating parents of preschoolers what is most important to include in your presentation? A. Use wrist guards with rollerblades. B. Teach preschoolers to tread water. C. Keep chemicals in a locked cabinet. D. Maintain strict discipline with potty training.

C. Keep chemicals in a locked cabinet.

A nurse is caring for a stable toddler diagnosed with accidental poisoning due to the ingestion of cleaning solution. What must be included in teaching parents about how to protect a toddler from accidental poisoning? A. Closely monitor the toddler's activity. B. Label poisonous solutions. C. Keep cleaning solutions locked up. D. Do not leave the toddler alone.

C. Keep cleaning solutions locked up.

A nurse is conducting a secondary assessment of a child who has experienced multiple trauma. When inspecting the child's back, which of the following would be most appropriate to do? A. Sit the child upright. B. Lift the child off the stretcher. C. Logroll the child to the side. D. Arch the child's back using two hands.

C. Logroll the child to the side.

The nurse is conducting a health history for a school-age client. The parents of the client tell the nurse that their child has the following behaviors: excessive handwashing, counting objects, and hoarding substances. Based on these assessment findings, which diagnosis does the nurse anticipate for this client? A. Depression B. Separation anxiety disorder C. Obsessive-compulsive disorder D. Bipolar disorder

C. Obsessive-compulsive disorder

A school-age client diagnosed with autism is admitted to the hospital because of recent vomiting and diarrhea. Which intervention by the nurse is most appropriate upon admission? A. Take the child on a quick tour of the whole unit. B. Take the child to the playroom immediately for arts and crafts. C. Orient the child to the hospital room with minimal distractions. D. Admit the child to a four-bed unit with small children.

C. Orient the child to the hospital room with minimal distractions.

The nurse is planning care for a 3-month-old infant diagnosed with eczema. Which should be the focus of the nurses care for this infant? A. Maintaining adequate nutrition B. Keeping the baby content C. Preventing infection of lesions D. Applying antibiotics to lesions

C. Preventing infection of lesions

Which action should the nurse incorporate into a care plan for a 14-year-old child in the emergency department? A. Limit the number of choices to be made by the adolescent. B. Insist that parents remain with the adolescent. C. Provide clear explanations and encourage questions. D. Give rewards for cooperation with procedures.

C. Provide clear explanations and encourage questions.

The mother of a 2-month-old infant questions the nurse about autism. She reports a close family member has a child with this disorder and she is concerned about her child. What information can be provided to the child's mother? Select all that apply. A. "The cause of autism is largely considered to be related to immunizations administered in infancy." B. "Concerns are often noted as early as 3 to 6 months of age." C. "Once your child begins to speak it will be easier to make a determination." D. "In infancy a lack of loving behaviors such as cuddling is concerning." E. "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact."

D, E (D. "In infancy a lack of loving behaviors such as cuddling is concerning." & "Infants who are on the autism spectrum may have difficulty establishing or maintaining eye contact.")

The nurse is providing teaching to a community group regarding preventative strategies to reduce the risk of burn injury. Which topics will the nurse include in the teaching session? Select all that apply. A. Avoid contact with unknown animals and wild animals. B. Layer children's clothing for warmth. C. Keep infants and toddlers off the lap when drinking hot beverages or eating soup. D. Lower the temperature settings for hot water heaters. E. Wear light-coloured clothes and avoid eating sweetened foods and beverages when outside.

D, E (Lower the temperature settings for hot water heaters & wear light-coloured clothes and avoid eating sweetened foods and beverages when outside)

The nurse is comforting a family who were just informed by the health care provider that their baby will likely be born with a significant genetic abnormality. What actions by the nurse would be therapeutic? Select all that apply. A. Advise the parents to discuss their fears with only each other B. Discuss the nurse's personal beliefs regarding genetic abnormalities C. Encourage the family to ask questions after they have researched the disorder D. Refer the family to appropriate parent group or local family with similar needs E. Allow the family to discuss their emotions in an authentic and trusting environment

D, E (Refer the family to appropriate parent group or local family with similar needs & allow the family to discuss their emotions in an authentic and trusting environment)

The nurse is caring for the family of a pediatric client during resuscitative efforts of their child following an accident. Which response by the nurse would be best? A. "I know this is overwhelming, but I want you to know he will be OK." B. "How could this accident have happened with you both there?" C. "You must be so scared right now...especially since you were the one driving." D. "I am here to answer your questions and be with you during this difficult time."

D. "I am here to answer your questions and be with you during this difficult time."

The nurse is educating a parent after the birth of a newborn who is diagnosed with phenylketonuria (PKU). Which parent statement indicates teaching has been effective? A. "I will supplement my breast milk with prescribed formula." B. "Once the baby is on solid foods, the dietary restriction will be gone." C. "The concern is the baby has an excess of a liver enzyme." D. "I will not breast feed the baby since breast milk contains phenylalanine."

D. "I will not breast feed the baby since breast milk contains phenylalanine."

The nurse is assessing a 30-month-old child during a routine well-child visit. Which statement by the parent would alert the nurse to further assess for a learning disorder? A. "My child seems to prefer playing with certain toys and will not play with other toys very much." B. "My child likes a certain type of food and does not want to try new foods very often." C. "My child gets restless when we go to a restaurant to eat and we have to wait for our food." D. "My child does not say more than one or two words and grunts to indicate needs."

D. "My child does not say more than one or two words and grunts to indicate needs."

The nurse is caring for a 6-year-old girl who was injured in a bicycle accident. Which question would be most important for the nurse to ask during the health history? A. "Has she been diagnosed with any chronic disorders?" B. "Is your daughter currently taking any medications?" C. "Is she allergic to any medications or drugs?" D. "Tell me how the bicycle accident happened."

D. "Tell me how the bicycle accident happened."

The parent of an infant born with trisomy 18 says to the nurse, "I am so lost...I can't even think about my baby not being healthy." How should the nurse respond? A. "I understand...we occasionally see clients with trisomy 18 and it is very sad." B. "This is a difficult time, but let's talk about the ways your baby will outgrow this." C. "I would encourage you to talk with the doctor about ways to cure this disorder." D. "This is a sad time for you. I will sit with you quietly in case you want to talk."

D. "This is a sad time for you. I will sit with you quietly in case you want to talk."

The nurse is providing teaching to the parents of a child with varicella. Which statement indicates that the parents have understood the instructions? A. "We should apply alcohol to the lesions every four hours." B. "If he has a fever, we can give him some aspirin." C. "The lesions should eventually form soft crusts that drain." D. "We need to make sure that he washes his hands frequently."

D. "We need to make sure that he washes his hands frequently."

A child is brought into the emergency department. After assessing a child's airway, breathing, and circulation (ABCs), which of the following would the nurse do next? A. Obtain a full set of vital signs. B. Remove the child's clothing. C. Provide pain management. D. Assess level of consciousness.

D. Assess level of consciousness.

A child presents to the emergency department via ambulance in critical condition following a traumatic motor vehicle crash. What would the first action of the nurse be? A. Update the parent and obtain consent to treat B. Remove the child's clothing to assess for injury C. Begin circulation/cardiac assessment and count the pulse D. Assess the child's airway and manage airway patency

D. Assess the child's airway and manage airway patency

A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. What action would be the priority? A. Determining the burn depth B. Eliciting a description of the burn C. Estimating burn extent D. Ensuring a patent airway

D. Ensuring a patent airway

An unconscious client is brought to the emergency department after ingesting too much prescribed medication. What is the highest priority nursing intervention? A. Call family members. B. Establish IV access. C. Administer antacids. D. Establish a patent airway.

D. Establish a patent airway.

A child is admitted to the pediatric medical unit with the diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH). Based on the typical signs and symptoms of this disorder, which nursing diagnosis will the nurse identify as relating to this client? A. Delayed growth and development B. Imbalanced nutrition: More than body requirements C. Noncompliance D. Excess fluid volume

D. Excess fluid volume Syndrome of inappropriate antidiuretic hormone (SIADH) occurs when ADH (vasopressin) is secreted in the presence of low serum osmolality because the feedback mechanism that regulates ADH does not function properly. ADH continues to be released, and this leads to water retention, decreased serum sodium due to hemodilution, and extracellular fluid volume expansion; thus, Excess fluid volume from edema is the highest priority.

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child who has issues with the anterior pituitary, the nurse would expect the child to have issues with which hormone? A. Vasopressin B. Antidiuretic hormone C. Oxytocin D. Growth hormone

D. Growth hormone Disorders of the pituitary gland depend on the location of the physiologic abnormality. The anterior pituitary, or adenohypophysis, is made up of endocrine glandular tissue and secretes growth hormone (GH), adrenocorticotropic hormone (ACTH), TSH, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. The posterior lobe is called the neurohypophysis because it is formed of neural tissue. It secretes antidiuretic hormone (ADH; vasopressin) and oxytocin. Usually, several target organs are affected when there is a disorder of the pituitary gland, especially the adenohypophysis.

The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which disorder? A. Generalized anxiety disorder B. Posttraumatic stress disorder C. Social phobia D. Obsessive-compulsive disorder

D. Obsessive-compulsive disorder

The nurse is educating the parents of a 6-year-old boy about his learning disorder. Which of the following facts would the nurse integrate into the discussion? A. Learning disorders indicate lower intelligence. B. Learning disorders are synonymous with learning deficits. C. The disorder requires comprehensive special education. D. The disorder is caused by a difference in brain architecture.

D. The disorder is caused by a difference in brain architecture.

The nurse is caring for a school-age child with varicella. What should the nurse observe about the rash that is associated with this infection? A. Dark red color B. Noticeable crusts but no pruritus C. Dark red, macular, very pruritic lesions D. Various stages of lesions present at the same time

D. Various stages of lesions present at the same time

The school nurse is conducting pediculosis capitis (head lice) checks. Which findings would indicate a positive head check? A. White, flaky particles throughout the entire scalp region B. Maculopapular lesions behind the ears C. Lesions in the scalp that extend to the hairline or neck D. White sacs attached to the hair shafts in the occipital area

D. White sacs attached to the hair shafts in the occipital area