New Exam 4 Questions

An adolescent weighing 55 kg is admitted to the hospital experiencing a sickle cell crisis. Intravenous fluid therapy as well as increased oral fluids are ordered as part of his treatment plan. Based on the understanding of the amount of fluids needed to promote hemodilution, the nurse would expect the adolescent to receive how much total fluid in 24 hours? __________ mL

8, 250

The nurse is caring for a child with widespread itching and has recommended bathing as a relief measure. After teaching the mother about this, which statement from the mother indicates a need for further instruction? A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry." B) "I must make sure I use lukewarm water instead of hot water." C) "Oatmeal baths are helpful; we can add Aveeno skin relief bath treatment." D) "We should leave his skin moist before applying medication or moisturizer."

A) "After bathing, I need to rub his skin everywhere to make sure he is completely dry."

The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder? A) "He has frequent temper tantrums." B) "He was pulling the neighbor's dog around by his leash." C) "He is constantly lying to me." D) "He has stolen hundreds of dollars from my purse."

A) "He has frequent temper tantrums."

The nurse is educating the parents of a 4-year-old boy with a Wilms tumor who is about to have chemotherapy prior to surgery. Which statement by the parents indicates that the nurse should review the instructions about preventing infection? A) "He takes his antibiotic twice a day." B) "We check his temperature orally." C) "We keep him away from crowds." D) "He must be clean and his teeth brushed."

A) "He takes his antibiotic twice a day."

The nurse is caring for a child with thalassemia who is receiving chelation therapy at home using a battery-operated pump. After teaching the parents about this treatment, which statement by the mother indicates a need for additional teaching? A) "I can have the nurse administer the chelation therapy if I am uncomfortable." B) "I must be very careful to strictly adhere to the chelation regimen." C) "The deferoxamine binds to the iron so it can be removed from the body." D) "The medication can be administered while my child is sleeping."

A) "I can have the nurse administer the chelation therapy if I am uncomfortable."

The nurse is caring for a child with a spinal cord injury and providing instruction to the parents on promoting skin integrity. Which response from the mother indicates a need for further teaching? A) "I need to monitor his skin at least twice a week." B) "I must monitor skin affected by his adaptive equipment." C) "He must change positions frequently." D) "We must avoid harsh cleaning products."

A) "I need to monitor his skin at least twice a week."

The nurse is providing postoperative care for a 14-month-old girl who has undergone a myelomeningocele repair. The girl's mother is extremely anxious and tells the nurse she is afraid she will never learn how to care for her daughter at home. Which response by the nurse would be most appropriate? A) "I will help you become comfortable in caring for your daughter." B) "You must learn how to care for your daughter at home." C) "You will need to learn to collaborate with all the caregivers." D) "There is a lot to learn, and you need a positive attitude."

A) "I will help you become comfortable in caring for your daughter."

The nurse is caring for a 12-year-old girl with nephrotic syndrome. The girl confides that she feels like a "freak" compared to her peers because of her weight, edema, and moon face. Which response by the nurse would be most appropriate? A) "Let's put you in touch with some other girls who are also having the same body changes." B) "Luckily, this is just a temporary, unfortunate part of your condition; you need to accept it." C) "Your real friends do not care about your appearance and just want you to get well." D) "You are beautiful in your own way; what matters is what is on the inside."

A) "Let's put you in touch with some other girls who are also having the same body changes."

The nurse is caring for a 4-year-old girl with vulvovaginitis. After explaining to the girl's mother how to help prevent subsequent episodes, which statement by the mother indicates a need for additional teaching? A) "She needs to wipe from front to back." B) "I will make sure she changes her underwear every day." C) "She should probably avoid bubble baths." D) "I will help supervise her wiping after bowel movements."

A) "She needs to wipe from front to back."

The nurse is caring for a 14-month-old boy with rickets who was recently adopted from overseas. His condition was likely a result of a diet very low in milk products. The nurse is providing teaching regarding treatment. Which response by the parents indicates a need for further teaching? A) "We must give him calcium and phosphorus with food every morning." B) "He must take vitamin D as prescribed and spend some time in the sunlight." C) "He must take calcium at breakfast and phosphorus at bedtime." D) "We should encourage him to have fish, dairy, and liver if he will eat it."

A) "We must give him calcium and phosphorus with food every morning."

A child with Duchenne muscular dystrophy is to receive prednisone as part of his treatment plan. After teaching the child's parents about this drug, which statement by the parents indicates the need for additional teaching? A) "We should give this drug before he eats anything." B) "We need to keep a close eye for possible infection." C) "The drug should not be stopped suddenly." D) "He might gain some weight with this drug."

A) "We should give this drug before he eats anything."

The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate? A) "You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea." B) "He might experience a significant decrease in his appetite and difficulty sleeping." C) "You need to watch for dry mouth, urinary retention, and constipation." D) "This medication can cause seizures, agitation, headache, and nausea."

A) "You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea."

A 10-month-old is brought to the emergency department by her parents after they found her face down in the bathtub. The mother said, "I just left the bathroom to answer the phone. When I came back, I found her." Which of the following assessments would be the priority? A) Airway, breathing, and circulation B) Level of consciousness C) Vital signs D) Pupillary response

A) Airway, breathing, and circulation

A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply. A) Allowing for breaks when tics occur B) Providing for "time-outs" during the day C) Using a tape recorder to take notes D) Ensuring a specified amount of time for test taking E) Implementing a reward system for behavior

A) Allowing for breaks when tics occur C) Using a tape recorder to take notes

The nurse is reviewing the laboratory test results of a child who is receiving chemotherapy. To calculate the child's absolute neutrophil count, in addition to the total number of white blood cells, which results would the nurse use? Select all answers that apply. A) Bands B) Segs C) Eosinophils D) Basophils

A) Bands B) Segs

A 14-year-old boy is diagnosed with Hodgkin disease. When palpating for enlarged lymph nodes, the nurse would expect to find which nodes as most commonly enlarged? Select all answers that apply. A) Cervical B) Axillary C) Supraclavicular D) Occipital E) Inguinal

A) Cervical C) Supraclavicular

A nurse is caring for a 7-year-old girl scheduled for an intravenous pyelogram (IVP). Which of the following would be the priority before the test? A) Checking with the parents for any allergies B) Ensuring adequate hydration C) Giving the girl an enema D) Screening her for pregnancy

A) Checking with the parents for any allergies

A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy? A) Cognitive therapy B) Behavioral therapy C) Milieu therapy D) Individual therapy

A) Cognitive therapy

A 15-year-old adolescent is brought to the emergency department by his parents. The adolescent is febrile with chills that started suddenly. He states, "I had a sinus infection and sore throat a couple of days ago." The nurse suspects bacterial meningitis based on which of the following? Select all answers that apply. A) Complaints of stiff neck B) Photophobia C) Absent headache D) Negative Brudzinski sign E) Vomiting

A) Complaints of stiff neck B) Photophobia E) Vomiting

The nurse is developing a plan of care for a 7-year-old boy with diabetes insipidus. Which of the following would the nurse most likely identify as the priority nursing diagnosis? A) Deficient fluid volume related to dehydration B) Excess fluid volume related to edema C) Deficient knowledge related to fluid intake regimen D) Imbalanced nutrition, more than body requirements related to excess weight

A) Deficient fluid volume related to dehydration

The nurse is preparing a teaching plan for the family and their 6-year-old son who has just been diagnosed with diabetes mellitus. Which of the following would the nurse identify as the initial goal for the teaching plan? A) Developing management and decision-making skills B) Educating the parents about diabetes mellitus type 1 C) Developing a nutritionally sound, 30-day meal plan D) Promoting independence with self-administration of insulin

A) Developing management and decision-making skills

The nurse is assessing a child with aplastic anemia. Which of the following would the nurse expect to assess? Select all that apply. A) Ecchymoses B) Tachycardia C) Guaiac-positive stool D) Epistaxis E) Severe pain F) Warm tender joints

A) Ecchymoses B) Tachycardia C) Guaiac-positive stool D) Epistaxis

The nurse is reviewing the medical record of a child diagnosed with septic arthritis. Which of the following would the nurse expect to find? Select all answers that apply. A) Elevated neutrophil count B) Decreased C-reactive protein level C) Joint fluid with increased white blood cells D) Decreased joint space with radiograph E) Increased erythrocyte sedimentation rate

A) Elevated neutrophil count C) Joint fluid with increased white blood cells E) Increased erythrocyte sedimentation rate

A group of students are preparing for a class exam on skin disorders. As part of their preparation, they are reviewing information about acne vulgaris and its association with increased sebum production. The students demonstrate understanding of the information when they identify which areas as having the highest sebaceous gland activity? Select all answers that apply. A) Face B) Upper chest C) Neck D) Back E) Shoulders

A) Face B) Upper chest D) Back

The nurse is caring for a child who is experiencing an acute renal transplant rejection and is to receive muromonab-CD3. Which of the following would the nurse most likely expect to assess after the first dose is administered? A) Fever with chills, chest tightness B) Cough, hyperkalemia C) Photosensitivity, gastrointestinal (GI) upset D) Urinary retention, decreased appetite

A) Fever with chills, chest tightness

A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. Which of the following would the nurse be least likely to include? A) Focus the child's attention on the negative behavior. B) Set limits with the child for responsible behavior. C) Ignore inappropriate behaviors. D) Provide positive feedback for self-control efforts.

A) Focus the child's attention on the negative behavior.

A 4-year-old boy has a history of seizures and has been started on a ketogenic diet. Which of the following food selections would be most appropriate for his lunch? A) Fried eggs, bacon, and iced tea B) A hamburger on a bun, French fries, and milk C) Spaghetti with meatballs, garlic bread, and a cola drink D) A grilled cheese sandwich, potato chips, and a milkshake

A) Fried eggs, bacon, and iced tea

When evaluating the hemogram of an 8-month-old infant, the nurse would identify which type of hemoglobin as being the predominant type? A) Hemoglobin A B) Hemoglobin F C) Hemoglobin A2 D) Hemoglobin S

A) Hemoglobin A

The parents bring their 4-year-old son to the emergency department. The child is receiving chemotherapy for acute lymphoblastic leukemia. The parents report that the child has become lethargic and has had significant episodes of vomiting and diarrhea. The nurse suspects the child may be experiencing tumor lysis syndrome based on which of the following? Select all answers that apply. A) Hyperkalemia B) Hypophosphatemia C) Polyuria D) Hypocalcemia E) Hyperuricemia

A) Hyperkalemia D) Hypocalcemia E) Hyperuricemia

A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, which of the following would the nurse include as being involved? Select all answers that apply. A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity E) Defiance F) Anxiety

A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity

The nurse is caring for a child hospitalized with Reye syndrome who is in the acute stage of the illness. The nurse would assess the child most carefully for which of the following? A) Indications of increased intracranial pressure B) An increase in the blood glucose level C) A decrease in the liver enzymes D) A presence of protein in the urine

A) Indications of increased intracranial pressure

The nurse is caring for a 13-year-old boy with acute myelogenous leukemia who is experiencing feelings of powerlessness due to the effects of chemotherapy. Which of the following interventions will best help the teen's sense of control? A) Involving the boy in decisions whenever possible B) Acknowledging the boy's feelings of anger with the disease C) Providing realistic expectations of treatments and outcomes D) Recognizing abilities that are unaffected by the disease

A) Involving the boy in decisions whenever possible

A group of students are reviewing information about head injuries in children. The students demonstrate understanding of this information when they identify which of the following as the most common type of skull fracture in children? A) Linear B) Depressed C) Diastatic D) Basilar

A) Linear

A school-age child diagnosed with depression is receiving antidepressant therapy. The nurse would instruct the parents to notify the physician immediately if the child demonstrates which of the following? A) Loss of interest B) Gastric upset C) Sedation D) Urinary retention

A) Loss of interest

The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason? A) Minimize stimuli that exacerbate the child's undesired behaviors B) Improve the child's ability to deal with external stressors C) Promote increased ability to follow through D) Encourage the child to adopt expectations into his routine

A) Minimize stimuli that exacerbate the child's undesired behaviors

The physician has ordered rectal diazepam (Valium) for a 2-year-old boy with status epilepticus. Which of the following instructions is essential for the nurse to teach the parents? A) Monitor their child's level of sedation. B) Watch for fever indicating infection. C) Gradually reduce the dosage as seizures stop. D) Monitor for an allergic reaction to the medication.

A) Monitor their child's level of sedation.

The nurse is planning a discussion group for parents with children who have cancer. Which of the following would the nurse include when describing the differences between cancer in children and adults? A) Most childhood cancers affect the tissues rather than organs. B) Childhood cancers are usually localized when found. C) Unlike adult cancers, childhood cancers are less responsive to treatment. D) The majority of childhood cancers can be prevented.

A) Most childhood cancers affect the tissues rather than organs.

An 8-year-old girl was diagnosed with a closed fracture of the radius at approximately 2 p.m. The fracture was reduced in the emergency department and her arm placed in a cast. At 11 p.m. her mother brings her back to the emergency department due to unrelenting pain that has not been relieved by the prescribed narcotics. Which action would be the priority? A) Notifying the doctor immediately B) Applying ice C) Elevating the arm D) Giving additional pain medication as ordered

A) Notifying the doctor immediately

A nurse is preparing a school-aged child for a lumbar puncture. The nurse would expect to position the child in which manner? A) On her side with the head flexed forward and knees flexed to the abdomen B) Sitting upright with the head flexed forward to the chest C) Supine with arms and legs pronated and extended D) Prone with the arms flexed under the chest

A) On her side with the head flexed forward and knees flexed to the abdomen

A child with increased intracranial pressure is being treated with hyperventilation. The nurse understands the need for this treatment is based on which of the following? A) PaCO2 levels decrease, causing vasoconstriction. B) Drainage of cerebrospinal fluid occurs. C) Activity is controlled via a stimulator. D) Hyperexcitability of the nerves is reduced.

A) PaCO2 levels decrease, causing vasoconstriction.

The nurse is developing a plan of care for a child with thalassemia. Which of the following would the nurse expect to include? Select all that apply. A) Packed RBC transfusions B) Deferoxamine therapy C) Heparin therapy D) Opioid analgesics E) Platelet transfusions F) Intravenous immunoglobulin

A) Packed RBC transfusions B) Deferoxamine therapy

The nurse is assessing a child who is suspected of having Guillain-Barré syndrome. Which assessment findings would the nurse correlate as supporting this diagnosis? Select all answers that apply. A) Recent cytomegalovirus infection B) Hyperactive deep tendon reflexes C) Numbness in the lower extremities D) Sustained clonus E) Difficulty swallowing

A) Recent cytomegalovirus infection C) Numbness in the lower extremities D) Sustained clonus

The nurse is conducting a physical examination of a toddler with suspected lead poisoning. Lab results indicate blood lead level 52 g/dL. Which action would the nurse expect to happen next? A) Repeat testing within 2 days and prepare to begin chelation therapy as ordered B) Repeat testing within 1 week with education to decrease lead exposure C) Confirm with repeat testing in 1 month and referral to local health department D) Prepare to admit child to begin chelation therapy

A) Repeat testing within 2 days and prepare to begin chelation therapy as ordered

The nurse is caring for a 10-year-old in traction. While performing a skin assessment, the nurse notices that the skin over the calcaneus appears slightly red and irritated. Which action would the nurse do first? A) Reposition the child's foot on a pressure-reducing device B) Apply lotion to his foot to maintain skin integrity C) Make sure the skin is clean and dry D) Gently massage his foot to promote circulation

A) Reposition the child's foot on a pressure-reducing device

The nurse is providing care to a child with a long-leg hip spica cast. Which of the following would be a priority nursing diagnosis? A) Risk for impaired skin integrity due to cast and location B) Deficient knowledge related to cast care C) Risk for delayed development related to immobility D) Self-care deficit related to immobility

A) Risk for impaired skin integrity due to cast and location

When providing care to a child with aplastic anemia, which nursing diagnosis most likely would be the priority? A) Risk for injury B) Imbalanced nutrition, less than body requirements C) Ineffective tissue perfusion D) Impaired gas exchange

A) Risk for injury

When developing the plan of care for a child with cerebral palsy, which treatment would the nurse expect as least likely? A) Skeletal traction B) Physical therapy C) Orthotics D) Occupational therapy

A) Skeletal traction

The nurse is assessing the neuromusculoskeletal system of a newborn. Which of the following would the nurse identify as an abnormal finding? A) Sluggish deep tendon reflexes B) Full range of motion in extremities C) Absence of hypotonia D) Lack of purposeful muscular control

A) Sluggish deep tendon reflexes

The mother of a 5-year-old girl brings the child to the clinic for an evaluation. The mother tells the nurse, "She seems to be so tired and irritable lately. And she looks so pale." Further assessment reveals pale conjunctiva and oral mucous membranes. The nurse suspects iron-deficiency anemia. Which additional finding would help provide additional evidence for this suspicion? A) Spooned nails B) Negative splenomegaly C) Oxygen saturation: 99% D) Bradycardia

A) Spooned nails

A nurse is preparing a presentation for a local health fair about meningitis and has developed a display that lists the following causes: Streptococcus group B Haemophilus influenzae type B Streptococcus pneumoniae Neisseria meningitidis Which of these would the nurse highlight as the most common cause of meningitis in newborns? A) Streptococcus group B B) Haemophilus influenzae type B C) Streptococcus pneumoniae D) Neisseria meningitides

A) Streptococcus group B

A nurse is assessing a child with suspected osteomyelitis. Which finding would help support this suspicion? A) Swelling and point tenderness B) Decreased erythrocyte sedimentation rate C) Coolness of the affected site D) Increased range of motion

A) Swelling and point tenderness

A child with diabetes insipidus is being treated with vasopressin. The nurse would assess the child closely for signs and symptoms of which of the following? A) Syndrome of inappropriate antidiuretic hormone (SIADH) B) Thyroid storm C) Cushing syndrome D) Vitamin D toxicity

A) Syndrome of inappropriate antidiuretic hormone (SIADH)

The nurse is assessing a 13-year-old girl with a family history of kidney cancer who has come to the clinic complaining of abdominal pain, nausea, and vomiting. Which of the following findings would the nurse identify as least likely indicative of cancer in a child? A) The child reports rectal bleeding and diarrhea. B) Observation reveals an asymmetric abdomen. C) The child experiences a broken bone without trauma. D) Palpation determines an abdominal mass.

A) The child reports rectal bleeding and diarrhea.

A 15-year-old boy comes to the emergency department accompanied by his parents. The boy reports an abrupt onset of sudden pain on the right side of his scrotum. When asked to rate his pain on a scale of 1 to 10, with 10 being the most severe, the boy states, "It's a 12." Further assessment reveals a blue-black swelling on the affected side. The nurse suspects testicular torsion and immediately notifies the physician based on the understanding of which of the following? A) The condition is a surgical emergency. B) The boy is at risk for sepsis C) Intravenous antibiotics need to be initiated. D) Renal failure is imminent.

A) The condition is a surgical emergency.

The nurse is providing care to a child with folliculitis. Which of the following would the nurse expect to administer? A) Topical mupirocin B) Oral cephalosporin C) Intravenous oxacillin D) Topical Eucerin cream

A) Topical mupirocin

The nurse is teaching the parents of a child diagnosed with iron-deficiency anemia about ways to increase their child's intake of iron. The parents demonstrate understanding of the teaching when they identify which foods as good choices for the child? Select all that apply. A) Tuna B) Salmon C) Tofu D) Cow's milk E) Dried fruits

A) Tuna B) Salmon C) Tofu E) Dried fruits

A child returns from surgery in which a stoma was created in the abdominal wall to the bladder. The nurse identifies this as which of the following? A) Vesicostomy B) Ureteral stent C) Continent urinary diversion D) Bladder augmentation

A) Vesicostomy

A group of students are reviewing information about glucose-6-phosphate dehydrogenase (G6PD) deficiency. The students demonstrate understanding of the material when they identify this disorder as due to which of the following? A) X-linked recessive inheritance B) Deficiency in clotting factors C) An excess supply of iron D) Autosomal recessive inheritance

A) X-linked recessive inheritance

While presenting a panel discussion to a group of parents about urinary tract infections in children, one of the parents asks the nurse, "Why would my daughter be more at risk than my son?" Which response by the nurse would be most accurate? A) "Girls have a smaller bladder size than boys do." B) "A girl's urethra is closer to the rectal opening." C) "A girl's urethra is longer than a boy's urethra." D) "Her kidneys are less well protected."

B) "A girl's urethra is closer to the rectal opening."

A nurse is leading a discussion with a group of new mothers about newborn nutrition and its importance for growth and development. One of the mothers asks, "Doesn't the baby get iron from me before birth?" Which response by the nurse would be most appropriate? A) "You give the baby some iron, but it is not enough to sustain him after birth." B) "Because the baby grows rapidly during the first months, he uses up what you gave him." C) "The iron you give him before birth is different from what he needs once he is born." D) "If the baby didn't use up what you gave him before birth, he excretes it soon after birth."

B) "Because the baby grows rapidly during the first months, he uses up what you gave him."

Which of the following would the nurse include when teaching an adolescent about tinea pedis? A) "Keep your feet moist and open to the air as much as possible." B) "Dry the area between your toes really well." C) "Wear nylon or synthetic socks every day." D) "Go barefoot when you are in the locker room at school."

B) "Dry the area between your toes really well."

The nurse is caring for a 12-year-old boy with idiopathic thrombocytopenia. The nurse is providing discharge instructions about home care and safety recommendations to the boy and his parents. Which response indicates a need for further teaching? A) "We should avoid aspirin and drugs like ibuprofen." B) "He can resume participation in football in 2 weeks." C) "Swimming would be a great activity." D) "Our son cannot take any antihistamines."

B) "He can resume participation in football in 2 weeks."

A child is scheduled to undergo radiation therapy as part of his treatment plan for newly diagnosed cancer. After teaching the child and parents about this treatment, the nurse determines that additional teaching is needed when the parents state which of the following? A) "We should not wash off the markings on his skin." B) "He can use petroleum jelly if the skin becomes reddened." C) "He needs to use a sunscreen with an SPF of 30 or more." D) "He should not apply deodorant to the treatment site."

B) "He can use petroleum jelly if the skin becomes reddened."

The nurse is taking a health history of a child with suspected acute poststreptococcal glomerulonephritis. Which of the following responses would alert the nurse to a confirmed risk factor for this condition? A) "She has been very healthy up to now." B) "He just got over a head cold with laryngitis." C) "My child is just 18 months old." D) "My child has not been sick at all."

B) "He just got over a head cold with laryngitis."

The nurse is caring for an 8-year-old boy with myasthenia gravis and is teaching his parents about the signs of cholinergic crisis. Which of the following responses by the parents indicates a need for further teaching? A) "Low blood pressure is a sign of crisis." B) "He might have difficulty swallowing." C) "He may start to sweat a lot." D) "More saliva in the mouth is a common sign."

B) "He might have difficulty swallowing."

The nurse is providing parental teaching about home care for an 8-year-old boy with widespread sunburn on his back and shoulders. Which of the following responses indicates a need for further teaching? A) "Cool compresses may help cool the burn." B) "He should manually peel off any flaking skin." C) "Nonsteroidal anti-inflammatory drugs like ibuprofen are helpful." D) "He should avoid hot showers or baths for a couple of days."

B) "He should manually peel off any flaking skin."

A child with myasthenia gravis is brought to the emergency department by his parents. The parents have noticed a sudden increase in respiratory difficulty. The nurse suspects myasthenic crisis based on which statement by the parents? A) "We gave him an extra dose of his medication earlier today." B) "He was coughing and had a slight fever yesterday and today." C) "Things have been pretty stress-free lately." D) "He's been resting when he gets tired."

B) "He was coughing and had a slight fever yesterday and today."

The nurse is caring for an infant with osteogenesis imperfecta and is providing instruction on how to reduce the risk of injury. Which response from the mother indicates a need for further teaching? A) "I need to avoid pushing or pulling on an arm or leg." B) "I must carefully lift the baby from under the armpits." C) "I should not bend an arm or leg into an awkward position." D) "We must avoid lifting the legs by the ankles to change diapers."

B) "I must carefully lift the baby from under the armpits."

The nurse is teaching the mother of a toddler about burn prevention. Which response by the mother indicates a need for further teaching? A) "We will leave fireworks displays to the professionals." B) "I will set our water heater at 130 degrees." C) "All sleepwear should be flame retardant." D) "The handles of pots on the stove should face inward."

B) "I will set our water heater at 130 degrees."

A newborn is diagnosed with metatarsus adductus. The parents ask the nurse about how this occurred. Which response by the nurse would be most appropriate? A) "This condition is due to a genetic defect in the bones." B) "It's most likely from how the baby was positioned in utero." C) "They really don't know what causes this condition." D) "There is probably an underlying deformity of the baby's hip."

B) "It's most likely from how the baby was positioned in utero."

The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching? A) "A family history of alcoholism is a risk factor for substance abuse." B) "Just because his friends are experimenting does not mean that he will." C) "If my husband or I have a substance abuse problem it could increase his risk." D) "Negative life events are a potential risk factor."

B) "Just because his friends are experimenting does not mean that he will."

The nurse is caring for a 4-year-old with a suspected urinary tract infection. Which of the following would be most appropriate when obtaining a urine specimen from the child? A) "I will need a urine sample." B) "Let your mom help you tinkle in this cup." C) "Please tinkle in this cup right now." D) "Please void in this cup instead of the toilet."

B) "Let your mom help you tinkle in this cup."

After teaching the parents of a daughter with central precocious puberty about medication therapy, which statement by the parents indicates successful teaching? A) "She needs to use the nasal spray once every day." B) "She'll start puberty again when the medication stops." C) "This medication will slow down the changes but not reverse them." D) "Once therapy is done, she'll need surgery."

B) "She'll start puberty again when the medication stops."

After teaching the parents of a child with a hydrocele about this condition, which statement indicates that the teaching was successful? A) "If this gets worse and we don't treat it, our son could become infertile." B) "This condition should gradually go away on its own." C) "The surgeon is going to operate on him immediately." D) "It's going to be difficult putting ice packs on his scrotum."

B) "This condition should gradually go away on its own."

A child is brought to the emergency department after sustaining a concussion. The child is to be discharged home with his parents. Which of the following would the nurse include in the child's discharge instructions? A) "Expect his headache to get worse initially and then disappear." B) "Wake him every 2 hours to check his movement and responses." C) "Call your medical provider if he vomits more than five times." D) "Any watery fluid draining from his ears is normal."

B) "Wake him every 2 hours to check his movement and responses."

A nurse is providing instructions to the parents of a 3-month-old with developmental dysplasia of the hip who is being treated with a Pavlik harness. Which statement by the parents demonstrates understanding of the instructions? Select all answers that apply. A) "We need to adjust the straps so that they are snug but not too tight." B) "We should change her diaper without taking her out of the harness." C) "We need to check the area behind her knees for redness and irritation." D) "We need to send the harness to the dry cleaners to have it cleaned." E) "We need to call the doctor if she is not able to actively kick her legs."

B) "We should change her diaper without taking her out of the harness." C) "We need to check the area behind her knees for redness and irritation." E) "We need to call the doctor if she is not able to actively kick her legs."

The nurse is preparing an 8-year-old girl for a cystoscopy. Which instruction would be most appropriate to give to the child? A) "You need to make sure that you don't go to the bathroom before the test." B) "You might feel some burning when you go to the bathroom afterward." C) "I'm going to have to put a tube into your bladder to empty it." D) "I have to put a thick tight rubber band around your arm to get a blood specimen."

B) "You might feel some burning when you go to the bathroom afterward."

A 5-year-old child with type 1 diabetes is brought to the clinic by his mother for a follow-up visit after having his hemoglobin A1C level drawn. Which result would indicate to the nurse that the child is achieving long-term glucose control? A) 9.0% B) 8.2% C) 7.3% D) 6.9%

B) 8.2%

The nurse is conducting a physical examination of a child with suspected developmental dysplasia of the hip. Which of the following findings would help confirm this diagnosis? A) Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis). B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers. C) A high-pitched "click" is heard with hip flexion or extension. D) The thigh and gluteal folds are symmetric.

B) A distinct "clunk" is heard with Barlow and Ortolani maneuvers.

When teaching a group of students about the skeletal development in children, which of the following would the instructor include? A) The growth plate is made up of the epiphysis. B) A young child's bones commonly bend instead of break with an injury. C) The infant's skeleton has undergone complete ossification by birth. D) Children's bones have a thin periosteum and limited blood supply.

B) A young child's bones commonly bend instead of break with an injury.

The nurse is assessing a child with acute poststreptococcal glomerulonephritis. Which of the following would the nurse expect to assess? Select all answers that apply. A) Irritability B) Abdominal pain C) Hypertension D) Crackles E) Polyphagia

B) Abdominal pain C) Hypertension D) Crackles

When assessing a child for slipped capital femoral epiphysis, which of the following would the nurse identify as a possible risk factor? Select all answers that apply. A) Age younger than 8 years B) African American ethnicity C) History of cystic fibrosis D) Excessive activity E) Obesity

B) African American ethnicity E) Obesity

The nurse is caring for an infant with candidal diaper rash. Which topical agent would the nurse expect the physician to order? A) Corticosteroids B) Antifungals C) Antibiotics D) Retinoid

B) Antifungals

The nurse is caring for an infant with bladder exstrophy. As part of the infant's preoperative plan of care, the nurse monitors for abdominal skin excoriation. Which action would be most appropriate for promoting healing and preventing further skin breakdown? A) Cleaning the area well with a scented diaper wipe B) Applying a barrier/healing cream or paste on skin C) Keeping the bladder moist and covered with a sterile bag D) Covering the area with sterile gauze pads after tub baths

B) Applying a barrier/healing cream or paste on skin

A nurse is preparing a presentation for a local parent group about burn prevention and care in children. Which of the following would the nurse be least likely to include in the presentation when describing how to care for a superficial burn? A) Using cool water over the burned area until the pain lessens B) Applying ice directly to the burned skin area C) Covering the burn with a clean, nonadhesive bandage D) Giving the child acetaminophen for pain relief

B) Applying ice directly to the burned skin area

A nurse is performing a primary survey on a child who has sustained partial thickness burns over his upper body areas. Which of the following would the nurse do first? A) Inspect the child's skin color B) Assess for a patent airway C) Observe for symmetric breathing D) Palpate the child's pulse

B) Assess for a patent airway

The nurse is assessing an 11-year-old girl with scoliosis. Which of the following would the nurse expect to find? Select all answers that apply. A) Complaints of severe back pain B) Asymmetric shoulder elevation C) Even curve at the waistline D) Pronounced one-sided hump on bending over E) Diminished motor function F) Hyperactive reflexes

B) Asymmetric shoulder elevation D) Pronounced one-sided hump on bending over

The nurse is caring for a 2-month-old with cerebral palsy. The infant is limp and flaccid with uncontrolled, slow, worm-like, writhing, and twisting movements. Which of the following would the nurse use when documenting these observations? A) Spastic B) Athetoid C) Ataxic D) Mixed

B) Athetoid

A nurse is instituting neutropenic precautions for a child. Which of the following would the nurse most likely include? Select all answers that apply. A) Placing the child in a semiprivate room B) Avoiding rectal exams, suppositories, and enemas C) Placing a mask on the child when outside the room D) Encouraging an intake of raw fruits and vegetables E) Discouraging fresh flowers in the child's room.

B) Avoiding rectal exams, suppositories, and enemas

A child with suspected sickle cell disease is scheduled for a hemoglobin electrophoresis. When reviewing the child's history, which of the following would the nurse identify as potentially interfering with the accuracy of the results? A) Use of iron supplementation B) Blood transfusion 1 month ago C) Lack of fasting for 12 hours D) History of recent infection

B) Blood transfusion 1 month ago

The nurse is preparing a teaching plan for the parents of a child with a urinary tract infection (UTI). Which of the following would the nurse encourage the parents to avoid? A) Liberal fluid intake B) Caffeine C) Cranberry juice D) Cotton underwear

B) Caffeine

Which of the following would lead the nurse to suspect that an adolescent has bulimia? A) Body mass index less than 17 B) Calluses on back of knuckles C) Nail pitting D) Bradycardia

B) Calluses on back of knuckles

The nurse is visually inspecting a urine specimen from a 12-year-old boy. The nurse documents gross hematuria with a specimen of which color? A) Cloudy yellow B) Cola colored C) Pale to almost clear urine D) Light orange to moderately yellow colored

B) Cola colored

Which of the following would the nurse include in the preoperative plan of care for an infant with myelomeningocele? A) Positioning supine with a pillow under the buttocks B) Covering the sac with saline-soaked nonadhesive gauze C) Wrapping the infant snugly in a blanket D) Applying a diaper to prevent fecal soiling of the sac

B) Covering the sac with saline-soaked nonadhesive gauze

A child is diagnosed with hemolytic-uremic syndrome (HUS). Review of the child's laboratory test results would reveal which of the following? A) Decreased blood urea nitrogen (BUN) and creatinine B) Decreased platelets and leukocytosis C) Hypernatremia and hypokalemia D) Respiratory acidosis and proteinuria

B) Decreased platelets and leukocytosis

A nurse is inspecting the skin of a child with atopic dermatitis. Which of the following would the nurse expect to observe? A) Erythematous papulovesicular rash B) Dry, red, scaly rash with lichenification C) Pustular vesicles with honey-colored exudates D) Hypopigmented oval scaly lesions

B) Dry, red, scaly rash with lichenification

A 10-year-old girl is brought to the emergency department by her father after tripping over a rock while running in the yard. She tells the nurse, "I think I twisted my ankle." When assessing the child, which of the following would the nurse most likely assess? A) Bruising B) Edema C) Limited range of motion D) Absent pulse

B) Edema

The nurse is caring for an 8-year-old girl who has been diagnosed with leukemia and will have a variety of tests, including a lumbar puncture, before beginning chemotherapy. Which of the following would be the priority? A) Applying EMLA to the lumbar puncture site B) Educating the child and family about the testing procedures C) Administering promethazine as ordered for nausea D) Educating the family about chemotherapy and its side effects

B) Educating the child and family about the testing procedures

The nurse is developing a plan of care for a child who is receiving cyclophosphamide. Which of the following would the nurse expect to include? A) Withholding food and fluids from the child during the infusion B) Encouraging frequent voiding during and after the infusion C) Monitoring for signs of anaphylaxis during infusion D) Assessing the child for complaints of bone pain

B) Encouraging frequent voiding during and after the infusion

A nurse is preparing a presentation for a parent group about musculoskeletal injuries. When describing a child's risk for this type of injury, the nurse integrates knowledge that bone growth occurs primarily in which area? A) Growth plate B) Epiphysis C) Physis D) Metaphysis

B) Epiphysis

A nurse is conducting a physical examination of an infant and observes the urethral opening on the dorsal side of the penis. The nurse documents this finding as which of the following? A) Hypospadias B) Epispadias C) Varicocele D) Hydrocele

B) Epispadias

A nurse is preparing a presentation for a local parent group about urinary tract infections (UTIs) in children. Which of the following would the nurse incorporate into the presentation as the most common cause? A) Klebsiella B) Escherichia coli C) Staphylococcus aureus D) Pseudomonas

B) Escherichia coli

The nurse is assessing a newborn who was delivered after a prolonged labor due to an abnormal presentation. The newborn sustained a cranial nerve injury. The nurse would most likely expect to assess deficits related to which cranial nerve? A) Optic B) Facial C) Acoustic D) Trigeminal

B) Facial

The nurse is caring for an adolescent girl with anorexia nervosa. Which of the following findings would indicate to the nurse that the girl requires hospitalization? A) Weight gain of one-half pound per week B) Food refusal C) Body mass index of 18 D) Soft, sparse body hair and dry, sallow skin

B) Food refusal

The nurse is assessing a child with suspected thalassemia. Which of the following would the nurse expect to assess? A) Dactylitis B) Frontal bossing C) Presence of clubbing D) Presence of spooning

B) Frontal bossing

A child with diabetes reports that he is feeling a little shaky. Further assessment reveals that the child is coherent but with some slight tremors and sweating. A fingerstick blood glucose level is 70 mg/dL. Which of the following would the nurse do next? A) Administer a sliding-scale dose of insulin B) Give 10 to 15 grams of a simple carbohydrate C) Offer a complex carbohydrate snack D) Administer glucagon intramuscularly

B) Give 10 to 15 grams of a simple carbohydrate

A group of students are reviewing information about neuromuscular disorders. The students demonstrate understanding of the information when they identify which of the following as examples of autoimmune neuromuscular disorders? Select all answers that apply. A) Cerebral palsy B) Guillain-Barré syndrome C) Myasthenia gravis D) Spinal muscular atrophy E) Dermatomyositis

B) Guillain-Barré syndrome C) Myasthenia gravis E) Dermatomyositis

The nurse knows that children have larger heads in relation to the body and a higher center of gravity. When developing a teaching plan for parents, the nurse includes information about an increased risk for which of the following problems? A) Febrile seizures B) Head trauma C) Caput succedaneum D) Posterior plagiocephaly

B) Head trauma

An instructor is developing a plan for a class of nursing students on the various skin disorders. When describing urticaria, which of the following would the instructor include? A) It is a type IV hypersensitivity reaction. B) Histamine release leads to vasodilation C) Wheals appear first followed by erythema. D) The nonpruritic rash blanches with pressure.

B) Histamine release leads to vasodilation

A group of nursing students are reviewing the components of the endocrine system. The students demonstrate understanding of the review when they identify which of the following as the primary function of this system? A) Regulation of water balance B) Hormonal secretion C) Cellular metabolism D) Growth stimulation

B) Hormonal secretion

The nurse is reviewing the laboratory test results of a child with Addison disease. Which of the following would the nurse expect to find? A) Hypernatremia B) Hyperkalemia C) Hyperglycemia D) Hypercalcemia

B) Hyperkalemia

The nurse is caring for a 5-year-old boy undergoing radiation treatment for a neuroblastoma. Which nursing diagnosis would be most applicable for this child? A) Activity intolerance related to anemia and weakness from medications B) Impaired skin integrity related to desquamation from cellular destruction C) Impaired oral mucosa related to the presence of oral lesions from malnutrition D) Imbalanced nutrition, less than body requirements related to nausea and vomiting

B) Impaired skin integrity related to desquamation from cellular destruction

A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign? A) Lack of babbling by 6 months B) Inability to say a single word by 16 months C) Lack of gestures by 8 months D) Inability to use two words by 18 months

B) Inability to say a single word by 16 months

A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. Which of the following would the nurse identify as characteristic of this disorder? Select all answers that apply. A) Easily annoyed B) Initiator of physical fights C) Temper tantrums D) Truancy E) Arrest for arson

B) Initiator of physical fights D) Truancy E) Arrest for arson

The nurse is caring for an 8-year-old girl with hyperpituitarism. Which of the following ordered treatments will the nurse expect to perform? A) Give desmopressin acetate intranasally B) Inject octreotide acetate C) Give 1 mg/kg/day of methimazole D) Administer glipizide orally

B) Inject octreotide acetate

A nurse is providing care to a child with idiopathic thrombocytopenic purpura with a platelet count of 18,000/mm3. Which medication would the nurse most likely expect to be ordered? A) Folic acid B) Intravenous immune globulin C) Dimercaprol D) Deferoxamine

B) Intravenous immune globulin

The nurse is caring for a 15-year-old boy who has sustained burn injuries. The nurse observes the burn developing a violaceous color with discharge and a foul odor. The nurse suspects which of the following infections? A) Burn wound cellulitis B) Invasive burn cellulitis C) Burn impetigo D) Staphylococcal scalded skin syndrom

B) Invasive burn cellulitis

The nurse is conducting a physical examination of a 9-month-old baby with a flat, discolored area on the skin. The nurse documents this as which of the following? A) Papule B) Macule C) Vesicle D) Scaling

B) Macule

A child is receiving fluorouracil as part of a chemotherapy protocol. Which of the following would be most important for the nurse to include in the child's plan of care? A) Monitoring for visual changes B) Maintaining adequate hydration C) Using prescribed eye drops to prevent conjunctivitis D) Avoiding administration with food or meals

B) Maintaining adequate hydration

The nurse is preparing a presentation for a parent group about childhood cancers, focusing on brain tumors in children. Which of the following would the nurse include as being the most common type of brain tumor? A) Brain stem glioma B) Medulloblastoma C) Ependymoma D) Astrocytoma

B) Medulloblastoma

A child is diagnosed with hyperthyroidism. Which agent would the nurse expect the physician to prescribe? A) Mineralocorticoid B) Methimazole C) Levothyroxine D) Dexamethasone

B) Methimazole

A nurse is caring for a 14-year-old girl following myelography. Which of the following would be the priority nursing action? A) Monitoring for a decrease in spasticity B) Observing for signs of meningeal irritation C) Assessing motor function D) Observing for mental confusion or hallucinations

B) Observing for signs of meningeal irritation

The nurse assesses a child's level of consciousness, noting that the child falls asleep unless he is stimulated. The nurse documents this finding as: A) Confusion B) Obtunded C) Stupor D) Coma

B) Obtunded

A child is prescribed monthly injections of vitamin B12. When developing the teaching plan for the family, the nurse would focus on which type of anemia? A) Aplastic anemia B) Pernicious anemia C) Folic acid anemia D) Sickle cell anemia

B) Pernicious anemia

A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist specializing in which type of therapy? A) Individual therapy B) Play therapy C) Behavioral therapy D) Hypnosis

B) Play therapy

The nurse is assessing a child with a possible fracture. Which of the following would the nurse identify as the most reliable indicator? A) Lack of spontaneous movement B) Point tenderness C) Bruising D) Inability to bear weight

B) Point tenderness

Which of the following would be most appropriate to include in the plan of care for a child who has undergone surgery for removal of an astrocytoma? A) Elevating the foot of the bed B) Positioning the child on his unaffected side C) Raising the head of the bed at least 45 degrees D) Administering large volumes of intravenous fluids

B) Positioning the child on his unaffected side

The nurse is evaluating the laboratory test results of a 7-year-old child with a suspected hematologic disorder. Which finding would cause the nurse to be concerned? A) WBC: 5.6 × 103/mm3 B) RBC: 2.8 × 106/mm3 C) Hemoglobin: 11.4 mg/dL D) Hematocrit: 35%

B) RBC: 2.8 × 106/mm3

The nurse is describing the phases of treatment to a child who was diagnosed with leukemia and his parents. The nurse explains the induction stage as which of the following? A) Intense therapy to strengthen remission B) Rapid promotion of complete remission C) Elimination of all residual leukemic cells D) Reduction of risk for central nervous system (CNS) disease

B) Rapid promotion of complete remission

The nurse is assessing a 5-year-old child's genitourinary system. Which of the following would the nurse document as a normal finding? Select all answers that apply. A) Labial fusion B) Round abdomen C) Positive bowel sounds D) Dullness over the spleen E) Undescended testicles

B) Round abdomen C) Positive bowel sounds D) Dullness over the spleen

The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which of the following? A) Anxiety disorder B) Sensory integration dysfunction C) Depression D) Obsessive-compulsive disorder

B) Sensory integration dysfunction

The nurse is caring for an 8-year-old girl with an endocrine disorder involving the posterior pituitary gland. Which of the following would the nurse expect to implement? A) Instructing the parents to report adverse reactions to the growth hormone treatment B) Teaching the parents how to administer the desmopressin acetate C) Informing the parents that treatment stops when puberty begins D) Educating the parents to report signs of acute adrenal crisis

B) Teaching the parents how to administer the desmopressin acetate

A child with iron-deficiency anemia is prescribed ferrous fumarate, 3 mg/kg/day in two divided doses. The nurse interprets this order as indicating which of the following? A) The child requires a prophylactic dose of iron. B) The child has mild to moderate iron deficiency. C) The child has severe iron deficiency. D) The child is being prepared for packed red blood cell administration.

B) The child has mild to moderate iron deficiency.

The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. Which of the following findings would suggest this child has a neuroblastoma? A) The child has a maculopapular rash on his palms. B) The parents report that their son is vomiting and not eating well. C) The parents report that their son is irritable and not gaining weight. D) Auscultation reveals wheezing with diminished lung sounds.

B) The parents report that their son is vomiting and not eating well.

The nurse is teaching a group of students about myelinization in a child. Which statement by the students indicates that the teaching was successful? A) Myelinization is completed by 4 years of age. B) The process occurs in a head-to-toe fashion. C) The speed of nerve impulses slows as myelinization occurs. D) Nerve impulses become less specific in focus with myelinization.

B) The process occurs in a head-to-toe fashion.

During a well-child visit, the nurse assesses an infant's ability to suck on a pacifier. The nurse is assessing which cranial nerve? A) Olfactory B) Trigeminal C) Facial D) Accessory

B) Trigeminal

The nurse is caring for a 10-year-old with Duchenne muscular dystrophy. As part of the plan of care, the nurse focuses on maintaining his cardiopulmonary function. Which intervention would the nurse implement to best promote maximum chest expansion? A) Deep-breathing exercises B) Upright positioning C) Coughing D) Chest percussion

B) Upright positioning

A nurse is preparing a class for parents of infants about managing diaper dermatitis. Which of the following would the nurse include in the presentation? Select all answers that apply. A) Applying topical nystatin to the diaper area B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers D) Using scented diaper wipes to clean the area E) Washing the diaper area with an antibacterial soap

B) Using a blow dryer on warm to dry the diaper area C) Refraining from using rubber pants over diapers

A nurse is assessing the skin of a child with cellulitis. Which of the following would the nurse expect to find? A) Red raised hair follicles B) Warmth at skin disruption site C) Papules progressing to vesicles D) Honey-colored exudate

B) Warmth at skin disruption site

A nursing instructor is preparing for a class discussion on spinal muscular atrophy (SMA). When describing type 2 SMA, which of the following would the instructor include? Select all answers that apply. A) Onset before 6 months of age B) Weakness most severe in shoulders and hips C) Difficulty with swallowing D) Slowly progressing condition E) Genetic disease with autosomal recessive inheritance

B) Weakness most severe in shoulders and hips D) Slowly progressing condition E) Genetic disease with autosomal recessive inheritance

The nurse is teaching the mother of a 5-year-old boy with a myelomeningocele who has developed a sensitivity to latex. Which of the following responses from his mother indicates a need for further teaching? A) "He needs to get a medical alert identification." B) "I will need to discuss this with his caregivers." C) "A product's label indicates whether it is latex-free." D) "He must avoid all contact with latex."

C) "A product's label indicates whether it is latex-free."

The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability? A) "He is not speaking in complete sentences." B) "We can understand a lot of what he says, but no one else can." C) "He seems to be speaking words less and less frequently." D) "He is unable to sit still for a short story."

C) "He seems to be speaking words less and less frequently."

A nurse is providing teaching to the parents of a child who has had a shunt inserted as treatment for hydrocephalus. The parents demonstrate understanding of the teaching when they state which of the following? A) "Having the shunt put in decreases his risk for developmental problems." B) "If he doesn't get an infection in the first week, the risk is greatly reduced." C) "He will need more surgeries to replace the shunt as he grows." D) "The shunt will help to prevent any further complications from his disease."

C) "He will need more surgeries to replace the shunt as he grows."

A 6-year-old boy with cerebral palsy has been admitted to the hospital for some tests. His condition is stable. The boy's mother remains with her son, but she is obviously exhausted and stressed. Which response by the nurse would be most appropriate? A) "Would you like me to bring you a blanket and pillow?" B) "You are doing such a wonderful job with your son." C) "He's in good hands; consider going home to get some sleep." D) "Are you planning to spend the night or to go home?"

C) "He's in good hands; consider going home to get some sleep."

After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state which of the following? A) "If he starts to act out, we'll have him do a time-out to help him refocus." B) "We can use a reward system when he behaves appropriately." C) "If he misbehaves, we need to punish him instead of reward him." D) "We need to help him set realistic goals that he can achieve."

C) "If he misbehaves, we need to punish him instead of reward him."

The nurse is caring for a 13-year-old boy in traction prior to surgery for slipped capital femoral epiphysis. He has been in an acute care setting for 2 weeks and will require an additional 10 days in the hospital. He is complaining that he feels isolated and is resisting further treatment. Which response by the nurse would be most appropriate? A) "I know it is boring, but you must remain immobile for 2 more weeks." B) "If there are no complications, you only have 2 more weeks here." C) "Let's come up with things to do like books, movies, games, and friends to visit." D) "If you resist your treatment, your condition will only get worse."

C) "Let's come up with things to do like books, movies, games, and friends to visit."

The nurse is caring for an active 14-year-old boy who has recently been diagnosed with scoliosis. He is dismayed that a "jock" like himself could have this condition, and is afraid it will impact his spot on the water polo team. Which response by the nurse would best address the boy's concerns? A) "If you wear your brace properly, you may not need surgery." B) "The good news is that you have very minimal curvature of your spine." C) "Let's talk to another boy with scoliosis, who is winning trophies for his swim team." D) "Let's talk to the doctor about your treatment options."

C) "Let's talk to another boy with scoliosis, who is winning trophies for his swim team."

The nurse is providing care for a 14-year-old girl with severe acne. The girl expresses sadness and distress about her appearance. Which response by the nurse would be most appropriate? A) "Are you using your medicine every day?" B) "Your condition will most likely improve in a year or two." C) "Many people feel this way; I know someone who can help." D) "If you have any scarring you can undergo dermabrasion."

C) "Many people feel this way; I know someone who can help."

A nurse is interviewing the parents of a child diagnosed with obstructive uropathy. Which statement by the parents would the nurse identify as significant? A) "She's been constipated quite a few times." B) "We've noticed that her bed is wet in the morning." C) "She had surgery to repair a problem with her anus." D) "She had a bacterial skin infection about a week ago."

C) "She had surgery to repair a problem with her anus."

After teaching a class about the differences in the skin of infants and adults, the nurse determines that additional teaching is necessary when the class states which of the following? A) "An infant's skin is thinner than an adult's, so substances placed on the skin are absorbed more readily." B) "The infant's epidermis is loosely connected to the dermis, increasing the risk for breakdown." C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented." D) "An infant has less subcutaneous fat, which places the infant at a higher risk for heat loss."

C) "The infant has a lower risk for damage from ultraviolet radiation because the skin is more pigmented."

The nurse is caring for a female infant with torticollis and is providing instructions to the parents about how to help their daughter. Which statement by the parents indicates a need for further teaching? A) "We must encourage our daughter to turn her head both ways." B) "Flatness on one side of the head is a common side effect." C) "We must apply firm pressure and stretching every other day." D) "We will do a daily stretching regimen with multiple sessions."

C) "We must apply firm pressure and stretching every other day."

The nurse is caring for a 13-year-old girl with von Willebrand disease. After teaching the adolescent and her parents about this disorder and care, which response by the parents indicates a need for additional teaching? A) "We need to administer Stimate prior to dental work." B) "We should be aware that she may suffer from menorrhagia." C) "We should administer desmopressin as often as needed." D) "We understand that she may have frequent nosebleeds."

C) "We should administer desmopressin as often as needed."

A 5-year-old girl is diagnosed with iron-deficiency anemia and is to receive iron supplements. The child has difficulty swallowing tablets, so a liquid formulation is prescribed. After teaching the parents about administering the iron supplement, which statement indicates the need for additional teaching? A) "She needs to eat foods that are high in fiber so she doesn't get constipated." B) "We'll try to get her to drink lots of fluids throughout the day." C) "We will place the liquid in the front of her gums, just below her teeth." D) "We need to measure the liquid carefully so that we give her the correct amount."

C) "We will place the liquid in the front of her gums, just below her teeth."

A nurse is conducting a physical examination of a 5-year-old with suspected iron-deficiency anemia. How would the nurse evaluate for changes in neurologic functioning? A) "Open your mouth so I can look inside your cheeks and lips." B) "Do you have any bruises on your feet or shins?" C) "Will you show me how you walk across the room?" D) "Let me see the palms of your hands and soles of your feet."

C) "Will you show me how you walk across the room?"

The nurse is caring for a 2-year-old girl in a bilateral brace with tibia vara. Her parents are upset by their toddler's limited mobility. Which response by the nurse would be most appropriate? A) "If you don't follow the therapy, your daughter could develop severe bowing of her legs." B) "It's important to use the brace or your daughter may need surgery." C) "You are doing a great job. Let's put our heads together on how to keep her busy." D) "You'll need to accept this since treatment may be required for several years."

C) "You are doing a great job. Let's put our heads together on how to keep her busy."

When developing the plan of care for a child with burns requiring fluid replacement therapy, which of the following would the nurse expect to include? A) Administration of colloid initially followed by a crystalloid B) Determination of fluid replacement based on the type of burn C) Administration of most of the volume during the first 8 hours D) Monitoring of hourly urine output to achieve less than 1 mL/kg/hour

C) Administration of most of the volume during the first 8 hours

A nurse is caring for a 10-year-old girl following joint fluid aspiration. The nurse would expect to perform which of the following immediately after the procedure? A) Transporting the aspirated fluid to the lab within 30 minutes B) Encouraging the child to drink fluids postprocedure C) Applying cold therapy and a pressure dressing to the site D) Elevating the extremity on a heating pad with several pillows

C) Applying cold therapy and a pressure dressing to the site

A nurse identifies a nursing diagnosis of impaired urinary elimination related to urinary tract infection. When developing the plan of care, which of the following would be most important for the nurse to do first? A) Develop a schedule for bladder emptying B) Encourage fluid intake C) Assess usual voiding patterns D) Monitor intake and output

C) Assess usual voiding patterns

The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions? A) Depression B) Anxiety disorder C) Attention deficit/hyperactivity disorder D) Asperger syndrome

C) Attention deficit/hyperactivity disorder

The nurse is preparing a class for a group of adolescents about reducing the risk of skin cancer. Which of the following would the nurse include? A) Using a sunscreen with para-aminobenzoic acid (PABA) with an SPF of at least 10 B) Applying sunscreen at least 1 hour before going outside in the sun C) Avoiding sun exposure between the hours of 10 a.m. and 2 p.m. D) Using artificial UV tanning beds instead of sun exposure

C) Avoiding sun exposure between the hours of 10 a.m. and 2 p.m.

The nurse is administering 10 units of NPH insulin to a child at 8 a.m. The nurse would expect this insulin to begin acting at which time? A) By 8:15 a.m. B) Between 8:30 and 9 a.m. C) Between 9 and 11 a.m. D) Around 12 noon

C) Between 9 and 11 a.m.

A 4-year-old is brought to the emergency department with a burn. Which of the following would alert the nurse to the possibility of child abuse? A) Burn assessment correlates with mother's report of contact with a portable heater. B) Parents state that the injury occurred approximately 15 to 20 minutes ago. C) Clear delineations are noted between burned and nonburned skin areas. D) The burn area appears asymmetric and nonuniform.

C) Clear delineations are noted between burned and nonburned skin areas.

The nurse is caring for a 9-year-old boy who is having chemotherapy. The nurse is developing a teaching plan for the child and family about nutrition. Which of the following would the nurse be least likely to include? A) Emphasizing the intake of grains, fruits, and vegetables B) Featuring high-fiber foods if opioid analgesics are being taken C) Concentrating on consuming primarily high-calorie shakes and puddings D) Avoiding milk products if diarrhea is a problem

C) Concentrating on consuming primarily high-calorie shakes and puddings

The nurse is reviewing the laboratory test results of a child with nephrotic syndrome. Which of the following would the nurse least likely expect to find? A) Hyperlipidemia B) Hypoalbuminemia C) Decreased blood urea nitrogen (BUN) D) Hypoproteinemia

C) Decreased blood urea nitrogen (BUN)

A nurse is preparing a presentation for a group of parents with children diagnosed with diabetes type 1. The children are all adolescents. Which of the following issues would the nurse need to address? Select all that apply. A) Self-monitoring of blood glucose levels B) Feelings of being different C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence

C) Deficient decision-making skills D) Body image conflicts E) Struggle for independence

The nurse suspects that a 4-year-old with type 1 diabetes is experiencing hypoglycemia based on which of the following? Select all that apply. A) Blurred vision B) Dry, flushed skin C) Diaphoresis D) Slurred speech E) Fruity breath odor F) Tachycardia

C) Diaphoresis D) Slurred speech F) Tachycardia

A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. Which of the following would be most important for the nurse to do first? A) Set clear limits on the child's behavior B) Teach the child problem-solving skills C) Encourage a discussion of the child's thoughts and feelings D) Role model appropriate social and conversation skills

C) Encourage a discussion of the child's thoughts and feelings

The nurse is caring for a 5-year-old girl with a disseminated medulloblastoma. Which of the following interventions would be most appropriate for this situation? A) Providing emotional support to the parents and siblings of the child B) Recommending support groups for people whose children have cancer C) Encouraging the family to cry and express feelings away from the child D) Educating the family about the disease, its treatments, and side effects

C) Encouraging the family to cry and express feelings away from the child

The nurse is reviewing the white blood cell differential of a 4-year-old girl. Which value would lead the nurse to be concerned? A) Bands: 8% B) Segs: 28% C) Eosinophils: 10% D) Basophils: 0%

C) Eosinophils: 10%

The nurse is preparing a teaching plan for a 10-year-old girl with hyperthyroidism. Which of the following would the nurse include in the plan? A) Describing surgery to remove an anterior pituitary tumor B) Teaching her parents to give injections of growth hormone C) Explaining about the radioactive iodine procedure D) Showing her parents how to give DDAVP intranasally

C) Explaining about the radioactive iodine procedure

A child diagnosed with stage IV neuroblastoma has undergone abdominal surgery to remove the tumor. He is now receiving chemotherapy. Which nursing diagnosis would be most important? A) Risk for infection related to chemotherapy B) Impaired skin integrity related to abdominal surgery C) Grieving related to advanced disease and poor prognosis D) Imbalanced nutrition related to adverse effects of chemotherapy

C) Grieving related to advanced disease and poor prognosis

A child with growth hormone deficiency is receiving growth hormone. Which of the following would the nurse interpret as indicating effectiveness of this therapy? A) Rapid weight gain B) Complaints of headaches C) Height increase of 4 inches D) Growth plate closure

C) Height increase of 4 inches

As a result of seizure activity, a computed tomography (CT) scan was performed and showed that an 18-month-old child has intracranial arteriovenous malformation. When developing the child's plan of care, the nurse would expect to implement actions to prevent which of the following? A) Drug interactions B) Developmental disabilities C) Hemorrhagic stroke D) Respiratory paralysis

C) Hemorrhagic stroke

The nurse is assessing a 9-year-old girl with a history of tuberculosis at age 6 years. She has been losing weight and has no appetite. The nurse suspects Addison disease based on which of the following assessment findings? A) Arrested height and increased weight B) Thin, fragile skin and multiple bruises C) Hyperpigmentation and hypotension D) Blurred vision and enuresis

C) Hyperpigmentation and hypotension

A nurse is preparing a program for a group of parents about injury prevention. Which of the following would the nurse include as an important contributing factor for cervical spine injury in a child? A) Exposure to teratogens while in utero B) Immaturity of the central nervous system C) Increased mobility of the spine D) Incomplete myelinization

C) Increased mobility of the spine

A group of nursing students are reviewing information about the endocrine system in infants and children. The students demonstrate understanding of the information when they state which of the following? A) Endocrine glands begin developing in the third trimester of gestation. B) At birth, the endocrine glands are completely functional. C) Infants have difficulty balancing glucose and electrolytes. D) A child's endocrine system has little effect on growth and development.

C) Infants have difficulty balancing glucose and electrolytes.

When providing care to a newborn infant who was born at 29 weeks' gestation, the nurse integrates knowledge of potential complications, being alert for signs and symptoms of which of the following? A) Neonatal conjunctivitis B) Facial deformities C) Intracranial hemorrhage D) Incomplete myelinization

C) Intracranial hemorrhage

A child with spastic cerebral palsy is to receive botulin toxin. The nurse prepares the child for administration of this drug by which route? A) Oral B) Subcutaneous injection C) Intramuscular injection D) Intravenous infusion

C) Intramuscular injection

A child is receiving methotrexate as part of his chemotherapy protocol. The nurse would anticipate administering which agent to counteract the toxic effects of methotrexate? A) Mesna B) Cyclosporine C) Leucovorin D) Nystatin

C) Leucovorin

Hydrocephalus is suspected in a 4-month-old infant. Which of the following would the nurse expect to assess? A) Sunken fontanels B) Diminished reflexes C) Lower extremity spasticity D) Skull symmetry

C) Lower extremity spasticity

The nurse is reviewing the medical record of a child who has dyspraxia. The nurse understands that this child experiences difficulty with which of the following? A) Reading and writing B) Mathematics and computation C) Manual dexterity and coordination D) Composition and spelling

C) Manual dexterity and coordination

A 3-year-old child has sustained significant severe burns and is ordered to receive 100% oxygen. Which of the following would the nurse use to administer the oxygen? A) Nasal cannula B) Venturi mask C) Nonrebreather mask D) Oxygen hood

C) Nonrebreather mask

A nurse is caring for a 5-year-old in Buck traction. When conducting a skin examination for signs of pressure ulcers, the nurse pays particular attention to which area? A) Sacral area B) Hip area C) Occiput D) Upper arm

C) Occiput

The school nurse is presenting a class to a group of students about common overuse disorders. Which of the following would the school nurse include? A) Dislocated radial head B) Transient synovitis of the hip C) Osgood-Schlatter disease D) Scoliosis

C) Osgood-Schlatter disease

The nurse is applying a urine bag to a 15-month-old boy to collect a urine specimen. Which of the following would the nurse do first? A) Apply benzoin to the scrotal area B) Tuck the bag downward inside the diaper C) Pat the perineal area dry after cleaning D) Apply the narrow portion of the bag on the perineal space

C) Pat the perineal area dry after cleaning

The nurse is reviewing the laboratory test results of a child diagnosed with disseminated intravascular coagulation (DIC). Which of the following would the nurse interpret as indicative of this disorder? A) Shortened prothrombin time B) Increased fibrinogen level C) Positive fibrin split products D) Increased platelets

C) Positive fibrin split products

The nurse is caring for a 10-year-old boy with hyperpituitarism due to a tumor on the anterior pituitary gland. Which of the following would be a priority for this child? A) Promoting a healthy body image B) Encouraging effective family coping C) Providing pre- and postoperative care D) Promoting knowledge about treatment options

C) Providing pre- and postoperative care

A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs? A) Atypical antidepressant B) Tricyclic antidepressant C) Selective serotonin reuptake inhibitor D) Psychostimulant

C) Selective serotonin reuptake inhibitor

A 6-year-old child has undergone a renal transplant and is receiving cyclosporine. The nurse instructs the parents to be especially alert for which of the following? A) Weight loss B) Hypotension C) Signs of infection D) Hair loss

C) Signs of infection

The nurse is developing a teaching plan for a child who is to have his cast removed. Which of the following would the nurse most likely include? A) Applying petroleum jelly to the dry skin B) Rubbing the skin vigorously to remove the dead skin C) Soaking the area in warm water every day D) Washing the skin with dilute peroxide and water

C) Soaking the area in warm water every day

An 18-month old was brought to the emergency department by her mother, who states, "I think she broke her arm." The child is sent for a radiograph to confirm the fracture. Additional assessment of the child leads the nurse to suspect possible child abuse. Which type of fracture would the radiograph most likely reveal? A) Plastic deformity B) Buckle fracture C) Spiral fracture D) Greenstick fracture

C) Spiral fracture

The nurse is caring for an 8-year-old boy who has chronic epilepsy. Which of the following would be most important to address when teaching the child and parents about living with this condition? A) Multiple corrective surgeries to slowly remove diseased parts of his brain B) Physical, occupational, and speech therapy to maximize his potential C) Support for maintaining self-esteem because of his altered lifestyle D) Hyperventilation therapy to counteract the periods of decreased oxygenation

C) Support for maintaining self-esteem because of his altered lifestyle

An 8-year-old boy with a fractured forearm is to have a fiberglass cast applied. Which of the following would the nurse include when teaching the child about the cast? A) The cast will take a day or two to dry completely. B) The edges will be covered with a soft material to prevent irritation. C) The child initially may experience a very warm feeling inside the cast. D) The child will need to keep his arm down at his side for 48 hours.

C) The child initially may experience a very warm feeling inside the cast.

The nurse is assessing a 13-year-old boy with type 2 diabetes mellitus. Which of the following would the nurse correlate with disorder? A) The parents report that their child had "a cold or flu" recently. B) Blood pressure is decreased when checking vital signs. C) The parents report that their son "can't drink enough water." D) Auscultation reveals Kussmaul breathing.

C) The parents report that their son "can't drink enough water."

The nurse is teaching the parents of a child with a hematologic disorder about the functions of the various blood cells. The nurse determines that the teaching was successful when the parents state which blood cell as being primarily responsible for blood clotting? A) Granulocytes B) Erythrocytes C) Thrombocytes D) Leukocytes

C) Thrombocytes

The mother of a child with end-stage renal disease asks the nurse why her son is getting an injection of erythropoietin. When responding to the mother, the nurse incorporates understanding of which of the following as the rationale? A) To treat low calcium levels B) To stimulate growth in stature C) To stimulate red blood cell growth D) To correct acidosis

C) To stimulate red blood cell growth

The nurse is caring for a child recently diagnosed with glucose-6-phosphate dehydrogenase (G6PD) deficiency. The nurse is teaching the parents about triggers that may result in oxidative stress. Which of the following responses indicates a need for further teaching? A) "I doubt he will ever eat fava beans, but they could trigger hemolysis." B) "He must avoid exposure to naphthalene, an agent found in mothballs." C) "He must never take methylene blue for a urinary tract infection." D) "My son can never take penicillin for an infection."

D) "My son can never take penicillin for an infection."

The nurse is caring for a 2-year-old boy with hemophilia. His parents are upset by the possibility that he will become infected with hepatitis or HIV from the clotting factor replacement therapy. Which response by the nurse would be most appropriate? A) "Parents commonly fear the worst; however, the factor will help your child lead a normal life." B) "There are risks with any treatment including using blood products, but these are very minor." C) "Although factor replacement is expensive, there's more financial strain from missing work if he has a bleeding episode." D) "Since dry heat treatment of the factor began in 1986, there have been no reports of virus transmission."

D) "Since dry heat treatment of the factor began in 1986, there have been no reports of virus transmission."

A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. Which of the following would the nurse include when teaching the child and his parents about this drug? A) "Give the drug three times a day: morning, midday, and after school." B) "This drug may cause drowsiness, so be careful when doing things." C) "Some increase in appetite may occur, so watch how much you eat." D) "Take this drug every day in the morning when you wake up."

D) "Take this drug every day in the morning when you wake up."

A group of nursing students are reviewing information about the type of skin and skeletal traction. The students demonstrate understanding of this information when they identify which of the following as a type of skeletal traction? A) Russell traction B) Bryant traction C) Buck traction D) 90-90 traction

D) 90-90 traction

A group of students are reviewing information about renal failure in children. The students demonstrate a need for additional teaching when they identify which agent as a potential contributor to renal failure? A) Vancomycin B) Gentamicin C) Co-trimoxazole D) Amoxicillin

D) Amoxicillin

A group of nursing students are reviewing the various drug classes used for cancer chemotherapy. The students demonstrate an understanding of these classes when they identify which agent as an example of a nitrosourea? A) Busulfan B) Thiotepa C) Cisplatin D) Carmustine

D) Carmustine

The nurse is caring for a 13-year-old girl with delayed puberty. Based on the nurse's knowledge of this condition, the nurse would include which nursing diagnosis in the child's plan of care? A) Disabled family coping related to the child's disorder B) Imbalanced nutrition, less than body requirements related to the child's short stature C) Noncompliance related to the need for lifelong hormone therapy D) Deficient knowledge related to the administration of estradiol

D) Deficient knowledge related to the administration of estradiol

A child with cerebral palsy has undergone surgery for placement of a baclofen pump. Which of the following would the nurse include when teaching the parents about caring for their child? A) Waiting 48 hours before allowing the child to take a tub bath B) Not allowing the child to sleep on his side for about 4 weeks C) Calling the physician if the child's temperature is over 100.5°F D) Discouraging the child from stretching or bending forward for 4 weeks

D) Discouraging the child from stretching or bending forward for 4 weeks

After teaching a class of nursing students about muscular dystrophy, the instructor determines that the teaching was successful when the students identify which type of muscular dystrophy as demonstrating an X-linked recessive pattern of inheritance? A) Limb-girdle B) Myotonic C) Distal D) Duchenne

D) Duchenne

A nurse is caring for a 14-year-old girl who received an electrical burn. The nurse would anticipate preparing the girl for which diagnostic tests as ordered? A) Pulse oximetry B) Fiberoptic bronchoscopy C) Xenon ventilation-perfusion scanning D) Electrocardiographic monitoring

D) Electrocardiographic monitoring

Which test result would the nurse least likely expect to find in a child diagnosed with Wilms tumor? A) Complete blood count (CBC) within normal limits B) Urinalysis positive for blood C) Mass on kidney D) Elevated homovanillic acid (HVA) with 24-hour urine collection

D) Elevated homovanillic acid (HVA) with 24-hour urine collection

A 6-year-old boy has been admitted to the hospital with burns. The nurse notes carbonaceous sputum. Which of the following would be the priority? A) Determining the burn depth B) Eliciting a description of the burn C) Estimating burn extent D) Ensuring a patent airway

D) Ensuring a patent airway

A nurse is talking with the parents of a child who has had a febrile seizure. The nurse would integrate an understanding of which of the following into the discussion? A) The child's risk for cognitive problems is greatly increased. B) Structural damage occurs with febrile seizure. C) The child's risk for epilepsy is now increased. D) Febrile seizures are benign in nature.

D) Febrile seizures are benign in nature.

A nurse is preparing a presentation for an expectant parent group about neural tube defects and prevention. Which of the following would the nurse emphasize? A) Smoking cessation B) Aerobic exercise C) Increased calcium intake D) Folic acid supplementation

D) Folic acid supplementation

Which of the following would the nurse be least likely to assess in a 6-year-old with septic arthritis of the hip? A) Moderate to severe pain of the affected hip B) Previous otitis media infection C) Refusal to straighten the affected extremity D) Full range of motion of the hip

D) Full range of motion of the hip

A group of students are reviewing information about the various types of insulin used to treat type 1 diabetes. The students demonstrate understanding of the information when they identify which insulin listed below as having the longest duration? A) Lispro B) Regular C) NPH D) Glargine

D) Glargine

The parents of a child with congenital adrenal hyperplasia bring the child to the emergency department for evaluation because the child has had persistent vomiting. Which of the following would lead the nurse to suspect that the child is experiencing an acute adrenal crisis? A) Hypernatremia B) Bradycardia C) Hypertension D) Hyperkalemia

D) Hyperkalemia

An 8-year-old girl is scheduled for a renal ultrasound. Which of the following would the nurse include in the plan of care when preparing the child for this test? A) Withholding food and fluids after midnight B) Checking the child for allergies to shellfish C) Ensuring the child has a full bladder D) Informing the child she should feel no discomfort

D) Informing the child she should feel no discomfort

The nurse is caring for a child who has been admitted for a sickle cell crisis. Which of the following would the nurse do first to provide adequate pain management? A) Administer a nonsteroidal anti-inflammatory drug as ordered. B) Use guided imagery and therapeutic touch. C) Administer meperidine as ordered. D) Initiate pain assessment with a standardized pain scale.

D) Initiate pain assessment with a standardized pain scale.

During class, a student states, "I didn't think children could have strokes. I thought this only occurred in older adults." When responding to the student, which of the following would be most important for the instructor to integrate into the response? A) Strokes in children often have an identifiable cause. B) The signs and symptoms in children are different from an adult. C) Research has identified specific treatments for children. D) Ischemic strokes are more common than hemorrhagic strokes.

D) Ischemic strokes are more common than hemorrhagic strokes.

The nurse is obtaining a health history from parents whose 4-month-old boy has congenital hypothyroidism. Which of the following would the nurse most likely assess? A) The child has above-normal growth for his age. B) The child is active and playful. C) The skin is pink and healthy looking. D) It is difficult to keep the child awake.

D) It is difficult to keep the child awake.

When reviewing the medical record of a child, which of the following would the nurse interpret as the most sensitive indicator of intellectual disability? A) History of seizures B) Preterm birth C) Vision deficit D) Language delay

D) Language delay

Which of the following would the nurse expect to find initially in a child with Guillain-Barré syndrome? A) Symmetric flaccid weakness B) Ataxia C) Sensory disturbances D) Lower extremity pain

D) Lower extremity pain

The nurse is caring for a 7-year-old girl who is undergoing a stem cell transplant. Which of the following would the nurse include in the child's postoperative plan of care? A) Assessing for petechiae, purpura, bruising, or bleeding B) Limiting blood draws to the minimum volume required C) Administering antiemetics around the clock as ordered D) Monitoring for severe diarrhea and maculopapular rash

D) Monitoring for severe diarrhea and maculopapular rash

A child is prescribed trazodone. Which of the following would the nurse be least likely to include in the plan of care related to this drug? A) Monitoring blood pressure for orthostatic hypotension B) Assessing the child for sedation and drowsiness C) Administering the drug with a snack D) Monitoring for tardive dyskinesia

D) Monitoring for tardive dyskinesia

When assessing the adolescent with anorexia, which of the following would the nurse expect to find? A) Tachycardia B) Hypertension C) Fever D) Murmur

D) Murmur

A group of nursing students are reviewing information related to seizures that occur in infants and children. The students demonstrate a need for additional review when they identify which type as common in neonates? A) Tonic B) Focal clonic C) Multifocal clonic D) Myoclonic

D) Myoclonic

The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which of the following? A) Generalized anxiety disorder B) Posttraumatic stress disorder C) Social phobia D) Obsessive-compulsive disorder

D) Obsessive-compulsive disorder

A nurse is teaching the parents of an infant with congenital adrenal hyperplasia about the signs and symptoms of adrenal crisis. The nurse determines that the teaching was successful when the parents identify which of the following? A) Bradycardia B) Constipation C) Fluid overload D) Persistent vomiting

D) Persistent vomiting

Which of the following would lead the nurse to suspect that a child is beginning to develop increased intracranial pressure? A) Bradycardia B) Cheyne-Stokes respirations C) Fixed, dilated pupils D) Projectile vomiting

D) Projectile vomiting

A 4-year-old boy has a febrile seizure during a well-child visit. Which of the following would be a priority? A) Hyperextending the child's head while placing him on his side B) Using a tongue blade to pry open the child's jaw C) Loosening the child's clothing to ensure a patent airway D) Protecting the child from harm during the seizure

D) Protecting the child from harm during the seizure

The nurse has developed a plan of care for a 6-year-old with muscular dystrophy. He was recently injured when he fell out of bed at home. Which intervention would the nurse suggest to prevent further injury? A) Recommend the bed's side rails be raised throughout the day and night. B) Suggest a caregiver be present continuously to prevent falls from bed. C) Encourage a loose restraint to be used when he is in bed. D) Recommend raising the bed's side rails when a caregiver is not present.

D) Recommend raising the bed's side rails when a caregiver is not present.

The nurse is caring for a 16-year-old boy with acute myelogenous leukemia who is having chemotherapy and who has incomplete records for varicella zoster immunization. Which of the following will be the priority nursing diagnosis? A) Pain related to adverse effects of treatment verbalized by the child B) Nausea related to side effects of chemotherapy verbalized by the child C) Constipation related to the use of opioid analgesics for pain D) Risk for infection related to neutropenia and immunosuppression

D) Risk for infection related to neutropenia and immunosuppression

A child is diagnosed with atopic dermatitis. Which laboratory test would the nurse expect the child to undergo to provide additional evidence for this condition? A) Erythrocyte sedimentation rate B) Potassium hydroxide prep C) Wound culture D) Serum immunoglobulin E level

D) Serum immunoglobulin E level

A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which of the following as an indicator of possible child abuse? A) Consistent delays in seeking treatment for the child's injuries B) Frequent changes in history information with visits C) Injuries that are inconsistent with the reported traumatic event D) Sexual behavior that correlates with the child's developmental age

D) Sexual behavior that correlates with the child's developmental age

A child has undergone surgery using steel bar placement to correct pectus excavatum. Which of the following would the nurse instruct the parents to avoid? A) Semi-Fowler B) Supine C) High Fowler D) Side-lying

D) Side-lying

As part of a clinical conference with a group of nursing students, the instructor is describing the burn classification. The instructor determines that the teaching has been successful when the group identifies which of the following as characteristic of full thickness burns? A) Skin that is reddened, dry, and slightly swollen B) Skin appearing wet with significant pain C) Skin with blistering and swelling D) Skin that is leathery and dry with some numbness

D) Skin that is leathery and dry with some numbness

The nurse is developing a teaching plan for the parents of a child with a myelomeningocele who will require clean intermittent catheterization. Which of the following would the nurse include? A) Applying petroleum jelly to lubricate the catheter B) Cleaning the reusable catheter with peroxide after each use C) Storing the reusable cleaned catheter in a brown paper bag D) Soaking the catheter in a vinegar and water solution to sterilize

D) Soaking the catheter in a vinegar and water solution to sterilize

The nurse has developed a teaching plan for the family of a 2-year-old boy who holds his breath when he gets frustrated. Which of the following will be most important to include in this plan? A) Provide cuddle time whenever the child begins to act out. B) Explain the child's behavior to the parents. C) Encourage the parents to interact more with the child. D) Stay close to prevent injury when he gets frustrated.

D) Stay close to prevent injury when he gets frustrated.

A 16-year-old boy complains to the school nurse of headaches and a stiff neck. Which of the following signs and symptoms would alert the nurse that the child may have bacterial meningitis? A) Fixed and dilated pupils B) Frequent urination C) Sunset eyes D) Sunlight is "too bright"

D) Sunlight is "too bright"

The nurse inspects the eyes of a child and observes that the sclera is showing over the top of the iris. The nurse documents this finding as: A) Decorticate posturing B) Nystagmus C) Doll's eye D) Sunsetting

D) Sunsetting

The nurse is providing postsurgical care for an infant who has undergone a hypospadias repair. Which action by the nurse would be most important to help keep the area clean while maintaining proper position of the drainage tubing? A) Keeping the drainage tube taped in an upright position B) Administering antibiotics as ordered C) Administering analgesics as prescribed D) Using a double-diapering technique

D) Using a double-diapering technique

Which of the following would the nurse expect to assess in a child with hypothyroidism? A) Nervousness B) Heat intolerance C) Smooth velvety skin D) Weight gain

D) Weight gain