Exam 1

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent? 1. "The immunization schedule will need to be altered." 2. "The child should not receive any hepatitis vaccines." 3. "The child will receive all of the immunizations except for the polio series." 4. "The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

4

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

A

A mother brings her 6-year-old child to the clinic because the child has developed a rash on the trunk and scalp. The mother reports that the child has had a low-grade fever, has not felt like eating, and has been tired. The child is diagnosed with chickenpox. The mother inquires about the communicable period associated with chickenpox, and the nurse bases the response on which statement? 1. The communicable period is unknown. 2. The communicable period ranges from 2 weeks or less to 4 weeks. 3. The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. 4. The communicable period is 1 to 2 days before the onset of the rash to 6 days, when crusts have formed.

4

A mother calls the health care provider's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother? 1. "Is your child crying and irritable?" 2. "Does your child have a productive cough?" 3. "Did he have a temperature last night of greater than 100°F (37.8°C)?" 4. "Is your child telling you at this time he is having trouble breathing?"

1

An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instructions on the list? Select all that apply. 1. Avoid hot fluids. 2. Avoid raw vegetables. 3. Consume pudding products. 4. Rest in bed or on a couch for 24 hours. 5. Drink cold milkshakes to soothe the throat.

1, 2, 4

A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition? 1. Warm, dry skin 2. Decreased wheezing 3. Pulse rate of 90 beats/minute 4. Respirations of 18 breaths/minute

2

A mother arrives at the clinic with her 3-year-old child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days and that this morning the child began to wheeze. Viral pneumonia is diagnosed. Based on the diagnosis, the nurse anticipates that which will be a component of the treatment plan? 1. Oral antibiotics 2. Supportive treatment 3. Intravenous (IV) fluid administration 4. Hospitalization and IV antibiotics

2

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action? 1. Initiate strict enteric precautions. 2. Move the infant to a room with another child with RSV. 3. Leave the infant in the present room because RSV is not contagious. 4. Inform the staff that they must wear a mask, gloves, and a gown when caring for the child.

2

Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the schoolchildren. Which statement made by a parent indicates a need for further teaching regarding this communicable disease? 1. "Small blue-white spots with a red base may appear in the mouth." 2. "The rash usually begins on the face and spreads downward toward the feet." 3. "The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears." 4. "Respiratory symptoms such as a profuse runny nose, cough, and fever occur before the development of a rash."

3

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action? 1. Tell the mother that the child must stay in the tent. 2. Place a toy in the tent to make the child feel more comfortable. 3. Call the health care provider and obtain a prescription for a mild sedative. 4. Let the mother hold the child and direct the cool mist over the child's face.

4

The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother? 1. Increase the dose of ibuprofen. 2. Increase the frequency of ibuprofen. 3. Encourage the child to lie on the left side. 4. Encourage the child to lie on the right side

4

The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures? 1. "The diet needs to be low in fat." 2. "The diet needs to be low in protein." 3. "The diet needs to be low in calories." 4. "The diet needs to be high in calories."

4

Children as young as age 3 years can use facial scales for discrimination. What are some suggested anchor words for the preschool age group? a. "No hurt." b. "Red pain." c. "Zero hurt." d. "Least pain."

A

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

B

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

B

A 3-year-old child is seen in the health care clinic, and a diagnosis of encopresis is made. The nurse reviews the record, expecting to note which sign as evidence of this disorder? A. Diarrhea B. Malaise anorexia C. Nausea and vomiting D. Evidence of soiled clothing

D

Which nonpharmacologic intervention appears to be effective in decreasing neonatal procedural pain? A. Tactile stimulation B. Commercial warm packs. C. Doing procedures during infants sleep. D. Oral sucrose and non nutritive sucking.

D

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position? 1. Supine 2. Side-lying 3. High Fowler's 4. Trendelenburg's

2

The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review? 1. Creatinine level 2. Prothrombin time 3. Sedimentation rate 4. Blood urea nitrogen level

2

• After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question? 1. Monitor for bleeding. 2. Suction every 2 hours. 3. Give no milk or milk products. 4. Give clear, cool liquids when awake and alert.

2

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply. 1. The child has symptoms of a cold. 2. The child had a previous anaphylactic reaction to the vaccine. 3. The mother reports that the child is having intermittent episodes of diarrhea. 4. The mother reports that the child has not had an appetite and has been fussy. 5. The child has a disorder that caused a severely deficient immune system. 6. The mother reports that the child has recently been exposed to an infectious disease.

2, 5

A child diagnosed with scarlet fever is being cared for at home. The home health nurse performs an assessment on the child and checks for which clinical manifestations of this disease? Select all that apply. 1. Pastia's sign 2. Koplik's spots 3. White strawberry tongue 4. Edematous and beefy-red pharynx 5. Petechial red, pinpoint spots on the soft palate 6. Small red spots with a bluish-white center and a red base located on the buccal mucosa

1, 3, 4

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply. 1. Place the infant in a private room. 2. Ensure that the infant's head is in a flexed position. 3. Wear a mask at all times when in contact with the infant. 4. Place the infant in a tent that delivers warm humidified air. 5. Position the infant on the side, with the head lower than the chest. 6. Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

1, 6

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent? 1. Monitor the infant for a fever. 2. Bring the infant back to the clinic. 3. Apply a hot pack to the injection site. 4. Apply a cold pack to the injection site.

4