N328 Final Exam Practice Questions

Which of the following terms is described by the following: "kidneys' response to hypoxia" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

G. Erythropoietin

Which of the following terms is described by the following: "blockage of a blood cell that occurs in sickle crisis" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

H. Vaso-occlusion

Determine the dermatological disorder based on the following description: An 18-month-old girl Chief compliant: Vesiculopapular lesions at both palms and soles for 2 days Present illness: She had been well since birth. 5 days prior to admission, She developed low grade fever, dry cough and running nose.2 days prior to admission, low grade fever persisted and she developed vesiculopapular lesions at both palms and soles.1 day prior to admission, although the fever subsided, the skin lesions increased in number. There is no pain nor itching. Past history: She has had normal growth and development Her immunizations are up-to-date.

Hand-Foot-Mouth disease

Determine the dermatological disorder based on the following description: This 4-year-old boy developed unilateral cervical lymphadenopathy, nonpurulent conjunctivitis, erythema and edema of the hands and feet, red dry fissured lips, and target lesions on the legs. He looked ill and had a fever for a week which was unresponsive to antipyretics. He improve dramatically with intravenous immunoglobulin

Kawasaki disease

Determine the dermatological disorder based on the following description: This is any of several bacterial strains of the genus Staphylococcus (S. aureus) that are resistant to beta-lactam antibiotics (as methicillin and nafcillin) and that are typically benign colonizers of the skin and mucous membranes (as of the nostrils) but may cause severe infections (as by entrance through a surgical wound) esp. in immunocompromised individuals .

MRSA

treatment for Hemophilia A

- factor VIII - DDAVP (1-deamino 8deargine vasopressin)

Treatment for iron deficiency anemia

- ferrous sulfate - dextran (parenteral form)

treatment for beta-thalassemia

- iron chelation - Deferoxamine (Desferal) - blood transfusions

treatment for lead poisoning

- lead chelation therapy, CaNa2EDTA and succimer - BAL

treatment for sickle cell crisis

- morphine - oxygen - hydration

treatment for ITP (idiopathic thrombocytopenic purpura)

- steroids - IVIG

A new nurse is caring for a child with a wound and asks you to remind her about the phases of wound healing. You describe the order as: - Contraction: Fibroblast movement causes contraction of the healing area, which helps bring wound edges closer together. - Maturation: The scar becomes pale, does not tan when exposed to sunlight, will not sweat or produce hair, and may itch. - Inflammatory phase: Erythema, heat, edema, pain, and functional disturbance occur. - Proliferation: Fibroblasts, immature connective tissue cells, migrate to the healing site and begin to secrete collagen into the meshwork spaces.

1. Inflammatory phase: Erythema, heat, edema, pain, and functional disturbance occur. 2. Proliferation: Fibroblasts, immature connective tissue cells, migrate to the healing site and begin to secrete collagen into the meshwork spaces. 3. Contraction: Fibroblast movement causes contraction of the healing area, which helps bring wound edges closer together. 4. Maturation: The scar becomes pale, does not tan when exposed to sunlight, will not sweat or produce hair, and may itch.

A nurse is caring for a child who is experiencing neuropathy due to chemotherapy. Which of the following are manifestations of neuropathy? (Select all that apply.) A. Constipation B. Skin breakdown C. Foot drop D. Jaw pain E. Hemorrhagic cystitis

A. Constipation C. Foot drop D. Jaw pain

A school nurse identifies that a child has pediculosis capitis and educates the child's parent about the condition. Which of the following statements by the parent indicates an understanding of the teaching? A. "All recently worn clothing, bedding, and towels must be washed in hot water." B. "My child must have a physician's note to return to school." C. "I will treat all the family members to be on the safe side." D. "Toys that can't be dry cleaned or washed must be thrown out."

A. "All recently worn clothing, bedding, and towels must be washed in hot water."

You are working with a new graduate on the pediatric unit and your patient is returning from the cardiac catheterization laboratory. You feel the graduate understands the important nursing interventions when she says which of the following? (Select all that apply.) A. "Check pulses, especially below the catheterization site, for equality and symmetry." B. "Check vital signs, which may be taken as frequently as every 30 to 45 minutes, with special emphasis on the heart rate, which is counted for 1 full minute for evidence of dysrhythmias or bradycardia." C. "Special attention needs to be given to the BP, especially for hypertension, which may indicate hemorrhage or bleeding from the catheterization site." D. "Check the dressing for evidence of bleeding or hematoma formation in the femoral or antecubital area." E. "Allow the child to ambulate because this will prevent skin breakdown from lying so long in one place."

A. "Check pulses, especially below the catheterization site, for equality and symmetry." D. "Check the dressing for evidence of bleeding or hematoma formation in the femoral or antecubital area."

A nurse is providing teaching to the parent of a child who has a neuroblastoma. Which of the following statements should the nurse include in the teaching? (Select all that apply.) A. "Chemotherapy and radiotherapy may be necessary for treatment." B. "Your child will need a bone marrow biopsy." C. "Your child will be paralyzed because of this tumor." D. "Most children are diagnosed around age 12." E. "Your child will need surgery for resection of the tumor."

A. "Chemotherapy and radiotherapy may be necessary for treatment." B. "Your child will need a bone marrow biopsy." E. "Your child will need surgery for resection of the tumor."

A nurse is admitting a 9 year old child who has rheumatic fever. When obtaining the client's history, it is appropriate for the nurse to ask the parent which of the following questions? A. "Has your son had a sore throat recently?" B. "Was your son born with this cardiac defect?" C. "Has your child had any injuries recently?" D. "Are you aware that your son will have to be in isolation?"

A. "Has your son had a sore throat recently?"

You are discharging a 5-week-old infant with a congenital heart defect who will be going home on digoxin. Which of the following answers by the father indicate the need for more teaching? (Select all that apply.) A. "I know I give the drug carefully by slowly directing it to the side and back of the mouth." B. "I give the medication every 12 hours, and I can place it in a bit of formula so I know the baby will take it." C. "If I miss a dose, I don't give an extra dose, but I give the next dose as ordered." D. "If the baby vomits, I should give a second dose." E. "If more than two doses have been missed, I should call the doctor."

A. "I know I give the drug carefully by slowly directing it to the side and back of the mouth." C. "If I miss a dose, I don't give an extra dose, but I give the next dose as ordered." E. "If more than two doses have been missed, I should call the doctor."

A nurse is caring for a child who has a fracture. Which of the following are manifestations of a fracture? (Select all that apply.) A. Crepitus B. Edema C. Pain D. Fever E. Ecchymosis

A. Crepitus B. Edema C. Pain E. Ecchymosis

You are working with a family with a child who has a congenital heart defect. Future surgery is planned, and you are teaching the parent how to reduce cardiac demands. The parent needs more teaching when she says which of the following? A. "I will wake my child for feeding every 2 hours so he can get enough calories to gain weight." B. "When I give the digoxin, I will listen to the pulse for 1 full minute." C. "I should protect my child from people who have respiratory infections." D. "I will count the number of wet diapers to be sure my child is not getting too much or too little fluid."

A. "I will wake my child for feeding every 2 hours so he can get enough calories to gain weight."

You are working with a new graduate and explaining prevention of infection for a child with acute lymphoblastic leukemia. Which statement by this new nurse indicates understanding? A. "Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer." B. "If blood is drawn, firm pressure should be applied to the area for a minimum of 10 minutes." C. "Having a roommate with a routine surgery would be acceptable for this child." D. "The child should be vaccinated completely to avoid childhood diseases."

A. "Prophylaxis against Pneumocystis pneumonia is routinely given to most children during treatment for cancer."

You are working with a recent graduate on the pediatric unit. You are assigned to take care of an adolescent with β-thalassemia. The nurse needs more information about this disease if she states which of the following? (Select all that apply.) A. "We need to check the patient's iron level to make sure he is not anemic." B. "I believe this is most common in those of Hispanic descent, although this patient is Mediterranean." C. "The doctor will be prescribing deferasirox (Exjade) or defoxamine (Desferal) for chelation therapy." D. "This patient looks much younger than I would expect. I guess he's just a late bloomer." E. "I think a transfusion will be ordered, since his hemoglobin level is 9.0."

A. "We need to check the patient's iron level to make sure he is not anemic." B. "I believe this is most common in those of Hispanic descent, although this patient is Mediterranean." D. "This patient looks much younger than I would expect. I guess he's just a late bloomer."

A nurse is collecting data on a child who is descending stairs by placing both feet on each step while holding on to the railing. This is developmentally appropriate at which of the following ages? A. 3 years B. 4 years C. 5 years D. 6 years

A. 3 years

An assistive personnel on the pediatric unit brings to the nurse's attention several clients' vital signs. Which of the following clients should the nurse plan to assess first? A. A 7-year-old client who has diabetes insipidus and a specific gravity of 1.002 B. A 1-year-old client with roseola and a temperature of 39°C (102.2°F) C. A 4-year-old client with status asthmaticus and an oximetry of 95% D. A 10-year-old client with sickle cell anemia and a pain rating of 6 out of 10

A. A 7-year-old client who has diabetes insipidus and a specific gravity of 1.002

A child who has leukemia is being admitted. Several rooms are available on the pediatric floor. Which of the following clients should the nurse place in the same room with this child? A. A child who has nephrotic syndrome B. A child recovering from a ruptured appendix C. A child who has rheumatic fever D. A child who has cystic fibrosis

A. A child who has nephrotic syndrome

Which assessment finding would the nurse most likely find in a child with Legg-Calves-Perthes disease? A. A limp and mild pain in the hip B. Severe sudden limp C. Tenderness and swelling over affected joint D. Fever and aching joints

A. A limp and mild pain in the hip

A nurse is caring for a child who has cellulitis on the hand. Which of the following actions should the nurse take? A. Administer oral antibiotics B. Cleanse area using Burrow solution C. Prepare for cryotherapy D. Apply a topical antifungal medication

A. Administer oral antibiotics

Which heart defect and hemodynamic change pairing is correct? A. Aortic stenosis and obstruction to blood flow out of the heart B. Ventricular septal defect and decreased pulmonary blood flow C. Tricuspid atresia and increased pulmonary blood flow D. Atrioventricular canal and mixed blood flow, in which saturated and desaturated blood mix within the heart or great arteries

A. Aortic stenosis and obstruction to blood flow out of the heart

A nurse is teaching a parent of a child who has eczema. Which of the following should be included in the teaching? A. Apply a cool, wet compress to the affected area. B. Launder clothing with fabric softener. C. Give bubble baths every day. D. Dress in thermal clothing during the night.

A. Apply a cool, wet compress to the affected area.

Care of the child with a wound includes which of the following? (Select all that apply.) A. Applying occlusive dressings, such as hydrocolloid dressings. Dressings adhere best if a wide margin is left around the wound and the dressing is gently pressed against intact skin until it adheres. B. The safest solution for cleansing and loosening sticky dressings is normal saline. C. To remove a transparent or hydrocolloid dressing, use one hand to hold the skin to which the dressing is secured firmly, then gently raise both edges of the dressing and pull the dressing away from the skin in a parallel direction. D. Wounds covering a very large area (>25% of the body) need medical attention, with the child undergoing conscious sedation and analgesia. E. Puncture wounds should initially be irrigated with sterile saline, then soaked in a basin of warm soapy water for several minutes before applying a clean dressing.

A. Applying occlusive dressings, such as hydrocolloid dressings. Dressings adhere best if a wide margin is left around the wound and the dressing is gently pressed against intact skin until it adheres. B. The safest solution for cleansing and loosening sticky dressings is normal saline. E. Puncture wounds should initially be irrigated with sterile saline, then soaked in a basin of warm soapy water for several minutes before applying a clean dressing.

A nurse is caring for a child that has red marks across his cheeks. Which of the following is an appropriate action for the nurse to take? A. Assess the rest of the child's body for a rash. B. Refer the family to child protective services. C. Question the parents about how the marks occurred on the child's cheeks. D. Obtain the child's temperature.

A. Assess the rest of the child's body for a rash.

Which of the following clinical manifestations of hip dysplasia would be seen in a newborn infant? A. Asymmetrical gluteal folds B. Trendelenberg sign C. Telescoping of the affected limb D. Lordosis

A. Asymmetrical gluteal folds

A nurse is caring for an 8 year old client admitted to the hospital with a diagnosis of acute rheumatic ever. Which of the following nursing assessments is most important immediately after admission? A. Auscultation of the rate and characteristics of heart sounds. B. Use of a pain-rating tool to determine the severity of joint pain. C. Identifying the degree of parental anxiety related to the diagnosis. D. Assessing the client's erythematous rash.

A. Auscultation of the rate and characteristics of heart sounds.

A nurse is providing teaching about iron deficiency anemia to the parents of a toddler. Which of the following should the nurse recommend as a method of preventing iron deficiency anemia? A. Avoid a diet consisting of primarily milk. B. Administer fat-soluble vitamins daily. C. Include fluoridated water in the diet. D. Limit intake of high-protein foods.

A. Avoid a diet consisting of primarily milk.

A nurse is caring for an infant and notices an audible click in their left hip. Which of the following diagnostic test should the nurse expect the provider to perform? (Select all that apply.) A. Barlow test B. Babinski sign C. Manipulation of foot and ankle D. Ortolani test E. Ponseti method

A. Barlow test D. Ortolani test

A nurse is caring for a child with Kawasaki disease. Which of the following is the primary system involved with this diagnosis? A. Cardiovascular B. Gastrointestinal C. Integumentary D. Respiratory

A. Cardiovascular

It is important to consider the child's developmental understanding of death when working with that child. Which option is the preschool child's developmental stage? A. Children of this age believe their thoughts are sufficient to cause death. B. They are still very much influenced by remnants of magical thinking and are subject to feelings of guilt and shame. C. They have a deeper understanding of death in a concrete sense. D. They can perceive events only in terms of their own frame of reference—living.

A. Children of this age believe their thoughts are sufficient to cause death.

A nurse is preparing to begin chest compressions for an infant. The nurse should perform compressions using which of the following techniques? A. Deliver compressions at 1/3 to 1/2 the depth of the chest. B. Deliver compressions with the heel of one hand only. C. Deliver compressions just above the nipple line. D. Deliver compressions at a depth of 1 1/2 to 2 inches.

A. Deliver compressions at 1/3 to 1/2 the depth of the chest.

A child is admitted with a possible diagnosis of Wilms' tumor (nephroblastoma). The nurse should obtain a sign with which of the following warnings to be placed over the child's bed? A. Do not palpate abdomen B. No venipuncture or blood pressure in left arm C. Contact precautions D. Collect all urine

A. Do not palpate abdomen

A nurse is assessing a child who has rhabdomyosarcoma of the nasopharynx. Which of the following are manifestations of rhabdomyosarcoma? (Select all that apply.) A. Enlarged neck lymph nodes B. Pain C. Vomiting D. Epistaxis E. Diplopia

A. Enlarged neck lymph nodes B. Pain D. Epistaxis

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following findings should the nurse expect? (Select all that apply.) A. Erythema marginatum (rash) B. Continuous joint pain of the digits C. Tender, subcutaneous nodules D. Decreased erythrocyte sedimentation rate E. Elevated C-reactive protein

A. Erythema marginatum (rash) E. Elevated C-reactive protein

Which of the following terms is described by the following: "the process through which RBCs are formed" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

A. Erythropoiesis

A school nurse is assessing a child for pediculosis capitis. Which of the following manifestations should the nurse recognize as an indication of this condition? A. Firmly attached white particles on the hair B. Itching and scratching of the head C. Patchy areas of hair loss D. Thick, yellow, crusted lesion on a red base

A. Firmly attached white particles on the hair

The long-term complications of thalassemia major are related to: A. Hemochromatosis B. Splenomegaly C. Anemia D. Growth retardation

A. Hemochromatosis

A mom calls the triage nurse that her son was playing in the woods where there is a lot of poison ivy. Nurse is correct in giving the following instructions... (select all that apply) A. Immediately take a cool shower and do not use any harsh detergents B. If contaminated the rash will appear in 1 week C. Wash clothes and shoes that he was playing in. D. Apply Bactroban antibiotic cream to the lesions

A. Immediately take a cool shower and do not use any harsh detergents C. Wash clothes and shoes that he was playing in.

A parent tells the nurse in the pediatric clinic that her toddler drinks a quart of milk a day and has a poor appetite for solid foods. The nurse should explain that this client is at risk or which of the following disorders? A. Iron-deficiency anemia B. Rickets C. Diabetes mellitus D. Obesity

A. Iron-deficiency anemia

A school nurse has a number of students with erythema infectiosum (Fifth Disease) in the grade school. She wants to send a letter home with the children to educate the parents about the disease. She would be correct in stating the following.... (Select all that apply.) A. It is caused by a virus (B19 human parvovirus) B. The reaction should last for 24-48 hrs C. Isolate the child if sx present D. Symptoms include slapped face appearance, maculopapular red spotted rash which is symmetrical and lacey appearance E. Offer aspirin for fever

A. It is caused by a virus (B19 human parvovirus) D. Symptoms include slapped face appearance, maculopapular red spotted rash which is symmetrical and lacey appearance

A nurse is caring for a school-age child with acute glomerulonephritis who has peripheral edema and is producing 35 mL of urine per hr. The client should be placed on which of the following diets? A. Low-sodium, fluid-restricted B. Regular diet, no added salt C. Low-carbohydrate, low-protein diet D. Low-protein, low-potassium diet

A. Low-sodium, fluid-restricted

A nurse is providing home care instructions to a parent of a child who is receiving chemotherapy. Which of the following instructions should the nurse include in the teaching? (Select all that apply.) A. Manifestations of infection B. Bleeding precautions C. Hand hygiene D. Homeschooling E.. Airborne precautions

A. Manifestations of infection B. Bleeding precautions C. Hand hygiene

A nurse is caring for a child who has thrombocytopenia. Which of the following actions should the nurse take? (Select all that apply.) A. Monitor for manifestations of bleeding B. Administer routine immunizations C. Obtain rectal temperatures D. Avoid peripheral venipunctures E. Limit visitors

A. Monitor for manifestations of bleeding D. Avoid peripheral venipunctures

A child develops a severe case of poison ivy. What medication should the nurse anticipate? A. Oral corticosteroids B. Antibiotics C. Calamine lotion D. Aveeno baths

A. Oral corticosteroids

A nurse is assessing a child who has rhabdomyosarcoma of the upper arm. Which of the following findings should the nurse expect? (Select all that apply.) A. Pain B. Discoloration of the skin C. Lymph node enlargement D. Easy bruising E. Palpable mass

A. Pain C. Lymph node enlargement E. Palpable mass

Which of the following factors should a nurse consider when managing the pain of a terminally ill child? (Select all that apply.) A. Pain medications are given on an as-needed schedule, and extra doses for breakthrough pain are available to maintain comfort. B. Opioid drugs, such as morphine, are given for severe pain, and the dosage is increased as necessary to maintain optimum pain relief. C. Addiction is a factor in managing terminal pain in a child, and the nurse plays an important role in educating parents that their child may become addicted. D. Nurses often express concern that administering dosages of opioids that exceed those with which they are familiar will hasten the child's death; in the principle of double effect. E. In addition to pain medication, techniques such as music therapy, distraction, and guided imagery should be combined with medications to provide the child and family strategies to control pain.

A. Pain medications are given on an as-needed schedule, and extra doses for breakthrough pain are available to maintain comfort. B. Opioid drugs, such as morphine, are given for severe pain, and the dosage is increased as necessary to maintain optimum pain relief. D. Nurses often express concern that administering dosages of opioids that exceed those with which they are familiar will hasten the child's death; in the principle of double effect.

A nurse in a provider's office is caring for a school-age child whose mother reports dandruff and a rash on the back of her child's neck. On examination, the nurse notices the white flakes don't brush off the hair. The nurse suspects which of the following disorders? A. Pediculosis capitis B. Psoriasis C. Seborrheic dermatitis D. Tinea capitis

A. Pediculosis capitis

A nurse is completing a history and physical on a 3 year old child who is admitted for a surgical repair of Tetralogy of Fallot (TOF). Which of the following manifestations of the condition should the nurse expect? (Select all that apply.) A. Polycythemia B. Hypertension C. Clubbing of the nail beds D. Failure to thrive E. Pallor F. Murmur

A. Polycythemia C. Clubbing of the nail beds D. Failure to thrive F. Murmur

A nurse is providing teaching about epistaxis to the parent of a school-age child. Which of the following should the nurse include as an action to take when managing an episode of epistaxis? (Select all that apply.) A. Press the nares together for at least 10 min B. Breathe through the nose until bleeding stops C. Pack cotton or tissue into the naris that is bleeding D. Apply a warm cloth across the bridge of the nose E. Insert petroleum into the naris after the bleeding stops

A. Press the nares together for at least 10 min C. Pack cotton or tissue into the naris that is bleeding

When planning a client education program for SCD, the nurse should include such topics as: A. Proper handwashing and infection avoidance B. High iron, high protein diet C. Fluid restriction to one quart per day D. Aerobic exercise to increase oxygenation

A. Proper handwashing and infection avoidance

A nurse is caring for a school-age child who has juvenile idiopathic arthritis. Which of the following home care instructions should the nurse include in the teaching? (Select all that apply.) A. Provide extra time for completion of ADLs B. Use cold compresses for joint pain C. Take ibuprofen on an empty stomach D. Remain home during periods of exacerbation E. Perform range-of-motion exercises

A. Provide extra time for completion of ADLs E. Perform range-of-motion exercises

A nurse often cares for children who are dying. Which of the following are actions for the nurse to take to maintain professional effectiveness? (Select all that apply.) A. Remain in contact with the family after their loss B. Develop a professional support system C. Take time off from work D. Suggest that a hospital representative attend the funeral E. Demonstrate feelings of sympathy toward the family

A. Remain in contact with the family after their loss B. Develop a professional support system C. Take time off from work

A nurse in a family health clinic is performing a routine physical examination of a client who is about to enter high school. The nurse observes an abnormal lateral curvature of the spine. The nurse should expect the provider to document which of the following disorders? A. Scoliosis B. Kyphosis C. Lordosis D. Ankylosis

A. Scoliosis

When caring for a child with acute renal failure, which nursing measure requires immediate attention? A. Serum potassium concentrations in excess of 7 mEq/L B. Sodium level of 135 C. Transfusion for hemoglobin of 8 D. Mannitol and furosemide for a urine output of 2 ml/kg/hr

A. Serum potassium concentrations in excess of 7 mEq/L

A nurse is providing teaching about the management of epistaxis to an adolescent. Which of the following positions should the nurse instruct the adolescent to take when experiencing a nosebleed? A. Sit up and lean forward B. Sit up and tilt the head up C. Lie in a supine position D. Lie in a prone position

A. Sit up and lean forward

The parents of a child with Hodgkin disease ask how the physician will know what type of cancer their child has. Which of the following definitive signs and symptoms should the nurse describe? (Select all that apply.) A. The most common finding is enlarged, firm, nontender, movable nodes in the supraclavicular or cervical area. B. Tests include complete blood count, prothrombin time and G6PD, erythropoietin, and sedimentation rate. C. Generally a bone marrow biopsy is done to look for the presence of blast cells. D. The presence of Reed-Sternberg cells is considered diagnostic of Hodgkin disease. E. The presence of a white reflection as opposed to the normal red pupillary reflex in the pupil of a child's eye is a classic sign.

A. The most common finding is enlarged, firm, nontender, movable nodes in the supraclavicular or cervical area. D. The presence of Reed-Sternberg cells is considered diagnostic of Hodgkin disease.

The nurse is caring for a 4-year-old girl with a history of frequent urinary tract infections. What should the nurse be aware of before obtaining a urine sample? (Select all that apply.) A. To obtain a clean-catch urine specimen, have the child sit on the toilet facing backward toward the tank. B. Because children who have a UTI will have painful urination, have the child drink a large amount of fluid before obtaining the sample. C. The specimen must be fresh—less than 1 hour after voiding with storage at room temperature or less than 4 hours after voiding with refrigeration. D. If a urinalysis obtained by a bag specimen is negative, a specimen still needs to be obtained by catheterization or suprapubic aspiration. E. The key to distinguishing a true UTI from asymptomatic bacteriuria is the presence of pyuria. F. Because the child is febrile, the nurse should immediately start an antimicrobial and then obtain a urine culture.

A. To obtain a clean-catch urine specimen, have the child sit on the toilet facing backward toward the tank. C. The specimen must be fresh—less than 1 hour after voiding with storage at room temperature or less than 4 hours after voiding with refrigeration. E. The key to distinguishing a true UTI from asymptomatic bacteriuria is the presence of pyuria.

A nurse is planning care for a child who has tinea capitis. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Treat infected house pets B. Use selenium sulfide shampoo C. Cleanse area with Burrow solution D. Administer antiviral medications E. Use moist, warm compresses

A. Treat infected house pets B. Use selenium sulfide shampoo

A 16 year old female is to be started on Accutane (Isotretinoin 12-cis-retoinic acid) and a method of birth control. What instructions should be given to the patient? (Select all that apply.) A. Utilizing sunscreen and hats or visors B. Accutane can cause severe birth defects in the fetus C. Do not eat fatty foods D. Scrub face with an antibacterial soap E. Notify MD of s/s of depression F. Educate re s/s of depression

A. Utilizing sunscreen and hats or visors B. Accutane can cause severe birth defects in the fetus C. Do not eat fatty foods E. Notify MD of s/s of depression F. Educate re s/s of depression

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Low blood pressure

A. Weak femoral pulses B. Cool skin of lower extremities E. Low blood pressure

A child is admitted with scarlet fever. What clinical findings should the nurse expect? (Select all that apply.) A. White strawberry tongue progressing to a red strawberry tongue B. Viral agent C. Koplik spots D. Red maculopapular rash spreading cephalocaudal E. Abrupt fever , headache, chills and malaise

A. White strawberry tongue progressing to a red strawberry tongue D. Red maculopapular rash spreading cephalocaudal E. Abrupt fever , headache, chills and malaise

A 10 year old is sent to the school nurse with a honey colored crusty, redden papules on his face. The child states that the lesion is itchy. The priority of the nurse is to do the following... A . Tell the child to wash his face and hands then send him back to class B. Call the caregiver and have the child seen by a physician or NP. C. Assess his temperature and lungs D. Examine the patients extremities for further infestation

B. Call the caregiver and have the child seen by a physician or NP.

A 5-year-old child is admitted to the pediatric unit from the recovery room, following application of a hip spica cast. Which of the following nursing actions would be priority? A. Elevate the head of the bed B. Check circulation C. Turn the client to right side-lying position D. Offer ice chips

B. Check circulation

What type of isolation should the child with scarlet fever be placed in, and for how long? A. Contact isolation throughout the hospital stay B. Respiratory precautions till 24-48 hrs of treatment C. None of the above

B. Respiratory precautions till 24-48 hrs of treatment

A nurse is assessing a child who has a UTI. Which of the following are manifestations of a UTI? (Select all that apply.) A. Night sweats B. Swelling of the face C. Pallor D. Pale-colored urine E. Fatigue

B. Swelling of the face C. Pallor E. Fatigue

A nurse is caring for a 2 year old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? A. Place on NPO status for 12 hr prior to the procedure B. Check for iodine or shellfish allergies prior to the procedure C. Elevate the affected extremity following the procedure D. Limit fluid intake following the procedure

B. Check for iodine or shellfish allergies prior to the procedure

A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring

B. Cool extremities C. Peripheral edema E. Nasal flaring

A nurse is caring for a toddler who has a Wilms' tumor. Which of the following actions should the nurse take? A. Palpate the child's abdomen to identify the size of the tumor B. Prepare the child for surgery C. Teach the parents about dialysis D. Obtain a 24 hr urine specimen from the child

B. Prepare the child for surgery

The parent of a school age child with osteogenesis imperfecta asks the nurse what type of activity would be appropriate for the child to participate in. The nurse best answer is: A. Track B. Swimming C. Soccer D. No physical activity

B. Swimming

A nurse is teaching a caregiver of a preschool child about the factors that affect the child's perception of death. Which of the following factors should the nurse include in the teaching? A. Preschool children have no concept of death B. Preschool children perceive death as temporary C. Preschool children often regress to an earlier stage of behavior D. Preschool children experience fear related to the disease process

B. Preschool children perceive death as temporary

Define the following congenital heart defect: Abnormal opening of the atria, allowing blood from the higher pressure left atrium to the lower pressure right atrium

Atrial Septal Defect

Define the following congenital heart defect: Incomplete fusion of the endocardial cushions, creating a large central AV valve, ASD, VSD, and allows blood to flow between all four chambers

Atrioventricular Canal

Define the following congenital heart defect: thickened aortic valve; can be repaired by cardiac catheterization with a balloon to open the valve and often diagnosed by exercise intolerance

Aortic Stenosis

You are discharging a patient with hemophilia. Which of the following responses by the parents indicate an understanding of this disorder? (Select all that apply.) A. "My child should remain active to decrease joint problems, and most children with hemophilia can participate in the same activities as peers." B. "Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge-tipped disposable toothbrush may be helpful." C. "Signs of internal bleeding should be recognized, such as headache, slurred speech, loss of consciousness (from cerebral bleeding), and black, tarry stools (from gastrointestinal bleeding)." D. "If there is bleeding in a joint, elevation, ice, and rest should help and may prevent the need for factor VIII replacement." E. "All of my son's teachers need to be aware of what to do if he gets a bloody nose."

B. "Care should be taken to avoid bleeding of gums, and softening the toothbrush in warm water before brushing or using a sponge-tipped disposable toothbrush may be helpful." C. "Signs of internal bleeding should be recognized, such as headache, slurred speech, loss of consciousness (from cerebral bleeding), and black, tarry stools (from gastrointestinal bleeding)." E. "All of my son's teachers need to be aware of what to do if he gets a bloody nose."

A nurse is providing teaching about lice to the parent of a school-age child at a well child visit. Which of the following should be included in the teaching? A. "Lice can jump from one child to another." B. "Encourage your child to avoid sharing hats with other children." C. "Lice do not survive away from the host." D. "Washing your child's hair daily will prevent lice."

B. "Encourage your child to avoid sharing hats with other children."

A nurse is teaching a group of caregivers about fractures. Which of the following information should the nurse include in the teaching? A. "Children need a longer time to heal from a fracture than an adult." B. "Epiphyseal plate injuries can result in altered bone growth." C. "A greenstick fracture is a complete break in the bone." D. "Bones are unable to bend, so they break."

B. "Epiphyseal plate injuries can result in altered bone growth."

A nurse is teaching a parent who has a fracture of the epiphyseal plate. Which of the following is an appropriate statement by the nurse? A. "The blood supply to the bone is disrupted." B. "Normal bone growth can be affected." C. "Bone marrow can be lost though the fracture." D. "The healing process will take longer."

B. "Normal bone growth can be affected."

A nurse is caring for a child who has rheumatic fever. When obtaining the client's medical history from the parent, the nurse recognizes the significance of which of the following data as the possible source of the child's infection? A. A classmate has fifth disease. B. A sibling had a sore throat 3 weeks ago. C. The father had gastritis 2 weeks ago. D. A neighbor's child has chickenpox.

B. A sibling had a sore throat 3 weeks ago.

The nurse taking care of a 5-year-old cancer patient with ulcerative stomatitis is getting ready to perform mouth care. Which of the following principles should be followed? (Select all that apply.) A. Due to pain of the stomatitis, viscous lidocaine should be used to swish the mouth three times per day. B. A soft, bland diet, although not the favorite of the child, will help with the pain. C. Lemon glycerine swabs are helpful because they remind children of lemon drops. D. Using a soft sponge-type toothbrush will decrease the tendency for gums to bleed. E. A solution of 1 tsp of baking soda and tsp of table salt in 1 quart of water is helpful for mouth rinse.

B. A soft, bland diet, although not the favorite of the child, will help with the pain. D. Using a soft sponge-type toothbrush will decrease the tendency for gums to bleed. E. A solution of 1 tsp of baking soda and tsp of table salt in 1 quart of water is helpful for mouth rinse.

An 8-year-old child sustained a fractured humerus in a fall from a tree house. Which of the following actions should be included in the client's plan of care? A. Advising the parents to dismantle the tree-house to prevent injuries B. Administering analgesic medication C. Applying moist heat to the fracture site D. Assessing involuntary muscle movement of the injured arm

B. Administering analgesic medication

Which of the following terms is described by the following: "a reduction in number of RBCs, quantity of Hgb, and volume of packed RBCs" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

B. Anemia

A nurse is monitoring a child for acute signs of lead poisoning. Which of the following should the nurse expect the client to manifest? A. Increase urinary output B. Anorexia C. Diarrhea D. Jaundice

B. Anorexia

A nurse is assessing a child who has leukemia. Which of the following are early manifestations of leukemia? (Select all that apply.) A. Hematuria B. Anorexia C. Petechiae D. Ulcerations in the mouth E. Unsteady gait

B. Anorexia C. Petechiae E. Unsteady gait

A nurse is planning care for an infant. Which of the following would be the most appropriate site to assess a pulse? A. Carotid artery B. Apex of the heart C. Brachial artery D. Temporal artery

B. Apex of the heart

Identify the interventions that can be safely used to manage diaper dermatitis. (Select all that apply.) A. Blow dry heat on skin with hair dryer. B. Apply a skin barrier paste such as zinc oxide. C. Keep skin surface irritants such as urine and stool off skin. D. Expose skin to air. E. Use only cloth diapers.

B. Apply a skin barrier paste such as zinc oxide. C. Keep skin surface irritants such as urine and stool off skin. D. Expose skin to air.

A nurse is caring for a child who is in skeletal traction. Which of the following actions should the nurse take? (Select all that apply.) A. Remove the weights to reposition the client B. Assess the child's position frequently C. Assess pin sites every 4 hr D. Ensure the weights are hanging freely E. Ensure the rope's knot is in contact with the pulley

B. Assess the child's position frequently C. Assess pin sites every 4 hr D. Ensure the weights are hanging freely

A nurse is caring for a child diagnosed with tinea pedis. The nurse should respond with which of the following when asked by the parent what the common name for this disorder is? A. Shingles B. Athlete's foot C. Fever blister D. Valley fever

B. Athlete's foot

A nurse is teaching a group of parents about preventing insect bites. Which of the following information should the nurse include in the teaching? (Select all that apply.) A. Wear perfumes when outside B. Avoid areas of tall grass C. Wear bright-colored clothing D. Wear insect repellent E. Check house pets frequently

B. Avoid areas of tall grass D. Wear insect repellent E. Check house pets frequently

A nurse is teaching a parent of a child who has a UTI. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Wear nylon underpants B. Avoid bubble baths C. Empty bladder completely with each void D. Watch for manifestations of infection E. Wipe perineal area back to front

B. Avoid bubble baths C. Empty bladder completely with each void D. Watch for manifestations of infection

A nurse is caring for a pediatric client who is about to receive chemotherapy to treat leukemia. The nurse reviewing the client's laboratory results notes that her platelet count is low. Which of the following precautions should the nurse add to the client's care plan? A. Neutropenic B. Bleeding precautions C. Contact D. Droplet

B. Bleeding precautions

A nurse is assessing a child who has neuroblastoma of the adrenal gland. Which of the following are manifestations of metastasis from the primary site? (Select all that apply.) A. Weight gain B. Bone pain C. Periorbital ecchymoses D. Proptosis E. Weight loss

B. Bone pain C. Periorbital ecchymoses D. Proptosis E. Weight loss

Children with disabilities or chronic illness and their families may have different methods of coping than those of healthy children. Often they have a resilience that is to be admired. Which of these statements reflect ways that they foster this resilience? (Select all that apply.) A. Protect the child from having to learn about his or her disability or illness on a repeated basis. B. Develop relationships with other children and their families with similar circumstances to build support. C. The parents set long-term goals to create a sense of hope. D. Focus on the child's strengths and encourage independence. E. Accept that chronic illness is part of living.

B. Develop relationships with other children and their families with similar circumstances to build support. D. Focus on the child's strengths and encourage independence. E. Accept that chronic illness is part of living.

A nurse is caring for a child who sustained a fracture. Which of the following actions should the nurse take? (Select all that apply.) A. Place a heat pack on the site of injury B. Elevate the affected limb C. Assess neurovascular status frequently D. Encourage ROM of the affected limb E. Stabilize the injury

B. Elevate the affected limb C. Assess neurovascular status frequently E. Stabilize the injury

When caring for a 4-year-old with a disability, the nurse notes that while encouraging the child to take part in his care, the mother constantly gives into the child, allowing him to have his own way. What anticipatory guidance can the nurse give to promote normalization in this relationship? A. "Giving in" is not a detriment to the child when he or she has a disability and limitations. B. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations. C. Advise the parent to wait to explain any procedure to the child until they are at the health care setting or just before the procedure to avoid unduly upsetting the child. D. Have the parent realize that it would be unfair to the siblings to expect similar rules to apply to all of the children in the family.

B. Explain that when parents establish reasonable limits, children are likely to develop independence that is appropriate for their age and achievement equal to their limitations.

At a visit to the pediatric clinic, a mother is concerned by her 4-year-old's symptoms over the last few weeks. Which of the following symptoms described by the mother would lead the nurse to be concerned about an oncologic disorder? (Select all that apply.) A. Bruising in various stages, mainly on the legs B. Frequent complaints of respiratory infections, while siblings remain healthy C. Enlarged, firm lymph nodes D. Asthma symptoms with increase in wheezing E. Fever for more than 1 week

B. Frequent complaints of respiratory infections, while siblings remain healthy C. Enlarged, firm lymph nodes E. Fever for more than 1 week

A nurse is caring for an infant whose screening test reveals a potential diagnosis of sickle cell disease. Which of the following tests should be performed to distinguish if the infant has the trait or the disease? A. Sickle solubility test B. Hemoglobin electrophoresis C. Complete blood count D. Transcranial Doppler

B. Hemoglobin electrophoresis

A child with sickle cell anemia is admitted in a vasoocclusive crisis. Which of the following interventions should the nurse expect to see ordered? (Select all that apply.) A. Cold compresses to painful joints B. IV fluids started, and oral fluids encouraged C. Meperidine ordered every 4 hours for pain D. High-calorie, high-protein diet E. Antibiotics ordered for any existing infection

B. IV fluids started, and oral fluids encouraged D. High-calorie, high-protein diet E. Antibiotics ordered for any existing infection

A nurse is assessing an infant who has a suspected UTI. Which of the following are expected findings? (Select all that apply.) A. Increase in hunger B. Irritability C. Decrease in urination D. Vomiting E. Fever

B. Irritability D. Vomiting E. Fever

A nurse is caring for a 17 year old client who is experiencing a relapse of leukemia and is refusing treatment. The client's mother insists that the client receive treatment. Which of the following nursing actions is appropriate at this time? A. Start the IV per the parent's request. B. Notify the charge nurse of the situation. C. Administer a sedative to calm the client. D. Offer the client an antiemetic.

B. Notify the charge nurse of the situation.

Which of the following tests is most helpful in diagnosing hemophilia? A. Bleeding time B. PTT C. Platelet count D. CBC

B. PTT

A nurse is caring for an infant who has a congenital heart defect. Which of the following is associated with increased pulmonary blood flow? A. Coarctation of the aorta B. Patent ductus arteriosus C. Tetralogy of Fallot D. Tricuspid atresia

B. Patent ductus arteriosus

A nurse is assessing an infant who has scabies. Which of the following findings should the nurse expect? (Select all that apply.) A. Presence of nits on the hair shaft B. Pencil-like marks on hands C. Blisters on the soles of the feet D. Small, red bumps on the scalp E. Pimples on the trunk

B. Pencil-like marks on hands C. Blisters on the soles of the feet E. Pimples on the trunk

A child is admitted to the pediatric unit with ITP. What assessment findings would you expect? A. Dark colored urine B. Petechiae C. Fever D. Joint swelling

B. Petechiae

You are working in the pediatric clinic, and a child presents with symptoms that are suspicious of the acute phase of Kawasaki disease. Which of the following symptoms are included? (Select all that apply.) A. Periungual desquamation (peeling that begins under the fingertips and toes) of the hands and feet is present. B. The bulbar conjunctivae of the eyes become reddened, with clearing around the iris. C. A temporary arthritis is evident, which may affect the larger weight-bearing joints. D. Inflammation of the pharynx and the oral mucosa develops, with red, cracked lips and the characteristic "strawberry tongue." E. Loud pansystolic murmur along with ECG changes are present.

B. The bulbar conjunctivae of the eyes become reddened, with clearing around the iris. D. Inflammation of the pharynx and the oral mucosa develops, with red, cracked lips and the characteristic "strawberry tongue."

A nurse is preparing to administer iron dextran IM to a school-age child who has iron deficiency anemia. Which of the following actions by the nurse is appropriate? A. Administer the dose in the deltoid muscle B. Use the Z-track method when administering the dose C. Avoid injecting more than 2 mL with each dose D. Massage the injection site for 1 min after administering the dose

B. Use the Z-track method when administering the dose

A nurse is instructing a mother on how to care for a child who has impetigo contagiosa. Which of the following should the nurse plan to include in her education of the mother? A. Isolate this child from others in his family. B. Wash toys with soap and very hot water. C. Vaccinated the other family member for disease. D. Implement no special precautions.

B. Wash toys with soap and very hot water.

A nurse is caring for a 9 year old client who needs to have an IV inserted. In the teaching plan, the nurse should first: A. provide an opportunity for the client to see and touch IV tubing and supplies. B. ask the client what he knows about the IV and why it is necessary. C. describe the insertion procedure to the client. D. explain to the client's parents what they can expect during and after IV insertion.

B. ask the client what he knows about the IV and why it is necessary.

A nurse is caring for a child admitted with suspicion of rheumatic fever. An anti-streptolysin O (ASO) titer is drawn on the child. The parent asks the nurse why the titer was drawn. The nurse should inform the child's parent that the titer will tell if the child: A. has rheumatic fever. B. had a recent streptococcal infection. C. has a therapeutic blood level of an aminoglycoside. D. has immunity to streptococcal bacteria.

B. had a recent streptococcal infection.

A nurse is caring for an infant who has CHF secondary to a ventricular septal defect (VSD) and was brought to the clinic by the parent with a report of poor feeding. After instructing the parent about nasogastric (NG) tube feedings, the nurse evaluates the teaching has been effective when the parent states, "I will... A. give every other feeding by the NG tube." B. nurse my baby for 20 minutes then give the rest by NG tube." C. administer all of my baby's feedings through the NG tube." D. let my baby suck until tired."

B. nurse my baby for 20 minutes then give the rest by NG tube."

A 6 yr old child comes to the clinic with a pruritic rash in the interdigital surfaces, axilla and antecubital area, and noted discrete papules with a grayish-brown , threadlike burrows. What should the nurse suspect? A. dermatitis B. scabies C. body lice

B. scabies

A nurse at the pediatric hotline receives a call from a mother who plans to administer aspirin to a toddler for a fever and wants to know the dosage. Which of the following statements by the nurse is an appropriate response? A. "You'll have to call your physician." B. "Give her no more than three baby aspirin every four hours." C. "Give her acetaminophen, not aspirin." D. "Follow directions on the aspirin bottle for her age and weight."

C. "Give her acetaminophen, not aspirin."

A nurse is providing discharge teaching to the caregiver of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? A. "Do not offer your baby fluids after giving the medication." B. "Digoxin increases your baby's heart rate." C. "Give the correct dose of medication at regularly scheduled times." D. "If your baby vomits a dose, you should repeat the dose to ensure that the correct amount is received."

C. "Give the correct dose of medication at regularly scheduled times."

The nurse is teaching the parents of a preschooler information about urinary tract infection and means of reducing their recurrence. Which statement by the parents indicates the need for additional teaching? A. "I should get her to drink a lot of water and juices." B. "I will buy her underwear a little large." C. "Soaking in a bubble bath will reduce the meatal irritation." D. "If I notice her starting to wet the bed again, I will need to have her checked for another urinary tract infection."

C. "Soaking in a bubble bath will reduce the meatal irritation."

A nurse is caring for a 10 month old infant who is in a cast for developmental dysplasia of the hip (DDH). Which of the following strategies should the nurse implement to promote the infant's growth and development? A. Tie colorful latex balloons to the side of the crib. B. Provide a small electronic toy. C. Change the infant's diaper as soon as soiling occurs. D. Allow infant to stand in the crib.

D. Allow infant to stand in the crib.

A nurse is teaching the parent of a child who has a Wilms' tumor. Which of the following statements should the nurse include in the teaching? (Select all that apply.) A. "Your child will need to have chemotherapy for 12 months." B. "Wilms' tumors are typically genetic in nature." C. "Surgery is done usually within 48 hr of diagnosis." D. "Palpating the tumor could cause spread of the cancer." E. "Further treatments will start immediately after surgery."

C. "Surgery is done usually within 48 hr of diagnosis." D. "Palpating the tumor could cause spread of the cancer." E. "Further treatments will start immediately after surgery."

A nurse is completing preoperative teaching with an adolescent client who is scheduled to receive spinal instrumentation for scoliosis. Which of the following information should the nurse include in the teaching? A. "You will go home the same day of surgery." B. "You will have minimal pain." C. "You will need to receive blood." D. "You will not be able to eat until the day after surgery."

C. "You will need to receive blood."

A child is admitted to the pediatric unit. The mother reports that the doctor says her son is anemic. What laboratory findings/manifestations would the nurse expect to see to confirm iron deficiency anemia? A. Cyanosis, due to inadequate oxygen saturation of existing hemoglobin B. A decreased reticulocyte count C. A total iron-binding capacity (TIBC) that is elevated above the normal range D. Decreased blood pressure changes, which are an early sign because of the compensatory mechanisms

C. A total iron-binding capacity (TIBC) that is elevated above the normal range

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? A. Abdominal girth 1 cm larger than yesterday B. Report of pain at the operative site C. Absent bowel sounds D. Passing of flatus every 30 min

C. Absent bowel sounds

A 2 year old boy with iron deficiency anemia is brought to the clinic for follow-up. He has been taken Ferrous iron drops. Which vitamin or supplements should the child take with the iron to enhance absorption? A. Niacin B. B12 C. Ascorbic acid D. Vitamin A

C. Ascorbic acid

Which of the following strategies initiated by the school nurse would be most effective in identifying adolescents with scoliosis? A. Teaching the parents to report changes in their child's posture B. Interviewing teens in school about any deviation in the appearance of their shoulders and back, and how their clothes fit C. Conducting a screening that includes observing students standing, walking and bending forward D. Teaching physical education teachers to recognize the disorder

C. Conducting a screening that includes observing students standing, walking and bending forward

A nurse at a pediatrician's office is contacted by a parent whose child just ingested half a bottle of vitamins with added ferrous sulfate. Which of the following instructions should the nurse provide to the parent? A. Provide a high carbohydrate meal. B. Give the child syrup of ipecac. C. Contact the poison control center. D. Do nothing because the ferrous sulfate will induce vomiting.

C. Contact the poison control center.

A nurse is caring for a child who is dying. Which of the following are findings of impending death? (Select all that apply.) A. Heightened sense of hearing B. Tachycardia C. Difficulty swallowing D. Sensation of being cold E. Cheyne-Stokes respirations

C. Difficulty swallowing E. Cheyne-Stokes respirations

A 9-year-old child in the emergency department is diagnosed with Lyme disease. The nurse anticipates that the health care provider's orders will include the administration of: A. Cefotaxime B. Aqueous penicillin C. Doxycycline D. Trimethoprim-sulfamethoxazole

C. Doxycycline

The nurse is caring for a child with thalassemia B major. The child is receiving chelation therapy. The family asks what is the purpose of the treatment. What is the best nursing response? A. Helps stop bleeding B. Increases the iron count C. Eliminates excess iron D. Decreases the risk of hypoxia

C. Eliminates excess iron

A nurse is discharging a child with sickle cell anemia after an acute crisis episode. Which of the following should the nurse teach the child's parents to do? A. Monitor the child's temperature daily. B. Restrict outdoor play activity to 1 hr per day. C. Encourage the child to drink lots of fluids. D. Have the child eat a high-protein diet.

C. Encourage the child to drink lots of fluids.

A nurse in a pediatric clinic is caring for a child who iron deficiency anemia who has a new prescription for ferrous sulfate tablets. Which of the following instructions should be given to the parent regarding administration of this medication? A. Give with an 8 oz glass of milk. B. Administer at meal time. C. Give with orange juice D. Administer at bedtime.

C. Give with orange juice

Which of the following terms is described by the following: "bleeding into a joint space" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

C. Hemarthrosis

Which is the most accurate genetic explanation for a family with hemophilia? A. It is a Y-linked dominant disorder. B. It is equally distributed among males and females. C. It is an X-linked recessive disorder. D. It is an autosomal recessive disorder.

C. It is an X-linked recessive disorder.

A nurse is caring for a child who has muscular dystrophy. For which of the following findings should the nurse assess? (Select all that apply.) A. Purposeless, involuntary, abnormal movements B. Spinal defect and saclike protrusion C. Muscle weakness in lower extremities D. Unsteady, wide-based or waddling gait E. Upward slant to the eyes

C. Muscle weakness in lower extremities D. Unsteady, wide-based or waddling gait

A nurse is caring for a child who has oral mucositis. Which of the following actions should the nurse take? (Select all that apply.) A. Swab the mucosa with lemon glycerin swabs B. Apply viscous lidocaine C. Offer soft foods D. Use a soft, disposable toothbrush for oral care E. Encourage gargling with a warm saline mouthwash

C. Offer soft foods D. Use a soft, disposable toothbrush for oral care E. Encourage gargling with a warm saline mouthwash

A pediatric client in sickle cell crisis comes to the hospital with his mother. When assessing the client, the nurse should expect to find which of the following manifestations? A. Fever B. Bradycardia C. Pain D. Constipation

C. Pain

A nurse is caring for a child following an above-the-knee amputation. Which of the following actions should the nurse take? A. Avoid discussing the amputation B. Administer aspirin for phantom pain C. Prepare the child for a prosthesis fitting D. Maintain the affected limb in the dependent position

C. Prepare the child for a prosthesis fitting

A nurse is planning care for a child who has sickle cell crisis. Which of the following actions is included in the plan of care? A. Active ROM exercises daily B. Application of cold compresses to the affected area C. Promote hydration with IV and oral fluids D. Implement pain management on a PRN basis

C. Promote hydration with IV and oral fluids

The nurse is caring for an adolescent whose femur was fractured yesterday, The client suddenly develops chest pain and dyspnea. The nurse should suspect which of the following complications? A. Sepsis B. Osteomyelitis C. Pulmonary embolism D. Acute respiratory infection

C. Pulmonary embolism

A school nurse is completing routine health evaluations for school-aged children. Which of the following should alert the nurse to the possibility of pediculosis? A. Patches of baldness B. Blisters on the scalp C. Reports of scalp itchiness D. Dry patches on the scalp

C. Reports of scalp itchiness

A school nurse conducting a screening for pediculosis identifies several children who require treatment. Which of the following is an appropriate instruction for the nurse to give the children's parents? A. Soak all combs and hairbrushes in alcohol. B. Inspect any dogs or cats at home for lice. C. Seal non-washable items in airtight plastic bags. D. Spray countertops and sinks with insecticide.

C. Seal non-washable items in airtight plastic bags.

A nurse is caring for an adolescent who has a new diagnosis of osteosarcoma. Which of the following actions should the nurse take first? A. Ensure that the adolescent has a referral for a psychiatrist visit B. Prepare a teaching plan to educate the adolescent in detail about the diagnosis and treatment C. Spend time with the adolescent to answer any questions D. Perform a mental status examination to assess the adolescent's thought patterns

C. Spend time with the adolescent to answer any questions

The nurse is caring for a toddler who is not toilet trained. The doctor has ordered intake and output measurement. The nurse will most accurately measure the urine by: A. Estimating output as small, moderate, or large and recording on the child's chart B. Weighing each diaper and recording the amount of urine output as the weight of the diaper C. Subtract the weight of the dry diaper from a wet diaper and record this amount D. Determine urine output by the number of diapers changes in each 24-hour period

C. Subtract the weight of the dry diaper from a wet diaper and record this amount

As the nurse caring for a culturally diverse population, it is important to understand cultural health beliefs of families. This can best be accomplished by: A. Asking the parents how their extended families feel about their child's illness B. Exploring the use of alternative medicines and therapies C. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition D. Acknowledging that language constraints may make it necessary for the health care team to make some decisions

C. Understanding the parents' perception of the seriousness or severity of the illness or disability, as well as concerns and worries they have about the condition

A nurse is teaching a parent of a child who has pediculosis capitis. Which of the following instructions should the nurse include in the teaching? A. Apply mayonnaise to the affected area at night B. Treat all household pets C. Use an OTC medication containing 1% permethrin D. Discard the child's stuffed animals

C. Use an OTC medication containing 1% permethrin

A 5-year-old girl has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have her daughter evaluated for is: A. school phobia B. emotional causes C. possible urinary tract infection D. possible structural defects of urinary tract

C. possible urinary tract infection Rationale: Always look for a pathologic/organic problem first, then move on to a possible psychological/emotional cause.

Determine the dermatological disorder based on the following description: This infant presents with confluent bright red papules and plaques with scattered pustules, overlying scale, and satellite lesions at the periphery. A potassium hydroxide wet mount of material scraped from this diaper dermatitis revealed abundant hyphae. The infant also had thrush. Treatment included oral (nystatin suspension to the oral mucosa four times a day) and topical nystatin (to diaper area), nystatin to mother's nipples, extra air drying between diaper changes, and boiling of rubber nipples.

Candidiasis

Determine the dermatological disorder based on the following description: Typically begins as a small, inflamed area of pain, swelling, warmth, and redness on a child's skin. As this red area begins to spread, the child may begin to feel sick and develop a fever, sometimes with chills and sweats. Conditions that create breaks in the skin and allow bacteria to enter, such as eczema and severe acne, will put a child at risk for this, as well as, chickenpox, scratched insect bites, animal bites, and puncture wounds are other causes.

Cellulitis

Define the following congenital heart defect: Narrowing of the aortic arch; when the fetal shunt closes, the defect will cause decreased flow to the descending aorta; clinical manifestations include higher BP in the upper extremities than the lower extremities, weak/absent femoral and pedal pulses, and pale/cooler lower extremities due to decreased systemic blood flow in the lower extremities

Coarctation of the Aorta

The nurse is planning to discharge a client with a cast. Instructions to the parents regarding home care should include which of the following statements? A. "Wash the cast daily with warm soapy water and a scrub brush" B. "Gently tap on the cast at the site of injury daily to assess for pain" C. "Use a rubber ruler padded with gauze to scratch under the cast" D. "Check the skin at the cast edges for redness or swelling each day"

D. "Check the skin at the cast edges for redness or swelling each day"

A nurse is teaching a guardian about complicated grief. Which of the following statements should the nurse make? A. "Complicated grief occurs when little time is spent thinking about the loss." B. "Personal activities are rarely affected when experiencing complicated grief." C. "Guardians will experience complicated grief." D. "Counseling can be helpful in resolving complicated grief."

D. "Counseling can be helpful in resolving complicated grief."

A nurse is teaching a parent of a child with hemophilia how to control a minor bleeding episode. Which of the following by the parent indicates a need for further teaching? A. "I will have my child rest." B. "I will elevate the affect part." C. "I will compress the site." D. "I will apply heat."

D. "I will apply heat."

A nurse is caring for a child who has a terminal illness and reviews palliative care with an assistive personnel (AP). Which of the following statements by the AP indicates understanding of this review? A. "I'm sure the family is hopeful that the new medication will stop the illness." B. "I'll miss working with this client now that only nurses will be caring for the child." C. "I will get all the client's personal objects out of the room." D. "I will listen and respond as the family talks about their child's life."

D. "I will listen and respond as the family talks about their child's life."

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? A. "I should take my child to the emergency department if his stools become dark." B. "My child should avoid eating citrus fruits while taking the supplements." C. "I should give the iron with milk to prevent an upset stomach." D. "My child should take the supplement through a straw."

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

A nurse is reinforcing teaching with the parents of a child who is taking iron supplements. Which of the following statements by the parents indicates understanding? A. "The medication should be administered in one large dose per day." B. "Restricting fiber from our child's diet will help absorption of the iron." C. "The medication will be more effective if it is administered with meals." D. "Our child's blood count will need to be monitored routinely for several weeks."

D. "Our child's blood count will need to be monitored routinely for several weeks."

A nurse is caring for a toddler who has hip dysplasia and has been placed in a hip spica cast. The child's guardian asks why a Pavlik harness is not being used. Which of the following responses should the nurse make? A. "The Pavlik harness is used for children with scoliosis, not hip dysplasia." B. "The Pavlik harness is used for school-age children." C. "The Pavlik harness cannot be used for your child because her condition is too severe." D. "The Pavlik harness is used for infants less than 6 months of age."

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

Which of the following medications should be avoided by children with ITP? A. Acetaminophen B. Codeine C. Morphine D. ASA

D. ASA

A nurse is caring for a child who is in a plaster spica cast. Which of the following actions should the nurse take? A. Use a heat lamp to facilitate drying B. Avoid turning the child until the cast is dry C. Assist the client with crutch walking after the cast is dry D. Apply moleskin to the edges of the cast

D. Apply moleskin to the edges of the cast

A nurse is planning care of a child who has a UTI. Which of the following interventions should the nurse include? A. Administer an antidiuretic B. Restrict fluids C. Evaluate the child's self-esteem D. Encourage frequent voiding

D. Encourage frequent voiding

A nurse is reinforcing teaching to a 17 year old female client who has severe acne regarding the use of isotretinoin (Accutane). Which of the following side effects should the nurse instruct the client is the priority side effect to report to the provider? A. Frequent nosebleeds B. Itching of skin C. Back pain D. Feelings of isolation

D. Feelings of isolation

A urinalysis is ordered for a child with a throat culture positive for group A beta-hemolytic streptococcus. The mother asks why this test is being ordered. The nurse explains: A. The urinalysis will indicate whether an HIV infection is also present. B. Urinary tract infections are common with streptococcal infections and need to receive prompt treatment. C. Pyelonephritis is a potential complication of antibiotic therapy. D. Group A beta hemolytic streptococcus infections can be followed by the complication of acute glomerulonephritis.

D. Group A beta hemolytic streptococcus infections can be followed by the complication of acute glomerulonephritis.

A parent calls the pediatric clinic to report that her child has a bloody nose. The nurse should give the parent which of the following instructions to stop the bleeding? A. Place the child in a sitting position with her head tilted back. B. Apply ice at the base of the nose for 5 min and then check for bleeding. C. Place the child in a supine position with a pillow under her back. D. Have the child sit with her head tilted forward and hold pressure on her nose for 10 min.

D. Have the child sit with her head tilted forward and hold pressure on her nose for 10 min.

Which of the following terms is described by the following: "excessive absorption or accumulation of iron in the body" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

D. Hemochromatosis

Which of the following symptoms would cause the nurse to suspect that an infection had developed under a cast? A. The patient's complaint of numbness and tingling B. Cool, pale toes C. Increased respiratory rate D. Hot spots felt on the cast surface

D. Hot spots felt on the cast surface

Steroids are prescribed for a child with ITP. What should the nurse monitor? A. Anemia B. Bleeding C. Bruising D. Infection

D. Infection

A nurse is planning care who has juvenile rheumatoid arthritis. Which of the following is an appropriate action for the nurse to take? A. Administer opioids on a schedule. B. Schedule prolonged periods of complete joint immobilization daily. C. Apply cool compresses for 20 minutes every hr. D. Maintain night splints to the affected joint.

D. Maintain night splints to the affected joint.

You are caring for a child on the pediatric unit with a suspected abdominal tumor. Which criterion would lead you to determine that this tumor is a neuroblastoma rather than a Wilms tumor? A. Most children present with neuroblastoma around age 4. B. Neuroblastoma is a firm, nontender, irregular mass confined to one side, generally deep in the flank. C. Hypertension is often noted due to secretion of excess amounts of rennin by the tumor. D. Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain.

D. Most tumors develop in the adrenal gland or the retroperitoneal sympathetic chain.

Iron deficiency anemia is prevalent in all of the following except: A. Toddlers B. Adolescents C. Pregnant women D. School children

D. School children

A nurse is caring for a toddler who has a fractured right femur and is in Bryant's traction. When monitoring to determine if the traction is appropriate, the nurse expects to observe which of the following? A. Skin straps maintaining the leg in an extended position. B. Weights attached to a pin that is inserted in the femur. C. A padded sling under the knee of the affected leg. D. The buttocks elevated slightly off of the bed.

D. The buttocks elevated slightly off of the bed.

A nurse is caring for an infant with diaper dermatitis. Which of the following is an appropriate action by the nurse? A. Apply a light layer of talc with each diaper change. B. Change to cloth diapers until the skin is healed. C. Expose excoriated area to hot air frequently. D. Use a moisturizer to wipe urine from the skin.

D. Use a moisturizer to wipe urine from the skin.

Which of the following terms is described by the following: "increased number of red cells in the blood" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

E. Polythycemia

Which of the following terms is described by the following: "platelet deficiency" A. Erythropoiesis B. Anemia C. Hemarthrosis D. Hemochromatosis E. Polythycemia F. Thrombocytopenia G. Erythropoietin H. Vaso-occlusion

F. Thrombocytopenia

Determine the dermatological disorder based on the following description: A 4 year old girl with cyclic vomiting developed fever and malaise in association with a diffuse reticulated exanthem with slapped cheek erythema and purpura particularly on the hands and feet. PCR for Parvovirus B 19 was positive.

Fifth Disease (Erythema Infectiosum)

Define the following congenital heart defect: Under development of the left side of the heart, consisting of small left ventricle, mitral atresia, and atretic aortic arch; the infant presents with symptoms of shock and will require heart transplantation or the Norwood surgery

Hypoplastic Left Heart Syndrome

Determine the dermatological disorder based on the following description: This child presents with pustules and round, oozing patches which have grown larger day by day. There are clear blisters and golden yellow crusts. This bacterial infection most often occurs on exposed areas such as the hands and face, or in skin folds.

Impetigo

Define the following congenital heart defect: Has a characteristic machinery-like murmur and is a continuation of a fetal shunt between pulmonary artery and aorta

Patent Ductus Arteriosus

Determine the dermatological disorder based on the following description: This healthy 7-week-old girl developed an itchy papulovesicularpustular eruption with crusting particularly in the right axilla. The lesions began in the right axilla and spread over the chest, abdomen, and back with sparing of the face, neck, arms, legs, and diaper area. An asymmetric truncal eczematous eruption comprised of linear red edematous papules and pustules, some with overlying crusts and surrounding hyperpigmentation. Her mother had a few pruritic excoriated papules on her wrists and forearms. The entire family was treated with 5 percent permethrin cream.

Scabies

Determine the dermatological disorder based on the following description: History: Abrupt onset of fever, headache, vomiting, malaise, chills, and sore throat occurs. Rash appeared 1-4 days after the onset. Physical: The mucous membranes bright red, scattered petechiae and small red papular lesions on the soft palate are present. A shiny red tongue with prominent papillae (red, strawberry tongue). The exanthem consists of a fine erythematous punctate eruption that appeared within 1-4 days following the onset of the illness. Pastia lines can be observed. The face is flushed, and circumoral pallor is observed. The eruption imparts a dry rough texture to the skin that is reported to resemble the feel of sandpaper followed by fine desquamation.

Scarlet Fever

Determine the dermatological disorder based on the following description: This 3 month old infant presented with a patchy, greasy, scaly and crusty skin rash on the scalp . This skin disorder may also affect other areas of the body such as behind the ears, in the creases of the neck, armpits and diaper area.

Seborrheic dermatitis

Determine the dermatological disorder based on the following description: Rapid onset of Sore throat . Fever, sometimes greater than 102° F. Back of the throat that is raw and red. mucous membranes bright red, scattered petechiae and small red papular lesions on the soft palate are present White pus on tonsils. Tender, high lymph nodes in neck. Absence of cough, stuffy nose, or other upper-respiratory symptoms

Strep throat

Define the following congenital heart defect: Defect with 4 abnormalities: ventricular septal defect, pulmonic stenosis, overriding aorta, and right ventricular hypertrophy

Tetrology of Fallot

Determine the dermatological disorder based on the following description: This 9-year-old girl developed thick scaly itchy plaques with broken hairs throughout the scalp

Tinea capitus (ringworm of the scalp)

Define the following congenital heart defect: Reversal of the aorta and pulmonary artery; the Aorta arises from the right ventricle and the Pulmonary artery arises from the left ventricle, causing parallel circulation; requires emergency palliative surgery in the catheterization lab called Rashkind Miller procedure, this will enlarge the foramen ovale and allow further mixing of blood till a Switch procedure can be done

Transposition of the Great Arteries

Define the following congenital heart defect: Atretic or absent tricuspid valve and small right ventricle, which causes cyanosis and decreased pulmonary blood flow; requires patency of the ductus arteriosus for pulmonary blood flow

Tricuspid Atresia

Define the following congenital heart defect: Failure of normal separation and division of the embryonic trunk into the pulmonary artery and aorta

Truncus Arteriosus

Determine the dermatological disorder based on the following description: This healthy 8-year-old girl developed widely disseminated red papules, clear vesicles on red bases (dew drop on a rose petal), and crusted vesicles after a 2 days of fever and upper respiratory symptoms. She had similar lesions on the palate and oral mucosa. New crops of papules appeared for 3 days and rapidly became vesicular before crusting and healing over 7 days.

Varicella (chickenpox)

Define the following congenital heart defect: Defect in the ventricles repaired with a suture or a Dacron patch requiring open heart surgery

Ventricular Septal Defect

Determine the dermatological disorder based on the following description: In the prodromal or beginning stages, one of the signs of the onset of this viral illness is the eruption of "Koplik spots" on the mucosa of the cheeks and tongue, which appear as irregularly-shaped, bright red spots often with a bluish-white central dot.

measles

treatment for Christmas disease (Hemophilia B)

factor IX

Determine the dermatological disorder based on the following description: Description: linear excoriated edematous crusted red papules and plaques Comments: A 15-year-old complained of an itchy eruption on her legs after a weekend camping trip

poison ivy