Exam 7 - PEDS
A 5-year-old girl is cyanotic, dusky, and anxious when she arrives in the emergency department. Which action would be most appropriate? A) Ventilating the child with a bag-valve-mask B) Estimating the child's weight using a Broselow tape C) Providing therapy using automated external defibrillation D) Using rescue breathing and chest compressions
A
A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy? A) Cognitive therapy B) Behavioral therapy C) Milieu therapy D) Individual therapy
A
A child is undergoing rapid sequence intubation and is receiving atropine. The nurse understands that this agent is used to: A) lessen the vagal effects of intubation. B) reduce intracranial pressure. C) induce amnesia. D) provide short-term paralysis.
A
A child weighing 51 lb (23.1 kg) requires defibrillation. How many joules would the nurse expect to give initially? A) 46 B) 92 C) 102 D) 204
A
A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A) "We should give this drug before he eats anything." B) "We need to watch carefully for possible infection." C) "The drug should not be stopped suddenly." D) "He might gain some weight with this drug."
A
A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. What would the nurse be least likely to include? A) Focus the child's attention on the negative behavior. B) Set limits with the child for responsible behavior. C) Ignore inappropriate behaviors. D) Provide positive feedback for self-control efforts.
A
A school-age child diagnosed with depression is receiving antidepressant therapy. What behavior would the nurse instruct the parents to watch for and to notify the physician immediately if the child demonstrates it? A) Loss of interest B) Gastric upset C) Sedation D) Urinary retention
A
An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A) Notifying the doctor immediately B) Applying ice C) Elevating the arm D) Giving additional pain medication as ordered
A
The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason? A) Minimize stimuli that exacerbate the child's undesired behaviors. B) Improve the child's ability to deal with external stressors. C) Promote increased ability to follow through. D) Encourage the child to adopt expectations into his routine.
A
The nurse is assessing the neuromusculoskeletal system of a newborn. What is an abnormal assessment finding? A) Sluggish deep tendon reflexes B) Full range of motion in extremities C) Absence of hypotonia D) Lack of purposeful muscular control
A
The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse take first? A) Reposition the child's foot on a pressure-reducing device. B) Apply lotion to his foot to maintain skin integrity. C) Make sure the skin is clean and dry. D) Gently massage his foot to promote circulation.
A
The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder? A) "He has frequent temper tantrums." B) "He was pulling the neighbor's dog around by his leash." C) "He is constantly lying to me." D) "He has stolen hundreds of dollars from my purse."
A
The nurse is caring for a 14-month-old boy with rickets who was recently adopted from overseas. His condition was likely a result of a diet very low in milk products. The nurse is providing teaching regarding treatment. Which response by the parents indicates a need for further teaching? A) "We must give him calcium and phosphorus with food every morning." B) "He must take vitamin D as prescribed and spend some time in the sunlight." C) "He must take calcium at breakfast and phosphorus at bedtime." D) "We should encourage him to have fish, dairy, and liver if he will eat it."
A
The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate? A) "You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea." B) "He might experience a significant decrease in his appetite and difficulty sleeping." C) "You need to watch for dry mouth, urinary retention, and constipation." D) "This medication can cause seizures, agitation, headache, and nausea."
A
The nurse is gathering the necessary equipment for tracheal intubation for a child who is 2 years old. Which tracheal tube size would the nurse obtain? A) 4.5 B) 5 C) 5.5 D) 6
A
The nurse is providing care to a child experiencing shock. Which intravenous solution would the nurse expect to administer? A) Ringer lactate B) Dextrose 5% and water C) Dextrose 5% and normal saline D) Dextrose 10% and water
A
The nurse is providing care to a child with a long-leg hip spica cast. What is the priority nursing diagnosis? A) Risk for impaired skin integrity due to cast and location B) Deficient knowledge related to cast care C) Risk for delayed development related to immobility D) Self-care deficit related to immobility
A
The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A) "I will help you become comfortable in caring for your daughter." B) "You must learn how to care for your daughter at home." C) "You will need to learn to collaborate with all the caregivers." D) "There is a lot to learn, and you need a positive attitude."
A
The parents bring their 3-year-old son to the emergency department after he ingested some of his mother's medicine. Which assessment would be of critical importance for this child? A) Assessing mental status and skin moisture and color B) Evaluating the effectiveness of the child's breathing C) Noting the child's pulse rate and quality D) Auscultating all lung fields for signs of edema
A
What would the nurse do first for a 5-year-old girl with profound bradycardia? A) Provide oxygen at 100% B) Administer epinephrine as ordered C) Use warming blankets D) Perform gastric lavage
A
When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A) Skeletal traction B) Physical therapy C) Orthotics D) Occupational therapy
A
The nurse is caring for a child who takes dextroamphetamine for treatment of ADHD. Which comments by the patient or family would concern the nurse? Select all that apply. A) "I take my sustained released capsule at night before I go to bed." B) "We have noticed that our child shows very little emotion over the last few weeks." C) "I haven't noticed any difference in my appetite." D) "Sometimes my head hurts a little for a short time after I take my medicine." E) "We notice our child gets a little irritable occasionally."
A,B
The nurse is preparing an educational program on behavioral management techniques used in children to help alter negative behavior. What information should the nurse include? Select all that apply. A) Set limits and hold the child responsible for their behavior. B) Do not argue, bargain or negotiate about the limits once established. C) Change caregivers occasionally so the child learns to respond to different people. D) Use a high-pitched voice and remain calm when speaking with the child. E) Ignore inappropriate behaviors.
A,B
A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, what would the nurse include as being involved? Select all that apply. A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity E) Defiance F) Anxiety
A,B,C,D
A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. What advice would be most helpful? Select all that apply. A) Allowing for breaks when tics occur B) Providing for "time-outs" during the day C) Using a tape recorder to take notes D) Ensuring a specified amount of time for test taking E) Implementing a reward system for behavior
A,C
A child has a tracheal tube in place and will be receiving medications via this tube. Which medications would the nurse expect to be administered in this manner? Select all that apply. A) Lidocaine B) Adenosine C) Atropine D) Dopamine E) Epinephrine F) Naloxone
A,C,E,F
A group of students are reviewing information about respiratory arrest in children. The students demonstrate understanding of this information when they identify what common causes of respiratory arrest involving the upper airway? Select all that apply. A) Croup B) Asthma C) Pertussis D) Epiglottitis E) Pneumothorax
A,D
A 9-year-old girl who has fallen from a second-story window is brought to the emergency department. Which assessment would be the priority? A) Evaluating pupils for equality and reactivity B) Monitoring oxygen saturation levels C) Asking the child if she knows where she is D) Using the appropriate pain assessment scale
B
A child is brought to the emergency department with a suspected poisoning. What treatment would the nurse least likely expect to be used? A) Gastric lavage B) Syrup of ipecac C) Activated charcoal D) Whole bowel irrigation
B
A newborn is diagnosed with metatarsus adductus. The parents ask the nurse how this occurred. Which response by the nurse would be most appropriate? A) "This condition is due to a genetic defect in the bones." B) "It's most likely from how the baby was positioned in utero." C) "They really don't know what causes this condition." D) "There is probably an underlying deformity of the baby's hip."
B
A nurse has just transferred from an adult medical-surgical unit to a pediatric unit. When reviewing CPR skills, what it is important for the nurse to realize? A) The pediatric chain of survival and the adult chain of survival are the same B) Prevention of cardiac arrest and injuries is the first step in the chain of survival for children C) Integrated post-cardiac arrest care is not part of the chain of survival for children D) Early CPR should occur before any steps of the chain of survival are considered
B
A nurse is caring for a 14-year-old girl following myelography. What is the priority nursing action? A) Monitoring for a decrease in spasticity B) Observing for signs of meningeal irritation C) Assessing motor function D) Observing for mental confusion or hallucinations
B
A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist that specializes in: A) individual therapy. B) play therapy. C) behavioral therapy. D) hypnosis.
B
A nurse is conducting a screening program for autism in infants and children. What would the nurse identify as a warning sign? A) Lack of babbling by 6 months B) Inability to say a single word by 16 months C) Lack of gestures by 8 months D) Inability to use two words by 18 months
B
A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A) Growth plate B) Epiphysis C) Physis D) Metaphysis
B
The nurse is assessing a child with a possible fracture. What would the nurse identify as the most reliable indicator? A) Lack of spontaneous movement B) Point tenderness C) Bruising D) Inability to bear weight
B
The nurse is assessing a newborn who was delivered after a prolonged labor due to an abnormal presentation. The newborn sustained a cranial nerve injury. The nurse would most likely expect to assess deficits related to which cranial nerve? A) Optic B) Facial C) Acoustic D) Trigeminal
B
The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A) Deep-breathing exercises B) Upright positioning C) Coughing D) Chest percussion
B
The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. What word would the nurse use when documenting these observations? A) Spastic B) Athetoid C) Ataxic D) Mixed
B
The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which disorder or condition? A) Anxiety disorder B) Sensory processing disorder C) Depression D) Obsessive-compulsive disorder
B
The nurse is caring for a 7-year-old boy experiencing respiratory distress who is scheduled to have a chest radiograph. What would be most important for the nurse to include in the child's plan of care? A) Administering a sedative to help calm the child B) Assisting the child to lie still during the chest radiograph C) Accompanying the child to continue observation D) Informing the child that he might hear a loud banging noise
B
The nurse is caring for an adolescent girl with anorexia nervosa. What findings would indicate to the nurse that the girl requires hospitalization? A) Weight gain of one-half pound per week B) Food refusal C) Body mass index of 18 D) Soft, sparse body hair and dry, sallow skin
B
The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching? A) "I need to avoid pushing or pulling on an arm or leg." B) "I must carefully lift the baby from under the armpits." C) "I should not bend an arm or leg into an awkward position." D) "We must avoid lifting the legs by the ankles to change diapers."
B
The nurse is conducting a physical examination of a child with a brachial plexus injury. Which finding would lead the nurse to be highly suspicious of Erb palsy? A) The child is unable to close one of his eyes. B) The involved extremity is adducted, prone, and internally rotated. C) Asymmetry of the face occurs when the child is crying. D) The mouth is drawn to the noninvolved side.
B
The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which finding would help confirm this diagnosis? A) Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis). B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers. C) A high-pitched "click" is heard with hip flexion or extension. D) The thigh and gluteal folds are symmetric.
B
The nurse is providing care to a 4-year-old boy with a broken arm and an infected laceration from a fall. The nurse notes a significant elevation in the child's heart rate. Which intervention would be least appropriate? A) Administering antipyretics as ordered for fever B) Using a defibrillator to reduce the heart rate C) Administering analgesics to reduce pain D) Allowing the parents to comfort the child
B
The nurse is providing care to a child who is intubated and the child's condition is deteriorating. What would the nurse do first? A) Check if the tracheal tube is obstructed B) Assess for displacement of the tracheal tube C) Look for signs of a possible pneumothorax D) Check the equipment for malfunction
B
The nurse is teaching a group of students about myelinization in a child. Which statement by the students indicates that the teaching was successful? A) Myelinization is completed by 4 years of age. B) The process occurs in a head-to-toe fashion. C) The speed of nerve impulses slows as myelinization occurs. D) Nerve impulses become less specific in focus with myelinization.
B
The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching? A) "A family history of alcoholism is a risk factor for substance abuse." B) "Just because his friends are experimenting does not mean that he will." C) "If my husband or I have a substance abuse problem it could increase his risk." D) "Negative life events are a potential risk factor."
B
The nurse working in a pediatric mental health clinic is assessing a 4-year-old child who has suffered from physical abuse. Which type of therapy does the nurse anticipate will be most helpful in developing a trusting relationship as well as assisting in determining the patient's current emotional state? A) Behavioral therapy B) Play therapy C) Cognitive behavioral therapy D) Family therapy
B
Two nurses are driving to work and have just come upon the scene of a motor vehicle accident (MVA) involving a child being hit by a car. The nurses decide to stop and find that only the child was injured. One of the nurses begins providing care. What is the first question the other nurse should ask the witnesses of the accident? A) "Can I get your name and numbers in case someone needs to contact you later?" B) "How did the accident happen?" C) "Do you know if the children have any health history I should know about?" D) "How long ago did someone activate the EMS?"
B
What information would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A) Positioning supine with a pillow under the buttocks B) Covering the sac with saline-soaked nonadhesive gauze C) Wrapping the infant snugly in a blanket D) Applying a diaper to prevent fecal soiling of the sac
B
What would lead the nurse to suspect that a 5-year-old child is experiencing supraventricular tachycardia? A) Heart rate 160 beats per minute B) Flattened P waves C) Normal QRS complex D) History of fever
B
What would lead the nurse to suspect that an adolescent has bulimia? A) Body mass index less than 17 B) Calluses on back of knuckles C) Nail pitting D) Bradycardia
B
When teaching a group of students about the skeletal development in children, what information would the instructor include? A) The growth plate is made up of the epiphysis. B) A young child's bones commonly bend instead of break with an injury. C) The infant's skeleton has undergone complete ossification by birth. D) Children's bones have a thin periosteum and limited blood supply.
B
The nurse is teaching a CPR course for a group of nursing students. Which responses indicate an understanding of the content provided regarding the AED? Select all that apply. A) "When considering the use of the AED, the child must weigh at least 30 pounds (13.6 kg)." B) "An AED must only be employed if the collapse is witnessed." C) "To use the device the child must be at least 1 year of age." D) "The AED can be used only if the victim is demonstrates no heart rate." E) "The AED is safe for use prehospital."
B,C,D,E
A nurse is providing instructions to the parents of a 3-month-old with developmental dysplasia of the hip who is being treated with a Pavlik harness. Which statements by the parents demonstrate understanding of the instructions? Select all that apply. A) "We need to adjust the straps so that they are snug but not too tight." B) "We should change her diaper without taking her out of the harness." C) "We need to check the area behind her knees for redness and irritation." D) "We need to send the harness to the dry cleaners to have it cleaned." E) "We need to call the doctor if she is not able to actively kick her legs."
B,C,E
A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. What would the nurse identify as characteristics of this disorder? Select all answers that apply. A) Easily annoyed B) Initiator of physical fights C) Temper tantrums D) Truancy E) Arrest for arson
B,D,E
A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA). When describing type 2 SMA, which information would the instructor include? Select all answers that apply. A) Onset before 6 months of age B) Weakness most severe in shoulders and hips C) Difficulty with swallowing D) Slowly progressing condition E) Genetic disease with autosomal recessive inheritance
B,D,E
A 1-month-old infant admitted to the emergency department in respiratory distress exhibits a regular pattern of breathing followed by brief periods of apnea, then tachypnea for a short time, eventually returning to a normal respiratory rate. This type of breathing is: A) hypoventilation. B) hyperventilation. C) periodic breathing D) stridor.
C
A 6-year-old boy with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A) "Would you like me to bring you a blanket and pillow?" B) "You are doing such a wonderful job with your son." C) "He's in good hands; consider going home to get some sleep." D) "Are you planning to spend the night or to go home?"
C
A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs? A) Atypical antidepressant B) Tricyclic antidepressant C) Selective serotonin reuptake inhibitor D) Psychostimulant
C
A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A) Oral B) Subcutaneous injection C) Intramuscular injection D) Intravenous infusion
C
A group of students are working on a presentation for a local health fair about safety for children. When developing this presentation, the students would address what cause as the most common in pediatric injury? A) Sports B) Firearm use C) Falls D) Automobile accidents
C
A nurse determines that a child is exhibiting compensated supraventricular tachycardia (SVT). What action would be attempted first? A) Adenosine B) Synchronized cardioversion C) Vagal maneuvers D) Amiodarone
C
A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. What action should the nurse to take first? A) Set clear limits on the child's behavior B) Teach the child problem-solving skills C) Encourage a discussion of the child's thoughts and feelings D) Role model appropriate social and conversation skills
C
A nurse is preparing a program for a group of parents about injury prevention. What would the nurse include as an important contributing factor for cervical spine injury in a child? A) Exposure to teratogens while in utero B) Immaturity of the central nervous system C) Increased mobility of the spine D) Incomplete myelinization
C
After teaching a group of nursing students about shock in children, the instructor determines that the teaching was successful when the students identify which type of shock as most common? A) Septic B) Cardiogenic C) Hypovolemic D) Distributive
C
After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state: A) "If he starts to act out, we'll have him do a time-out to help him refocus." B) "We can use a reward system when he behaves appropriately." C) "If he misbehaves, we need to punish him instead of reward him." D) "We need to help him set realistic goals that he can achieve."
C
An 8-year-old boy with a fractured forearm is to have a fiberglass cast applied. What information would the nurse include when teaching the child about the cast? A) The cast will take a day or two to dry completely. B) The edges will be covered with a soft material to prevent irritation. C) The child initially may experience a very warm feeling inside the cast. D) The child will need to keep his arm down at his side for 48 hours.
C
As part of their orientation to their pediatric clinical rotation, an instructor is teaching a group of students how to perform cardiopulmonary resuscitation (CPR) on a child. Two students return demonstrate the skill using an infant manikin. What action indicates the proper technique? A) Compressing 30 times for every 2 breaths B) Placing the heel of the hand on the midsternum C) Giving 2 breaths followed by 15 compressions D) Using two hands to perform chest compressions
C
The nurse is caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate? A) "I know it is boring, but you must remain immobile for 2 more weeks." B) "If there are no complications, you only have 2 more weeks here." C) "Let's come up with things to do like books, movies, games, and friends to visit." D) "If you resist your treatment, your condition will only get worse."
C
The nurse is caring for a 2-year-old girl in a bilateral brace with tibia vara. Her parents are upset by their toddler's limited mobility. Which response by the nurse would be most appropriate? A) "If you don't follow the therapy, your daughter could develop severe bowing of her legs." B) "It's important to use the brace or your daughter may need surgery." C) "You are doing a great job. Let's put our heads together on how to keep her busy." D) "You'll need to accept this since treatment may be required for several years."
C
The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability? A) "He is not speaking in complete sentences." B) "We can understand a lot of what he says, but no one else can." C) "He seems to be speaking words less and less frequently." D) "He is unable to sit still for a short story."
C
The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which comorbid condition? A) Depression B) Anxiety disorder C) Attention deficit/hyperactivity disorder D) Asperger syndrome
C
The nurse is caring for a female infant with torticollis and is providing instructions to the parents about how to help their daughter. Which statement by the parents indicates a need for further teaching? A) "We must encourage our daughter to turn her head both ways." B) "Flatness on one side of the head is a common side effect." C) "We must apply firm pressure and stretching every other day." D) "We will do a daily stretching regimen with multiple sessions."
C
The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? A) "If you wear your brace properly, you may not need surgery." B) "The good news is that you have very minimal curvature of your spine." C) "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." D) "Let's talk to the doctor about your treatment options."
C
The nurse is developing a teaching plan for a child who is to have his cast removed. What instruction would the nurse most likely include? A) Applying petroleum jelly to the dry skin B) Rubbing the skin vigorously to remove the dead skin C) Soaking the area in warm water every day D) Washing the skin with dilute peroxide and water
C
The nurse is reviewing the medical record of a child who has dyspraxia. This child will experience difficulty with: A) reading and writing. B) mathematics and computation. C) manual dexterity and coordination. D) composition and spelling.
C
The nurse is speaking with a parent regarding their child's recent diagnosis of oppositional defiant disorder. Which statement by the parent would cause the nurse to question the diagnosis? A) "I am so tired of arguing with my daughter all the time." B) "My son purposely does exactly the opposite of what his father tells him to do." C) "I feel so bad that my daughter intentionally hurt the neighbor's cat." D) "My daughter gets so annoyed at me when she doesn't get her way."
C
The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has developed a sensitivity to latex. Which response from his mother indicates a need for further teaching? A) "He needs to get a medical alert identification." B) "I will need to discuss this with his caregivers." C) "A product's label indicates whether it is latex-free."
C
The school nurse is presenting a class to a group of students about common overuse disorders. Which disorder would the school nurse include? A) Dislocated radial head B) Transient synovitis of the hip C) Osgood-Schlatter disease D) Scoliosis
C
When caring for an 8-year-old boy injured in an automobile accident, the nurse demonstrates understanding of the principles of Pediatric Advanced Life Support (PALS) by which action? A) Assisting ventilation with a bag-valve-mask (BVM) device B) Treating ventricular fibrillation using a defibrillator C) Managing compensated shock to prevent decompensated shock D) Treating supraventricular tachycardia using cardioversion
C
Which measure would be most appropriate for the nurse to do to ensure that a child's endotracheal (ET) tube is correctly positioned? A) Auscultate for abdominal breath sounds B) Mark the tracheal tube at the child's lip C) Watch for a yellow display on a CO 2 monitor D) Inspect for water vapor in the tracheal tube
C
A child has undergone surgery using steel bar placement to correct pectus excavatum. What position would the nurse instruct the parents to avoid? A) Semi-Fowler B) Supine C) High Fowler D) Side-lying
D
A child is prescribed trazodone. What would the nurse be least likely to include in the plan of care related to this drug? A) Monitoring blood pressure for orthostatic hypotension B) Assessing the child for sedation and drowsiness C) Administering the drug with a snack D) Monitoring for tardive dyskinesia
D
A child who weighs 53 lb is receiving fluid volume replacement as part of the treatment for shock. The nurse is evaluating the child's hourly urinary output to determine if the child's condition is improving. Which output would the nurse interpret as most indicative of improvement? A) 12 mL B) 15 mL C) 22 mL D) 30 mL
D
A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. What information would the nurse include when teaching the child and his parents about this drug? A) "Give the drug three times a day: morning, midday, and after school." B) "This drug may cause drowsiness, so be careful when doing things." C) "Some increase in appetite may occur, so watch how much you eat." D) "Take this drug every day in the morning when you wake up."
D
A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which instruction would the nurse include when teaching the parents about caring for their child? A) Waiting 48 hours before allowing the child to take a tub bath B) Not allowing the child to sleep on his side for about 4 weeks C) Calling the physician if the child's temperature is over 100.5°F D) Discouraging the child from stretching or bending forward for 4 weeks
D
A group of nursing students are reviewing information about the type of skin and skeletal traction. The students demonstrate understanding of this information when they identify which of these as a type of skeletal traction? A) Russell traction B) Bryant traction C) Buck traction D) Side arm 90-90 traction
D
After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance? A) Limb-girdle B) Myotonic C) Distal D) Duchenne
D
The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? A) Recommend the bed's side rails be raised throughout the day and night. B) Suggest a caregiver be present continuously to prevent falls from bed. C) Encourage a loose restraint to be used when he is in bed. D) Recommend raising the bed's side rails when a caregiver is not present.
D
The nurse is caring for a 6-year-old girl who was injured in a bicycle accident. Which question would be most important for the nurse to ask during the health history? A) "Has she been diagnosed with any chronic disorders?" B) "Is your daughter currently taking any medications?" C) "Is she allergic to any medications or drugs?" D) "Tell me how the bicycle accident happened."
D
The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which disorder? A) Generalized anxiety disorder B) Posttraumatic stress disorder C) Social phobia D) Obsessive-compulsive disorder
D
The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. What information would the nurse include? A) Applying petroleum jelly to lubricate the catheter B) Cleaning the reusable catheter with peroxide after each use C) Storing the reusable cleaned catheter in a brown paper bag D) Soaking the catheter in a vinegar and water solution to sterilize
D
The nurse is preparing the plan of care for a child experiencing respiratory distress. What action would be the top priority? A) Providing supplemental oxygen B) Monitoring for changes in status C) Assisting ventilation D) Maintaining a patent airway
D
What would be most appropriate to use to help maintain a patent airway in an infant experiencing a respiratory emergency? A) Neck hyperextension B) Head tilt-chin lift technique C) Jaw-thrust maneuver D) Small towel under shoulders
D
When assessing the adolescent with anorexia, what would the nurse expect to find? A) Tachycardia B) Hypertension C) Fever D) Sparse body hair
D
When reviewing the medical record of a child, what would the nurse interpret as the most sensitive indicator of intellectual disability? A) History of seizures B) Preterm birth C) Vision deficit D) Language delay
D
Which intervention would be most helpful in preventing barotrauma when ventilating a 3-year-old girl with a bag-valve-mask? A) Choosing the correct size bag and face mask B) Setting the flow rate at exactly 10 L/minute C) Maintaining the airway in the open position D) Delivering one breath every 3 to 5 seconds
D
