Pediatric Hesi

C. Clamp the catheter.

1) A toddler is receiving an infusion of total parenteral nutrition via a Broviac catheter. As the child plays, the I.V. tubing becomes disconnected from the catheter. What should the LPN/LVN do first? a. Turn off the infusion pump. b. Position the child on the side. c. Clamp the catheter. d. Flush the catheter with heparin.

b. Observe him carefully

39.A 16 year old male client who has been treated in the past for a seizure disorder is admitted to the hospital. Immediately after admission he begins to have a grand mal seizure. Which action should the nurse take? a. Obtain assistance in holding him to prevent injury b. Observe him carefully c. Call a CODE d. Place a padded tongue blade between the teeth

B. Parallel play

19) A LPN/LVN observes a 2½-year-old child playing with another child of the same age in the playroom on the pediatric unit. What type of play should the nurse expect the children to engage in? a. Associative play b. Parallel play c. Cooperative play d. Therapeutic play

D. I have to wear long sleeves and pants when we're hiking around the pond.

20.Which statement by a school aged client going to summer camp indicates the best understanding of the mode of transmission of Lyme disease? A. I'll cover my mouth with a wet cloth if there's too much dust blowing. B. Cuts and scrapes need to be washed out and covered right away. C. I'm not going to swim where the water is standing still or feels too hot. D. I have to wear long sleeves and pants when we're hiking around the pond.

B. establishing an identity.

When developing a care plan for an adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development focuses on: a. becoming industrious. b. establishing an identity. c. achieving intimacy. d. developing initiative.

B. Proximodistal

13) A LPN/LVN notes that an infant develops arm movement before finemotor finger skills and interprets this as an example of which pattern of development? a. Cephalocaudal b. Proximodistal c. Differentiation d. Mass-to-specific

D. Lemonade.

13.Which drink choice on a hot day indicates to the nurse that a teenager with sickle cell anemia understands dietary consideration related to the disease? A. Milkshake. B. Iced tea. C. Diet cola. D. Lemonade.

A. Potassium level of 6.5 mEq/L

15) Which finding in a 3-year-old child with acute renal failure requires immediate follow-up? a. Potassium level of 6.5 mEq/L b. Blood pressure in right leg of 90/50 mm Hg c. Abdominal cramps d. No albumin in the urine

A. Tachycardia.

14.The nurse is assessing an infant with diarrhea and lethargy. Which finding should the nurse identify that is consistent with early dehydration? A. Tachycardia. B. Bradycardia. C. Dry mucous membrane. D. Increased skin turgor.

C. Repairs typically should be done before the child is potty trained.

12.The parents of a newborn infant with hypospadia are concerned about when the surgical correction should occur. What information should the nurse provide? A. Repair should be done by one month to prevent bladder infection. B. To form a proper urethra repair, it should be done after sexual maturity. C. Repairs typically should be done before the child is potty trained. D. Delaying the repair until school age reduces castration fears.

B. Inquire about the use of alternative methods of treatment.

15. While auscultating the lung sounds of a 5-year-old Chinese boy who recently completed antibiotic therapy for pneumonia, the nurse notices symmetrical, round, bruise-like blemishes on his chest. What action is best for the nurse to take? A. Identify the antibiotic used to treat pneumonia. B. Inquire about the use of alternative methods of treatment. C. Ask the parents if the child has been in a recent accident. D. Report suspected child abuse to the authorities.

B. prepare to ventilate the child.

16) A school nurse is evaluating a 7-year-old child who is having an asthma attack. The child is cyanotic and unable to speak, with decreased breath sounds and shallow respirations. Based on these physical findings, the nurse should first: a. monitor the child with a pulse oximeter in her office. b. prepare to ventilate the child. c. return the child to class. d. contact the child's parent or guardian.

1875mg

17.A child who weights 25 kg is receiving IV ampicillin 300 mg/kg/24 hours in equally divided doses every 4 hours. How many mg should the nurse administer to the child for each dose? 1875mg

C. Set of cloth and hand puppets.

2. Following a motor vehicle collision, a 3-year old girl has a spica cast applied. Which toy is best for the nurse for this 3 year old child? A. Duck that squeaks. B. Fashion doll and clothes. C. Set of cloth and hand puppets. D. Hand held video game.

A bedtime snack of an 8-oz glass of milk and graham crackers with peanut butter

20) A 14-year-old adolescent with type 1 diabetes checks his blood glucose level at 9:00 p.m. before going to bed. It has been 4 hours since his dinner and his regular insulin dose. His blood glucose level is 60 mg/dl, and he states that he feels a little shaky. What should the nurse suggest? a. A bedtime snack of an 8-oz glass of milk and graham crackers with peanut butter b. Going to sleep to decrease the metabolic demands on the body c. Taking a dose of glucagon d. Doing nothing because the glucose level is unreliable because the adolescent measured it himself

D. Colonoscopy with biopsy

21) A 13-year-old girl is being evaluated for possible Crohn's disease. The nurse expects to prepare her for which diagnostic study? a. Genetic testing b. Cystoscopy c. Myelography d. Colonoscopy with biopsy

187.5 milligrams

22) An infant who weighs 7.5 kg is to receive ampicillin (Omnipen) 25 mg/kg I.V. every 6 hours. How many milligrams should the nurse administer per dose? Record your answer using one decimal place.

B. latex.

3) A mother tells the nurse that her preschool-age daughter with spina bifida sneezes and gets a rash when playing with brightly colored balloons, and that recently she had an allergic reaction after eating kiwifruit and bananas. The LPN/LVN would suspect that the child may have an allergy to: a. bananas. b. latex. c. kiwifruit. d. color dyes.

C. Place the infant in a knee-chest position.

3. An infant with tetralogy of Fallot becomes acutely cyanotic and hyperpneic. Which action should the nurse implement first? A. Administer morphine sulphate. B. Start IV fluids. C. Place the infant in a knee-chest position. D. Provide 100% oxygen by face mask.

b. Administer the scheduled dose

32.A two year old child with a heart failure (HF) is admitted for replacement of a graft for coarctation of the aorta. Prior to administering the next dose of digoxin (Lanoxin) the nurse obtains an apical heart rate of 128 bpm. What action should the nurse implement? a. Determine the pulse deficit b. Administer the scheduled dose c. calculate the safe dose range d. review the serum digoxin level

B. provide the family with the drug's name, dosage, route, and frequency of administration.

33) A child's physician orders a drug for home use. Before the child is discharged, the nurse should: a. teach the family how to adjust the drug dosage according to the child's needs. b. provide the family with the drug's name, dosage, route, and frequency of administration. c. instruct the family to encourage the child to take responsibility for ensuring timely drug administration. d. tell the family to avoid explaining the purpose of the medication to the child.

D. Weighing the infant daily

30) Which intervention provides the most accurate information about an infant's hydration status? a. Monitoring the infant's vital signs b. Accurately measuring intake and output c. Monitoring serum electrolyte levels d. Weighing the infant daily

d. flaring of the nares

30.A 4 month-old girl is brought to the clinic by her mother because she has had a cold for 2 o 3 days and woke up this morning with a hacking cough and difficulty breathing. Which additional assessment finding should alert the nurse that the child is in acute respiratory distress? a. Bilateral bronchial breath sounds b. Diaphragmatic respiration c. A resting respiratory rate of 35 breathe per minute d. flaring of the nares

b. Allow the child to eat any food desired and tolerated

33.A child with leukemia is admitted for Chemotherapy and the nursing diagnosis "altered nutrition, less those body requirements related to anorexia, nausea and vomiting" is identified. Which intervention the nurse included in this child plan of care? a. Encourage a variety of large portions of food at every meal b. Allow the child to eat any food desired and tolerated c. Recommended eating the food as sibling eat at home d. Restrict food brought form fast food restaurants

C. blindness.

34) A child, age 5, has acute lymphocytic leukemia (ALL) and is receiving induction chemotherapy consisting of vincristine (Oncovin), asparaginase (Lasparaginase [Elspar]), and prednisone (Deltasone). When teaching the parents about the adverse effects of this regimen, the nurse should stress the importance of promptly reporting: a. hair loss. b. moon face. c. blindness. d. bone pain.

D. Metabolic acidosis.

4. A child admitted with diabetic ketoacidosis is demonstrating Kussmaul respirations. The nurse determines that the increased respiratory rate is a compensatory mechanism for which acid base alteration? A. Metabolic alkalosis. B. Respiratory acidosis. C. Respiratory alkalosis. D. Metabolic acidosis.

B. A 2-year-old child with a ruptured spleen and hypovolemia

40) Intraosseous infusion of a medication would be most appropriate for which child? a. An 18-month-old child with cystic fibrosis b. A 2-year-old child with a ruptured spleen and hypovolemia c. A 4-year-old child with celiac disease d. A 5-year-old child with status asthmaticus

A. Creamed corn.

6. The nurse is evaluating diet teaching for a client who has nontropical sprue (celiac disease). Choosing which food indicates that the teaching has been effective? A. Creamed corn. B. Pancakes. C. Rye crackers. D. Cooked oatmeal.

C. Arm restraints while asleep

18) Which item in the care plan for a toddler with a seizure disorder should a nurse revise? a. Padded side rails b. Oxygen mask and bag system at bedside c. Arm restraints while asleep d. Cardiorespiratory monitoring

5 ml

35.The nurse plans to administer 10 mcg/kg of digoxin elixir as a loading dose to a child who weights 55 pounds. Digoxin is available as elixir of 50 mcg/ml. How many ml of the digoxin elixir should the nurse administer to this child?

B. Right foot is cool to the touch and appears pale and blanched.

1. The nurse is caring for a 3-year old child who is 2 hours postop from a cardiac catheterization via the right femoral artery. Which assessment finding is an indication of arterial obstruction? A. Blood pressure trend is downward and pulse is rapid and irregular. B. Right foot is cool to the touch and appears pale and blanched. C. Pulse distal to the femoral artery is weaker on the left foot than right foot. D. The pressure dressing at right femoral area is moist and oozing blood.

A. Laughs readily, turns from back to side.

21.The nurse is evaluating the effects of thyroid therapy used to treat a 5 months old with hypothyroidism. Which behavior indicates that the treatment has been effective? A. Laughs readily, turns from back to side. B. Has strong Moro and tonic neck reflexes. C. Keeps fists clenched, opens hands when grasping an object. D. Can lift head, but not chest when lying on abdomen.

a. Administer a prescribed bronchodilator

34. a 6 year old who has asthma is demonstrating a prolonged expiratory phase and wheezing and has a35% of personal best peak expiratory flow rate (PEFR) based on these finding, actions should the nurse take first? a. Administer a prescribed bronchodilator b. Encourage the child to cough and deep breath c. Report findings to the heath care provider d. determine what triggers precipitated this attack

D. Increased carbohydrate need

35) A LPN/LVN is providing care to a 5-year-old child with a fractured femur whose nursing diagnosis is Imbalanced nutrition: Less than body requirements. Which change is most likely to occur with this condition? a. Decreased protein catabolism b. Increased calorie intake c. Increased digestive enzymes d. Increased carbohydrate need

B. Transplant coordinator

36) A LPN/LVN is caring for a 9-year-old child who has a grave prognosis after receiving a closed injury from being struck by a car. Which health team member should approach the family about organ donation? a. Nurse-manager b. Transplant coordinator c. Emergency department nurse d. Pastoral care staff member

c. weigh the child daily

37.Which nursing intervention is most important to include in the plan of care for a child with acute glomerulonephritis a. encourage fluid intake b. promote complete bed rest c. weigh the child daily d. administer vitamin supplements

C. "I will avoid using soap and water on the affected area and will apply an emollient cream on this area frequently."

47) To treat a child's atopic dermatitis, a physician orders a topical application of hydrocortisone cream twice daily. After medication instruction by the LPN/ LVN , which statement by the parent indicates effective teaching? a. "I will spread a thick coat of hydrocortisone cream on the affected area and will wash this area once a week." b. "I will gently scrape the skin before applying the cream to promote absorption." c. "I will avoid using soap and water on the affected area and will apply an emollient cream on this area frequently." d. "I will apply a moisturizing cream sparingly and will wash the affected area frequently."

D. A preoccupation with death

7) A LPN/LVN is assessing a severely depressed adolescent. Which finding indicates a risk of suicide? a. Excessive talking b. Excessive sleepiness c. A history of cocaine used. d. A preoccupation with death

C. place the infant's arms in soft elbow restraints.

42) A 3-month-old infant just had a cleft lip and palette repair. To prevent trauma to the operative site, the nurse should: a. give the infant a pacifier to help soothe him. b. lie the infant in the prone position. c. place the infant's arms in soft elbow restraints. d. avoid touching the suture line, even to clean.

D. Demonstrate startle reflex

42.The nurse is assessing a 6 month old infant. Which response requires further evaluation by the nurse? A. Has doubled birth weight B. Turn head to locate sound C. Plays pick a boo D. Demonstrate startle reflex

A. Snellen's test

43) A child is suspected of having amblyopia ("lazy eye"). To help diagnose this disorder, the child will undergo which test? a. Snellen's test b. Near vision test c. Weber's test d. Peripheral vision test

C. Prevent cardiac damage

43.A child is brought to the clinic complaining of fever and joins pain, and is DX with rheumatic fever. When planning care for this child what is the goal of nursing care? A. Reduce fever B. Maintain fluid and electrolytes C. Prevent cardiac damage D. Maintain join mobility and function

B. Honey-colored, crusted lesions

10) When assessing a child for impetigo, the nurse expects which assessment findings? a. Small, brown, benign lesions b. Honey-colored, crusted lesions c. Linear, threadlike burrows d. Circular lesions that clear centrally

B. Thicken formula with cereal for each feeding.

10.The nurse is planning for a 5-month old with gastroesophageal reflux disease whose weight has decreased by 3 ounces since the last clinic visit one month ago. To increase caloric intake and decrease vomiting, what instructions should the nurse provide this mother? A. Give small amounts of baby food with each feeding. B. Thicken formula with cereal for each feeding. C. Dilute the childs formula with equal parts of water. D. Offer 10 % dextrose in water between most feedings.

B. Direct the child through the six cardinal position of glaze

41.When screening a 5 year old for strabism, what action should the nurse take A. Have the child identify colored patterns on polychromatic cards B. Direct the child through the six cardinal position of glaze C. Inspect the child for the setting sun sign D. Observe the child for blank, sunken eyes

D. BP 70/40.

22.The HR for a 3 year old with a congenital heart defect has steadily decreased over the last few hours, now it's 76 bpm, the previous reading 4 hours ago was 110 bpm. Which additional finding should be reported immediately to a healthcare provider? A. Oxygen saturation 94%. B. RR of 25 breaths/minute. C. Urine output 20 mL/hr. D. BP 70/40.

C. Irrigate the NG tube to ensure patency

23) A 4-year-old has just returned from surgery. He has a nasogastric (NG) tube in place and is attached to intermittent suction. The child says to the nurse, "I'm going to throw up." What should the nurse do first? a. Notify the physician because the child has an NG tube. b. Immediately give the child an antiemetic I.V. c. Irrigate the NG tube to ensure patency. d. Encourage the mother to calm the child down.

C. Irrigate the NG tube to ensure patency.

23) A 4-year-old has just returned from surgery. He has a nasogastric (NG) tube in place and is attached to intermittent suction. The child says to the nurse, "I'm going to throw up." What should the nurse do first? a. Notify the physician because the child has an NG tube. b. Immediately give the child an antiemetic I.V. c. Irrigate the NG tube to ensure patency. d. Encourage the mother to calm the child down.

A. Describe the side-lying, knees to chest position that must be assumed during the procedure.

23.2 year old is admitted to the hospital with possible encephalitis, and a lumbar puncture is scheduled. Which information should the nurse provide this child concerning the procedure? A. Describe the side-lying, knees to chest position that must be assumed during the procedure. B. Tell the child to expect loud clicking noises during the procedure that may be slightly annoying. C. Reassure the child that there will be no restrictions on activity after the procedure is completed. D. Explain that fluids cannot be taken for 8 hours before the procedure and for 4 hours after the procedure.

A. Meats

24) A child, age 5, is diagnosed with chronic renal failure. When teaching the parents about diet therapy, the nurse should instruct them to restrict which foods from the child's diet? a. Meats b. Carbohydrates c. Fats d. Dairy products

A. This is an inherited X-linked recessive disorder, which primarly affects male children in the family

24.the parenst of a 3 y/o boy who has Duchenne muscular dystrophy (DMD) ask "how can our son have this disease? We are wondering if we should have any more children" What information should the nurse provide these parents? A. This is an inherited X-linked recessive disorder, which primarly affects male children in the family B. The male infant had a viral infectrion that went unnoticed and iuntreated, so mucle damage was incurred C. The XXXX muscle groups of males can be impacted by a lack of the protein dystrophyn in the mother D. Birth trauma with a breech vaginal birth causes damage to the spinal cord, thus weakening the muscles

C. Kernig's sign.

25) An 8-year-old child is suspected of having meningitis. Signs of meningitis include: a. Cullen's sign. b. Koplik's spots. c. Kernig's sign. d. Chvostek's sign.

C. Notify the physician and request assistance from the interdisciplinary team.

26) A 6-year-old child is admitted to the pediatric unit for evaluation of recurrent abdominal pain. The child has been admitted to the pediatric unit with similar complaints several times in the past few months. The child's symptoms are vague, yet his mother provides detailed information about the problem. The nurse is suspicious of the situation. What should the LPN/LVN do next? a. Request that the parent leave the hospital unit immediately. b. Ask to speak with the child without the parent being present. c. Notify the physician and request assistance from the interdisciplinary team. d. Contact the authorities immediately.

D. Review the immunization documentation of the child who has HIV

26.A 3 year old with HIV infection is staying with a foster family who is caring for 3 other foster children in their home. When one of the children acquires pertussis, the foster mother calls the clinic and asks the nurse what she should do. Which action should the nurse take first? A. Remove the child who has HIV from the foster home B. Report the exposure of the child with HIV to the health department C. Place the chould who has HIV in reverse isolation D. Review the immunization documentation of the child who has HIV

A. provide beneficial care and avoid harming the child.

27) When making ethical decisions about caring for preschoolers, a nurse should remember to: a. provide beneficial care and avoid harming the child. b. make decisions that will prevent legal trouble. c. do what she would do for her own child or loved ones. d. be sure to do what the physician says.

d. How often the MDI is used daily

27. . A 16 y/o female student with a history of asthma controlled with both an oral antihistamine and an albuterol (Provenfil) metere-dose inhaler (MDI) comes to the school nurse. The student complains that she cannot sleep at night, feels shaky and her heart feels like it is "beating a mile per minute" Which information is most important for the nurse to obtain? a. When she last took the antihistamine b. When her last Asthma attack occurred c. Duration of most asthmas attacks d. How often the MDI is used daily

B. poor hygiene and weight loss.

28) An emergency department nurse suspects neglect in a 3-year-old boy admitted for failure to thrive. Signs of neglect in the child would include: a. slapping, kicking, and punching others. b. poor hygiene and weight loss. c. loud crying and screaming. d. pulling hair and hitting.

c. Poor coordination and sense of position

28.The nurse is assessing a child for neurological soft signs, which finding is most likely demonstrated in the child's behavior? a. Inability to move tongue in a direction b. Presence of vertigo c. Poor coordination and sense of position d. Loss of visual acuity

C. A serum trough and peak level around the third dose

29) When administering gentamicin (Garamicin) to a preschooler, which monitoring schedule is best for determining the drug's effectiveness? a. A serum trough level every morning b. A serum peak level after the second dose c. A serum trough and peak level around the third dose d. Serial serum trough levels after three doses (24 hours)

C. Trust versus mistrust

31) When developing a care plan for a child, the nurse identifies which Eriksonian stage as corresponding to Freud's oral stage of psychosexual development? a. Initiative versus guilt b. Autonomy versus shame and doubt c. Trust versus mistrust d. Industry versus inferiority

a. Let me read this book to you

31.a two year old boy begins to cry when the mother starts to leave. What is the nurse's best response in this situation? a. Let me read this book to you b. Two years old usually stop crying the minute the parent leaves c. Now be a big boy. Mommy will be back soon d. Let's wave bye-bye to mommy

C. A protuberant abdomen

38) An 18-month-old boy is admitted to the pediatric unit with a diagnosis of celiac disease. What finding would the LPN/LVN expect in this child? a. A concave abdomen b. Bulges in the groin area c. A protuberant abdomen d. A palpable abdominal mass

b. Gently manipulate the hernia for reduction

38.During a well baby visit the parents explain that a soft bulge appears in the groin of their 4 month old son when he cries or strain stooling. The infant is schedule for surgical repair of the inguinal; hernia in two weeks. The parent should be instructed to take which measure if the hernia becomes incarcerated prior to the surgery? a. Use rectal thermometer for straining on stool b. Gently manipulate the hernia for reduction c. Offer oral electrolyte fluids for comfort d. Give acetaminophen or aspirin for crying

B. Place the infant in an upright position when giving a bottle.

4) A LPN/LVN is developing a plan to teach a mother how to reduce her infant's risk of developing otitis media. Which direction should the nurse include in the teaching plan? a. Administer antibiotics whenever the infant has a cold. b. Place the infant in an upright position when giving a bottle. c. Avoid getting the infant's ears wet while bathing or swimming. d. Clean the infant's external ear canal daily.

d. Do not expose other children to RSV. It is very contagious even without direct contact

40.The mother of a 9 month old who was diagnosed with respiratory syncytial virus yesterday calls the clinic to inquire if it will be all right to take her infant to the first b-day party of a friend's child the following day. What response should the nurse provide this mother? a. The child will not longer be contagious, no need to take any further precaution b. Make sure there are not children under the age of 6 months around the infected child c. The child can be around other children but should wear mask at all times d. Do not expose other children to RSV. It is very contagious even without direct contact

A. Selecting a board game

44.The nurse working on the pediatric unit takes two 8-year old girls to the playroom. Which activity is best for the nurse to plan for these girls? A. Selecting a board game B. Playing Doctor and nurse C. Watching cartoon on TV D. Coloring, cutting and pasting

B. Palpate the anterior fontanel for tension and bulging.

8. The nurse is measuring the frontal occipital circumference (FOC) of a 3-months old infant, and notes that the FOC has increased 5 inches since birth and the child's head appears large in relation to body size. Which action is most important for the nurse to take next? A. Measure the infant's head-to-toe length. B. Palpate the anterior fontanel for tension and bulging. C. Observe the infant for sunken eyes. D. Plot the measurement on the infant's growth chart.

B. develop an identity and independence.

55) A LPN/LVN is caring for an adolescent who underwent surgery for a perforated appendix. When caring for this adolescent, the nurse should keep in mind that the main life-stage task for an adolescent is to: a. resolve conflict with parents. b. develop an identity and independence. c. develop trust. d. plan for the future.

D. Performing frequent visual assessments of jaundice

52) A LPN/LVN is reviewing a care plan for an infant undergoing phototherapy for hyperbilirubinemia. Which intervention should the nurse remove from the care plan? a. Repositioning the infant frequently to expose all body surfaces b. Obtaining frequent serum bilirubin levels c. Shielding the infant's eyes with an opaque mask to prevent exposure to the light d. Performing frequent visual assessments of jaundice

A. Obtain specimen for blood cultures.

16. A child with acute lymphocytic leukemia (ALL) who is receiving chemotherapy via a subclavian IV infusion, has an oral temperature of 103 degrees. In assessing the IV site, the nurse determines that there are no signs of infection at the site. Which intervention is the most important for the nurse to implement? A. Obtain specimen for blood cultures. B. Assess the CBC. C. Monitor the oral temperature every hour. D. Administer acetaminophen as prescribed.

B. Disturbed body image

54) A 13-year-old with anorexia nervosa is admitted to the facility for I.V. fluid therapy and nutritional management. She says she's worried that the I.V. fluids will make her gain weight. Which nursing diagnosis is most appropriate? a. Noncompliance (dietary regimen) b. Disturbed body image c. Complicated grieving d. Grieving

B. Ask the mother for more information about the infant's sleep patterns.

17) The mother of an 11-month-old infant reports to the nurse that her infant sleeps much less than other children. The mother asks the nurse whether her infant is getting sufficient sleep. What should be the nurse's initial response? a. Reassure the mother that each infant's sleep needs are individual. b. Ask the mother for more information about the infant's sleep patterns. c. Instruct the mother to decrease the infant's daytime sleep to increase his nighttime sleep. d. Inform the mother that her infant's growth and development are appropriate for his age, so sleep isn't a concern.

B. Notify the healthcare provider of the passage of brown stool.

18.The nurse is caring for an infant scheduled for reduction of intussusceptions. The day before the scheduled procedure the infant passes a soft-formed brown stool. Which intervention should the nurse implement? A. Instruct the parents that the infant needs to be NPO. B. Notify the healthcare provider of the passage of brown stool. C. Obtain a stool specimen for laboratory analysis. D. Ask the parents about recent changes in the infant's diet.

C. assess the child's current developmental level and plan care accordingly.

51) When planning care for a 7-year-old boy with Down syndrome, the LPN/ LVN should: a. plan interventions at the developmental level of a 7-year-old because that is the child's age. b. plan interventions at the developmental level of a 5-year-old because the child will have developmental delays. c. assess the child's current developmental level and plan care accordingly. d. direct all teaching to the parents because the child can't understand.

C. They provide the child with a sense of security.

11.While teaching a parenting class to new parents the nurse describes the needs of infants and toddlers regarding discipline and limit setting. What is the most important reason for implementing such parenting behaviors? A. Children need help in developing social skills. B. This age child fears loss of self control. C. They provide the child with a sense of security. D. Children must to learn to deal with authority.

Correct Answer: b. Lay the infant on his back or side to sleep. c. Sit the infant up for each feeding. e. Clean the suture line after each feeding by dabbing it with saline solution. f. Give the infant extra care and support.

12) A LPN/LVN is reviewing a teaching plan with parents of an infant undergoing repair for a cleft lip. Which instructions are the most appropriate for the nurse to give? Select all that apply. a. Offer a pacifier as needed. b. Lay the infant on his back or side to sleep. c. Sit the infant up for each feeding. d. Loosen the arm restraints every 4 hours. e. Clean the suture line after each feeding by dabbing it with saline solution. f. Give the infant extra care and support.

C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change.

19.The mother of a 4-month old asks the nurse for advice in preventing diaper rash. What suggestion should the nurse provide? A. At diaper change generously powder the baby's diaper area with talcum powder to promote dryness. B. Wash the diaper area every 2 hours with soap and water to help prevent skin breakdown. C. Use a barrier cream, such as zinc oxide, which does not have to be completely removed with each diaper change. D. Place a cloth diaper inside the disposable diaper for overnight periods when increased wearing time is likely.

B. "Let's see about further developmental testing."

14) A teenage mother brings her 1-year-old child to the pediatrician's office for a well-baby checkup. She says that her infant can't sit alone or roll over. An appropriate response by the nurse would be: a. "This is very abnormal. Your child must be sick." b. "Let's see about further developmental testing." c. "Don't worry, this is normal for her age." d. "Maybe you just haven't seen her do it."

b. Pureed fruits d. Rice cereal e. Strained vegetables

2) A LPN/LVN is conducting an infant nutrition class for parents. Which foods are appropriate to introduce during the first year of life? Select all that apply. a. Sliced beef b. Pureed fruits c. Whole milk d. Rice cereal e. Strained vegetables f. Fruit juice

D. Gown, gloves, mask, and eye goggles or eye shield

37) An 11-year-old child contracted severe acute respiratory syndrome (SARS) when traveling abroad with her parents. The nurse knows she must put on personal protective equipment to protect herself while providing care. Based on the mode of SARS transmission, which personal protective equipment should the LPN/LVN wear? a. Gloves b. Gown and gloves c. Gown, gloves, and mask d. Gown, gloves, mask, and eye goggles or eye shield

B. Softer than the heart sounds

48) A LPN/LVN is auscultating for heart sounds in a 2-year-old child. She notes a grade 1 heart murmur. Which characteristic best describes a grade 1 heart murmur? a. Equal in loudness to the heart sounds b. Softer than the heart sounds c. Can be heard without a stethoscope d. Associated with a precordial thrill

B. Sadness

8) A child is admitted with a tentative diagnosis of clinical depression. Which assessment finding is most significant in confirming this diagnosis? a. Irritability b. Sadness c. Weight gain d. Fatigue

d. Give positive feedback about the way she administered the sulfate

36.the nurse observes a mother giving her 11 month-old ferrous sulfate, followed by two onces of orange juice. What should the nurse do next? a. suggest placing the iron drops in the orange juice and feed the infant b. Tell the mother to follow the iron drops with formula instead of orange juice c. instruct the mother to feed the infant nothing in the next 30 minutes after the iron d. Give positive feedback about the way she administered the sulfate

C. Give two breath that makes the chest rise

25.The nurse finds a 6 month old infant unresponsive and calls for help. After opening the airway and finding the XXXX the infant is still no breathing. Which action should the nurse take? A. Palpate femoral pulse and check for regularity B. Deliver cycles of 30 chest compressions and 2 breaths C. Give two breath that makes the chest rise D. Feel the carotid pulse and check for adequate breathing

a. Metabolic alkalosis

29.The nurse is assessing an infant with pyloric stenosis. Which pathophysiological mechanism is the most likely consequence of this infant's clinical picture? a. Metabolic alkalosis b. Respiratory acidosis c. Metabolic acidosis d. Respiratory Alkalosis

Correct Answer: a. Frequent clearing of the throat c. Frequent swallowing f. Bright red vomitus

32) An 8-year-old child has just returned from the operating room after having a tonsillectomy. The nurse is preparing to do a postoperative assessment. The nurse should be alert for which signs and symptoms of bleeding? Select all that apply. a. Frequent clearing of the throat b. Breathing through the mouth c. Frequent swallowing d. Sleeping for long intervals e. Pulse rate of 98 beats/minute f. Bright red vomitus

D. "I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my son."

39) A boy, age 3, develops a fever and rash and is diagnosed with rubella. His mother has just given birth to a baby girl. Which statement by the mother best indicates that she understands the implications of rubella? a. "I told my husband to give my son aspirin for his fever." b. "I'll ask the physician about giving the baby an immunization shot." c. "I don't have to worry because I've had the measles." d. "I'll call my neighbor who's 2 months pregnant and tell her not to have contact with my son."

B. instruct the mother to place the food at the back and toward the side of the infant's mouth.

41) An infant, age 10 months, is brought to the well-baby clinic for a follow-up visit. The mother tells the nurse that she has been having trouble feeding her infant solid foods. To help correct this problem, the nurse should: a. point out that tongue thrusting is the infant's way of rejecting food. b. instruct the mother to place the food at the back and toward the side of the infant's mouth. c. advise the mother to puree foods if the child resists them in solid form. d. suggest that the mother force-feed the child if necessary.

A. Taking vital signs every 4 hours and obtaining daily weight

44) A 10-year-old child diagnosed with acute glomerulonephritis is admitted to the pediatric unit. The nurse should ensure that which action is a part of the child's care? a. Taking vital signs every 4 hours and obtaining daily weight b. Obtaining a blood sample for electrolyte analysis every morning c. Checking every urine specimen for protein and specific gravity d. Ensuring that the child has accurate intake and output and eats a highprotein diet

D. a low-intensity, painless electrical current is applied to the skin.

45) A 4-month-old infant is taken to the pediatrician by his parents because they're concerned about his frequent respiratory infections, poor feeding habits, frequent vomiting, and colic. The physician notes that the infant has failed to gain expected weight and recommends that the infant have a sweat test performed to detect possible cystic fibrosis. To prepare the parents for the test, the nurse should explain that: a. the baby will need to fast before the test. b. a sample of blood will be necessary. c. a low-sodium diet is necessary for 24 hours before the test. d. a low-intensity, painless electrical current is applied to the skin.

C. Decreased blood pressure

49) When a LPN/LVN assesses a 2-year-old child with suspected dehydration, which condition should be reported to the physician immediately? a. Irritability for the past 12 hours b. Capillary refill less than 2 seconds c. Decreased blood pressure d. Tachycardia, dry skin, and dry mucous membranes

C. Serum potassium of 3.0 mg/dL.

5. 7 years old is admitted to the hospital with persistent vomiting, and a nasogastric tube attached to low intermittent suction is applied. Which finding is most important for the nurse to report to the healthcare provider? A. Gastric output of 100 mL in the last 8 hours. B. Shift intake of 640 mL IV fluids plus 30 mL PO ice chips. C. Serum potassium of 3.0 mg/dL. D. Serum pH of 7.45.

D. Right to privacy

11) A female adolescent client refuses to allow male nurses to care for her while she's hospitalized. Which of these health care rights is this adolescent exerting? a. Right to competent care b. Right to have an advance directive on file c. Right to confidentiality of her medical record d. Right to privacy

A. "The vitamin C in the citrus juice helps with iron absorption."

9) A child with iron deficiency anemia is ordered ferrous sulfate (Ferralyn), an oral iron supplement. When teaching the child and parent how to administer this preparation, the mother asks why she needs to mix the supplement with citrus juice. Which response by the nurse is best? a. "The vitamin C in the citrus juice helps with iron absorption." b. "Having food and juice in the stomach helps with iron absorption." c. "The citrus juice counteracts the unpleasant taste of the iron." d. "There isn't a specific reason for it."

D. Please decide who will stay when the healthcare provider begins suturing.

9. The nurse is preparing a 10 year old with a lacerated forehead for suturing. Both parents and 12 year old sibling are at the child's bedside. Which instruction best supports family? A. While waiting for the healthcare provider, only one visitor may stay with the child. B. All of you should leave while the healthcare provider sutures the child's forehead. C. It is best if the sibling goes to the waiting room until the suturing is completed. D. Please decide who will stay when the healthcare provider begins suturing.

C. Guard against bleeding injuries

45.The nurse is developing the plan of care for a hospitalized child with von Willebrand disease. What priority nursing intervention should be included in this child plan of care A. Reduce exposure to infection B. Eliminate contact with cold grafts (crafts? Is not legible) C. Guard against bleeding injuries D. Reduce contact with other children

C. cerebral hyperemia.

46) An 8-month-old infant is admitted to the pediatric unit following a fall from his high chair. The child is awake, alert, and crying. The nurse should know that a brain injury is more severe in children because of: a. increased myelination. b. intracranial hypotension. c. cerebral hyperemia. d. a slightly thicker cranium.

Correct Answer: a. Automobile accidents b. Drowning c. Pedestrian accidents d. Fire

50) A LPN/LVN is teaching a safety class for parents of preschoolers. Which injuries should the nurse include as common among preschoolers? Select all that apply. a. Automobile accidents b. Drowning c. Pedestrian accidents d. Fire e. Sexually transmitted diseases f. Homicide

B. Reading books

6) A LPN/LVN is planning care for a 10-year-old child in the acute phase of rheumatic fever. Which activity is most appropriate for the nurse to schedule in the care plan? a. Playing ping-pong b. Reading books c. Climbing on play equipment in the playroom d. Ambulating without restrictions

D. Object permanence

7. During a well-baby check, the nurse hides a block under the baby's blanket, and the baby looks for the block. Which normal growth and development milestone is the baby developing? A. Separation anxiety. B. Associative play. C. Object prehension. D. Object permanence