NURS 3444 Practice Questions

The nurse is providing discharge teaching to a school-age client who was recently diagnosed with a latex allergy. Which product will the nurse educate the client and family to avoid? 1. Plastic bottles 2. Footballs 3. Chewing gum 4. Paper bags

3

Which athletic activity can the nurse recommend for a school-age client with pulmonary-artery hypertension? 1. Cross-country running 2. Soccer 3. Golf 4. Basketball

3

Which genetic test would be best for the prospective father who recently had a positive screen for a genetic condition? 1. Carrier testing 2. Predictive testing 3. Diagnostic testing 4. Prenatal testing

3

The nurse is evaluating the activity tolerance of a 9-month-old with iron deficiency anemia. Which finding indicates that the infant is not tolerating activity? 1. Heart rate of 138 2. Increased alertness 3. Respiratory rate less than 40 with activity 4. Muscle weakness

4

A child is admitted with infective endocarditis. Which nursing intervention is most appropriate for this child? 1. Start an intravenous line. 2. Place the child in contact isolation. 3. Place the child on seizure precautions. 4. Assist with a lumbar puncture.

1

A child is diagnosed with sickle cell disease. The parents are unsure how their child contracted the disease. Which explanation by the nurse is the most appropriate? 1. Both the mother and the father have the sickle cell trait. 2. The mother has the trait, but the father doesn't. 3. The father has the trait, but the mother doesn't. 4. The mother has sickle cell disease, but the father doesn't have the disease or the trait.

1

A child with human immunodeficiency virus (HIV) also has oral candidiasis. Which type of mouth care solution will the nurse teach the child to use? 1. Normal saline 2. Listerine 3. Scope 4. Viscous lidocaine

1

A nurse is planning care for a child with human immunodeficiency virus (HIV). Which nursing diagnosis is the highest priority for this child? 1. Risk for Infection 2. Risk for Fluid-Volume Deficit 3. Ineffective Thermoregulation 4. Ineffective Tissue Perfusion, Peripheral

1

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? SATA a. weak femoral pulses b. cool skin of lower extremities c. severe cyanosis d. clubbing of the fingers e. heart failure

a, b, e

A nurse is assessing an infant who has coarctation of the aorta. Which of the following findings should the nurse expect? SATA a. weak femoral pulses b. cool skin of lower extremities c. severe cyanosis d. clubbing of fingers e. heart failure

a, b, e

A nurse is teaching a parent of a child who has HIV. Which of the following information should the nurse include? SATA a. obtain yearly flu vaccine b. monitor a fever for 24 hr before seeking medical care c. avoid individuals who have colds d. provide nutritional supplements e. administer aspirin for pain

a, c, d

An infant with tetralogy of Fallot is having a hypercyanotic episode (tet spell). Which nursing interventions are appropriate for the nurse to implement for this infant? Standard Text: Select all that apply. 1. Place the child in knee-chest position. 2. Draw blood for a serum hemoglobin. 3. Administer oxygen. 4. Administer morphine and propranolol intravenously as ordered. 5. Administer Benadryl as ordered.

1, 3, 4

The nurse is providing an educational session for parents with children diagnosed with iron deficiency anemia. Which statements will the nurse include educate about the normal functions of red blood cells? Standard Text: Select all that apply. 1. Red blood cells transport oxygen from the lungs to the tissue. 2. Red blood cells carbon dioxide to the lungs. 3. Red blood cells protect the body against bacterial invaders. 4. Red blood cells form hemostatic plugs to stop bleeding. 5. Red blood cells are responsible for psychosocial development.

1, 2

A preschool-age child has just had a moderate reaction to latex. When teaching the parents about latex allergy, the nurse should inform the parents of what common household items that contain latex? Standard Text: Select all that apply. 1. Rubber bands 2. Sneakers 3. Toothbrushes 4. Big Wheel tricycle 5. Water toys

1, 2, 3, 5

A school-age child diagnosed with rheumatoid arthritis asks the nurse to recommend an exercise activity. Which activity is most appropriate for this child? 1. Softball 2. Football 3. Swimming 4. Basketball

3

The nurse is teaching parents how to prevent a sickle cell crisis in the child with sickle cell disease. Which precipitating factors to a sickle cell crisis will the nurse include in the explanation? Standard Text: Select all that apply. 1. Fever 2. Dehydration 3. Regular exercise 4. Altitude 5. Increased fluid intake

1, 2, 4

A child recently diagnosed with aplastic anemia is being prepared for discharge. When planning support for the family, which service should the nurse plan to include in the discharge plan? 1. Referrals to support groups and social services 2. Short-term support 3. Genetic counseling 4. Nutrition counseling

1

A three-generation pedigree is constructed around the designated index patient. Based on this knowledge which explanation of the term proband is the most accurate? 1. The index patient has the disorder of interest 2. One parent of the index patient has the disorder of interest 3. The index patient does not have the disorder of interest 4. Siblings of the index patient do not have the disorder of interest

1

An HIV-positive mother states she is relieved after the birth of her child to hear that the child is HIV-negative. Which response by the nurse is the most appropriate? 1. Symptoms could still appear over the next 2 years. 2. You took good care of yourself, so your child did not get HIV. 3. We will assess for signs of pneumonia to be sure. 4. The test will be repeated in 1 week to verify the negative status.

1

The mother of a child with a heart defect is questioning the nurse about the child's diuretic. When teaching the mother about the medication, what should the emphasis from the nurse? 1. Close monitoring of output 2. The digitalization process 3. The possibility that pulses in the child might be weak 4. The child's increased appetite

1

The nurse has admitted a child with tricuspid atresia. The nurse would expect which initial lab result? 1. A high hemoglobin 2. A low hematocrit 3. A high white blood cell count 4. A low platelet count

1

The nurse is admitting an infant diagnosed with supraventricular tachycardia. Which intervention is the priority for this infant? 1. Apply ice to the face. 2. Perform Valsalvas maneuver. 3. Administer a beta blocker. 4. Prepare for cardioversion.

1

The nurse is caring for an adolescent client diagnosed with rheumatoid arthritis. Which nonpharmacological measure to reduce joint pain is most appropriate for the nurse to recommend to this client? 1. Moist heat 2. Elevation of extremity 3. Massage 4. Immobilization

1

The nurse is performing the initial assessment of a child newly diagnosed Kawasaki disease. Which symptoms would the nurse expect to assess with this child? 1. Dry, swollen, fissured lips 2. Non-palpable lymph nodes 3. Conjunctivitis with exudates 4. Cyanosis of the hands and feet

1

The nurse is providing care for an adolescent client who is experiencing pain related to a sickle cell crisis. Which medication does the nurse prepare to administer to this client? 1. Morphine sulfate 2. Meperidine 3. Acetaminophen 4. Ibuprofen

1

The nurse is providing care to a school-age client diagnosed with idiopathic thrombocytopenic purpura (ITP). Which nursing diagnosis is the priority for this client? 1. Risk for Injury 2. Ineffective Breathing Pattern 3. Nausea 4. Fluid-Volume Deficit.

1

The nurse admits a child with a ventricular septal defect (VSD) to the unit. Which nursing diagnosis for this child is the most appropriate? 1. Impaired Gas Exchange Related to Pulmonary Congestion Secondary to the Increased Pulmonary Blood Flow 2. Deficient Fluid Volume Related to Hyperthermia Secondary to the Congenital Heart Defect 3. Acute Pain Related to the Effects of a Congenital Heart Defect 4. Hypothermia Related to Decreased Metabolic State

1.

A child diagnosed with hemophilia plans on participating in a bicycling club. Which recommendation by the nurse is the most appropriate? 1. Consider a swim club instead of the bicycling club. 2. Wear kneepads, elbow pads, and a helmet while bicycling. 3. Participate only in the social activities of the club. 4. Not join the club.

2

A nurse is planning care for a family who is undergoing genetic screening. Which expected outcome will the nurse include in the plan of care for this family? 1. Decide whether social issues outweigh genetic issues. 2. Make a voluntary decision related to genetic health issues. 3. Not consider the influence of genetics on health promotion. 4. Look closely at the present before considering the future as it relates to genetic screening.

2

Parents of a child with a congenital heart defect ask what the chances are of recurrence in future pregnancies. Which response by the nurse is the most appropriate? 1. There is a 50% chance of recurrence in a future pregnancy. 2. There is a very low chance of recurrence. 3. It should not happen again with a future pregnancy. 4. There is a strong chance of recurrence.

2

The nurse is administering packed red blood cells to a child with sickle cell disease (SCD). The nurse is monitoring for a transfusion reaction and knows it is most likely to occur during which time frame? 1. Six hours after the transfusion is given 2. Within the first 20 minutes of administration of the transfusion 3. At the end of the administration of the transfusion 4. Never; children with SCD do not have reactions. Correct Answer: 2

2

The nurse is teaching the parents of a group of cardiac patients. Which teaching guideline will the nurse include for any child who has undergone cardiac surgery? 1. The child should be restricted from most play activities. 2. The child should be evaluated to determine if prophylactic antibiotics for dental, oral, or upper-respiratory-tract procedures are necessary. 3. The child should not receive routine immunizations. 4. The child can be expected to have a fever for several weeks following the surgery.

2

When discussing inheritance with parents of a child with a genetic disorder, which statement by the parents indicates they understand inheritance risk? 1. This child has a genetic disorder, so future children will not have it. 2. Each pregnancy carries the same percent risk of inheritance. 3. I cannot have any more children, because they will all have the disorder. 4. There is a good chance future children will be normal.

2

Which action by the parents demonstrates an understanding of the nurses teaching with regard to prevention of iron-deficient anemia? 1. Feeding their infant with a formula that is not iron fortified 2. Starting iron-fortified infant cereal at 4 to 6 months of age 3. Introducing cows milk at 6 months of age 4. Limiting vitamin C consumption after 1 year of age

2

The nurse is providing care to a school-age client with a documented immunodeficiency who is admitted to the general pediatric unit for intravenous medication administration. Which interventions are appropriate for this client? Standard Text: Select all that apply. 1. Institute droplet precautions. 2. Place in a positive-pressure room. 3. Avoid live vaccines. 4. Perform frequent handwashing. 5. Recommend fresh fruits brought in by the family.

2, 3, 4

The nurse is providing care to an adolescent child who is at risk for developing adult-onset cardiovascular disease. Which teaching points will decrease the adolescents risk? Standard Text: Select all that apply. 1. Encourage a decrease in smoking. 2. Limit fat intake to 20% to 35% of intake. 3. Encourage participation in vigorous exercise for at least 30 minutes. 4. Maintain a normal weight. 5. Include high-fat dairy products in the daily diet.

2, 3, 4

The nurse is preparing to discharge an infant with a congenital heart defect. The infant will be cared for at home by the parents until surgery. Which items will the nurse include in the discharge teaching for this infant and family? Standard Text: Select all that apply. 1. Allow the infant to feed for 60 minutes. 2. Hold the infant at a 45 degree angle. 3. Encourage frequent hand hygiene. 4. Notify the health care provider for fever. 5. Pump the breasts and feed with a bottle if weight gain is an issue.

2, 3, 4, 5

A child has been admitted to the hospital unit in congestive heart failure (CHF). Which symptom would the nurse anticipate upon assessment of the child? 1. Weight loss 2. Bradycardia 3. Tachycardia 4. Increased blood pressure

3

A child is prescribed Didanosine (Videx), a nucleoside reverse transcriptase inhibitor, for human immunodeficiency virus (HIV). Which lab value will the nurse monitor closely for this child? 1. Potassium 2. Sodium 3. Red blood cell count 4. Glucose

3

A father is a known carrier of an X-linked condition, and asks when he will know whether his newborn son has the condition he carries. Which response by the nurse is the most appropriate? 1. Genetic studies have been ordered, and they will take about a week to determine the results. 2. We plan to run additional tests this afternoon, and should have results by the end of the day. 3. Your son cannot have the condition because the condition is X-linked and cannot be passed on to him. 4. There is a 50% chance you passed it on, but further tests are not recommended until he is a month old.

3

A school-age child with hemophilia falls on the playground and goes to the nurses office with superficial bleeding above the knee. Which action by the nurse is the most appropriate? 1. Apply a warm, moist pack to the area. 2. Perform some passive range of motion to the affected leg. 3. Apply pressure to the area for at least 15 minutes. 4. Keep the affected extremity in a dependent position.

3

The nurse is caring for a child who is in a sickle cell crisis and has severe pain. Which nursing intervention is the most appropriate for this child? 1. Giving comfort measures, such as back rubs 2. Suggesting diversional activities, such as coloring 3. Administering pain medication 4. Preparing the child for painful procedures

3

The nurse is providing care to an adolescent client diagnosed with systemic lupus erythematosus (SLE). Which action by the client indicates acceptance of body changes associated with SLE? 1. She refuses to attend school. 2. She doesn't want to attend any social functions. 3. She discusses the body changes with a peer. 4. She discusses the body changes with healthcare personnel only.

3

The nurse is providing care to a preschool-age client who is diagnosed with acquired immune deficiency syndrome (AIDS). In planning the clients care, which vaccine is inappropriate for the client to receive? 1. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) 2. Haemophilus influenzae type B (HIB conjugate vaccine) 3. Varicella vaccine 4. Hepatitis B vaccine (Hep B)

3. because child with HIV/AIDS should not be immunized with a live virus

A nurse is planning an education session on genetic testing. What would not concern the nurse when planning the session? 1. Cultural beliefs 2. Religious beliefs 3. Family values 4. Insurance reimbursement

4

A toddler is started on digoxin (Lanoxin) for cardiac failure. Which is the initial symptom the nurse would assess if the child develops digoxin (Lanoxin) toxicity? 1. Lowered blood pressure 2. Tinnitus 3. Ataxia 4. A change in heart rhythm

4

The charge nurse on a pediatric unit is making a room assignment for a school-age child diagnosed with sickle cell disease, who is in splenic sequestration crisis. Which room assignment is most appropriate for this client? 1. Semiprivate room 2. Reverse-isolation room 3. Contact-isolation room 4. Private room

4

The nurse finds that an infant has stronger pulses in the upper extremities than in the lower extremities, and higher blood pressure readings in the arms than in the legs. Which assessment will the nurse perform next on this infant? 1. Pedal pulses 2. Pulse oximetry level 3. Hemoglobin and hematocrit values 4. Blood pressure of the four extremities

4

The nurse is checking peripheral perfusion to a child's extremity following a cardiac catheterization. Which assessment finding indicates adequate peripheral circulation to the affected extremity? 1. A capillary refill of greater than three seconds 2. A palpable dorsalis pedis pulse but a weak posterior tibial pulse 3. A decrease in sensation with a weakened dorsalis pedis pulse 4. A capillary refill of less than three seconds with palpable warmth

4

A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? SATA a. bradycardia b. cool extremities c. peripheral edema d. increased urinary output e. nasal flaring

b, c, e

A nurse is providing teaching to the mother of an infant who has a prescription for digoxin. Which of the following instructions should the nurse include? a. do not offer your baby fluids after giving medication b. digoxin increases your baby's heart rate c. give the correct dose of medications at regularly scheduled times d. if your baby vomits a dose, you should repeat the dose to ensure that he gets the correct amount

c

A nurse is caring for a 2-year-old child who has a heart defect and is scheduled for cardiac catheterization. Which of the following actions should the nurse take? a. place on NPO status for 12 hr prior to the procedure b. check for iodine or shellfish allergies prior to procedure c. elevate the affected extremity following the procedure d. limit fluid intake following procedure

b