Final exam questions

A nurse is teaching an adolescent with type 1 diabetes about the disease. Which instruction by the nurse about how to prevent hypoglycemia would be most appropriate for the adolescent?

"Carry crackers or fruit to eat before or during periods of increased activity."

A child is prescribed glargine (Lantus) insulin. Which of the following would the nurse include when teaching the child and parents about this insulin?

"Do not mix this insulin with other insulins."

A nurse is providing teaching about expected changes during puberty to a group of parents of early adolescent girls. Which of the following statements by one of the parents indicates an understanding of the teaching?

"Girls usually stop growing about 2 years after menarche."

A nurse is teaching a child who has type 1 diabetes mellitus about self care. Which of the following statements by the child indicates understanding of the teaching?

"I should drink a glass of milk when I am feeling irritable."

A nurse is providing teaching to the parent of a child who has a new prescription for liquid oral iron supplements. Which of the following statements by the parent indicates an understanding of the teaching?

"My child should take the supplement through a straw."

The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which of the following statements made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?

"My child sleeps between 11 and 12 hours a night."

A nurse is caring for a toddler who is diagnosed with hip dysplasia and has been placed in a hip spica cast. The child's mother asks the nurse why a Pavlik harness is not being used? Which of the following responses by the nurse appropriately addresses the mother's question?

"The Pavlik harness is used for infants less than 6 months of age."

A nurse is teaching an adolescent who has diabetes about foot care. Which of the following should the nurse include in the teaching?

"You can use cornstarch on your foot."

A nurse is caring for a toddler who has rhinitis, cough, and diarrhea for 2 days. Upon assessment, it is noted that the tympanic membrane has a orange discoloration and decreased movement. Which of the following is an appropriate statement for the nurse to make?

"Your child could experience transient hearing loss."

A nurse is caring for an infant whose screening test reveals that he may have sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease?

Hemoglobin electrophoresis

A nurse is planning to administer immunizations to a 4-year-old child who has up-to-date immunizations. Which of the following should the nurse anticipate giving? (Select all that apply.)

Inactivated poliovirus (IPV), MMR, Varicella, DTap

An 8-year-old boy, who says he wants to be a doctor when he grows up, pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then, he asks, "did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age, which is what?

Industry

A nurse is planning to administer immunizations to a 2-month-old infant. Which of the following should the nurse anticipate giving? (Select all that apply.)

Rotavirus (RV), DTaP, Hib, Pneumococcal

A nurse is conducting a well-child visit with a child who is scheduled to receive the recommended immunizations for 11- to 12-year-olds. Which of the following immunizations should the nurse administer? (Select all that apply.)

TIV; meningococcal (MCV4); Tdap

Conformity is vital to school-age children.

True

You care for a 6-year-old boy with acute glomerulonephritis. When planning care for him, you should be aware that glomerulonephritis usually follows an infection of what organism?

a Beta-hemolytic Streptococcus

A hospitalized 7 year old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise?

a feeling of inferiority

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. Which of the following is part of this stage of Erikson's theory?

a sense of competence, mastery, and worth

The nurse is caring for an 8-month-old in Bryant traction for developmental dysplasia of the hip and is monitoring for complications. Which assessment finding would alert the nurse to a possible complication?

a weak pedal pulse

A nurse is caring for a child who is postoperative following surgical removal of a Wilms' tumor. Which of the following assessments is an indication to continue NPO status?

absent bowel sounds

An 8-year-old boy and his father visit the pediatrician's office with reports of a sudden onset of abdominal pain and reddish-brown urine. A urinalysis shows 4+ protein. On taking the boy's health history, the nurse learns that he had strep throat a little over a week ago. Which of the following conditions should the nurse suspect?

acute glomerulonephritis

A nurse is caring for a client who has a major burn and is experiencing severe pain. Which of the following is an appropriate nursing intervention to manage this child's pain?

administer morphine sulfate IV via continuous infusion

A nurse is caring for a client who has a superficial partial thickness burn. Which of the following is an appropriate action for the nurse to take?

apply cool, wet compresses to affected area

The nurse is caring for a child admitted with nephrotic syndrome. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

ascites

A nurse is assessing an infant. Which of the following findings are clinical manifestations of acute otitis media? (Select all that apply.)

bce rolling head side to side; loss of appetite; crying

The nurse is collecting data on a child recently diagnosed with acute glomerulonephritis. Which of the following clinical manifestations was likely noted in this child?

bloody urine

Complications associated with bleeding most often involve joints and muscles. Adjunct measures to control bleeding include:

compression

When caring for hospitalized school-aged children, it is important to

consistently reinforce their worth

A nurse is caring for a child who is receiving chemotherapy. Which of the following are clinical manifestations of neuropathy? (Select all that apply.)

constipation, foot drop, jaw pain

The nurse caring for a client diagnosed with muscular dystrophy would expect which laboratory values to be most abnormal?

creatinine

In a child diagnosed with sickle cell disease, which of the following clinical manifestations would the nurse most likely see?

decreased hemoglobin level

A nurse is caring for a child. Which of the following are clinical manifestations of nephrotic syndrome? (Select all that apply.)

edema in the ankles; hyperlipidemia; anorexia

A symptom often seen in acute glomerulonephritis is edema. The most common site the edema is first noted is in which area of the body?

eyes

After hospital discharge, the mother of a child newly diagnosed with type 1 diabetes mellitus telephones you because her daughter is acting confused and very sleepy. Which emergency measure would you suggest the mother carry out before she brings the child to see her doctor?

give her a glass of orange juice

A nurse is caring for a client who has a skin graft. Which of the following clinical manifestations indicate infection? (Select all that apply.)

green color to subcutaneous fat; unstable body temperature; subeschar hemorrhage; change in skin color around the affected area

Goal of growth promotion

grow atleast 3-5 inches in linear growth in the first year of treatment without complications; treatment stops when the epiphyseal growth plates fuse (16 for boys and 14 for girls)

A nurse is discussing prepubescence and preadolescence with a group of parents of school-age children. Which of the following information should the nurse include in the discussion?

growth differences between boys and girls become evident

The nurse knows that disorders of the pituitary gland depend on the location of the physiologic abnormality. Caring for a child that has issues with the anterior pituitary, the child has issues with which hormone?

growth hormone

A boy with hemophilia A is scheduled for surgery. Which of the following precautions would you institute with him?

handle him gently when transferring him to a stretcher

Possible adverse effects of growth hormone

headaches, rapid weight gain, increased thirst or urination, or painful hip or knee joints

A 9-month-old boy with iron-deficiency anemia is given ferrous sulfate therapy. Which of the following assessments would best help you determine that he is actually taking it daily?

his stools will appear black

A nurse is teaching an adolescent who has diabetes about clinical manifestations of hypoglycemia. Which of the following should be included in the teaching? (Select all that apply.)

hunger; irritability; sweating and pallor

A nurse is caring for a client who has major burns and suspected septic shock. Which of the following findings are consistent with septic shock? (Select all that apply.)

increased body temperature; altered sensorium; decreased urine output

The developmental task of the school-aged period, according to Erikson, is gaining a sense of

industry versus inferiority.

A nurse is caring for a client who has a moderate burn. Which of the following is an appropriate action for the nurse to take?

initiate a high-protein, high-calorie diet

You care for a 10-year-old boy with growth hormone deficiency. Which therapy would you anticipate will be prescribed for him?

intramuscular injections of growth hormone

A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in his care should be given priority?

maintaining a fluid intravenous line

Somatropin

medication used as human growth hormone that is a replacement for deficiency in growth hormones; administer subcut injections; caution in children receiving insulin; no side effets is used in appropriate doses

A nurse is reviewing sick day management with a parent of a child who has type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (Select all that apply.)

monitor blood glucose levels every 3 hrs; test urine for ketones; call the health care provider if blood glucose is greater than 240

To prevent further sickle cell crisis, you would advise the parents of a child with sickle cell anemia to

notify a health care provider if the child develops an upper respiratory infection.

A nurse is teaching a group of parents about communicable diseases. Which of the following is the most appropriate method to prevent a communicable disease?

obtaining immunizations

A nurse is caring for a child who has oral mucositis. Which of the following is an appropriate action for the nurse to take? (Select all that apply.)

offer soft foods, use a soft, disposable toothbrush for oral care, encourage gargling with a warm saline mouthwash

Growth hormone

powder that is mixed with packaged diluents; rotate sites in the subcut tissue to prevent skin irritation; should be administered 6-7 days a week

A nurse is caring for a child who has swallowed paint thinner. The child is lethargic, gagging, and cyanotic. Which of the following is an appropriate action for the nurse to take?

prepare for intubation with a cuffed endotracheal tube

A nurse is teaching a parent of a preschool child about factors that affect the child's perception of death. Which of the following should be included in the teaching?

preschool children perceive death as temporary

The nurse is caring for a 3-year-old diagnosed with diabetes mellitus. The child's eating patterns are unpredictable. One day the child will eat almost nothing, the next day the child eats everything on her tray. The nurse recognizes that which of the following types of insulin would most likely be used in treating this child?

rapid-acting insulin

The nurse is observing a group of 8-year-olds who are being taught the concept of conservation of numbers. Which of the following activities would best help these children understand this concept?

rearranging a group of coins first into a circle, then a triangle and then a square

A nurse is caring for an infant who has diaper dermatitis. Which of the following should be included in the plan of care? (Select all that apply.)

remove the clothing over the rash, apply calamine lotion to the skin

When developing the postoperative plan of care for a child with sickle cell anemia who has undergone a splenectomy, which of the following would the nurse identify as the priority?

risk for infection

A nurse is teaching a group of parents about complications of communicable diseases. Which of the following communicable diseases may lead to pneumonia? (Select all that apply.)

rubeola (measles); pertussis (whooping cough); varicella (chickenpox)

The nurse is administering meperidine as ordered for pain management for a 10-year-old boy in sickle cell crisis. The nurse would be alert for which of the following?

seizures

The nurse is caring for a 6-month-old infant diagnosed with otitis media. Which of the following clinical manifestations would likely have been noted in this child?

shaking the head and pulling the ear

Which of the following statements is most accurate related to sickle cell disease?

sickle cell disease is genetically inherited

A nurse is teaching a parent of a child who is receiving chemotherapy for bone cancer. Which of the following should be included in the teaching?

signs of infection, bleeding precautions, hand hygiene, nutritional requirements

The type of traction in which a pin, wire, tongs, or other device is surgically inserted through a bone is which of the following?

skeletal traction

A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following are appropriate home care instructions? (Select all that apply.)

sleep on a firm mattress; take frequent rest periods throughout the day; perform ROM exercises

The nurse is caring for a child admitted with acute glomerulonephritis. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

smoky colored urine

A nurse is caring for a 2-year-old child who has had three ear infections in the past 5 months. The nurse should know that the child is at risk for developing which of the following as a long-term complication?

speech delays

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which of the following forms of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

spica cast

A nurse is teaching a class about puberty in males. Which of the following should the nurse include as the first manifestation of sexual maturation?

testicular enlargement

The pediatric nurse practioner (PNP) records "positive Gowers' sign" after finishing the assessment of a young boy. How will the student nurse reading the PNP's note interpret this?

the boy rises from the floor by walking his hands up his legs

In caring for a child in traction, of the following interventions, which is the highest priority for the nurse?

the nurse should monitor for decreased circulation every four hours

The nurse is caring for a child in a type of traction in which weights are being used. Which of the following is true regarding the weights?

the weights must be hanging freely, not touching the bed or floor

An adolescent girl has spinal instrumentation surgery at 16 years of age. Immediately after this procedure, you would teach her to

wait to be log rolled before turning from one side to the other

In caring for a child with nephrotic syndrome, which of the following interventions will be included in the child's plan of care?

weighing on the same scale each day

Complications

without hormone replacement= disruption of vertical growth, delayed epiphyseal closure, retarded bone age, delayed sexual development, and premature aging later in life