Final Review Practice

A child had a femoral fracture of his right leg last year. Examination reveals that the right leg is now slightly shorter than the left leg. What is the most likely explanation of this finding: a. The child is probably guarding the leg out of fear of pain b. Muscle atrophy in the affected leg has slowed the rate of growth c. The fracture damaged the epiphyseal plates with resultant growth impairment d. Joint contracture caused by prolonged immobilization of the fractured leg has caused the leg to appear shorter

The fracture damaged the epiphyseal plates with resultant growth impairment

To facilitate digestion and absorption of nutrients, the child with cystic fibrosis needs to take: a. Thiamine b. Pyridoxine c. Vitamin K d. pancrelipase (Pancrease)

pancrelipase (Pancrease)

The nurse who is talking on the telephone with a depressed adolescent recognizes that the statement indicating the greatest immediate suicide risk is: a. "I just needed to talk to someone to keep myself from thinking silly thoughts about killing myself." b. "My parents aren't home and won't be back for 4 hours. That should be enough time for the pills to work. I've got a hundred of them." c. "My dad will be home first, so he will find me. So I think I'll use his gun. I hope he didn't lock the cabinet." d. "My girlfriend is here with me. She told me to call because I was talking crazy about killing myself."

"My dad will be home first, so he will find me. So I think I'll use his gun. I hope he didn't lock the cabinet."

The statement made by a parent of an adolescent with anorexia nervosa that indicates an understanding of this condition is: a. "There really isn't anything to worry about. You can never be too thin" b. "My daughter just doesn't have much of an appetite." c. "She is just trying to punish me for divorcing her father." d. "She seems to see herself as fat, even though her weight is below normal."

"She seems to see herself as fat, even though her weight is below normal."

You have a patient that weighs 33 pounds. The order is for 125 mg/kg/day in divided doses every 8 hours. Supply: 500mg/5ml. (Refer to this scenario to answer questions 97-100) What is the amount they will receive each day? _____ a. 375mg/day b. 1875mg/day c. 9050mg/day d. 3750mg/day

1875mg/day

For the infant with tracheoesophageal fistula (TEF), the most serious complication is: a. Hemorrhage b. Delayed development c. Impaired sucking d. Aspiration

Aspiration

You have a patient that weighs 33 pounds. The order is for 125 mg/kg/day in divided doses every 8 hours. Supply: 500mg/5ml. (Refer to this scenario to answer questions 97-100) What is the weight in kilograms? _____ a. 15kg b. 72.6kg c. 10kg d. 66kg

15kg

In caring for the hospitalized child who is failing to thrive, the child should be assigned to: a. A variety of caregivers to increase stimulation b. A caregiver with a heavy assignment so the mother can give care c. A consistent caregiver to role-model care d. A team of caregivers to concentrate on the baby and the mother.

A consistent caregiver to role-model care

Of the choices below, the nursing diagnosis that is of greatest initial importance when an infant has a cleft lip is: a. Disturbed body image b. Imbalanced nutrition: less than body requirements c. Knowledge deficit d. Delayed speech

Imbalanced nutrition: less than body requirements

You have a patient that weighs 33 pounds. The order is for 125 mg/kg/day in divided doses every 8 hours. Supply: 500mg/5ml. (Refer to this scenario to answer questions 97-100) What is the amount they will receive each dose? _____ a. 500mg/dose b. 375mg/dose c. 625mg/dose d. 425mg/dose

625mg/dose

You have a patient that weighs 33 pounds. The order is for 125 mg/kg/day in divided doses every 8 hours. Supply: 500mg/5ml. (Refer to this scenario to answer questions 97-100) What volume will the patient receive per dose? (To the nearest WHOLE number)____ a. 20ml b. 10ml c. 12ml d. 6ml

6ml

Patient teaching regarding croup would include the following: a. Most of the time croup can be managed at home b. Steam from the shower can relieve spasms c. Keep infant calm as prolonged crying can bring on spasms d. Exposure to cold air can relieve spasms e. All the above

All the above

The dose of Lanoxin (digoxin) should be withheld from a 3 month old infant when the nurse assesses: a. An apical pulse of 88 b. An apical pulse of 120 c. Respirations of 30 d. Periorbital edema

An apical pulse of 88

Your patient has been diagnosed with osteomyelitis. Which medication would you as the nurse be administering: a. Vitamin B6 b. Antibiotics c. NSAIDS d. Chemotherapy agents

Antibiotics

How would a nurse screen a preadolescent child for scoliosis? a. Ask the child to bend forward at the waist and observe the back for asymmetry b. Observe the gait while the child is walking forward heel to toe c. Have the child flex the knees and look for uneven knee height d. Look at the child's shoulders and hips while fully clothed

Ask the child to bend forward at the waist and observe the back for asymmetry

Which of the following statements are TRUE a. Infants do not feel pain because of their immature nervous system b. Children cannot describe their pain c. Children always become addicted to pain medication d. Behavior and vital signs are observed to assess pain in very young children

Behavior and vital signs are observed to assess pain in very young children

Treatment of the infant of a human immunodeficiency virus (HIV) positive mother should include: a. Monitoring for signs of infection b. Prenatal treatment with AZT c. Isolation from other infants d. Both a. and b.

Both a. and b.

What clinical manifestations would suggest hydrocephalus in an infant? MARK ALL THAT APPLY a. Bulging fontanels b. Sunken fontanels c. High-pitched cry d. Sunset eyes

Bulging fontanels High-pitched cry Sunset eyes

Your 15-year-old daughter is manifesting signs of bulimia. Which of the following statements about bulimia is correct? a. Bulimics are always severely underweight b. Bulimics alternate binge eating with purging c. The individual with bulimia has high self esteem d. Girls with bulimia have extremely close relationships

Bulimics alternate binge eating with purging

The most serious complication of acute rheumatic fever is: a. Cardiac damage b. Erythema marginatum c. Chronic arthritis d. Renal failure

Cardiac damage

The following statement regarding child abuse is TRUE: a. Child abuse can be physical, sexual or emotional b. Only physicians can report child abuse c. Most states have penalties for failure to report child abuse d. Physical disability is not a risk factor for child abuse

Child abuse can be physical, sexual or emotional

In caring for a baby with failure to thrive, the nurse should: a. Compliment or praise the mother on her assisting with care. b. Lecture the mother on the aspects of loving care. c. Insist that the mother takes part in the care of the infant d. Point out methods that the mother might use to improve care

Compliment or praise the mother on her assisting with care.

A preschool-aged child admitted with Reye Syndrome will most likely be placed: a. On isolation b. On a surgical unit c. On the pediatric floor d. In the intensive care unit (ICU)

In the intensive care unit (ICU)

The infant presented in the ER with severe pain in the abdomen, evidenced by loud cries, straining efforts and kicking and drawing the legs toward the abdomen. The mother states that this just happened. The ER nurse, Crystal, would suspect intussusception when the mother described the infant's stool as being: a. Currant jelly b. Tarry and black c. Green liquid d. Greasy and foul smelling

Currant jelly

Which of the following is a common clinical manifestation of Hodgkin's disease? a. Petechiae b. Bone and joint pain c. Painful, enlarged lymph nodes d. Enlarged, firm, nontender lymph nodes

Enlarged, firm, nontender lymph nodes

Studies have shown that the incidence of neural tube defects has been greatly reduced by the use of: a. Vitamin A b. Folic Acid c. Niacin d. Vitamin B

Folic Acid

A nurse reviews the record of a 3 week old infant and notes that the physician has documented a diagnosis of suspected Hirschsprung's disease. The nurse understands that which of the following symptoms led the mother to seek health care for the infant? a. Diarrhea b. Projectile vomiting c. Regurgitation of feedings d. Foul smelling ribbon like stools

Foul smelling ribbon like stools

To prepare a toddler for a procedure, nurse Lisa knows to: a. Give a brief, simple explanation just before the procedure b. Provide a detailed explanation of the procedure c. Never wear gloves as this will frighten the child d. Administer the Denver II to determine what the child will understand

Give a brief, simple explanation just before the procedure

A child who had rheumatic fever 1 year ago requires extraction of an impacted tooth. Prior to this procedure the dentist or physician should: a. Request an electrocardiogram to assess for rheumatic heart disease b. Advise the parents that the child is at high risk of excess bleeding c. Consult with an anesthesiologist about the advantages of general anesthesia d. Give the child a course of antibiotics prior to prevent bacterial endocarditis

Give the child a course of antibiotics prior to prevent bacterial endocarditis

The characteristic way a child with Duchenne's muscular dystrophy rises from the floor is known as: a. Hand assisted b. Thigh assisted c. Gowers' sign/maneuver d. Bright's sign

Gowers' sign/maneuver

Which nursing action is avoided when giving care to the child with a confirmed diagnosis of Wilms' tumor? a. Palpating the child's abdomen b. Giving the child a ball c. Feeding the child d. Combing the child's hair

Palpating the child's abdomen

A child is having a generalized tonic-clonic seizure. The appropriate nursing action would be to: a. Guide the child to the bed and go for help b. Move objects out of the child's immediate area c. Stick a padded tongue blade under the child's tongue d. Quickly slip soft restraints on the child's wrist

Move objects out of the child's immediate area

To bathe a newborn safely, Brittany knows that you should: a. Not immerse the body until the cord has fallen off b. Test the water temperature with your fingertips c. Have the bath water at 90 degrees F d. Cleanse the eyes with a soapy washcloth

Not immerse the body until the cord has fallen off

A 3-year-old child is brought to the clinic. She has a muffled voice, is agitated, and is drooling. She insists on sitting upright. The nurse should immediately: a. Examine her oral pharynx and report to the physician b. Make her lie down and rest c. Auscultate her lungs and make preparations for placement in a mist tent d. Notify the physician and be prepared to assist with a tracheotomy or intubation

Notify the physician and be prepared to assist with a tracheotomy or intubation

A 4-week-old infant has been diagnosed with pyloric stenosis. The findings are peristaltic waves across the abdomen and projectile vomiting. What other finding might the nurse, Trish assess for? a. Diarrhea b. Gastric pain c. Poor sucking reflex d. Olive-shaped mass

Olive-shaped mass

Which statement regarding impetigo is true: a. "It is caused by a staph infection and is extremely contagious" b. "No treatment is needed, it will resolve on its own" c. "Children have no symptoms" d. "It follows a viral infection"

"It is caused by a staph infection and is extremely contagious"

1. The nurse is explaining to the parents of a child with acute epiglottitis that this is a severe, potentially life threatening disease because it could: a. Increase carbon dioxide levels b. Lead to airway obstruction c. Prevent swallowing d. Prevent bronchus dilation

Lead to airway obstruction

A toddler was brought to the clinic with a cough which her mother has not been able to control. The doctor explains that the baby has croup. Which of the following characteristics best describes croup? a. Inflammation of the palatine tonsils b. Acute, highly contagious respiratory infection c. Infection of the supraglottic area with involvement of the epiglottis d. A general term for a barking cough and varying degrees of inspiratory stridor

A general term for a barking cough and varying degrees of inspiratory stridor

1. Today the pediatric lecture is "The Child with a Sensory or Neurological Condition." Tike learns that cerebral palsy is: a. A form of mental retardation that does not improve with treatment b. A non-progressive disorder that affects the motor center of the brain c. Always caused by a birth injury occurring in early gestational births d. Related to the lack of early childhood stimulation and is irreversible

A non-progressive disorder that affects the motor center of the brain

Which action takes priority when a child has a tracheostomy? a. Humidify the air b. Keep the room warm c. Maintain airway tube patent (open) d. Document suctioning results

Maintain airway tube patent (open)

A nurse who is caring for a 2-day-old neonate suspects that the infant has cystic fibrosis. What early sign of this disorder did the nurse identify? a. Meconium ileus b. Imperforate anus c. Hemoglobin level of 20 g/dL d. Total bilirubin level of 8 mg/dL

Meconium ileus

Absence of stools, vomiting and abdominal distention are symptoms to watch for in the newborn nursery, indicating what condition? a. Meconium ileus b. Intussusception c. Appendicitis d. Pyloric stenosis

Meconium ileus

Betsy, the nurse in the recovery room, performs care for Michelle who has had surgery for appendicitis. Expected nursing care during the immediate post-surgical period would include: a. Cleansing the incision site b. Assessing the dressing for bleeding c. Measuring the abdominal girth d. Palpating the abdomen for bowel sounds

Assessing the dressing for bleeding

When preparing a child with asthma for discharge, what instructions must the nurse emphasize to the family? a. Prevent exposure to infection by having the child tutored at home. b. Avoid placing limits on the child's behavior. c. Maintain a dry home environment. d. Avoid and eliminate allergens in the home.

Avoid and eliminate allergens in the home.

The nurse outlines precautions parents can take to prevent SIDS, which include: a. Placing the baby on the stomach to sleep b. Using a soft, comfortable mattress c. Avoiding soft objects and loose bedding d. Using a device to maintain the baby's sleep position

Avoiding soft objects and loose bedding

The parents of a child with a terminal illness ask the nurse what hospice is and if they should find out more about it. Select the most appropriate response: a. Hospice care usually is provided in a nursing home setting b. Hospice is for patients who prefer alternative therapies to traditional medical care c. Hospice services generally are not available for children d. Hospice provides sensitive and supportive care to the patient and family

Hospice provides sensitive and supportive care to the patient and family

The nurse in the Emergency Room is admitting a 6-year-old child with a fractured arm. There is suspicion of child abuse due to what observation by the nurse: a. Child is clinging to the parent during exam b. Child will not answer questions concerning the injury c. Parents don't ask about child's condition d. Inconsistency between the injury and the parents' explanation of the injury

Inconsistency between the injury and the parents' explanation of the injury

The medication used to facilitate the closing of the PDA (patent ductus arteriosis ) is: a. Ethambutol b. Indocin (indomethicin) c. Lanoxin (digoxin) d. Prostagladin E

Indocin (indomethicin)

Kari understands that TB is transmitted by: a. Skin contact b. Handling of feces or urine c. Ingestion d. Inhalation of an infected droplet

Inhalation of an infected droplet

1. A 5-year-old is hospitalized for treatment of partial thickness burns she received 6 days ago. The burns cover 20% of her body, mostly her legs. To ensure that her nutritional needs are met, Janet her nurse should: a. Restrict eating between meals b. Order small, frequent meals of favorite foods to help ensure that high protein/high calorie requirements are met c. Discourage her parents from bringing in food from home d. Discourage supplements that prevent her from eating regular meals

Order small, frequent meals of favorite foods to help ensure that high protein/high calorie requirements are met

A nurse is caring for a school-aged child with type 1 diabetes and determines that the child may be experiencing diabetic ketoacidosis. What symptoms led the nurse to this conclusion? a. Patient has fruity smelling breath and ketones in the urine b. Patient is having bouts of diarrhea c. Patient has urinary retention d. Patient is complaining of hunger

Patient has fruity smelling breath and ketones in the urine

On return to the pediatric unit after a tonsillectomy, a nurse notes that a 4-year-old child is swallowing frequently. What is the probable cause of this response? a. Pharyngeal edema b. Tenacious oral secretions c. Postoperative bleeding d. Increased saliva production

Postoperative bleeding

The most important reason for positioning infants on their backs to sleep is to: a. Provide sensory stimulation b. Encourage motor activity c. Prevent sudden infant death syndrome (SIDS) d. Avoid aspiration of regurgitated fluids

Prevent sudden infant death syndrome (SIDS)

The nurse interviewing the parents of an infant with pyloric stenosis would expect the parents to report the symptom of: a. Diarrhea b. Projectile vomiting c. Poor appetite d. Constipation

Projectile vomiting

A preschooler, was hospitalized with a diagnosis of nephrosis. You know characteristic sign of nephrosis is: a. Proteinuria b. Increased urine output c. Red-brown urine d. Hematuria

Proteinuria

A child is experiencing sickle cell crisis, and the parents want to know what to do to help. The nurse, Chelsi, explains that the medical management of sickle cell crisis includes: a. Information for the parents including home care b. Providing adequate hydration and pain management c. Pain management and administration of iron supplements d. Adequate oxygenation and Factor VIII

Providing adequate hydration and pain management

An 8-year-old child is admitted to the emergency department with signs and symptoms of Reye syndrome. What information from the child's history is most important for the nurse to obtain in light of the child's tentative diagnosis? a. Recent rash b. Tonsillitis attacks c. Recent viral infection d. Recurrent high fevers

Recent viral infection

What action should the nurse take if abuse of a 10-year-old child is suspected? a. Report the suspicion to local authorities. b. Elicit more information from the parents. c. Refer the parents to a group therapy meeting. d. Notify the health care provider of the suspicion.

Report the suspicion to local authorities.

An emergency tracheotomy has been performed on a 6-year-old child with acute epiglottitis, and the child is receiving humidified air through a tracheotomy collar. What early clinical manifestations of hypoxia should alert the nurse to suction the tracheotomy? a. Dyspnea and cyanosis b. Agitation and diaphoresis c. Restlessness and increase in pulse d. Severe substernal retractions and stridor

Restlessness and increase in pulse

The home-care nurse, Dawn, reinforces instructions to the parents of a child with celiac disease. Which of the following food items would the nurse advise the parents to include in the child's diet? a. Oatmeal b. Rye toast c. Whole wheat pizza d. Rice

Rice

Which symptom is present in anorexia nervosa but not in bulimia? a. Binge eating b. Self-imposed starvation c. Feelings of depression d. Dissatisfaction of body weight

Self-imposed starvation

When the child receiving a transfusion complains of back pain and itching, the nurse's initial action would be to: a. Notify the charge nurse b. Disconnect IV lines immediately c. Give Benadryl d. Stop the infusion and keep the line open with normal saline

Stop the infusion and keep the line open with normal saline

A 7-year-old child was sent to the school nurse because she was squinting and covering one eye and tilting her head to see the blackboard. These are signs of which visual impairment? a. Presbycusis b. Conjunctivitis c. Strabismus d. Hyphema

Strabismus

A month-old infant, is admitted with severe diarrhea and dehydration. The nurse would expect to find the following symptom: a. Increased urinary output b. Decreased heart rate c. Sunken anterior fontanel d. Decreased respiratory rate

Sunken anterior fontanel

An 8-year-old is admitted to the hospital as a newly diagnosed diabetic. You come to her room in the late afternoon and find her diaphoretic and she says she feels "funny." Your immediate action should be to: a. Call the physician b. Give her insulin dose immediately c. Take a bedside glucose reading and be prepared to give her orange juice d. Give her a snack of crackers and cheese

Take a bedside glucose reading and be prepared to give her orange juice

A congenital heart defect that decreases pulmonary blood flow, has dextroposition of the aorta (overriding of the aorta), hypertrophy of the right ventricle, and ventricular septal defect is: a. Tetralogy of Fallot b. Ventricular septal defect c. Coarctation of the aorta d. Patent ductus arteriosus

Tetralogy of Fallot

The home health nurse discovers a family infected with pediculosis and helps the mother to start eradication of the lice, such as a. Washing clothing and bedding in cold water and detergent. b. Using over-the-counter pediculosis shampoos c. Wrapping the head in a towel after a shampoo with dog soap d. Brushing the hair briskly with a stiff brush

Using over-the-counter pediculosis shampoos

A 6-year-old had chicken pox two weeks ago and was given ASA for his discomfort. He may be exhibiting early signs of Reye's syndrome which includes: a. Diarrhea and headache b. Nausea and malaise c. Vomiting and decreased LOC d. Hyperactivity and vomiting

Vomiting and decreased LOC

The nurse reviews the general rules for maintaining adequate traction, which include: a. Weights should be tied down b. Traction can be removed at any time c. All ace bandages should be wrapped tightly d. Weights should hang freely

Weights should hang freely