One
Priority nursing consideration for a child with pneumonia are
Respiratory compromise
A 3 year old child has a high red blood cell count and polycythemia. In planning care, the nurse would anticipate which goal to help prevent blood clot formation?
The child won't show signs of dehydration
Which one(s) are the sign and symptom of esophageal-atresia?
excessive salivation since birth
A 6 year old arrives in the E reporting dizziness and collapses before he can be taken into an examination room. Prioritize in ascending chronological order the steps to take during intial intervention. Use all the options
1. Establish in responsiveness 2. Check carotid pulse 3. Begin chest compressions 4. Tilt the child's head back 5. Give two rescue breaths
You are rotating in the newborn nursery. Your next admission is a term newborn born at 3.5 kg, and all maternal labs are negative. The infant's exam is normal. 1. What vaccine(s) should she receive and why? 2. What would you do if the mother tested positive for Hepatitis B? 3. What would you do if the mother's Hepatitis B status was unknown?
1. The baby should receive the Hepatitis B vaccine. 2. If mom has tested positive for Hep B than the newborn must be given a proper prevention immediately. They should be given a first dose of the hep b vaccine and then given the first dose of the hepatitis B immune Globulin. 3. If the mother's status is unknown the baby should receive the hepatitis B immune Globulin and the hepatitis B vaccine but it should not be counted as the first dose. The child should then receive the full series at ages 1-2 months.
A 2 year old child is showing signs of shock. A 10 mL/kg bolus of normal saline solution is ordered. The child weighs 20 kg. How many mL should be administered?
200 mL
A child with heart failure is given captopril. The nurse should educate the child's parents on which action of captopril?
It increases sodium excretion
When caring for the child with Reye syndrome, what is the priority nursing intervention? A. Monitor intake and output B. Do range of motion exercises C. Observe for Petechiae D. Prevent skin breakdown
A. Monitor intake and output
During family education regarding coarctation of the aorta, which statement should b included that best describes the condition?
Localized construction or narrowing of the aortic wall
The nurse recognizes that intubation and mechanical ventilation are indicated for a patient in status asthmaticus when A. Forced vital capacity > 75% B. Decreased level of consciousness and an O2 saturation of 85% develop C. Patient has a Nasal flare D. Pulsus paradoxes is greater than 40 mm Hg
B. Decreased level of consciousness and an O2 saturation of 85% develop
The parent of child with asthma asks the nurse about the condition. Which description of asthma would be most accurate? A. Inflammation of the pulmonary parenchyma B. Disease of the airway characterized by construction of the bronchi C. Infection of the lower airway, most commonly caused by a viral agent D. Chronic lung diseases caused by damage to the alveoli
B. Disease of the airway characterized by construction of the bronchi
You are caring for a child with croup that have to be in a cool mist tent, what action would you need to take if the child become frightened and began crying consistently? A. Give the child a toy to play with in the tent B. Place the child in mom's lap and direct cool mist over the child's face C. Notify the physician and get an order for sedation D. Have the mother make the child stay in the tent
B. Place the child in mom's lap and direct cool mist over the child's face
You are caring for a child with epiglottis. On assessment of the child what would indicate to you that the child is experiencing airway obstruction? A. The child coughing B. The child is leaning forward with the chin thrust out C. The child has a low grade fever and complains of a sore throat D. The child is leaning backwards and supporting himself with his hands and arms
B. The child is leaning forward with the chin thrust out
What are the nursing care for cleft lip and palate before and after surgery?
Before: Address feeding challenges by using longer, softer nipples, X or Y nipples, squeezable bottle and NG or GT for insufficient PO intake After:include multidisciplinary care, address psychosocial implications (child is going to look a little different), challenges include airway, suture line and feeding issues. Pain management and elbow restraints will be required to prevent child from touching incision and decrease pain from surgery. Child will have risk for hearing loss, and will need early screening with AABR (Automated Auditory Brainstem Response)
The nurse is admitting a young child to the hospital because bacterial meningitis is suspected. What is the major priority of nursing care? A. Administer sedatives and analgesics on a preventive schedule to manage pain B. Set the cool mist for patient C. Administer antibiotic therapy as soon as it is ordered D. Give the patient SABA
C. Administer antibiotic therapy as soon as it is ordered
You are admitting a 13/y patient with a history of asthma to the hospital with complication of acute respiratory distress. What sign and symptom makes you notify that your patient needs immediately attention A. A pulse oximetry reading of 96% B. A peak expiratory flow rate of 240 ml/min C. Strider and wheezing D. A respiratory rate of 26 breaths/min
C. Strider and wheezing
A teenager with heart failure who has been prescribed digoxin asks the nurse, "What's the drug supposed to do?" The nurse responds to the teenager based on the understanding that this drug is classified as;
Cardiac glycoside
Which intervention is most appropriate when caring for an infant with heart failure?
Cluster nursing activities
Which childhood vaccine provides some protection against bacterial meningitis, influenza type B, epiglottitis, and bacterial pneumonia? a. Hib vaccine b. Influenza vaccine c. Hepatitis B vaccine d. Varicella vaccine
a. Hib vaccine
A nurse-manager appropriately behaves as an autocrat in which situation?
Directing staff activities if a client has cardiac arrest
A child is scheduled for echocardiography. The nurse is providing education to the child's mother. Which statement about echocardiography indicated the need for further instruction?
How am I ever going to explain to my son that he can't have anything to eat before this test?
A mother is taught to administer digoxin to her 6 month old infant at home. Which statement by the mother indicated the need for additional education?
I'll withhold the medication if the pulse is below 60
The RN is teaching a mom about the development of a newborn diagnosed with OI. Which developmental milestone is a predictor of the potential for ambulation? a. Independent sitting by age 10 months. b. Toilet training by age 18 months. c. Feeding self with a utensil by age 14 months. d. Turning over independently by age 6 months.
a. Independent sitting by age 10 months
During observation of a child who has undergone cardiac catherization, the nurse notes significant bleeding from the percutaneous femoral catherization site. Which action should be taken first?
Apply direct, continuous pressure
Which nursing intervention is most appropriate when caring for a child in the immediate femoral postcatherization phase?
Encourage the child to remain flat
A 6 month old infant with uncorrected tetralogy of fallot suddenly becomes increasingly cynatoic and diaphoretic with weak peripheral pulses and an increased respiratory rate.
Place the infant in a knee-chest position
What would be the most common adverse reaction a nurse might observe after administering enteric coated erythromycin?
Nausea and vomiting
A child receives prednisone after a heart transplant. Which adverse reaction to prednisone would a nurse monitor for in this child?
Poor wound healing
What are the pre-up and post-up care for spina bifida?
Pre-Op: 1. Cover the sac with a moist sterile dressing to prevent infection 2. Be mindful of the baby's thermoregulation 3. No pressure should be applied over affected area, place baby prone. 4. Give antibiotics to prevent infection, and IV fluids 5. Observe Latex precautions. Post-Op: 1. Baby should lay prone for 7 days. Then on sides but not supine 2. Foley progresses to intermittent catheterizing 3. Protect incision from stool and urine 4. Observe for leaks 5. Administer antibiotics 6. Daily head circumference and weekly head ultrasounds 7. Meds: Urecholine to reduce urinary retention and Colac to soften the stool
Which one is the treatment plan for Seborrheic dermatitis? a. shampoo with salicylic acid everyday b. Use Permethrin 1% c. Use Nix shampoo d. Nothing is needed to be done
a. Shampoo with salicylic acid everyday
The recommended treatment for cow's milk protein allergy is the substitution of cow's milk-based formula for: a. Soy milk or a hydrolyzed formula b. Whole milk c. Evaporated milk d. Goat's milk
a. Soy milk or a hydrolyzed formula
A neonate with a patent ductus arteriosus was delivered 6 hours earlier and is being held by his mother. As the nurse enters the room to assess the neonate's vital signs, the mother says "The physician says that my baby has a heart murmur. Does that mean he has a bad heart?" Which response by the nurse would be most appropriate?
The murmur is caused by the natural opening, which can take a day or two to close. It's a normal part of your baby's transition
A child with a ventricular septal repair is receiving dopamine postop. The nurse should educate the child's parents that this medication is most likely to be given for which action?
To increase cardiac output
Barlow and Ortolani are rarely positive after 3 months of age. T/ F
True
The mother of a 1 month old infant tells the nurse she worries that her baby will get meningitis like her oldest son did when he was an infant. The nurse should base her response in which statement?
Vaccination to prevent Haemophilus influenzae type b meningitis has decreased the frequency of this disease in children.
Which condition may lead to sinus arrest or sinus pause in a child?
Valsalva Maneuver
The Salter-Harris classification system of fractures is used to describe: a. Breaks that involve the epiphysis b. Compound fractures c. Non-displaced fractures d. Stress fractures
a. Breaks that involve the epiphysis
Select the statement that is TRUE regarding childhood fractures. a. Children's bones contain less collagen than the bones of an adult. b. Children require longer periods of immobilization than adults. c. Intra-articular fractures can result in early osteo-arthritis. d. Trauma is the third leading cause of death in children.
a. Children's bones contain less collagen than the bones of an adult.
While working at a clinic in, a pediatrician is assisting in examining patients who come for treatment. A 3-year-old boy, is brought to the clinic with a facial rash. According to mother, the rash started 4 days ago as little red bumps below his nose. The rash has spread around his mouth and chin. The rash also has changed in appearance to flat, straw colored with fluid-filled pustules. What is your diagnosis? a. Impetigo b. Varicella c. Mumps d. Roseola
a. Impetigo
When teaching a 6-year-old child with sickle cell disease and his family about pain management,which of the following should the nurse discuss? a. Nonpharmacologic methods of pain relief, including heat, massage, physical therapy, humor and distraction b. when pain medications are used, all pain will be eliminated c. none of the above d. long-term medication use considers many factors
a. Nonpharmacologic methods of pain relief, including heart, massage, physical therapy, humor and distraction
A 7-year-old child has come to the hospital for a rash for 3 days. Upon inspection of the rash the nurse notes small itchy blisters across the child's chest, arms, abdomen, and back, some of which have crusts on them and some that are wet and oozing. The child is itching the rash and looks uncomfortable. The child has a temperature of 101°F, all other vital signs are within normal limits. What is your diagnosis? a. Varicella b. Erythema Infectiosum c. Roseola d. Measles
a. Varicella
The nurse observes that a 2-year-old is able to use a spoon steadily at mealtime. What does self-feeding help to develop in the toddler? a. a sense of independence b. healthy teeth c. good nutrition d. adequate height and weight
a. a sense of independence By the end of the second year, toddlers can feed themselves. This helps them to develop a sense of independence.
When caring for their infant, a parent asks you, "Is Emily in a lot of pain? How would you know since she can't really tell you?" The best answer to this question is a. although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain b. the nurses give pain medication before she really feels the pain c. we assess her pain medication before she really feels the pain d. we assess her pain using an infant pain assessment tool and give the medicine as needed e. infants don't feel pain as we do because their pain receptors are not fully developed yet
a. although we try to give her medicine before she feels pain, we watch her very closely and use different techniques to help relieve the pain
The mother of a 6 month old infant with a topic dermatitis asks for advice on bathing the child. Which instructions or information should the nurse give to her? a. bath the infant every other day b. the frequency of the infant's baths isn't important in atopic dermatitis c. use bubble baths to decrease itching d. bathe the infant twice daily
a. bath the infant every other day Bathing removes lipoprotein complexes that hold water in the stratum corenum and increase water loss. Decreasing bathing to every other day can help to prevent the removal of lipoprotein complexes. Soap and bubble bath should be used sparingly while bathing the child
Which childhood vaccine provides protection against streptococcal infections, such as otitis media, sinusitis, and pneumonia? a. pneumococcal vaccine b. Hib vaccine c. MMR vaccine d. Rotavirus vaccine
a. pneumococcal vaccine
Which of the following condition you will see in premature baby? a. poor thermal regulation b. immature immunity (infection) c. all of the above d. Mature GI system
a. poor thermal regulation
Parents of a 6-month-old infant ask the nurse why it is necessary to offer iron-rich formula to their child. What is the correct response? a. the infant has exhausted maternal iron stores b. the infant has need of the iron to support dentition c. the infant has ineffective digestive enzymes d. the infant has limited ability to produce red blood cells
a. the infant has exhausted maternal iron stores Many pediatricians recommend iron-fortified formulas because maternal iron stores decrease by 6 months of age
An infant born at 8lbs 2 ounces weighs 13 lbs at the 6-month check-up. the RN explains to the parent that: a. We should review the baby's diet to see if we can boost his weight b. this is appropriate for the age c. the baby is overweight and should feed less often d. we would expect the baby to weigh about 24lbs by this time
a. we should review the baby's diet to see if we can boost his weight baby should be 16lbs 4 oz
Identify the interventions that can be safely used to manage diaper dermatitis. Select all that apply. a. keep skin surface irritants such as urine and stool off skin b. blow dry heat on skin with hair dryer c. use only cloth diapers d. expose skin to air e. apply a skin barrier paste such as zinc oxide
apply a barrier paste such as zinc oxide
Which finding would be considered abnormal when performing a physical assessment on 6-month-old infant? a. lower incisors have begun to erupt b. Anterior Fontanel is closed c. Birth weight has doubled d. Posterior fontanel is closed
b. Anterior Fontanel is closed Anterior Fontanel closed by 12-18 months
A parent is concerned because her infant has a diaper rash. What is the best action the nurse would advise the parent to implement? a. keep the diaper area covered all of the time b. Apply zinc oxide and Vitamin A+D on the area c. Use commercial diaper wipes to clean the area d. Change the infant's diaper less frequently
b. Apply Zinc oxide and Vitamin A+D on the area A protective ointment can be applied when the skin in the diaper area appears pink and irritated.
Pain scales for infants and their uses include but are not limited to a. Non-communicating Children's Pain Checklist (NCCPC): Parent and health care giver questionnaire assessing acute and chronic pain b. FLACC Pain Assessment Tool: Facial expression, Leg movement, Activity, Cry and Consolability c. CRIES: Crying, Requiring increased oxygen, Inability to console, Expression, and Sleeplessness d. Neonatal Pain, Agitation, and Sedation Scale (NPASS): For infants from 3 to 6 months old
b. FLACC Pain Assessment Tool: Facial expression, Leg movement, Activity, Cry and Consolability
The nurse is educating a group of preschool parents about the importance of safety. Which statement by a parent indicates the need for further education? a. medications are kept in a locked cabinet b. I only leave my child in the car for brief moments c. my stairway is always free of clutter d. I continue to provide a great deal of indirect supervision for my child
b. I only leave my child in the car for brief moments Children must not play in or around the car or be left alone, even for a brief moment, in the car. Preschool children still require a good deal of indirect supervision to protect them from dangers that arise from their immature judgment or social environment. Stairways should be free of clutter and medications kept out of reach
A 2-week-old infant is referred for a hip clunk. Examination demonstrates a right hip Ortolani sign. What treatment does the RN anticipate? a. Observation with repeat check-up in 1 month b. Pavlik harness application c. Closed reduction and spica casting d. Open reduction and osteotomy
b. Pavlik harness application
Phenylketonuria(PKU) is a genetic disease that results in the body's inability to correctly metabolize: a. glucose b. Phenylalanine c. Thyroxine d. Phenylketones
b. Phenylalanine
Which vaccine do the Advisory Committee on Immunization Practices (Centers for DiseaseControl and Prevention) and American College of Obstetricians and Gynecologists recommendthat pregnant adolescents and women who are not protected against pertussis receive optimallybetween 27 and 36 weeks gestation or postpartum prior to discharge from the hospital? a. IPV b. Tdap c. Td d. DTaP
b. Tdap
Which stage of cognitive development is a 9-year-old child in according to Piaget? a. formal operations b. concrete operations c. preoperational d. sensorimotor
b. concrete operations School-age children are in the concrete operations stage of cognitive development.
The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." What is the most appropriate response by the nurse? a. have you tried offering her finger foods? b. how much milk does she drink in a day? c. has your daughter been sick recently? d. has she become a fussy eater, too?
b. how much milk does she drink in a day? Milk should be limited to 23 ounces a day. Too few solid foods can lead to dietary deficiencies of iron
What could the nurse recommend to a child's mother to encourage a toddler to practice independence? a. allow the child to determine his own daily routine b. offer him a choice between two items c. offer a variety of items to choose from to stimulate his mind d. set the routine herself, but discuss with her toddler how he or she would have done it differently
b. offer him a choice between two items The toddler can be allowed to make choices as the situation warrants, but the number of choices should be limited because too many confuse the toddler
The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately? a. pulse rate of 100 beats per minute b. respiratory rate of 60 breaths per minute c. fussy behavior d. minimal verbalization
b. respiratory rate of 60 breaths per minute Respirations of a 1-year-old should be 20 to 40 breaths per minute. Increased respiratory rate can lead to distress and should be reported immediately. Pulse rate of 100 to 140 beats/minute is normal. Minimal verbalization and fussy behavior are not emergency situations or abnormal for this age
The nurse is advising parents of a 10-year-old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Erikson's theory? a. feeling healthy and strong b. successful performance in little league c. constant variety of activities d. having a girlfriend
b. successful performance in Little League The child who is successful in activities will feel positively about himself or herself
While counseling a parent about the treatment plan for an infant with congenital clubfoot, the nurse explains that: a. All babies with this condition need surgery to correct the misalignment b. Surgery is needed if the child does not grow out of the condition c. Casting is the first step, with a new cast every week for about 3 months d. Tendon lengthening is necessary to ensure ambulation
c. Casting is the first step, with a new cast every week for about 3 months
An 8-year-old boy presented to the ED with several days of fever, malaise and a diffuse rash. The rash started on the face, then nearly resolved before spreading to the rest of the body. His history was otherwise unremarkable, and he denied ever having a similar rash. His immunizations were up to date. He denied any past medical history or chronic medication use. His parents had been giving him ibuprofen and acetaminophen for symptomatic relief. What is your diagnosis? a. Rubeola b. Varicella c. Rubella d. Fifth disease
c. Rubella
The mother of a 12 month old infant expresses concern about the effect of frequent thumb sucking on her child's teeth. After the nurse educates her about this matter, which response by the mother indicates that the education has been effective? a. I'll give the baby a pacifier instead b. Thumb sucking should be discouraged at 12 months c. Sucking is soothing to the baby d. I'll wrap the thumb in a bandage
c. Sucking is soothing to the baby Sucking is the infant's chief pleasure., However, thumb sucking can cause malocclusion if it persists after age 4. Many fetuses begin sucking their fingers in utero and as infants refuse a pacifier as a substitute. A young child is likely to chew on a bandage, which could lead to airway obstruction
The RN is doing discharge teaching with the parents of an infant with the Pavlik harness. What information is essential for the nurse to convey? a. Absolutely no padding should be used between the harness and the skin. b. The child must wear the harness on a 2 hour on and 2 hour off schedule. c. The harness strap should be placed at the nipple line. d. Neurologic assessments should be performed every 8-10 hours.
c. The harness strap should be placed at the nipple line
Which case would most warrant a report of potential child abuse? a. a dislocated elbow in a 5-year-old reported to have been pulled by the hand when running toward the street b. a subdural hematoma in a 9-year-old reported to have fallen backward off a skateboard c. a femur fracture in an 8-month-old who was reported to have fallen off the bed. d. partial thickness burns on the face and chest of a 4-year-old reported to have pulled a pot off the stove
c. a femur fracture in an 8-month-old who was reported to have fallen off the bed.
A 2 year old child's mother is worried hat her little girl may have ADHD because "she has so much energy, doesn't pay attention for long, and is always getting into things." Which response is best? a. Set the time-out for the her b. Keep her intake of sugar to a minimum. This well help her settle down c. Her behavior is normal. She's exploring and learning about the world around her d. I'd suggest taking her to a child psychologist. She probably needs an evaluation
c. her behavior is normal. She's exploring and learning about the world around her 1. It is normal for a 2 year old child to eagerly explore her environment for new sensory experiences. Talking to the pediatrician is inappropriate because the nurse is assuming a corrective, parental role toward the mother without addressing her concerns. Restricting the child's intake of sugar and sugary treats is incorrect because the nurse is making assumptions and recommendations that don't relate to the mother's concerns. Suggesting evaluation by a psychologist reinforces the mother's fear that something is wrong with her normal child
Which factors are considered protective factors for sudden infant death syndrome (SIDS)? a. supine sleeping position, breastfeeding, soft bedding b. prone sleeping position, exposure to maternal tobacco use, updated childhood immunization status c. supine sleeping position, breastfeeding, updated childhood immunization status d. side sleeping position, breastfeeding, updated childhood immunization status
c. supine sleeping position, breastfeeding, updated childhood immunization status
The nurse is checking for capillary refill on a school aged kid in Bryant's traction. How long does it take for the toe to regain color if adequate perfusion is assessed? a. 6 seconds b. 4 seconds c. 5 seconds d. 3 seconds
d. 3 seconds Capillary refill in 3 seconds or less is determined to be indicative of adequate perfusion
The home health nurse discovers a family infected with pediculosis. What information can the nurse provide to the mother to start eradication of the lice? a. cover the hair with Vaseline b. Apply a soda-vinegar solution to the hair c. Shampoo the hair with dish detergent d. Comb through the hair with a NIX shampoo
d. Comb through the hair with a NIX shampoo Use the Nix shampoo through the hair with a fine-tooth comb is an initial step toward eradication
A 9-year-old child in the emergency department is diagnosed with Lyme disease. The nurseanticipates that the health care personnel orders will include the administration of: a. Trimethoprim-sulfamethoxazole b. Aqueous Penicillin c. Cefotaxime d. Doxycycline
d. Doxycycline
The nurse discusses child-proofing the home for safety with the mother of a 9-month-old. Which statement made by the mother would indicate an unsafe behavior? a. I have a gate at the top and bottom of the stairs b. There are locks on all of the cabinets in the house c. I put covers on all of the electrical outlets d. In the car, she rides in a front-facing car seat
d. In the car, she rides in a front-facing car seat A rear-facing infant car seat should be used for infants younger than 1 year of age
what is the treatment plan for Scabies? a. Permethrin 1% b. Zinc Oxide c. Lindane d. Permethrin 5%
d. Permethrin 5%
A teen with moderate scoliosis asks how long she needs to wear the brace before her back will become straight. The nurse's best response is: a. The brace is worn 23 hours/day for a year to straighten the spine b. The doctor will determine how long it will take based on your history c. There is no way to tell how long it takes, but we will monitor you d. The brace doesn't straighten the spine, it only slows progression of the curve.
d. The brace doesn't straighten the spine, it only slows progression of the curve.
What does the nurse consider as an appropriate snack for a 2-year-old child? a. hot dog sections b. grapes c. popcorn d. applesauce
d. applesauce Applesauce is a healthy and safe snack food for the toddler. The toddler is at risk for choking on foods such as grapes, hot dogs, and popcorn
The nurse is planning a safety program for high school students. To what will the nurse relay that most accidental deaths in adolescence are related? a. drowning b. firearms c. diving injuries d. automobiles
d. automobiles The chief safety hazard for the adolescent is automobiles
What activity would the nurse choose to meet Erikson's developmental task of industry when caring for a 7-year-old? a. Playing a game of "I Spy" with the nurse b. Coloring a picture in a coloring book c. Looking at comic book d. Completing a 20-piece jigsaw puzzle
d. completing a 20-piece jigsaw puzzle In the developmental period of late childhood, children are striving to develop a sense of industry. The completion of a jigsaw puzzle is industrious play.
Which developmental milestones would the nurse expect a 10 month old infant to display during a routine health maintenance visit? Select all that apply a. demonstrating good bowel & bladder control b. self-feeding c. walking alone d. hold his head up e. sitting on a firm surface without support
d. hold his head up e. sitting on a firm surface without support
On a home visit, the nurse notes that the parents require teaching intervention to protect the 15-month-old child who lives there. What observation would lead the nurse to this conclusion? a. the kitchen floor is clean but not shiny b. the fireplace has a screen c. there are paintings on the wall d. the dining room table has a tablecloth on it
d. the dining room table has a tablecloth on it A tablecloth presents a safety hazard because the curious toddler will reach up and pull on it. The toddler could be injured if items on the table are moved when the tablecloth is pulled.
