Exam 4 PEDs

A nurse is teaching a caregiver of a child with leukemia. Which statement is true relating to care of the child? A: Neutropenia with infection of skin and lungs is present. B: Prepare child for radiation and decrease activity intolerance C: Represents 50% of childhood cancers D: Headache on awakening

A

A parent visits the clinic and tells the nurse that her 5-week-old male infant has had projectile vomiting that smells sour for the past two days. The nurse should refer the family to a health care provider for a possible diagnosis of: A: Pyloric stenosis B: Hiatal hernia C: Peptic ulcer D: Intestinal atresia

A

A preadolescent client with a history of Chiari malformation type II arrives for a sports physical. What information is essential for the nurse to collect before beginning the physical assessment? A: Type of sport B: Head circumference C: Grade level in school D: Current height and weight

A

The nurse suspects a child with bone and joint pain has leukemia after past chemotherapy treatments. What type of leukemia has most likely occurred? A: Acute lymphocytic leukemia (ALL) B: Acute myeloblastic leukemia (AML) C: Chronic myeloid leukemia (CML) D: Chronic lymphocytic leukemia(CLL)

A

A premature infant is diagnosed with severe necrotizing enterocolitis (NEC). The infant had surgery to remove all but 12 inches of bowel and now has short bowel syndrome (SBS). What actions would be appropriate for the nurse to take for an infant with severe SBS in the immediate post-operative period? A: Administer total parenteral nutrition (TPN) to provide immediate nutrition B: Start PO feeds in small quantities immediately postoperatively C: Prepare for a colostomy D: Administer laxatives to maintain bowel patency

A

A nurse is planning to administer a blood transfusion to a child with sickle cell disorder. Please identify the steps in order for administration. A: Obtaining the informed consent-3 B: Reviewing the results of blood count and plan of care-1 C: Educating the child/family-2 D: Obtaining vital signs-4

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A nurse is planning to administer chemotherapy to a child. Please prioritize nursing interventions for administration. A: Provide child safety by using two forms of patient identifiers.-3 B: Anticipate need for anti-emetic medication and hydration.-2 C: Identify adverse effects of medication promptly.-4 D: Assess child and caregiver understanding of the disease and treatment.-1

1234

A school-age child requires a lumbar puncture. In what order should the nurse provide care to this client? A: Assess the puncture site for bleeding.-4 B: Support in a lateral side-lying position.- 1 C: Apply a dry dressing to the puncture site.-2 D: Maintain strict bed rest for 4 to 24 hours.- 3

1234

The nurse enters the room of an infant who is being admitted for severe dehydration. What order of care should the nurse provide for the infant? A: Start an intravenous line-3 B: Perform a quick assessment of the child-1 C: Administer 20 ml/kg or isotonic normal saline solution-4 D: Obtain the infant's weight-2

1234

The nurse is admitting a toddler with suspected meningitis. In what order should the nurse perform these tasks? A: Start antibiotics.-4 B: Obtain the lumbar puncture. -2 C: Begin IV fluids as ordered.-3 D: Start an IV. - 1

1234

The nurse is preparing an educational poster on reflexes present in a newborn. In what order should the nurse identify that the reflexes disappear? A: Moro reflex-3 B: Babinski sign-4 C: Placing reflex-2 D: Rooting reflex-1

1234

What screening will be used by the nurse for assessing appropriate 5- year-old growth and development of the musculoskeletal system? A: Health history B: Vocabulary ability C: Toileting compliance D: Medication tolerance

A

A nurse is teaching a caregiver of a child with cancer. Which statement regarding caregiver education is true? Select all that apply. A: Discourage discussions centered around caregiver guilt. B: Provide education to the caregiver and child. C: Explain the plan of care for the child. D: Avoid discussions on survival rate. E: Encourage emotional support.

B, C, E

A toddler is admitted to the hospital with a respiratory infection and a history of osteogenesis imperfecta. What safety precaution will the nurse use to prevent bone injury of the toddler? A: Allow toddler to ambulate in the pediatric unit B: Use noninvasive blood pressure measurements as needed C: Monitor temperature with a tympanic thermometer D: Encourage gentle holding of the toddler by staff

B

A nurse is planning care for a positive human immunodeficiency child (HIV) positive child. Which interventions will the nurse include? Select all that apply. A: Follow standard precautions when providing care. B: Administer highly active antiretroviral therapy drugs (HAART) combination therapy. C: Strictly adhere to a low sodium, low calorie diet. D: Immunization is not recommended against common childhood illnesses. E: Prevent and manage opportunistic infections.

A, B, E

In educating parents of an adolescent diagnosed with ulcerative colitis, which statement would indicate that the learner understands what the most important part of care is? A: "We should take them to the emergency department with signs of bleeding or pain." B: "We should make sure they eat when having a flare in order to optimize their nutrition." C: "Stress reduction techniques like visualization and relaxation should be avoided when dealing with ulcerative colitis." D: "If side effects occur, we should try to cope with them, since the medications are important to take."

A

The nurse in a pain clinic is seeing an adolescent about recurrent headaches. What is an initial step the nurse could suggest that would help manage the client's headache pain? A: Have the client keep a headache diary. B: Give samples of some new medications targeted for migraines. C: Administer a pain injection. D: Have the client avoid gluten.

A

The nurse is caring for a school-age client who was recently diagnosed with Guillain-Barré syndrome. The parent asks, "What happens with this disease?" How should the nurse respond? A: "It involves ascending paralysis; weakness occurs in the lower limbs and spreads upward." B: "It involves your muscles; they become spastic and difficult to control. " C: "It involves the blood; you get an overproduction of immature white blood cells." D: "It involves your nerve endings; you lose feeling and sensation in your extremities."

A

The nurse is educating a client diagnosed with Irritable Bowel Syndrome (IBS). What statement indicates that the client understands the education provided? A: "IBS does not cause changes in bowel tissue." B: "IBS increases the risk of colorectal cancer." C: "This is a condition that is acute, temporary, and usually only occurs once in a life-time." D: "Abdominal pain is limited with IBS."

A

The nurse is educating the parent about non-medicinal measures that can be tried to treat constipation in children. Which measures are accurate? A: Increase fruits and vegetables in the diet B: Decrease fluid intake C: Decrease daily fiber intake D: Use behavior modification and have the child sit on the toilet until they defecate, even if it takes an hour

A

A nurse is planning prioritized care for children with complex hematologic and oncologic disorders. Which statements are true related to prioritized care? Select all that apply. A: Triage clients quickly and place in a treatment room as soon as possible. B: Avoid invasive procedures. C: Use strict standard precautions. D: Start antibiotics if febrile within 24 hours of assessment. E: Dedicate stethoscopes and equipment to the room.

A, B, E

The nurse is providing education to a family who recently delivered a child with a myelomeningocele and the parents ask, "What issues can this cause?" How should the nurse respond? A: "This can cause paralysis of the legs, flaccid muscles, and problems with control of the bowel and bladder." B: "This can cause progressive muscle deterioration and mild mental delays." C: "This can cause spastic muscles, which can prompt difficulty with ambulation and cognitive deficits." D: "This can cause problems with mental abilities, a lack of coordination, and uncoordinated, jerky body movements."

A

A nurse is teaching a caregiver of a child receiving radiation therapy about possible side effects. Which would the nurse identify? Select all that apply A: Retinopathy B: Alopecia C: Bulimia D: Cardiomegaly E: Sterility

A, B, E

The nurse is talking to a group of adolescents who are overweight. Which verbalized behavior is an example of the best exercise plan for weight loss? A: Walking for 30 minutes 6 or 7 days/week B: Playing soccer for an hour on the weekend C: Lifting weights 15 minutes a day, 3 times a week D: Playing an interactive video game every day for an hour

A

A nursing priority is the high-risk of infection for the child with an oncologic disorder. The child's laboratory findings reveal (3% Bands , 50% Segs) Total WBC count=1000 Calculate the child's Absolute Neutrophil Count (ANC) based on the provided information.

530

The nurse is teaching a baseball team in the community about avoiding overuse injuries. What will the nurse include in the teaching? A: Start out the game with warm-up exercises B: Try to do physical exercises quickly to build up endurance C: Wear stylish footwear D: Play the game through any pain to finish the game

A

The nurse is with a family as the mother is receiving an ultrasound. The test reveals a defect in the fetus in which the unborn child is missing a large part of the brain and skull. Which defect would the nurse identify this as being? A: Anencephaly B: Encephalocele C: Chiari malformation D: Microcephaly

A

The nurse notes that a client with cerebral palsy has difficulty with balance and illegible writing. For which type of cerebral palsy should the nurse plan care for this client? A: Ataxic B: Mixed C: Spastic D: Athetoid

A

The nurse notes that a preschool-age client makes sudden repetitive shoulder movements. The nurse should assess this client for which health problem? A: Tic B: Chorea C: Tremor D: Dystonia

A

A 5-year-old client has been experiencing seizure activity for the last 20 minutes. What medication should the nurse prepare to administer to this client? A: Diazepam B: Clonazepam C: Ethosuximide D: Carbamazepine

A

A 7 -year-old child presents to the emergency department (ED) with a low-grade fever, knee pain, and a limp. What assessment can the nurse perform to add data to a potential transient monoarticular synovitis diagnosis? A: Roll test B: Hip abduction assessment C: Lower leg rotation assessment D: Antalgic gait test

A

A child falls and fractures a clavicle. What statement indicates that further teaching is needed? A: "My son can no longer play football." B: "My son will pain until it heals." C: "It is important to wear a sling for 4 weeks until healing occurs." D: "My son may have a bump that will smooth out."

A

A child fell and injured an arm during an evening soccer game. What does the nurse understand to the best easily available diagnostic test that can be used to confirm an arm fracture? A: Radiograph B: Computerized tomography scan C: Bone scan D: Magnetic resonance imaging

A

A child has a metabolic hereditary disorder with soft bones and abnormal gait. The pediatrician suggests that the child may have rickets. What data support the child's rickets diagnosis? A: Calcium level of 6.9mg and a phosphate level of 2.5 mg/dL B: Purulent drainage from the knee C: Presence of bands D: C-Reactive protein < 0.8

A

A child is diagnosed with iron deficiency anemia. What will the nurse see as common clinical presentation findings? A: Irritability, tachycardia, brittle and concave nails B: Increased serum concentration of the proteins albumin, gamma globulin, and transferrin C: Anorexia, bradycardia, and systolic murmur D: Normal growth, spastic muscle tone, and delayed learning

A

A child is hospitalized with skeletal traction. What medication will the nurse plan to administer for muscle spasms? A: Lorazepam B: Morphine C: Acetaminophen D: Codeine

A

A child is in a wellness clinic. The parents are vegetarian and the child does not eat fish or milk products. What calcium level would the nurse relate to a diagnosis of rickets? A: 6.8 mg B: 8.7 mg C: 9.7 mg D: 10.0 mg

A

A nurse is assessing a child for leukemia. Which assessment finding confirms diagnosis? A: Purpura B: Auditory hallucinations C: Bulimia D: Bone and joint infection

A

A nurse is caring for a severely dehydrated child. The child has had nausea and vomiting for three days. The health care provider orders a 20 ml/kg bolus of intravenous (IV) fluid of an isotonic crystalloid. Which IV fluid would be the best choice? A: Sodium Chloride 0.9% (normal saline) B: Dextrose 10% and water (D10W) C: Dextrose 5% and 0.45% normal saline (D5 ½ NSS) D: Dextrose 5% and 0.9% normal saline (D5NSS)

A

A nurse is planning care for a child with non-Hodgkin's lymphoma. Which statement is true for the child? A: Enlargement of lymph nodes B: Reed-Sternberg cells are present C: Noticeable enlarged cervical or supraclavicular nodes D: Stages I-IV using the Cotswold Modified Ann Arbor system

A

A nurse is planning nursing interventions for a child with Wilms' tumor. Which intervention should be included? A: Monitor manual blood pressures. B: Plan chemotherapy after surgery. C: Palpate the abdomen to assess for mass. D: Wear fitted material for comfort.

A

The nurse recognizes that the most common symptom of a peptic ulcer is: A: Pain B: Bleeding C: Vomiting D: Diarrhea

A

Which choice describes spina bifida cystica, also known as myelomeningocele? A: A section of the spinal cord and the nerves that come from the cord are exposed and visible on the outside of the body. It causes partial or complete paralysis below the spinal opening. B: The membrane that surrounds the spinal cord is enlarged, creating a cyst-like sac. The sac that is present usually on the lower back contains meninges, which are the membranes covering the spinal cord. C: A section of the spinal vertebrae is malformed, but the spinal cord and nerves are normal. The defect is not visible, though newborns may display dimpling, hair, or hemangioma in the lumbar sacral area. D: Tissue attachments limit the movement of the spinal cord within the spinal column.

A

The nurse knows the emergent care for clients with Crohn's disease include which of the following? Select all that apply. A: High dose corticosteroid therapy B: Encourage the client to eat solids C: Diet high in potassium D: Intravenous (IV) fluid therapy E: Treatment with aspirin to decrease inflammation

A, D

The nurse is teaching a family about avascular necrosis development and treatment. What are important considerations for the nurse to include in teaching? Select all that apply. A: The treatment modalities can be bracing, traction, and surgery. B: The process of avascular necrosis may take two years to develop. C: The younger the child is at the time of diagnosis, the better the outcome. D: The child feels well and has no pain with the development of avascular necrosis. E: The femoral head by x-ray appears perfectly shaped.

A, B, C

The nurse is teaching a group of parents about the common medications used in children with stomach ulcers. Which medication should the nurse include in the teaching? Select all that apply. A: Omeprazole B: Lansoprazole C: Ranitidine D: Bisacodyl E: Mineral oil

A, B, C

A nurse is admitting a 5-year-old child with osteomyelitis of the hip. What are clinical presentations of a child with osteomyelitis of the hip? Select all that apply. A: Externally rotated hip B: Febrile state C: Surgical history D: Positive leukocytosis E: Mild limb rotation

A, B, C, D

The nurse is educating the client about "trigger" foods associated with irritable bowel syndrome (IBS). What do some of these foods include? Select all that apply. A: Fatty foods B: Dairy C: Carbonated beverages D: Caffeine E: Spaghetti/pasta

A, B, C, D

A 9-year-old is admitted with an inguinal hernia. In assessing this child, what signs would indicate incarceration? Select all that apply. A: Increase in pain B: Bilious vomiting C: Bradycardia D: Diarrhea E: Presence of a hydrocele

A, B

The nurse is caring for a child admitted with congenital hip dysplasia. What nursing assessments can the nurse use to confirm the hip dysplasia? Select all that apply. A: A positive Galeazzi sign B: Absence of knee flexion C: Symmetrical thigh skinfolds D: Febrile state E: Inwardly turned forefoot

A, B

The nurse is preparing to admit a child with hip dysplasia. What are treatments that the child may receive for the hip dysplasia? Select all that apply. A: Pavlik harness B: Spica cast C: Medial physeal stapling D: Ponseti techniques E: Orthotics

A, B

The nurse is preparing to transfuse a unit of packed red blood cells to a child. What are the clinical signs and symptoms of anemia that may require the child to receive a blood transfusion? Select all that apply. A: Tachycardia B: Inability to perform activities of daily living C: Cool skin D: Nose bleed E: Increased urine output

A, B

A child is diagnosed with acute lymphocytic leukemia (ALL). The parents are asking the nurse what treatments are available for the child. What are the nurse's responses? Select all that apply. A: Antibiotics B: Stem cell transplant C: Immunotherapy D: Radiation E: No treatment

A, B, C

A nurse is working in a child wellness clinic. Which musculoskeletal disorders may cause limping? Select all that apply. A: Septic arthritis B: Osteomyelitis C: Legg-Calve-Perthes disease D: Juvenile Idiopathic arthritis E: Juvenile Scoliosis

A, B, C

A premature infant is diagnosed with necrotizing enterocolitis (NEC). What assessment findings would the nurse expect to see? Select all that apply. A: Large nasogastric residuals (> 2mls) B: Stool positive for occult blood C: Distended, tense abdomen D: No issues with apnea E: Good temperature stability and thermoregulation

A, B, C

An 8-week-old infant is diagnosed with reflux (GERD) and has been started on medications. What medications will the nurse administer to decrease stomach acid and help with the symptoms of reflux? Select all that apply. A: Ranitidine B: Metoclopramide C: Omeprazole D: Prevenique E: Promethazine

A, B, C

The nurse is caring for a child in Bryant's traction. What are important concepts related to the care of child in Bryant's traction? Select all that apply. A: Keep weights free from bed frame B: Position child with care to avoid friction C: Monitor skin for breakdown and irritation D: Limit fluid intake E: Keep the environment calm and quiet at all times

A, B, C

What are some critical nursing actions associated with transfusion of fresh frozen plasma for a child with active bleeding? Select all that apply. A: Don appropriate personal protective equipment. B: Monitor coagulation studies. C: Assess for infusion reactions. D: Infuse the fresh frozen plasma within 6 hours of thawing. E: Pre-medicate with antihistamines.

A, B, C, D

A newborn had a repair of Type I tracheoesophageal fistula (TEF). Which statement would be correct in educating the family of what to expect in the immediate post-operative period? Select that apply. A: "Frequent suctioning with a pre-measured catheter is required." B: "The head of bed should be elevated 30-45 degrees." C: "If there is no leak 5-7 days after the surgical repair, oral feedings will be started." D: "This type of TEF cannot be surgically repaired." E: "The baby will be on acid suppression therapy using a proton pump inhibitor (PPI), such as Lansoprazole postoperatively."

A, B, C, E

A nurse is planning care for a patient with thrombocytopenia. Which nursing intervention will be included? Select all that apply. A: Monitoring stools for blood B: Avoiding injections C: Avoiding use of salicylates (aspirin) D: Avoiding steroids E: Monitoring activities

A, B, C, E

A school-age child is diagnosed with meningitis. What should the nurse expect to assess in this client? Select all that apply. A: Stiff neck B: Photosensitivity C: Severe headache D: Lower extremity weakness E: Elevated body temperature

A, B, C, E

A school-age child is reported as having a seizure at school. Which finding should indicate to the nurse that the client is experiencing focal seizures? Select all that apply. A: Spasms B: Muscle rigidity C: Head turning D: Loss of muscle tone E: Jerking of the extremities

A, B, C, E

An 8-month-old client is diagnosed with microcephaly. What should the nurse expect to assess in this client? Select all that apply. A: Seizures B: Hyperactivity C: Dysmorphic facial features D: Paralysis on one side of the body E: Circumference more than two standard deviations below normal

A, B, C, E

The nurse is accessing a child's central line for chemotherapy. What are important nursing actions with central line access? Select all that apply. A: Use only 10mL syringes to flush the line. B: Maintain aseptic technique. C: Identify the child with two identifiers. D: Have the child preform hand hygiene. E: Wear gloves when working with a child's central line.

A, B, C, E

The nurse is caring for an adolescent with a head injury and suspects increased intracranial pressure (ICP). What findings support that belief? Select all that apply. A: Headache B: Vomiting that can increase to projectile C: Papilledema and blurred or double vision D: Petechial hemorrhages E: Sunsetting eyes

A, B, C, E

The nurse suspects that a preadolescent client is experiencing migraine headaches. Which finding caused the nurse to make this clinical determination? Select all that apply. Begins to vomit A: Reports dizziness B: Asks for the lights to be turned off C: Turns the volume up on the television D: Asks for something to stop the "head pounding"

A, B, C, E

A nurse is describing nursing interventions for a client that is obese. Which interventions would be accurate? Select all that apply. A: Educating client for symptoms of heart disease B: Monitoring for uncontrolled hypertension C: Checking blood sugars only if there is a family history of diabetes D: Suggesting a sleep study E: Urging parents to give children whatever they want to eat when they become upset in order to enhance emotional well-being

A, B, D

A nurse is planning care for a child with acute lymphocytic leukemia (ALL). Which statement is true? Select all that apply. A: Swollen glands are a clinical manifestation of ALL. B: ALL is the most common type of cancer in children. C: Philadelphia chromosome abnormality is a possible cause of ALL. D: Previous chemotherapy is a possible cause of ALL. E: The cause is unknown.

A, B, D

A nurse is providing care to a child with an oncologic disorder. Please identify nursing interventions for the child. Select all that apply. A: Monitor for seizures and changes in posturing. B: Assess oral cavity for stomatitis. C: Place the child in Trendelenburg position to facilitate drainage. D: Monitor level of consciousness and sleep patterns. E: Allow the child to lie with head sideways on the pillow.

A, B, D

A preschool-age child requires an MRI of the brain and spinal cord. Which action should the nurse take when caring for this client? Select all that apply. A: Remove earrings from both ears. B: Provide age-appropriate sedation. C: Restrict oral fluids after the study. D: Monitor level of responsiveness after the study. E: Report crying after the study to the health care provider.

A, B, D

An adolescent is admitted and diagnosed with irritable bowel syndrome (IBS). The nursing providing discharge instructions should instruct the child to avoid which foods? Select all that apply. A: Caffeinated soda B: Milk and cheese C: Kiwi and strawberries D: Oranges and grapefruit E: Lean chicken and fish

A, B, D

The nurse is assessing a child who presents with diarrhea. Which questions would be important to ask the caregivers? Select all that apply. A: "How frequent is the diarrhea?" B: "Are the stools bloody?" C: "Did you insert anything in the rectum to cause this?" D: "Is the stool watery?" E: "Don't you make your child wash their hands so they don't get sick?"

A, B, D

The nurse recognizes which symptoms as typical signs of dehydration? Select all that apply. A: Little to no urine output B: Crying without tears C: Urine specific gravity of 1.005 D: Sunken fontanel E: Heart palpitations

A, B, D

The nurse is providing education to a school-age client and her family on how to avoid headache triggers when possible, along with a list of some common headache triggers. What should the nurse include in that list? Select all that apply. A: Sleep deprivation B: Inadequate fluid intake C: Eating too many sugary sweets D: Stress E: Skipping meals, most commonly breakfast

A, B, D, E

The nurse is reviewing the plan of care for an adolescent child with cerebral palsy. Which treatment modalities would the nurse expect? Select all that apply. A: Speech therapy B: Physical therapy C: Respiratory therapy D: Occupational therapy E: Educational therapy

A, B, D, E

A nurse is assessing for indications to administer packed red blood cells. Select indications for administration. Select all that apply. A: Impending heart failure B: Recurrent priapism C: Hemoglobin >8 grams in a stable patient with chronic anemia D: Hypervolemia E: Splenic sequestration

A, B, E

A nurse is teaching the caregiver of a child with lead poisoning. Caregiver education will include which of the following? Select all that apply. A: Instructing about lead hazards and sources B: Relocating the child from the environment until lead is removed C: Cleaning the environment with a disinfectant and discard in a puncture resistant container D: Referring to a physical therapist to evaluate the child as needed E: Referring to a speech and child developmental specialist to evaluate child as needed

A, B, E

The nurse is teaching a family about bilirubin encephalopathy (kernicterus). Which statement would be accurate in educating the family? Select all that apply. A: "Your baby may exhibit a high-pitched cry." B: "Hypotonia or hypertonia may be present." C: "Seizures are not common with this condition." D: "Your baby will have no problems sucking or taking a bottle." E: "Opisthonic posturing or arching can happen with this condition."

A, B, E

The nurse is assessing an out- toeing in a 6-month-old child. What musculoskeletal foot deformities should be considered? Select all that apply. A: Calcaneovalgus foot B: Clubfoot C: Lateral tibial torsion D: Metatarsus adductus E: Genu varum

A, C

A nurse is assessing a child with a hematologic disorder. Children with a hematologic disorder may present with: (Select all that apply) A: Edema B: Bradycardia C: Delayed learning D: Brittle and concave nails E: Increased serum concentration of the proteins albumin, gamma globulin, and transferrin

A, C, D

A nurse is planning care for a child with suspected lead poisoning. Which diagnostic tests are utilized? Select all that apply. A: Free erythrocyte protoporphyrin (FEP) B: Liver function test C: Urinalysis D: Bone radiography E: Blood glucose

A, C, D

A nurse is teaching a caregiver of a child with aplastic anemia. Which statement should the nurse include in the teaching? Select all that apply. A: There is a history of illness that does not heal. B: Monitor for hyperactivity. C: Monitor immunosuppressive therapy to remove functions that prolong aplasia. D: There is an increased percentage of reticulocytes. E: Prevent infection with strict adherence to droplet precautions.

A, C, D

Peptic ulcers are usually treated with "triple therapy." What does "triple therapy" consist of? Select all that apply. A: Proton pump inhibitor (PPI) B: Vancomycin C: Amoxicillin D: Clarithromycin E: Milk of magnesia

A, C, D

The nurse commonly sees children in the emergency department (ED) with what fracture sites? Select all that apply. A: Distal radius B: Fibula C: Tibia D: Clavicle E: Femur

A, C, D

The nurse is caring for an adolescent with idiopathic scoliosis. The adolescent had a spinal fusion and is preparing to go home. What are the discharge instructions regarding mobility? Select all that apply. A: Walk three times a day B: Maintain a urinary catheter C: Avoid contact sports including gym classes for up to 5 months D: Avoid bending, twisting or sudden motions for up to 3 months E: Continue with supplemental oxygen

A, C, D

The nurse is assessing an infant for hydrocephalus. What signs and symptoms should the nurse identify to support this potential diagnosis? Select all that apply. A: Rapid increase in head circumference or an unusually large head size B: Bulging fontanel with crying C: Vomiting D: A high-pitched, shrill cry E: Sunsetting eyes

A, C, D, E

The nurse is caring for a newborn who was born with gastroschisis. Which nursing interventions are accurate in the care of and newborn born with this condition? Select all that apply. A: Insert an orogastric tube to decompress the intestines B: Place the newborn in a prone position C: Cover the defect with sterile normal saline non-adherent dressing after delivery D: Observe closely for defecation E: Support the newborn with fluids and parenteral nutrition

A, C, D, E

The nurse is preparing a school-age child for magnetic resonance imaging (MRI). What considerations should the nurse identify as important when preparing a pediatric client for an MRI? Select all that apply. A: The child is often given age-appropriate sedation for the MRI. B: Children should be encouraged to eat and drink prior to going into the MRI due to the long length of time they may be in the test. C: Nursing care is aimed at alleviating anxiety and complications. D: Any metallic piercings or jewelry must be removed from the child prior to the procedure. E: Intake and output must be monitored.

A, C, D, E

The nurse is teaching a client about their Crohn's disease diagnosis. Which responses determine that the client understands the education provided? Select all that apply. A: "Crohn's disease is an immune response to injured tissue." B: "Crohn's disease is an acute one-time inflammatory disorder." C: "Crohn's disease can affect any part of the GI tract from the mouth to the anus." D: "Crohn's disease is more commonly found in the small intestine." E: "Crohn's disease may extend through the entire thickness of the bowel."

A, C, D, E

A nurse is assessing a child with acquired thrombocytopenia. Which findings would the nurse identify as consistent with this diagnosis? Select all that apply. A: Recent exposure to Rocky Mountain spotted fever B: Painful urination C: Petechiae over bony prominences D: Exposure to radiation E: Exposure to chemicals

A, C, E

A nurse is assessing clinical indications for administration of platelets. Select indications for administration. Select all that apply. A: Platelet count <20,000 B: Hypervolemia C: Thrombocytopenia D: Pallor E: Active bleeding

A, C, E

The nurse is asked to prepare a teaching tool about acquired hydrocephalus in pediatric clients. Which type should the nurse include? Select all that apply. A: Ex-vacuo B: Incomplete C: Communicating D: Normal pressure E: Non-communicating

A, C, E

The nurse is discharging a newborn that was diagnosed with pediatric gastroesophageal reflux disease (GERD). Upon discharge, what information should the nurse provide to the parent? A: "It is important to position your infant upright, elevating the head of the bed." B: "You should discontinue breastfeeding, as this might worsen your infant's condition." C: "If you are bottle feeding, it is important to use a concentrated formula." D: "You should avoid placing your infant in a carrier directly after feeding." E: "You should provide your infant with large, less frequent feedings."

A, D

A nurse is teaching a child and caregiver prior to diagnostic testing for a childhood cancer. Which statement is true relating to diagnostic testing? Select all that apply. A: State what the child will experience. B: Encourage the child to be a big boy/girl. C: Avoid distraction techniques. D: Consider the developmental level of the child. E: Give the child equipment or pictures of equipment to play with prior to the procedure.

A, D, E

An infant is born with an open spinal cord defect. Which action should the nurse take when caring for this client? Select all that apply. A: Position the client prone. B: Position the client supine. C: Keep the defect open to air. D: Place the client on an open diaper. E: Cover the defect with a moist, sterile dressing.

A, D, E

Celiac disease is suspected in a 6-month-old child. What signs and symptoms would this child most likely experience? Select all that apply. A: Abdominal bloating B: Constipation C: Accelerated growth and development D: Flatulence E: Dental enamel defects in the teeth

A, D, E

The nurse is caring for a child with Legg-Calve-Perthes (LPC) disease. What ethnicities are most commonly are affected with LPC? Select all that apply. A: Caucasian B: Black C: Polynesian D: Asian E: Alaska-native

A, D, E

The nurse is teaching a caregiver of a child with human immunodeficiency virus (HIV). Which statement regarding caring for a child with HIV are true? Select all that apply. A: Educate day-care and school staff on current HIV information. B: Encourage the use of pharmacologic pain interventions. C: Dependence on opioids may require decreased dosing over time. D: Emphasize time of administration of highly active antiviral therapy (HAART) E: Foster positive self-concept.

A, D, E

A child with a Spica cast is admitted to the hospital. What are the possible reasons for the Spica cast? Select all that apply. A: Hip dysphasia B: Scoliosis C: Osteomyelitis of the hip D: Avascular necrosis E: Fractured femur

A, E

A mother brings a 7-month-old child to the emergency department (ED) because after being picked up from daycare today, the child cries when the leg is touched. The x-ray confirms a spiral femur fracture. What are appropriate questions for the nurse to ask to investigate child abuse? Select all that apply. A: Was the child involved in any accidents? B: What type of insurance do you have? C: Do you have other children at home? D: What type of work do you do? E: Who are the caregivers of this child?

A, E

The nurse is educating the client about peptic ulcer disease. Which are the most common causes of peptic ulcer disease that should be emphasized? Select all that apply. A: Helicobacter pylori (H Pylori) B: Long-term acetaminophen usage C: Stress D: Spicy food E: Chronic aspirin use

A, E

A 3-month-old infant has gastroesophageal reflux disease (GERD), but is thriving without complications. Which interventions should the nurse suggest to minimize reflux? A: Give continuous nasogastric feedings B: Give larger, less frequent feedings C: Thicken formula with rice cereal D: Place infant in a car seat after feeding

C

An 8-year-old reports right lower quadrant (RLQ) abdominal pain. The parent states, "He is just not himself. He's not playing and just lays on the sofa in a fetal position." Upon physical exam, he has rebound pain and pain in the RLQ when jumping. What does the assessment data indicate may be occurring with this child? A: Celiac disease B: Appendicitis C: Rotavirus D: Inflammatory bowel disease

B

A 2-month-old has severe reflux disease (GERD) and is not gaining weight. Which surgical intervention would be indicated that entails wrapping the stomach around the esophagus to prevent reflux? A: Hiatal hernia repair B: Nissen fundoplication C: Pyloromyotomy D: Cardiac sphincterotomy

B

A 6-year-old is admitted with suspected appendicitis. The client reports abdominal pain. What would be the best way to quantify the child's pain? A: Use the FLACC scale B: Use the revised FACES scale C: Use the 0 to 10 numeric scale D: Ask the child to describe the pain

B

A child fell and injured a knee during a baseball game. The parents ask what the best inexpensive diagnostic test that can be used to visualize the knee is. How should the nurse respond? A: Radiograph B: Arthrography C: Ultrasound D: Computerized tomography scan

B

A child has had serial castings for a club foot. What are indications the club foot deformity is returning and the parents need to return to the clinic? A: The child is walking on the balls of the feet. B: The child's foot is turning inward. C: The child has abducted feet. D: The child's Achilles tendon is loose.

B

A 10-year-old child is admitted to the hospital with a suspected brain tumor and is scheduled for a magnetic resonance imaging (MRI) in the morning. What should the nurse include in the child's teaching? A: "The MRI will explain the type of abnormal growth." B: "The MRI will locate the exact place that is causing you to be sick." C: "The MRI room is hot and noisy during the study." D: "The next test will differentiate the cells and help with future treatments."

B

A young child is suspected of having intussusception. Which assessment findings correlate with this condition? A: Legs extended when crying B: Severe gastroesophageal reflux C: Irritability D: Bloody diarrhea

C

A child has just been diagnosed with cystic fibrosis (CF). The nurse is teaching the client and their family about the importance of maintaining proper nutrition. Which statement made by the nurse is accurate? A: "The diet of a child with CF should be low calorie and low protein." B: "A gastrostomy tube may be required if failure to thrive occurs." C: "It is okay to eat whatever you want as long as you eat something." D: "It is important for you to take vitamin B & C since you have trouble absorbing them."

B

A child is diagnosed with nonalcoholic fatty liver disease (NAFLD). When explaining what this is to the parents, which statement would be most accurate? A: "This condition leads to liver disease and your child may need a liver transplant." B: "There is fat in the liver but little or no inflammation or liver cell damage." C: "Nonalcoholic steatohepatitis (NASH) is a type of NAFLD that can be diagnosed in utero." D: "Left lower quadrant pain frequently occurs with NAFLD."

B

A child participating in a sporting event hears a "pop" after throwing a ball. What does the hearing of the "pop" indicate to the nurse? A: A shoulder dislocation B: A tear in the bicep tendon C: A fractured humerus D: A sprained elbow

B

A hospitalized preadolescent client is having difficulty waking up in the morning. Which observation should the nurse identify as contributing to this client's issue with sleep? A: Reading a book before bed B: Playing computer games until after midnight C: Eating a light snack with milk before bedtime D: Talking with the parents before turning out the light

B

A mother is telling a nurse in the community that a Denis-Browne bar has been prescribed for her 2-year-old son. What musculoskeletal abnormality uses a Denis-Browne bar for at least 23 hours a day? A: Metatarsus adductus B: Clubfoot C: Genu varum D: Genu valgum

B

A nurse in the emergency department (ED) is assessing a pre-school age client who had a febrile seizure at home. The parent is very concerned and asks the nurse if this is very serious. How should the nurse respond? A: "Yes, the child is likely to get brain damage when a fever gets too high." B: "Generally they are not. But it is best to treat a fever when it starts." C: "No, they don't cause any issues." D: "Yes, you should consider this a medical emergency any time something like this occurs."

B

A nurse is assessing for clinical signs and symptoms of anemia. Which assessment findings are present? A: Hypertension B: Syncope C: Bradycardia D: Ruddiness

B

A nurse is monitoring a child with suspected thrombocytopenia. The nurse will observe for which clinical manifestations: A: History of epistaxis B: Petechiae, often over bony prominences C: History of sickle cell D: Recent exposure to bacterial pneumonia

B

A nurse is planning administration of fresh frozen plasma (FFP). Which statement is true? A: It is a replacement for deficiency of hemoglobin and hematocrit. B: FFP product must be used within eight hours of thawing C: Fibrinogen levels must be below 150 mg/dL. D: Warfarin anticoagulant administration indicates FFP.

B

A nurse is planning care for a child with suspected sickle cell disease. Which diagnostic test will yield results within minutes to determine if Hgb S present? A: Hematocrit B: Sickle cell turbidity test C: Hemoglobin electrophoresis D: Liver function test

B

A nurse is planning nursing interventions to promote nutrition and hydration in a child diagnosed with cancer. Which interventions should the nurse include? A: Offer any tolerated food and drink every four hours if needed. B: Allow the child to be involved in food and drink selection. C: Avoid allowing the parents to bring food from home. D: Assess the child for bulimia.

B

A nurse is teaching a caregiver of a child regarding oncology emergencies. Which would the nurse consider? A: Hypervolemia B: Hyperleukocytosis C: Hyperglycemia D: Hypernatremia

B

A nurse is teaching about various cancers in children. Which type of cancer is usually diagnosed <1 year of age? A: Wilms' tumor B: Neuroblastoma C: Eye cancer D: Hodgkin's cancer

B

A parent is concerned about the child's sport's schedule. What statement made by the nurse explains overuse injuries? A: The child's body will not be able to overuse the musculoskeletal system. B: Overuse injuries occur when activity levels exceed the body's ability to recover. C: Only adults can suffer from overuse injuries. D: The child will stop the activity with any pain.

B

A parent tells a nurse during a wellness visit at a pediatrician's office that her toddler sits differently than other children. The mother describes the sitting as a "W" position and asks if there are any treatments. What is the nurse's best response? A: You should ask the physician to schedule surgery to correct the internal femoral torsion. B: This deformity may correct itself as the child gets older. C: If the child is comfortable sitting in the "W" position let him be. D: I think you should encourage your child to walk more.

B

A patient asks the nurse why non-Hodgkin's lymphoma (NHL) is more difficult to treat compared to Hodgkin's lymphoma. What is the nurse's best response? A: "The NHL cell type may be highly differentiated and spreads slowly." B: "NHL occurs in the peripheral lymph nodes and spreads to tissues throughout the body, while Hodgkin's lymphoma develops in a single lymph node." C: "Hodgkin\"s disease develops in a single lymph node and NHL occurs in every organ throughout the body." D: "NHL and Hodgkin's lymphoma are malignant diseases of the bone marrow and lymphatic system."

B

A pediatrician tells a mother that the infant has metatarsus adductus. The mother asks the nurse what she could have done during her pregnancy to cause this congenital abnormality. What is the nurse's best response? A: The deformity may be related to the difficult pregnancy. B: The foot was deformed due to utero forces with the feet positioning. C: The foot deformity is most likely from the gestational diabetes. D: The foot deformity is because the mother is a multigravida.

B

A preschool-age child is diagnosed with type 1 neurofibromatosis. What should the nurse expect to assess in this client? A: Rash B: Café au lait spots C: Edematous lower extremities D: Tiny red veins that appear in the corners of the eyes

B

A school-age client is experiencing bilateral lower extremity weakness that is spreading to the hands and arms. Which diagnostic test should the nurse expect to prepare this client? A: MRI of the spine B: Lumbar puncture C: CT scan of the head D: Electroencephalogram

B

An adolescent asks the nurse what a biopsy will do for a new growth in the abdomen. What is the nurse's best response? A: "The biopsy will help confirm the cancer type of cells and treatment needed." B: "The biopsy will determine the type of benign or malignant tumor." C: "The biopsy will identify if a central intravenous line is needed." D: "The biopsy will determine if antibiotics are needed."

B

The nurse assesses a child and notes a rib hump. What musculoskeletal deformity will exhibit a rib hump? A: Genu valgum B: Juvenile Scoliosis C: Lateral tibial torsion D: Genu varum

B

The nurse is assessing motor skills of a preschool-age child. What method would best accomplish this goal? A: Ask the parent what the child is able to do. B: Offer age-appropriate toys to see if the child manipulates the toy appropriately. C: Ask the child questions to determine the level of capability. D: Give the child a physical exam.

B

The nurse is assigned an adolescent client with newly diagnosed meningitis and is going in the client's room to hang the antibiotics. What personal protective equipment (PPE) should the nurse put on? A: Gown and gloves B: Gown, mask, and gloves C: Gown, goggles, mask, and gloves D: Gloves

B

The nurse is caring for a child with juvenile arthritis. What laboratory study may correlate with juvenile arthritis? A: C-Reactive protein 2.6mg/dL B: Positive Rheumatoid factor C: Bone biopsy with normal bone cells D: Erythrocyte sedimentation rate 99 mm/hr

B

The nurse is doing post-procedure education with a school-age child after a lumbar puncture. What factor is important for the nurse to emphasize? A: The child will be NPO for 6 hours post-procedure. B: The child will need to lay flat for 4 to 24 hours. C: The child will need hourly vital signs for the first 6 hours post-procedure. D: The child will need to be assessed for adequate urinary elimination within 4 hours post-procedure.

B

The nurse is giving medications to an adolescent with cerebral palsy (CP). What symptom(s) do a majority of the CP medications target? A: Decreased cardiac output B: Muscle spasm and spasticity C: Respiratory compromise D: Muscle atrophy

B

The nurse is performing a home assessment on a preschool-age child. The nurse notices that when in a squatting position, the child has to use his hands and arms to "walk up" his own body, pushing as he goes, in order to stand. What condition should the nurse investigate further? A: Cerebral palsy B: Muscular dystrophy C: Myasthenia gravis D: Guillain-Barré

B

The nurse is providing education to the parent of a child about how medications are used to treat constipation in children. What is the most commonly used, well-tolerated medication that the nurse suggests? A: Mineral oil B: Polyethylene glycol C: Lactulose D: Bisacodyl

B

The nurse is screening children and parents for lead exposure. What is an appropriate question for the nurse to detect lead exposure? A: Do you use stainless steel pots to cook? B: Is your house plumbed with copper pipes? C: How often do you snack on potato chips? D: Do your children play with stuffed animals in your house?

B

The nurse is teaching a caregiver about foods to include in an iron-rich diet. Which food should be included? A: Lean beef B: Organ meats C: Dark green leafy vegetables D: Potatoes

B

The nurse is teaching about Crohn's disease. Which symptoms would the nurse include in explaining the clinical presentation of Crohn's disease? A: Constipation B: Diarrhea C: Symptoms of gastric reflux D: Weight gain

B

The nurse observes a newborn become cyanotic when feeding. What procedure will the nurse perform as prescribed to assess for a tracheoesophageal fistula (TEF)? A: Feed the newborn with smaller, frequent feedings B: Attempt to pass a nasogastric tube (NG tube) C: Check for simian creases on the palms of the hands D: Administer a saline lavage

B

The nurse understands that a diagnosis of osteogenesis imperfecta is detectable in utero by ultrasound. What ultrasound finding would identify a suspected osteogenesis imperfecta? A: Growth plate deformities B: Identification of bowing of the long bones C: Fractured clavicle D: Painful lower extremities

B

The parent shares with the nurse that her mother had pain with cancer and is wondering why her child is not experiencing pain with a newly diagnosed lymphoma. What is the nurse's best response? A: "All cancers have or will have pain." B: "Pain occurs when the neoplasm directly or indirectly affects nerve receptors." C: "The child's cancer is different and treatment is based on the type and stage of cancer." D: "Children do not experience pain like adults."

B

The parents are concerned about the recommended treatment of a thoracolumbosacral orthosis for their child. What medical condition does the nurse understand the child to have? A: Femur fracture B: Juvenile scoliosis C: Internal tibial torsion D: Genu valgum

B

The physician is discussing Blount's disease with parents. What is the relationship between Blount's disease and musculoskeletal deformity? A: Blount's disease does not have any hereditary and genetics factors. B: Blount's disease is seen with heavy children with early ambulation. C: Blount's disease in infants is treated with long leg braces. D: Blount's disease is a psychosocial concern for infants.

B

The school nurse is being consulted by a teacher with concerns about a student who is doing poorly in class. The student stares off into space regularly and is unable to recall information that was just discussed. What disorder should the nurse suspect? A: Myoclonic seizures B: Absence seizures C: Febrile seizures D: Tonic-clonic seizures

B

Which choice describes meningocele? A: A section of the spinal cord and the nerves that come from the cord are exposed and visible on the outside of the body. It causes partial or complete paralysis below the spinal opening. B: The membrane that surrounds the spinal cord is enlarged, creating a cyst-like sac. The sac that is present usually on the lower back contains meninges, which are the membranes covering the spinal cord. C: A section of the spinal vertebrae is malformed, but the spinal cord and nerves are normal. The defect is not visible, though newborns may display dimpling, hair, or hemangioma in the lumbar sacral area. D: Tissue attachments limit the movement of the spinal cord within the spinal column.

B

The nurse recognizes that infant septic arthritis and osteomyelitis of the hip require immediate treatment. What is the potential outcome of delay treatment? A: Femur neck fracture B: External tibial toeing C: Hip deformity D: Scoliosis

C

A nurse is assessing a child with a brain tumor. Identify assessment findings associated with this diagnosis. Select all that apply. A: Decrease in head size B: Sluggish pupils C: Unequal and weak hand grasp D: Headache at bedtime E: Nausea and vomiting

B, C, E

The parent is questioning the nurse about the child's leg cast. What statements are true about casting? Select all that apply. A: All children do better with fiberglass casts. B: The child may have a plaster cast for molding then a fiber glass cast to protect the plaster cast. C: The plaster cast allows for molding. D: The plaster cast is rigid. E: Fiberglass casts can be exposed to water.

B, C

A nurse is caring for an infant admitted with pyloric stenosis. What are some of the assessment findings the nurse would expect? Select all that apply. A: Bilious vomiting B: Failure to thrive (FTT) C: Irritability D: Metabolic alkalosis E: Diarrhea

B, C, D

A nurse is planning care for a child with hemophilia. Which statement is true in the care of the child with hemophilia? Select all that apply. A: Hemophilia is commonly a deficiency of factor X. B: Hemarthrosis into the joint cavities of a child with hemophilia is a clinical manifestation. C: Hemophilia A and B are inherited as X-linked recessive traits. D: Spontaneous hematuria in children with hemophilia is a clinical manifestation. E: Males are carriers and do not have the disease.

B, C, D

A nurse is planning care for a child with sickle cell disease. Which interventions are utilized in the care of the child? Select all that apply. A: Metabolic alkalosis treatment with IV replacement B: Administration of Hydroxyurea C: Positive self-talk D: Activity and rest cycling for periods of activity intolerance E: Liver resection as a life saving measure

B, C, D

A nurse is teaching a caregiver of a child with Wilms' tumor. Which statement regarding care of the child is true? Select all that apply. A: Side effects of cancer treatment are usually not evident after six months. B: Do not palpate the tumor. C: Avoid pushing or lifting in tumor area. D: Genetic counseling may be ordered. E: Chemotherapy and radiation typically eradicate the tumor

B, C, D

A parent asks the nurse what could have caused his child to have cancer. What are possible causes of cancers? Select all that apply. A: Surgeries B: Chemical carcinogens C: Radiation D: Viruses E: Infections

B, C, D

The nurse is providing anticipatory guidance to a family with a toddler who is getting ready to sleep in his own bed. What information should the nurse share with the parents to help establish healthy sleep patterns? Select all that apply. A: Put the child to bed at the same time each night through the week, with more freedom on the weekends. B: The child should only sleep in bed. C: The bedroom should be dark, quiet, and cool. D: Establish a bedtime routine. E: Perform vigorous activity before bed to burn off extra energy.

B, C, D

The nursing students asks the nurse what the main causes of failure to thrive (FTT) are. What should the nurse include as some of the main causes? Select all that apply. A: Intermittent diarrhea B: Inadequate intake for age C: Inadequate caloric absorption D: Excessive calorie expenditure with poor intake E: An infant being fed every 4 ounces of formula 3-4 hours

B, C, D

A 2-month-old presents to the emergency department (ED). The parent states, "I was feeding my child a bottle and he just turned blue. He frequently does this, but this time I had to rub his chest to get him to breathe. I notice a lot of crying after eating too." What further questions might the nurse ask the parent to assess if the infant has reflux? Select all that apply. A: "Does he arch? If he does, it is definitely reflux." B: "Have you noticed your baby spit up after feedings and, if so, how much?' C: "Can you tell me how often during the feeding you burp your baby?" D: "Tell me more about these episodes of turning blue. Is it always after he eats?" E: "What position do you feed your baby in? Is he lying flat, or do you have his head slightly elevated when feeding?"

B, C, D, E

A school-age child is reported as experiencing sleepwalking at home. Which behavior should the nurse anticipate this client demonstrating? Select all that apply. A: Wakes up screaming in fear B: Appears awake with the eyes open C: Conversation does not makes sense D: Found sleeping on the floor near the window E: Appears confused and disoriented when awakened

B, C, D, E

At a well checkup, the parent reports that her child is constipated. What questions should the nurse ask to gain knowledge about the child's stool pattern? Select all that apply. A: "Do you force your child to go to the bathroom?" B: "How often does your child have a bowel movement?" C: "What is the consistency of the stool when they have one? Is it hard, soft, or liquid?" D: "Does your child have a ritual when they go to the bathroom?" E: "Does your child strain when having a bowel movement?"

B, C, D, E

The nurse is caring for a child with septic arthritis. What laboratory studies correlate with septic arthritis? Select all that apply. A: Platelet count 600,000/L B: White blood cell count 12,800/L C: Blood culture positive for D: Staphylococcus aureus D: C-Reactive protein 5.6mg/dL E: Erythrocyte sedimentation rate 89 mm/hr

B, C, D, E

The nurse is discussing treatments for intussusception with a client. Which statement made by the nurse is correct? Select all that apply. A: "Intussusception most often resolves on its own without intervention." B: "Reduction may be performed with barium or air insufflation." C: "Intussusception can block blood supply to the affected portion of the intestine." D: "This is the most common cause of intestinal obstruction in children less than 3 years of age." E: "Surgical intervention may be required if the initial attempt at reduction fails."

B, C, D, E

A nurse is teaching a caregiver of a child with iron deficiency anemia. Caregiver education relating to iron deficiency anemia includes: A: Avoid consumption of cow's milk in infants until age 10 months. B: For breastfed infants, provide an iron supplement. C: Teach parents to add iron-rich foods to child's diet. D: Iron supplementation is required if the child is bottle fed. E: Whole milk is recommended from 12 months to two years.

B, C, E

The nurse is assessing a child's arm after casting. What nursing assessments show there is vascular compromise in the child casted arm? Select all that apply. A: The child feels no pain or needles. B: The fingers are pale in color. C: The child cannot move the fingers. D: The fingers are warm to touch. E: The child feels severe pain in the elbow.

B, C, E

The nurse is educating a family about hepatitis. Which statements are true about hepatitis? Select all that apply. A: "Hepatitis B is caused by the oral-fecal route." B: "Hepatitis A, B, & C may not exhibit symptoms early on in the disease process." C: "Hepatitis C is caused by exposure to infected blood or blood products through sexual contact." D: "Good hand hygiene is important in hepatitis B." E: "In children older than 12 years of age, Ledipasvir/sofosbuvir (Harvoni) is an antiviral treatment that can treat Hepatitis C."

B, C, E

The nursing instructor is teaching students about slipped capital femoral epiphysis (SCFE). What are risk factors of SCFE? Select all that apply. A: Infant onset B: Adolescent onset C: Obesity D: Firstborn child E: African-American ethnicity

B, C, E

A nurse is assessing a child with Acquired Immunodeficiency Syndrome (AIDS). Which assessment findings are present? Select all that apply. A: Chronic or recurrent urinary tract infection B: Mucocutaneous eruptions C: Epiglottitis D: Parotitis E: Chronic or recurrent diarrhea

B, D, E

A nurse is teaching a caregiver about autologous blood transfusion. Which statements are true? Select all that apply. A: Confirm parents' willingness for transfusion. B: Confirm patient's self-donation with parents. C: Observe urinary output. D: Observe vital signs as with other blood products. E: Verify client identification.

B, D, E

A 1-month-old infant is noted to have significant jaundice. The mother states the urine in the infant's diapers appear very dark. She also noticed the color of the stool is gray in color. What might the nurse suspect this infant has? A: Malabsorption syndrome B: Dehydration C: Biliary atresia D: Nonalcoholic fatty liver disease (NAFLD)

C

A 10-year-old presents with epigastric pain and nausea, and states they have pain that wakes them up at night. They say they feel better if they eat cookies or crackers. What condition does the nurse suspect the symptoms indicate? A: Ulcerative colitis B: Lactose intolerance C: Peptic ulcer disease D: Intussusception

C

A 12-year-old male child is diagnosed with acquired thrombocytopenia (ATP) after an infection with Rocky Mountain spotted fever. The nurse understands that which diagnostic exam will identify ATP? A: Partial thromboplastin time: 28 seconds B: Total iron-binding capacity values: 280 mg/dL C: Platelet count: 80 x 103/mcL D: Hemoglobin: 13.5 g/dL

C

A 3-year-old child is brought to the emergency department with severe dehydration secondary to acute diarrhea and vomiting from gastroenteritis. The child is listless and lethargic. What action by the nurse would assist in the management of the child's condition? A: Administer oral rehydration solutions B: Administer clear liquids by mouth, 1 to 2 ounces at a time C: Initiate intravenous (IV) fluids D: Administer of antidiarrheal medications

C

A 5-year-old client is being tested for muscular dystrophy. Which type of this disorder should the nurse expect the client to perform Gowers' sign? A: Becker muscular dystrophy B: Acquired muscular dystrophy C: Duchenne muscular dystrophy D: Facioscapulohumeral muscular dystrophy

C

A child arrives in the emergency department with a painful warm swollen knee. The child is not able to bear weight and the knee is very difficult to move from pressure. What action does the nurse anticipate will be done? A: The healthcare provider will consult a physical therapist. B: The healthcare provider will prescribe a narcotic to relieve knee pain and pressure. C: The healthcare provider will do a fluid aspiration from the knee. D: The healthcare provider will discharge the child with prescribed ice treatments.

C

A child fell and had difficulty walking on the foot. The emergent x-ray did not show a fracture. What feature on the four-week repeat x-ray indicates to the nurse that the child had an occult fracture? A: A compression at the growth plate B: A perfectly aligned healing fracture C: A healing callus formation along the seam of the bone D: A thick periosteum

C

A child had trauma to the leg 6 months ago and now the orthopedic physician suspects osteomyelitis. What diagnostic exam will identify osteomyelitis? A: Calcium level B: Radiograph C: Bone biopsy D: Magnetic resource imaging

C

A child is diagnosed with juvenile idiopathic arthritis. What does the nurse recognize as the most common reason to seek medical care? A: Anorexia B: Limping in the early morning C: On and off joint pain in several different joints D: Low- grade fever

C

A child is diagnosed with ulcerative colitis (UC). The child states, "Why do I have this disease? It is not fair." Which statement by the nurse would be best to help this child cope? A: "I'm sorry but no one knows why, so you will just have to make the best of it." B: "At least you will be able to eat anything you want and not gain weight." C: "Why don't you go to a camp with other children who have ulcerative colitis?" D: "I will be here every time you come into the hospital, so don't worry."

C

A child with idiopathic thrombocytopenia (ITP) is receiving intravenous immunoglobulin. For what adverse effect will the nurse monitor the child during the start of the infusion? A: Renal failure B: Bruising C: Fever D: Hypertension

C

A mother is talking to the nurse and is concerned that her infant will get meningitis and die like her cousin's child did many years ago. The mother asks the nurse, "What is the best way I can protect my child?" How should the nurse respond? A: "There is no way to prevent it, unfortunately, but you must be quick to respond to any symptoms." B: "You should avoid taking your baby anywhere." C: "Many strains are vaccine-preventable, so getting all your vaccinations is a good start." D: "Keep your baby away from anyone who is sick."

C

A nurse is examining an infant with left-sided curved scoliosis. The mother asks the nurse what diagnostic study will be used to determine severity of the scoliosis. What diagnostic study does the nurse anticipate will be ordered for the infant? A: Spinal X-ray B: Ultrasound C: Magnetic resonance imaging D: Bone biopsy

C

A nurse is preparing medications for administration. Nursing interventions for iron administration include: A: SQ injection method for iron dextran (Imferon) B: Iron supplementation may be necessary in some populations C: Z-track injection method for iron dextran (Imferon) D: Liquid dosage of iron administered with a medication cup

C

A nurse is providing education to a pregnant woman who is believed to have been exposed to the Zika virus. The woman asks, "What is the biggest complication babies born with this syndrome often experience?" How should the nurse respond? A: "Most babies born with this syndrome suffer with paralysis." B: "Most babies born with this syndrome suffer with hydrocephalus." C: "Most babies born with this syndrome suffer with microcephaly." D: "Most babies born with this syndrome suffer with Down syndrome."

C

A nurse is teaching a caregiver for the child undergoing hematopoietic stem cell transplantation (HSCT). Which statement is true for the child? A: Discourage sibling participation in child's care until stabilized. B: Care will be provided only by trained personnel. C: Prepare the child for isolation to undergo intensive ablative therapy. D: Adherence to standard precautions is warranted.

C

A patient is diagnosed with a terminal brain tumor. What teaching should the nurse include with the recommended palliative treatments? A: The chemotherapy will shrink the brain tumor. B: The child will not have pain as therapy continues. C: Radiotherapy will shrink the brain tumor. D: There are no side effects with radiation therapy.

C

A preadolescent client experiences severe migraine headaches. Which medication should the nurse expect to be prescribed to treat this client's health problem? A: Valproate B: Propranolol C: Sumatriptan D: Nortriptyline

C

A preschool-age client begins to experience a tonic-clonic seizure. What action should the nurse take first? A: Apply oxygen. B: Support the head. C: Position the client on the side. D: Place a padded tongue blade in the mouth.

C

A school-age child with acute diarrhea from gastroenteritis has mild dehydration and is being given oral rehydration solutions (ORS). The client's parent calls the clinic nurse because their child is also occasionally vomiting. The nurse should recommend which intervention to the parent? A: "Bring the child to the hospital immediately for intravenous fluids." B: "Alternate between giving oral rehydration solutions (ORS) and carbonated drinks, as they soothe the stomach." C: "Continue to give oral rehydration solutions (ORS) frequently in small amounts." D: "Recommend making the child nothing by mouth (NPO) for 8 hours and resume oral rehydration solutions (ORS) if vomiting has subsided."

C

A school-age client who has been on bed rest for several days becomes dizzy when moving to a sitting position. What type of hypotension should the nurse document in this client's medical record? A: Cardiac B: Vasovagal C: Orthostatic D: Psychogenic

C

An 8 -year-old female is diagnosed with a severe S spinal curvature. The parents are concerned about the recommended thoracolumbosacral orthosis treatment. What teaching should the nurse include with the recommended treatment? A: The brace cannot be removed once it is placed. B: The brace is the only treatment for the scoliosis. C: Many children grow up without limitations after treatment. D: Juvenile scoliosis is more common with males.

C

An infant is diagnosed with septic arthritis. What will the nurse see as a common clinical presentation finding? A: Adequate appetite B: Abnormal complete blood count C: Hip flexion contracture D: Negative leukocytosis

C

An infant is suspected of having neonatal jaundice. What symptoms would the nurse expect to see that would correlate with neonatal jaundice? A: Blue sclera B: Hyper-excitability and tremors C: Poor feeding by mouth D: Present with anemia from red blood cell breakdown

C

The nurse in the clinic is assessing a school-age child brought in by his parent with reports of prolonged muscle weakness and fatigue. The nurse notes ptosis of the eyelids and an inability to smile. What condition should the nurse investigate further? A: Cerebral palsy B: Muscular dystrophy C: Myasthenia gravis D: Guillain-Barré

C

The nurse in the emergency department (ED) is assessing a school-age child with a new ventriculoperitoneal (VP) shunt. The child is being seen for lethargy, irritability, vomiting, severe headache, and a fever of 102.4°. What initial action should the nurse expect would be taken? A: An admission to the hospital for IV fluids and monitoring B: Give mannitol for increased intracranial pressure. C: Obtain a CT scan of the brain with X-rays of the chest and abdomen. D: A surgical intervention for hydrocephalus

C

The nurse is admitting a child after a trauma with a history of acquired thrombocytopenia (ATP). What nursing care is important to prevent further bleeding? A: Encourage mouth care with a firm toothbrush to prevent plaque buildup. B: Perform suctioning of the oral airway. C: Administer prescribed steroids. D: Maintain bed rest.

C

The nurse is assessing a full-term newborn infant and notes the lack of a Moro reflex. What should this finding represent to the nurse? A: A birth defect B: A normal finding C: An impairment of the central nervous system D: A dysfunction of the neuromuscular junction

C

The nurse is caring for a newborn after delivery and recognizes that the child was with born with a myelomeningocele. What action should the nurse take? A: Clean the area and leave it open to air. B: Clean the defect and cover with impregnated gauze. C: Cover the defect with a sterile dressing moistened with warm and sterile normal saline. D: Cover the defect with a simple dressing until the infant can go directly into surgery.

C

The nurse is caring for an adolescent client with myasthenia gravis. What issues should the nurse be vigilant and monitor for due to the complications it causes? A: Blood clots B: Heart failure C: Aspiration D: Hemorrhage

C

The nurse is discussing a child's fracture with parents. What statement is true about children's bones in comparison to adults' bones? A: Children tend to heal fractures longer than adults. B: Children have bones that break rather than bow. C: Children with open growth plates will remodel deformities. D: Children bones are the same as adults.

C

The nurse is discussing the child's care after a plaster arm cast was placed after a radial fracture. What statement made by the parent requires the nurse to provide more teaching? A: "I will wrap the arm in a plastic bag for the evening bath." B: "When we go for a hike I will protect the cast from water." C: "I will allow him to swim for only one hour per day." D: "I will expect the cast to stay in place for the next 4-6 weeks."

C

The nurse is doing health promotion education with a group of young women. Because of the risk of neural tube defects, the nurse should stress the importance of taking which supplement daily while of childbearing age? A: Calcium B: Magnesium C: Folic acid D: Iron

C

The nurse is educating a client with celiac disease about nutrition. Which diet would be the best choice? A: Tuna on wheat toast B: Ham and Swiss cheese on rye bread C: Rice and beans D: Chicken salad on a croissant

C

The nurse is explaining the need for a diagnostic test for a child with leg pain. The parents are concerned about radiation exposure and prefer a test without radiation exposure. What orthopedic diagnostic test will not expose the child to radiation? A: Fluoroscopy B: Bone scan C: Magnetic resonance imaging D: Electrocardiogram

C

The nurse is explaining the similarities and differences between Crohn's disease and ulcerative colitis to a group of student nurses. Which statement is most accurate in explaining a similarity or difference between the two? A: "Corticosteroids are used only in Crohn's to induce remission." B: "Surgery is always required with Crohn's." C: "Both Crohn's disease and ulcerative colitis are forms of inflammatory bowel disease." D: "Taking antidiarrheals will cure ulcerative colitis but not Crohn's disease."

C

The nurse is performing an abdominal assessment on a child. Why is it important to perform auscultation before palpation? A: Children don't like the coldness of the stethoscope and this will alter the exam. B: Bowel sounds are a priority in abdominal assessment. C: Palpation will change the quality of bowel sounds and therefore alter the assessment. D: Children view palpation as tickling, so this should be done last.

C

The nurse is preparing an education program on the Zika virus for a community health fair. Which information should the nurse include? A: Sleep in a room that is not air-conditioned. B: Apply insect repellant to the skin of all children. C: Avoid travelling to areas with outbreaks if pregnant. D: Spray porches and lawn areas with water at nightfall.

C

The nurse is visiting the home of a school-age child who is recovering from shunt placement for hydrocephalus. Which assessment finding indicates that the shunt is draining too aggressively? A: Fever B: Lethargy C: Dizziness D: Severe headache

C

The nurse knows that there are differences between normal leg bowing and deformity. When should the nurse be concerned that a surgical correction is required for a 4-year-old child? A: There has been no worsening with growth B: The bowing is symmetrical C: There is increased lateral knee thrust. D: There are no radiographic changes in severity.

C

The parent of a client who had a ruptured appendix thought their child was just constipated. The parent is now verbalizing feelings of guilt. What should the nurse say in order to reassure the parent? A: "Perhaps you should have brought the child in sooner." B: "Would you like me to call your husband, as children and youth services have been notified?" C: "It's OK, there was no way for you to know that it was his appendix." D: "He has a fever. Did he have cold recently? It could be related to that."

C

The parent of a school-age child who is recovering from a concussion that took place several weeks ago reports the child fell off a bicycle and hit the head again. What direction should the nurse provide to the parent? A: Place on bed rest. B: Monitor for orientation. C: Take to the nearest medical facility. D: Provide an over-the-counter analgesic.

C

The parent reports to the nurse at a pediatrician's office that the child sleeps on his stomach with his feet tucked underneath his stomach. What does this musculoskeletal abnormality suggest? A: Clubfoot B: Metatarsus adductus C: Internal tibial torsion D: Internal femoral torsion

C

A nurse is planning care for a human immunodeficiency virus (HIV) positive child. Which interventions will the nurse include? Select all that apply. A: HIV enzyme-linked immunosorbent assay (ELISA) is recommended for children six months and older. B: Virologic diagnostic testing is recommended for infants six months and older. C: In children 18 months or older, use HIV antibody assays. D: Western blot immunoassay is used for children 18 months and older. E: Rapid HIV testing may include oral specimen collection.

C, D, E

The nurse is assessing a newborn. What are assessment findings related to the diagnosis osteogenesis imperfecta? Select all that apply. A: Low-grade fever B: Irritability C: Bluish tinge of the eyes D: Fracture of the shoulder E: Fracture of the humerus

C, D, E

A 1-month-old infant is demonstrating tremulous movements. Which action should the nurse take to determine if the client is experiencing a seizure? A: Place in a side-lying position B: Assess heart and breath sounds C: Count the number of respirations D: Gently grasp the tremulous extremity

D

A 3-month-old child has a Spica cast with hip dysplasia. What is a nursing intervention to care for the child's urinary elimination? A: Insert a Foley catheter B: Remove the cast for toileting C: Turn and reposition the child every 2 hours D: Pad the cast to keep the sides dry

D

A 6-month-old child with cerebral palsy has a positive Ortolani test indicating hip dysplasia. The parents are asking what caused the hip dysplasia at this age. What is the nurse's best response? A: Neuromuscular conditions always progress to hip dysplasia with time. B: The hip dysplasia was missed with prior examinations. C: The nature of cerebral palsy lends itself many musculoskeletal diseases. D: The spasticity overpowers the muscles that keep the femoral head located in the socket.

D

A child is diagnosed with cystic fibrosis (CF). The nurse is educating the family about pancreatic enzymes. The nurse would determine that education has been successful if the family states: A: Pancreatic enzymes can be skipped from time to time." B: "Enzymes work for about 4 hours after eating." C: "Lower doses of enzymes may be required for foods high in fat." D: "Enzymes are not needed with foods like fruits, juice, soft drinks, or sports drinks."

D

A child is in a Spica cast. What is a nursing intervention for preventing constipation? A: Reduce consumption of fresh fruit B: Reduce ingestion of clear fluids C: Increase cheese in the diet D: Decrease the intake of sugary foods

D

A child is wearing a thoracolumbosacral orthosis. What musculoskeletal abnormality is the child correcting? A: Genu valgum B: Genu varum C: Calcaneovalgus foot D: Scoliosis

D

A child with a vegan diet is diagnosed with iron-deficiency anemia. What iron-rich foods will the nurse suggest the parents add to child's diet? A: Dark leafy vegetables, fish, lean beef B: Poultry, fortified cereals, fish C: Organ meat, shellfish, legumes D: Legumes, fortified cereals, molasses

D

A newborn has been diagnosed with Hirschsprung's disease. The parents are confused and ask the nurse what symptoms lead to this diagnosis. The nurse should explain the most common symptoms as: A: Development of acute diarrhea and dehydration B: Currant, jelly-like gelatinous stools C: Severe projectile vomiting and electrolyte imbalance D: Failure to pass a meconium stool with abdominal distention

D

A nurse is assessing a child with suspected lead poisoning. Which should the nurse expect to assess in this patient? A: Screening should occur no later than six months. B: Selective screening should occur ages seven and eight. C: Assess for urinary symptoms. D: Assess for central nervous symptoms.

D

A nurse is attempting to differentiate between gastroschisis and an omphalocele to a group of nursing students. Which statement is correct? A: "Malrotation is not present in either defect." B: "An omphalocele is contained in a membranous sac." C: "Gastroschisis is usually located at the umbilicus." D: "Gastroschisis is an abdominal wall defect where the intestinal contents are outside of the abdominal wall in a newborn."

D

A nurse is planning care for a child with a suspected oncologic disorder. Which statement is true relating to oncologic disorders with children? A: Possible cancer causes are heredity and genetics. B: Causes of most cancers are known. C: Hodgkin's lymphoma is typically untreatable. D: Wilms' tumor of the kidney is typically discovered by caregivers.

D

A parent brings a 10-year-old with a painful ankle to the emergency department (ED) after a fall. The medical diagnosis is an ankle sprain after an x-ray. What is an important initial nursing care intervention as the child waits for discharge teaching papers? A: Walk as prior to coming into the ED B: Sleep in a chair to keep the ankle free of pressure C: Apply heat to ease the pain D: Maintain the ace bandage for compression

D

A parent brings a child to the emergency department (ED). The client has been reporting abdominal pain for over a week and reports feeling constipated. Admission vital signs are: Temp 102.1, HR 110, RR 30, BP 115/84. An abdominal ultrasound revealed free fluid in the abdomen. What would most likely be the child's issue? A: Constipation B: Intussusception C: Crohn's disease D: Ruptured appendix

D

A toddler is scheduled for a routine wellness examination. What should the nurse do before beginning the assessment? A: Encourage the parent to hold the child. B: Ask the child to state his or her name and age. C: Allow the child to manipulate the stethoscope. D: Watch the child play with an age-appropriate toy.

D

An 18-month-old client is scheduled for an electroencephalogram (EEG). What should the nurse do to facilitate this diagnostic test? A: Wash the client's hair before the test. B: Provide a sedative 30 minutes prior to the test. C: Withhold food and fluids for 2 hours before the test. D: Transport the client to the testing site during naptime.

D

The mother of a newborn diagnosed with tracheoesophageal fistula (TEF) asks the nurse about the condition. Which statement is correct in educating this mother about TEF? A: "This was caused because of you not taking enough folic acid in the first trimester of your pregnancy." B: "Your child will most likely be prone to frequent fractures of the extremities." C: "Your child will need to be on antibiotics of invasive procedures prophylactically." D: "Your baby should be able to start tube feedings in 2 to 3 days after the surgical repair."

D

The nurse is collecting data from the caregivers of a child admitted with seizures. Which of the following statements indicates the child most likely had an atonic seizure? A: "He fell down and his whole body started shaking." B: "His arms had rapid jerking movements." C: "He was just staring into space and was totally unaware." D: "He usually is very coordinated, but he couldn't even walk without falling."

D

The nurse is discharging a child home after a sickle cell crisis. What statement indicates the parents need further teaching? A: "We will talk to the dentist about any planned dental care visits. " B: "We will contact the healthcare provider if the child has a fever." C: "We will report any signs of a respiratory infection immediately to prevent recurrent crises." D: "If my child has a headache, I will let him rest."

D

The nurse is providing care to a child post craniotomy for a brain tumor removal. What is the rationale to prevent the child from vomiting? A: Stabilize hydration status. B: Limit weight loss. C: Prevent oral candidiasis. D: Prevent increased intracranial pressure.

D

The nurse is providing education to a parent whose toddler is diagnosed with Duchenne muscular dystrophy. Which statement by the parent indicates the teaching was understood? A: "I am glad that my child's disability will not progress beyond where it is now." B: "It is acquired related to a maternal infection." C: "This disorder is characterized by muscle spasticity and mental deficits." D: "Life expectancy is in the twenties and death is usually caused by respiratory or cardiac failure."

D

The nurse is teaching a soccer team in the community about avoiding overuse injuries. What will the nurse include in the teaching? A: There is no need to stretch or do warm-up exercises before the game. B: The game rules are for the coaches. C: The only time you can talk about pain is when the game is over. D: The preparation before the game is important for the body to be stretched.

D

The nurse is working with a child receiving cancer treatments. What is the most important nursing intervention to promote hydration? A: Limit fluid intake to 1 liter per day. B: Keep the water cup filled with fresh ice and water. C: Weigh the child weekly. D: Offer fluids of choice frequently.

D

The nurse, caring for a school-age client recovering from a ventriculoperitoneal (VP) shunt implant, completes an assessment and immediately notifies the healthcare provider. Which assessment finding caused the nurse to be concerned? A: Poor appetite B: Blood pressure 110/70 mm Hg C: Pain level 4 on a scale from 1 to 10 D: Blood tinged spot on the pillowcase encircled by a lighter ring

D

The parent of a 3-month-old client is concerned because the child's eyes are deviating downward. What additional assessment should the nurse complete with this client? A: Oral intake B: Urine output C: Status of reflexes D: Integrity of the fontanelles

D

The parent reports that a 3-year-old child receiving Lamotrigine for partial seizures has developed a rash. Which response should the nurse make to the parent? A: "Stop the medication immediately." B: "This means the dose needs to be doubled." C: "Take the client to the nearest medical facility." D: "This is something that occurs within the first 6 weeks of treatment."

D

What is an appropriate nursing intervention for the school-age child diagnosed with juvenile idiopathic arthritis who is experiencing nausea with nonsteroidal anti-inflammatory medications? A: Providing water with medications B: Encouraging the child to participate in school activities C: Minimizing pain by limiting activities D: Encouraging the child to take medications with food

D

The nurse is caring for a patient with an arm injury. Which arm muscle's strength will the nurse assess? Select all that apply. A: Vastus medialis B: Radius C: Sartorius D: Brachioradialis E: Triceps brachii

D, E